The document discusses how free open-access medical education (FOAM) through platforms like podcasts, blogs, and social media can significantly reduce the time it takes for new medical knowledge to be implemented in practice. It provides examples of how techniques learned from medical research publications or podcasts were put into practice within months, compared to the traditional 10 year lag. It also explains how the online medical community acts as a "swarm" that identifies high quality sources and provides peer feedback, helping to validate information and more quickly influence guidelines and practices.

3. Swarm-based MedicalSwarm-based Medical
EducationEducation

4. KnowledgeKnowledge
Translation TimeTranslation Time
Known ————> used in practiceKnown ————> used in practice
TimTim
ee
10 years ->10 years ->
weeksweeks

7. Mike CadoganMike Cadogan

8. PodcastsPodcasts
BlogsBlogs
TwitterTwitter
Google PlusGoogle Plus

9. Advantages of FOAMAdvantages of FOAM
MultimediaMultimedia
Listen to podcasts while biking or kayakingListen to podcasts while biking or kayaking
Great for people with short attention spans. CheckGreat for people with short attention spans. Check
Twitter on the looTwitter on the loo
Short KT TimeShort KT Time

10. ExampleExample
Apnoeic oxygenationApnoeic oxygenation
Nasal prongs oxygenation during rapid sequenceNasal prongs oxygenation during rapid sequence
intubation to reduce risk of hypoxia.intubation to reduce risk of hypoxia.
Article in Journal of Emergency Medicine Feb 2010 andArticle in Journal of Emergency Medicine Feb 2010 and
EP Monthly Dec 2010, quoting anaesthetic research.EP Monthly Dec 2010, quoting anaesthetic research.
March 2011 EMCrit Podcast -> Put into practice in ourMarch 2011 EMCrit Podcast -> Put into practice in our
ED that month and probably within a year was standardED that month and probably within a year was standard
practice in all EDs around the worldpractice in all EDs around the world

11. Example 2Example 2
Targeted Temperature ManagementTargeted Temperature Management
NEJM Dec 2013 Post cardiac arrest cooling to 36˚ asNEJM Dec 2013 Post cardiac arrest cooling to 36˚ as
effective as cooling to 33˚effective as cooling to 33˚
Discussions via various FOAM mediaDiscussions via various FOAM media
Practice change Dec 2013 in many hospitals (not thisPractice change Dec 2013 in many hospitals (not this
one :-(one :-(

12. But there’s all this dubiousBut there’s all this dubious
stuff on the internetstuff on the internet
Who can you believe?Who can you believe?
What can you trust?What can you trust?
What can you trust?What can you trust?
What can you trust?What can you trust?
What can you trust?What can you trust?
What can you trust?What can you trust?

13. Swarm intelligence (SI) is the collective behaviorSwarm intelligence (SI) is the collective behavior
of decentralized, self-organized systems, naturalof decentralized, self-organized systems, natural
or artificial.or artificial.

14. The swarm, the online medical community, is choosing who to listenThe swarm, the online medical community, is choosing who to listen
to.to.
Meritocracy, cream floats, good blogs and podcasts become popularMeritocracy, cream floats, good blogs and podcasts become popular
Opinion leaders quickly change opinions based on feedback from theOpinion leaders quickly change opinions based on feedback from the
swarm e.g. Anand Swaminathan on EM:RAP re calcium gluconate vsswarm e.g. Anand Swaminathan on EM:RAP re calcium gluconate vs
calcium chloride jan 2014calcium chloride jan 2014
Swarm based critique and feedbackSwarm based critique and feedback
e.g. possible foreign body on a Wanganui X-Ray picked up by ae.g. possible foreign body on a Wanganui X-Ray picked up by a
doctor in Venezuela last year (coarctation stent)doctor in Venezuela last year (coarctation stent)
e.g. Dr Minh Le Cong edits the whole of FOAM. Corrected a dose ofe.g. Dr Minh Le Cong edits the whole of FOAM. Corrected a dose of
ketamine in one of my tweets within a few minutesketamine in one of my tweets within a few minutes

15. • + a smattering of several other+ a smattering of several other
good podcastsgood podcasts

17. Niche: new docs, small hospitalsNiche: new docs, small hospitals
Helps attract good quality doctorsHelps attract good quality doctors
Most importantly helps orientate andMost importantly helps orientate and
up-skill our new docsup-skill our new docs