Five Strategies to Effectively Use Online Resources in Emergency Medicine
2014; Elsevier BV; Volume: 64; Issue: 4 Linguagem: Inglês
10.1016/j.annemergmed.2014.05.029
ISSN1097-6760
AutoresBrent Thoma, Nikita Joshi, N. Seth Trueger, Teresa M. Chan, Michelle Lin,
Tópico(s)Health Literacy and Information Accessibility
ResumoIntroductionFor health professions learners of all levels, staying abreast of the literature can seem like an insurmountable task as the number of clinically oriented articles continues to grow at an increasing rate.1Priem J. MEDLINE literature growth chart. jasonpriem.org. 2010. Available at: http://jasonpriem.org/2010/10/medline-literature-growth-chart/. Accessed March 15, 2014.Google Scholar, 2Larsen P.O. von Ins M. The rate of growth in scientific publication and the decline in coverage provided by Science Citation Index.Scientometrics. 2010; 84: 575-603Crossref PubMed Scopus (571) Google Scholar Fortunately, there has been a veritable explosion of online secondary resources that endeavor to digest the expanding medical literature and present it in a format that is optimized for adult learners. Particularly in emergency medicine, these resources have been dubbed "free open access medical education," also known as free open access meducation (FOAM).3Nickson C.P. Cadogan M.D. Free open access medical education (FOAM) for the emergency physician.Emerg Med Australas. 2014; 26: 76-83Crossref PubMed Scopus (133) Google Scholar The FOAM movement has figured prominently in the proliferation of blogs and podcasts made available online by practicing clinicians.3Nickson C.P. Cadogan M.D. Free open access medical education (FOAM) for the emergency physician.Emerg Med Australas. 2014; 26: 76-83Crossref PubMed Scopus (133) Google Scholar, 4Cadogan M. Thoma B. Chan T.M. et al.Free open access meducation (FOAM): the rise of emergency medicine and critical care blogs and podcasts (2002-2013).Emerg Med J. 2014; http://dx.doi.org/10.1136/emermed-2013-203502Crossref Scopus (167) Google Scholar As an unintended consequence, learners must now contend with an exponentially expanding library of both primary literature and secondary online resources.To make effective use of this stream of knowledge, learners must filter and choose from myriad resources. Simple digital tools can be used to organize and manage this otherwise overwhelming amount of information. This article outlines 5 strategies to help learners and practicing physicians stay abreast of both foundational and cutting-edge literature by using digital solutions. Table 1 provides an overview of each step.Table 1Examples and brief descriptions of the 5 strategies to effectively use online resources in emergency medicine.InnovationExamplesDescriptionRSS readerDigg Reader, http://digg.com/Feedly, http://feedly.com/G2Reader, http://www.g2reader.com/An RSS feed reader gathers and automatically delivers articles from Web sites that you follow as they are published. This can prevent you from needing to repeatedly visit the same Web sites.Podcast applicationPocket Cast (Android/iOS, $4)AntennaPod (Android, free)Podcasts (iOS, free)Podcatcher (Windows telephone, $1)Podcast streaming applications automate the process of downloading and listening to podcasts by indicating when new podcasts are available for download, downloading them, and playing them.Resource compilationsLITFL Review, http://lifeinthefastlane.com/blog-news/litfl-review/A team of authors at LITFL writes a review article outlining the best new blog posts and podcasts released each week in emergency medicine, critical care, pediatric emergency medicine, toxicology, and medical education.FOAM EM, http://www.foamem.com/FOAM EM is a blog that reposts content from other popular emergency medicine blogs and podcasts.Social networksTwitter, https://twitter.com/Most producers of blogs and podcasts have Twitter accounts. With a Twitter account, you can follow and interact with them through brief (≤140 characters) notes. They send out links to their resources and other helpful information.Facebook, https://www.facebook.com/Most blogs and podcasts have Facebook pages. With a Facebook account, you can follow their updates, which often include links to their resources, and contact their editors.Google+, https://plus.google.com/Some blogs and podcasts have Google+ pages and communities. With a Google account, you can follow their updates and participate in detailed discussions.Custom search engineFOAMSearch, http://foamsearch.net/FOAMSearch is a custom search engine that searches only specific medical journals, blogs, and podcasts, which cuts down the number of irrelevant search results by finding only resources published on Web sites