It is no secret that I am a huge fan of FOAMed. I’ve probably learnt more in the past two years via FOAMed than I ever would have via the traditional routes of attending courses & conferences, even those ostensibly aimed at rural proceduralists.
I’ve tried to collate stuff that I find useful (mostly rural GP, EM and Anaes focus) over at www.ruraldoctors.net – preserving the KIdocs.org as a more idiosyncratic collection of thoughts and commentary on issues that affect the practice of medicine locally.
As a consequence, KIdocs.org is more of a stream-of-consciousness whinge about bureaucracy, deficits in training and commentary on (mostly) airway related issues.
But it’s not FOAMed.
In fact, despite the increasing numbers of primary care doctors on twitter and the blog-o-sphere, there’s still a paucity of decent primary care FOAMed.
That’s in no way a reflection on those (self included) who are currently contributing…and indeed there are some excellent nuggets of clinical info out there. But they are interspersed with more reflective pieces – many of which I really enjoy as they relate to the day-to-day matters of working in medicine, running a business or dealing with the PCEHR etc. There have also been some epic wins using the tools of social media – the #scrapthecap and #savetelederm campaigns in particular.
But a lot of it isn’t FOAMed.
Whilst many GP blogs are excellently written and often discuss quirky or interesting facets of work as a GP, this is often old hat to those who have been doing it for years. It’s also very hard to showcase this to educators who are ‘FOAMed-curious’ – wondering what all the fuss is about – and possibly underwhelmed with the academic rigeur of FOAMed resources in primary care. In contrast the EM and prehospital crowd have taken FOAMed and run with it – sure, there are some reflective pieces, but there’s a LOT of hardcore clinical commentary on the way. Some of this is relative to rural docs (think Casey Parker’s BroomeDocs and Minh le Cong’s PHARM) – but it may not be content that mainstream GPs identify with.
I received an interesting email from a colleague who reported that some of the more conservative GPs being turned off by recent presentations on FOAMed and SoMe at GP conferences. Their comments:
“If we want to engage the masses, we need to do the topics / core content that GPs are interested in well and with an edge – some panache – hat makes it readable / watchable and memorable. We need a focus somewhere as a purely clinical repository where we could direct teachers and learners of primary care – with a broad base of contributors.
“I just scrolled through some of last months content from GPs – and a lot of it was what I would class as “MedEd fluff” – not a lot of clinical content, very little EBM, lots of musings around teaching and politics – even the PCEHR got a few spots”
“In short, a lot of us felt that it was more about the blogger than the content”
Again I ENJOY reading a lot of these reflective pieces (and freely admit that KIDocs.org is along those lines, tinged with a lot of jaundice and antipathy to bureaucracy)…but I think this contributor is spot on. We need to raise the bar if FOAMed is going to be taken seriously by medical educators and frontline GPs.
I must admit that I have a healthy scepticism of some of the “meducationalista” – my background before medicine (believe it or not) was in pure science, with higher postgraduate degrees in medical research. I’ve been out of the research field for a decade or more, but on return have been increasingly frustrated with some of the ‘research’ presented at GP conferences – there seems to be a LOT of emphasis on topics such as rural retention, workforce planning, registrar training pathways, training medical students, educational theory & telehealth. What I’d consider as ’lite’ topics. Not much quality research on clinical conditions or critical appraisal of contentious issues relevant to clinical primary care.
Kudos then to the FOAM4GP.com website which has undergone a makeover – and some excellent recent posts of relevance to all GPs. In particular, credit to GP registrar Robin Park (@robapark) whose series of FOAM4GP Maps is a clear leader in terms of quality primary care FOAMed … check out ‘Paediatric Fever Phobia‘ and ‘To Statin or Not to Statin, That is the Question‘ as examples. This is the sort of medical educator I can take seriously.
These are topics that those of us who use FOAMed have already figured out for ourselves – but articulated nicely for the masses and easy to digest. It’s good stuff and good advertisement for FOAMed as “about the content – not the messenger“.
Stay-tuned, Robin promises that there’s more to follow. It looks like he and like-minded colleagues will turn primary care medical education on it’s head, which I applaud.
Bottomline, FOAMed has the potential to shape our practice as we evolve. It’s a great form of CPD (although not currently recognised) and makes us better doctors. What’s not to like?
Of course, if we are serious about FOAMed, we need to be able to keep up to date with the literature (not just read various blogs) and critically appraise topics for ourselves.
I wasn’t able to make it to RMA2013, but tried to make the point via twitter that, without access to online journals, any pretence of ‘research’ in rural medicine is doomed to failure – unless we stick to surveys, reflective pieces or yet more papers on teaching medical students and registrars.
All useful stuff, but shouldn’t be the “be all and end all” of primary care research. Getting neck deep into the literature – heck, even publishing some yourself – should be the aspiration of GPs and educators.
Who knows, some of you may even come along to smaccGOLD?
More on barriers to effective research in another post…