Just got back from Fremantle and the #RMA2012 Rural Medicine Australia conference hosted by ACRRM and RDAA. To be honest I was disappointed. Some pearls amongst the three day academic programme. But perhaps recent exposure to high-quality asynchronous #FOAMed learning has raised my expectations.
That said attendance was high at over 450 delegates and it was great to hear fellow South Australian doctors Martin & Fiona Altman of Murray Bridge, SA get the ‘rural doctor of the year’ award.
However a conference shouldn’t be just about the venue or the quantity of attendees – for my money I want quality medical education and networking.
So in no particular order, here are some thoughts…
1/ not enough hands on skills sessions for frontline rural doctors, too much on training pathways and RTPs etc
A real bugbear of mine. As isolated rural docs we may struggle to engage in high quality education events. It makes sense to host them at the annual Rural Medicine conference.
On offer before the academic conference were the two-day REST course and one day sessions on burns, obstetrics and ultrasound (the latter hosted by Broome Docs author and blog-o-sphere #FOAMed guru Dr Casey Parker). Casey has posted his thoughts on ‘courses for horses’ this week – have a read of his thoughts and the comments. Add your own, please…
Whether the College will pick up on this is anyone’s guess.
There was also a hands on demo in mucosal atomisation techniques from Tim Wolfe, ED doc and innovator, who was also over for the Australian Trauma Society do in Perth. A really useful technique for rural docs (as well as retrievalists and EM docs) – but old hat to those of us swimming in the soup of #FOAMed. Better than nowt though. More info at www.intranasal.net
2/ turgid education sessions, mostly delivered to large lecture theatres
A conference should be about dynamism and rapid turnover of ideas, preferably in small groups – which in turn engenders breakout discussion in breaks, over meals & outside the confines of the lecture hall.
Maybe I signed up to the wrong events, but a whole day session on telehealth? C’mon, it’s not that complicated – an iPad, Skype and a robust referral pathway is all that is needed. OK, perhaps that’s oversimplification, but this session would have benefitted from more hands on, not repeated talks of existing telehealth examples and pilot studies. I lasted about an hour then drifted in/out. Similar reports from other attendees.
Shame as telehealth and social media will revolutionise medicine, especially for the rural doc. Better to offer small group sessions repeatedly throughout the event to maximise coverage. Same for other sessions, which seemed more weighted to the medical educationalista than the frontline rural doctor.
There were a few more sessions on dermatology, parallel consulting with medical students, Nextplanon and Mirena insertion etc…but sadly all held on the last day when most delegates had to check out and catch flights back to East Coast fairly early, thus cutting short these potentially valuable sessions. Bah!
I was of course excited to present my data on difficult airways and rural docs – although to be honest this would be far better and more valuable as hands on workshop aimed at anyone who is an ‘occasional intubator’. Thankfully there’s a wealth of resources out there, including Minh le Cong’s excellent online airway training at www.prehospitalmed.com. I did run an impromtu airway workshop for interested docs over a PubMed session in the hotel bar…you can download more from the ‘resources’ and ‘videos’ sections on this site.
I have reflected that using FOAMed I could’ve presented this data back in March…getting the paper published in October and presenting two weeks later was just by chance. But next time I;ll get message out sooner using #FOAMed.
Unfortunately the paper presentations were run in 4 separate venues, with erratic timekeeping making it difficult to move between concurrent sessions. I was a bit gutted to miss Dave Townsend’s talk on SoMe in medicine, but true to form he’s bunged his slides up on the interweb for all to see at http://www.davidtownsend.com.au/blog/articles/rma2012-social-media-resources/
3/ Failure to embrace #FOAMed and the power of the interweb
Well, Joe Lex put’s this better than I ever will :
If you want to know how we practiced medicine 5 years ago – read a textbook
If you want to know how we practiced medicine 2 years ago – read a journal
If you want to know how we practice medicine now – go to a (good) conference
If you want to know how we will practice medicine in the future – use FOAM
FOAM of course being Free Open Access Medical education as exemplified by medical bloggers such as www.lifeinthefastlane.com, www.BroomeDocs.com and ww.prehospitalmed.com etc
Gerry Considine @ruralflyingdoc summed it all up in a cheeky manner, just in a single Tweet
“if you want to know how we practiced medicine last century, ask a rural doctor”
Perhaps a that was a little harsh – rural docs aren’t deliberately obtuse. But the systems we work in are slow to adapt.
Examples abound – my airway survey showed that few rural docs have access to the same up-to-date kit as their city specialist colleagues. Of course cost and caseload constraints factor in this, but to hear rural docs having to practice without a minimum standard of equipment is of concern.