directed at physicians.LITFL, Life in the Fast Lane. Open table in a new tab Strategy 1: Use a Really Simple Syndication ReaderFollowing FOAM by visiting individual Web sites can be time consuming and overwhelming. Rich Site Summary, also know as Really Simple Syndication (RSS), feeds allow the latest content from specified Web sites to be exported directly to a personalized reader. Rather than going to each site to check for updates, content is automatically synced when it is published and presented in a magazine-like format that is easy to read. There is a variety of free or inexpensive RSS readers available. A video tutorial demonstrating how to use Feedly, a popular multiplatform reader, is available (Video E1, available online at http://www.annemergmed.com).The flexibility of an RSS reader, however, can be a double-edged sword. This strategy works well when an appropriate amount of content is added by a user. However, new users can have difficulty finding good content, whereas experienced users may add so much over time that they cannot keep up with the reading list. New users should consider asking trusted colleagues for recommendations or an exported list of the Web sites they follow. Additionally, they can look at the list of recommended blogs or podcasts that their favorite blogs or podcasts follow, which can often be found on the home page (sometimes referred to as a "blog roll").Strategy 2: Use a Podcast ApplicationDownloading, formatting, and organizing podcasts can be time consuming and overwhelming. Podcast applications are to podcasts as RSS readers are to blogs. In both cases, the user specifies the content, and the software automatically acquires and queues the content for consumption. Podcast applications notify users when new podcasts have been released, download them, and play them. There is a variety of free and inexpensive podcast applications available for all models of smartphones. As with RSS readers, users must specify which podcasts they want to download, leading to the same potential problems. Again, a good place to start is to ask for recommendations from a trusted colleague, as well as recommended sites on blog rolls.Strategy 3: Use Compilations to Find Quality ResourcesThe difficulty of identifying good resources has long been recognized. We have compiled and categorized a list of recommended resources in Table 2. Several innovators have developed unique solutions to help collate and curate content:•The Life in the Fast Lane Review5Guthrie K, Davis T, Thoma B, et al. LITFL Review. Life in the Fast Lane. 2014. Available at: http://lifeinthefastlane.com/blog-news/litfl-review/. Accessed March 15, 2014.Google Scholar outlines the top FOAM content published each week. It is written by an international team of authors that identifies quality resources in 5 categories (emergency medicine, critical care, pediatric emergency medicine, toxicology, and medical education).•FOAM EM is a blog that simply reposts content from most of the popular FOAM blogs and podcasts. The aggregated content is linked to the original Web site.•A recent survey of Canadian residents found that faculty recommendations are highly valued by residents selecting online resources.6Purdy E. Thoma B. Bednarczyk J. et al.The use of free online educational resources by Canadian emergency medicine residents and program directors.CJEM. 2014; Google Scholar It may be worthwhile for residency programs to compile internal lists of resources that have been vetted by faculty.Table 2Recommended emergency medicine blogs, podcasts, and Web sites.ResourceTypeURLBasic emergency medicine resourcesBoringEMBloghttp://boringem.org/EM BasicPodcasthttp://embasic.org/Flipped EM ClassroomVideo podcasthttp://flippedemclassroom.wordpress.com/Critical care resourcesEMCritPodcasthttp://emcrit.org/Pulm CCMBloghttp://pulmccm.org/The RAGE PodcastPodcasthttp://ragepodcast.com/Resus.MeBloghttp://resus.me/EMS/retrieval medicinePHARMBlog/podcasthttp://prehospitalmed.com/Rural Flying DoctorBloghttp://ruralflyingdoc.com/Evidence-based medicineBest BetsWeb sitehttp://bestbets.org/EM Literature of NoteBloghttp://emlitofnote.com/EM NerdBloghttp://emnerd.com/The NNTWeb sitehttp://thennt.com/SMART EMPodcasthttp://smartem.org/General emergency medicine resourcesAcademic Life in Emergency MedicineBloghttp://academiclifeinem.comEM CasesPodcasthttp://emergencymedicinecases.com/Emergency Medicine IrelandBlog/video podcasthttp://emergencymedicineireland.com/ER CastPodcasthttp://ercast.org/Life in the Fast LaneBloghttp://lifeinthefastlane.com/REBEL EMBloghttp://rebelem.com/St. Emlyn'sBloghttp://stemlynsblog.org/The Skeptic's Guide to EMPodcasthttp://thesgem.com/Interpretive resourcesAmal Mattu's Emergency ECG of the WeekVideo podcasthttp://ekgumem.tumblr.com/Dr. Smith's EKG BlogBloghttp://hqmeded-ecg.blogspot.com/SonospotBloghttp://sonospot.com/Ultrasound PodcastVideo podcasthttp://ultrasoundpodcast.com/Pediatric emergency medicineDon't Forget the BubblesBloghttp://dontforgetthebubbles.com/Pediatric EM MorselsBloghttp://pedemmorsels.com/PEM EDPodcasthttp://pemed.org/EM PEMPodcasthttp://empem.org/Toxicology resourcesThe Poison ReviewBloghttp://thepoisonreview.com/Tox TalkPodcasthttp://toxtalk.org/TraumaTrauma Professional's BlogBloghttp://regionstraumapro.com/ Open table in a new tab Strategy 4: Use Social Networks to Connect With Content Producers and PeersWith 1-way media (eg, textbooks, e-books, podcasts), some learners can feel disconnected from the creators of the resources. Social networks have revolutionized communication between producers and consumers of educational content by removing traditional barriers. Authors, presenters, innovators, and thought leaders are readily available on platforms such as Twitter, Google+, and Facebook.Twitter is a microblogging platform for sharing and receiving brief (≤140 characters) pearls and links to recommended content. Most blog and podcast content producers use it to publicize, share, and discuss their material. Twitter is also used to extend the reach of conferences7Neill A. Cronin J.J. Brannigan D. et al.The impact of social media on a major international emergency medicine conference.Emerg Med J. 2013; : 1-4Google Scholar and local academic teaching sessions by reporting lessons learned.8Lin M. Residency programs on Twitter.Acad Life Emerg Med. 2014; (Available at:) (Accessed March 15, 2014)http://academiclifeinem.com/em-im-residency-on-twitter/Google Scholar Recent tweets about FOAM resources can be easily found by searching for the hashtag #FOAMed. Some organizations and groups are using Twitter to discuss literature through microblogging-based journal clubs.9Thangasamy I.A. Leveridge M. Davies B.J. et al.International Urology Journal Club via Twitter: 12-month experience.Eur Urol. 2014; 66: 112-117Abstract Full Text Full Text PDF PubMed Scopus (118) Google Scholar Pearls from the weekly didactic sessions incorporated into most emergency medicine residency programs are tweeted out with the hashtag #EMConf. A video tutorial demonstrating how to follow other users, tweet, and use hashtags is available (Video E2, available online at http://www.annemergmed.com).Google+ is better suited to detailed discussions because there are no space limitations. Like Twitter, it is possible to follow the producers of online content, and some independent Web sites have companion Google+ pages. Google+ also allows users to establish communities to foster discussion on particular niches such as critical care.10Nickson CP, Greenwood J, Le Cong M, et al. FOAM critical care community. Google Plus. 2014. Available at: https://plus.google.com/communities/108570392322669871916. Accessed March 15, 2014.Google ScholarMany of the larger blogs and podcasts have Facebook pages that can be "liked." Although it is not as easy to engage the content producers or have detailed discussions on Facebook as it is on Twitter and Google+, it is a well-recognized social media platform for personal and professional use.Social media sites can also be used as an informal feed of online resources. By following select members of the FOAM community, users can see what new podcasts or blog posts are available and which garner the most discussion. In comparison to RSS reader curation, this social media–based curation strategy trades comprehensiveness for diversity and allows the user to selectively choose content that has been implicitly endorsed by various individuals.Strategy 5: Use Custom Search Engines to Find Resources When They Are NeededFinding specific resources quickly when needed can be a challenge. FOAMSearch11Raine T. FOAM search. 2014. Available at: http://googlefoam.com/. Accessed March 15, 2014.Google Scholar (formerly GoogleFOAM) is a Google custom search engine that searches only specific sites that are relevant to emergency medicine and critical care clinicians. By focusing on both medical journals and reputable FOAM resources (including blogs, podcasts, decision support Web sites, and medical calculators), it is easier to find specific, helpful resources.Future DirectionsMedical education, particularly within emergency medicine, is rapidly embracing online educational resources. In fact, the Accreditation Council for Graduate Medical Education Residency Review Committee now permits residency programs to replace up to 20% of didactic lectures with "individualized interactive instruction"12Reiter