Similarly access to bedside ultrasound is constrained – resources like the newly launched iBook (Introduction to Bedside Ultrasound) will help improve training. The cost of a decent USS machine may seem prohibitive, it will pay for itself if it means avoiding a costly transfer out of Dingo Creek to tertiary centre.
Finally, sitting in the medicopolitics session, one of the founding fathers of RDAA commented to me that ‘nothing has changed’ in 25 years of such debates. Sobering stuff, more so when the politicians are talking about linking pay to performance – despite the clear concerns elsewhere about such systems.
If you haven’t already read it, see Dr Clare Gerada’s address to the GPs at RACGP conference last week – key points about problems inherent in the overzealous measuring, medicalisation and marketisation which have destroyed UK medicine. This does not bode well for us in Australia – read Dr Gerada’s thoughts at http://tinyurl.com/GeradaSpeech
SoMe has the potential to link doctors concerned with such events – we’re seeing this with the #interncrisis campaign which has snowballed in past few days to maximise media exposure.
As isolated rural doctors, using these resources could help us do two main things
(i) speak with a common voice on medico-political matters
(ii) vastly raise the bar in ongoing medical education and the delivery of ‘quality care, out there’ – not through the turgid medium of conferences, papers and ALS courses, but through evolving, dynamic, cutting-edge media bringing evidence-based practice to rural docs and their patients.
So, what for the future?
Despite my gripes about medical conferences, I am going to attend #SMACC2013 www.smacc.net.au next year. Although a critical care conference, there are valuable lessons applicable to my workplace in rural emergency medicine. Besides, casey Parker @BroomeDocs owes me a beer.
I’m also going to focus more on the maxim of delivering ‘quality care, out there’.
From 2013 I’ll move try and focus www.ki-docs.com towards more hypothetical case discussions – not so much though on ins/outs of EBM (www.broomedocs.com does that well) – but explore concepts such as situational awareness, logistics over strategy, audit and other topics to help “get things done” to aid the rural doctor improve his/her practice.
“Quality care, out there” – the future is #FOAMed
7 thoughts on “Is the medical conference dead?”
Hi Tim. I generally agree. But I love the social aspect most of all. The biggest frustration for me (at my 2nd ACRRM conference) was – nowhere near enough time to meet everybody.
What struck me: Where were the 35-50 year olds? A big demographic missing in action.
Are you sending your feedback to ACRRM directly? Notice how the feedback form system didn’t seem to work?
Agree that there was too much RTP/training stuff (directed at supervisors), but as a recent registrar I have to say – try doing the ACRRM pathway with an RTP that knows less than you about it and has no other ACRRM registrars! Also, the needs of a rural generalist reg are radically different to those of an urban RACGP reg. Not much fun. Maybe this was ACRRM listened to my feedback!
I agree entirely with your self-reflection that your session would have been better as a workshop. Sorry, I missed it. But I read the article (preaching to the converted, etc) and I have an videolaryngoscope which we now use for any intubation…
‘How we upskill’ is such a good question. The traditional ‘anaesth. upskilling at big centre’ is waning in interest for me. Will look at some of the stuff mentioned – never heard of FOAMed before…
Can I also raise the KISS (keep it simple) principle as key to good rural practice, much of which is occasional?
Look at any Dept of Health DKA, MH, or N-acetylcysteine protocol and your head pretty much explodes. Some are outright dangerous. Why do we tolerate their existence?
Even some rural ED/crit care enthusiasts I’ve been reading online tend to ‘overdo it’ a bit with teaching points. Some of it is fine if you’re already experienced and can experiment a bit with your practice, but that’s no good for the occasional mob.
The key to good rural teaching and practice is distilling what is essential.
The medicopolitical stuff was indeed disappointing. There was a sense that we had failed to engage health ministers, federal and state. So we just ended up ranting a bit amongst ourselves.
My ideal conference model, really, is the ‘wilderness medicine retreat’!
Or maybe a big conference which is just more fun? A 4 day Womadelaide/ACRRM conference, say?
Hmmm, yes. Wmadelaide then a wilderness med / prehospital / rural ED hands on workshop on nearby Kangaroo Island….
Tim – beer tab is safe. Defintely need social catch ups to put faces to names and have fun.
Catch you at SMACC – my shout this time!
I would like to give a perspective from USA emergency department nursing. As my career in nursing has progressed into research and education, I have been using national conferences to meet people and put faces with the names that I email & tweet to regularly. At the last Emergency Nurses Association conference, I was texting to set up meetings and sprinting around the convention center to meet all of the people I’d hope to meet face-to-face. I ended up skipping a fair amount of the continuing ed to do this. When I DID go into a session, it seemed like EVERY time, I was yawning through the lecture while the session in the next room had everybody laughing uproariously and madly applauding every five minutes!
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