D.A. Lakoff D.J. Trueger N.S. et al.Individual interactive instruction: an innovative enhancement to resident education.Ann Emerg Med. 2013; 61: 110-113Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar that may include these resources. However, there is substantial room for continued growth in terms of quality, responsible use, curation, and academic recognition.Quality remains a primary concern with online content because of its lack of peer review or other mechanisms to ensure accuracy. Despite the many examples of high-quality online content and the successes of peer review in FOAM,13Thoma B. Chan T.M. Desouza N. et al.Implementing peer review at an emergency medicine blog: bridging the gap between educators and clinical experts.CJEM. 2014; 16: 1-4PubMed Google Scholar verifying reliability remains elusive. There are increasing efforts to adapt and implement peer review for online educational resources13Thoma B. Chan T.M. Desouza N. et al.Implementing peer review at an emergency medicine blog: bridging the gap between educators and clinical experts.CJEM. 2014; 16: 1-4PubMed Google Scholar, 14Reynolds R.J. Candler C.S. MedEdPORTAL: educational scholarship for teaching.J Contin Educ Health Prof. 2008; 28: 91-94Crossref PubMed Scopus (19) Google Scholar and, in the future, quality indicators may be developed to assist with the evaluation of these resources. However, as with other secondary scholarly resources, online content needs to be considered and discussed critically.15Glassick C.E. Boyer's expanded definitions of scholarship, the standards for assessing scholarship, and the elusiveness of the scholarship of teaching.Acad Med. 2000; 75: 877-880Crossref PubMed Scopus (223) Google ScholarDespite the tools discussed in this article, curation remains a constant challenge. Developing archival systems for diverse groups of digital resources and enhancing custom search engines will enhance their usefulness. The Social Media Index16Thoma B. Social media index.Acad Life Emerg Med. 2013; (Available at:) (Accessed March 15, 2014)http://academiclifeinem.com/social-media-indexGoogle Scholar is a tool that attempts to quantify impact for these resources in a way that is similar to journal impact factors for scientific journals: it uses objective metrics of distribution, including Web site traffic, to create a ranked list of the most widely accessed emergency medicine and critical care content and, with further validation, may serve as a helpful directory of resources. iClickEM is a search engine currently in beta testing. Rather than using a Google search engine to search specified resources on the Internet (such as FOAMSearch), iClickEM uses customized algorithms to search the entire Internet and return the highest-yield resources for emergency physicians. Natural language search17Wu W. Proactive natural language search engine: tapping into structured data on the Web. In: Proceedings of the 16th International Conference on Extending Database Technology; Genoa, Italy, March 18-22, 2013.Google Scholar (search that uses naturally spoken language or questions rather than key words) may also help physicians to find what they are looking for, especially when combined with a search engine that can make use of medical terminology and physician-specific algorithms.Finally, although there has been an explosion of the number of these educational resources,4Cadogan M. Thoma B. Chan T.M. et al.Free open access meducation (FOAM): the rise of emergency medicine and critical care blogs and podcasts (2002-2013).Emerg Med J. 2014; http://dx.doi.org/10.1136/emermed-2013-203502Crossref Scopus (167) Google Scholar they receive minimal academic recognition.18Anderson M.G. Alessandro D.D. Quelle D. et al.Recognizing diverse forms of scholarship in the modern medical college.Int J Med Educ. 2013; : 120-125Crossref Google Scholar, 19ProfHackerThe challenges of digital scholarship.Chron High Educ. 2012; Google Scholar This may inhibit the involvement of academic physicians and slow the advancement of the field. Measures must be taken to acknowledge these forms of scholarly expression on par with similar techniques for dissemination, such as national lectures, review publications, and textbook chapters. After all, a podcast is simply a permanent lecture that can be shared with a much wider audience. For these works to be rewarded as scholarly activities, reporting standards for impact will need to be created.ConclusionThe world of online educational resources in medicine is growing quickly. Tools such as RSS readers, podcast applications, curated lists of current blog or podcast content, social networks, and custom search engines have been developed that can assist learners to navigate the flood of information. Educators and learners should consider adopting these tools to customize their online medical education and personal learning network. IntroductionFor health professions learners of all levels, staying abreast of the literature can seem like an insurmountable task as the number of clinically oriented articles continues to grow at an increasing rate.1Priem J. MEDLINE literature growth chart. jasonpriem.org. 2010. Available at: http://jasonpriem.org/2010/10/medline-literature-growth-chart/. Accessed March 15, 2014.Google Scholar, 2Larsen P.O. von Ins M. The rate of growth in scientific publication and the decline in coverage provided by Science Citation Index.Scientometrics. 2010; 84: 575-603Crossref PubMed Scopus (571) Google Scholar Fortunately, there has been a veritable explosion of online secondary resources that endeavor to digest the expanding medical literature and present it in a format that is optimized for adult learners. Particularly in emergency medicine, these resources have been dubbed "free open access medical education," also known as free open access meducation (FOAM).3Nickson C.P. Cadogan M.D. Free open access medical education (FOAM) for the emergency physician.Emerg Med Australas. 2014; 26: 76-83Crossref PubMed Scopus (133) Google Scholar The FOAM movement has figured prominently in the proliferation of blogs and podcasts made available online by practicing clinicians.3Nickson C.P. Cadogan M.D. Free open access medical education (FOAM) for the emergency physician.Emerg Med Australas. 2014; 26: 76-83Crossref PubMed Scopus (133) Google Scholar, 4Cadogan M. Thoma B. Chan T.M. et al.Free open access meducation (FOAM): the rise of emergency medicine and critical care blogs and podcasts (2002-2013).Emerg Med J. 2014; http://dx.doi.org/10.1136/emermed-2013-203502Crossref Scopus (167) Google Scholar As an unintended consequence, learners must now contend with an exponentially expanding library of both primary literature and secondary online resources.To make effective use of this stream of knowledge, learners must filter and choose from myriad resources. Simple digital tools can be used to organize and manage this otherwise overwhelming amount of information. This article outlines 5 strategies to help learners and practicing physicians stay abreast of both foundational and cutting-edge literature by using digital solutions. Table 1 provides an overview of each step.Table 1Examples and brief descriptions of the 5 strategies to effectively use online resources in emergency medicine.InnovationExamplesDescriptionRSS readerDigg Reader, http://digg.com/Feedly, http://feedly.com/G2Reader, http://www.g2reader.com/An RSS feed reader gathers and automatically delivers articles from Web sites that you follow as they are published. This can prevent you from needing to repeatedly visit the same Web sites.Podcast applicationPocket Cast (Android/iOS, $4)AntennaPod (Android, free)Podcasts (iOS, free)Podcatcher (Windows telephone, $1)Podcast streaming applications automate the process of downloading and listening to podcasts by indicating when new podcasts are available for download, downloading them, and playing them.Resource compilationsLITFL Review, http://lifeinthefastlane.com/blog-news/litfl-review/A team of authors at LITFL writes a review article outlining the best new blog posts and podcasts released each week in emergency medicine, critical care, pediatric emergency medicine, toxicology, and medical education.FOAM EM, http://www.foamem.com/FOAM EM is a blog that reposts content from other popular emergency medicine blogs and podcasts.Social networksTwitter, https://twitter.com/Most producers of blogs and podcasts have Twitter accounts. With a Twitter account, you can follow and interact with them through brief (≤140 characters) notes. They send out links to their resources and other helpful information.Facebook, https://www.facebook.com/Most blogs and podcasts have Facebook pages. With a Facebook account, you can follow their updates, which often include links to their resources, and contact their editors.Google+, https://plus.google.com/Some blogs and podcasts have Google+ pages and communities. With a Google account, you can follow their updates and participate in detailed discussions.Custom search engineFOAMSearch, http://foamsearch.net/FOAMSearch is a custom search engine that searches only specific medical journals, blogs, and podcasts, which cuts down the number of irrelevant search results by finding only resources published on Web sites directed at physicians.LITFL, Life in the Fast Lane. Open table in a new tab
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