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The Evolution of Medicine ...

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on 8 August 2017

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Transcript of The Evolution of Medicine ...

TODAY's Medical Education & Learning from your phone......
.......the Ongoing Evolution


G-G-ma, when you were little, Doctors actually cut hearts OUT of dead peope and put them into live people??
Why Didn't you just print new ones?
-Your G-G -child in 40 yrs (2056).
If you want to know how we practiced medicine 5 yrs ago, read a TEXTBOOK.

If you want to know how we practiced medicine 2 yrs 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, listen in the hallways and use FOAM.

— from International EM Education Efforts & E-Learning by Joe Lex 2012
KNOWLEDGE in the InterWeb.
FOAM has sophisticated, cutting edge learning resources
Enable clinicians / students to update knowledge, improve understanding in a fun, motivating and time efficient way.
Can be accessed by anyone, at anytime, anywhere.
"We believe that together with asynchronous learning and the flipped classroom, FOAM is part of the future of medical education and lifelong learning."
FOAM is a dynamic collection of resources
Tools for lifelong learning in medicine
Asynchronous Learning
Individual Interactive Instruction -learning away from groups of similar-level learners, which allows learners to consume material at their own pace on their own timetable.”- Reiter et al, 2012
Rapidly Evolving- attracting interest from practicing clinicians, trainees, educators, researchers and publishers
Twitter® has been central to the development of the FOAM community.
FOAM is sometimes considered synonymous with ‘educational social media for medicine’
It is much more.
FOAM Origins - Hippocratic Oath
‘. . . and to teach them this art –
if they desire to learn it –
without fee and covenant’.
Social media (SM) & FOAM growing role in:
Postpublication analysis of scientific research
Bridging gap b/w research and practice.
Journals are expanding into SM
NOT peer reviewed -in traditional sense
- It's not traditional research (yet)
- Often directly leads to traditional research

FOAM is a useful way of disseminating, discussing, dissecting & deliberating over products of research <17-23years
Exploring issues where research findings do not apply OR exist.
Akin to the editorials & commentary
articles in journals, usually solicited
by editorial request BUT w/o same
traditional peer review
FOAM opinions & arguments live or die by being hammered on
‘the Anvil of Truth’ that is free &
open debate & discussion

Asynchronous learning meshes nicely with adult learning theory- self-directed, problem-orientated & relating new knowledge to past experiences learning, targeted by individual towards own personal knowledge gaps
Operate on own schedules, different resources & media can be used according to the learner’s preferred learning styles and accessibility.
Blog posts, podcasts or videos

Take responsibility for own learning, develop the skills needed for life-long learning beyond the walls of the lecture hall

Casting out traditional synchronous learning?

The two approaches are complementary, each addressing the weaknesses of the other.

Learners still need face-to-face time.

Need critical feedback, when simulating procedures or resuscitation scenarios for instance.

Need real time discussion with peers and with experts to clarify their understanding of what they read, watched or heard.

Need guidance to ensure that entire breadth of the curriculum is covered; may not be aware of all knowledge gaps, may be (definitely are) seduced by sexy subjects rather than bread-and-butter
mundanities (PITArse minutiae).
But WHO are actually making these
resources and WHY would anyone
do such a thing for FREE?

First the who: WE ARE. You and me.
Our motivation?

Just answer these three questions:

Q1. Have you ever spent untold hours
preparing a talk that was attended by 8
people — of which a few were cognitively incapacitated by a recent night shift and the rest by post-prandial stupor?
(The lowest level of expertise is NOT Unconscious Incompetence, it’s plain old UNconscious!)

Q2. Did you go into medicine to help others?

Q3. Do you want a quick, easy way to
establish an international reputation as a cutting edge clinician &/or effective clinical educator?

Many of us interested in clinical education would say ‘hell yes!’ to all of these questions.

That’s why it makes perfect sense to record videos of our presentations, turn the research we’ve done and experiences we’ve had into a blogposts, and record our discussions as podcasts.


Create a FOAM Impact Factor? ALEXA?
- The cream rises

Is this a revolution?
...it is at LEAST an EVolution


-satirical medical news website created by a bunch of wannabe stand up comedians who ended up in healthcare.

Ramachandran SK, Cosnowski A,
Shanks A, Turner CR. Apneic oxygenation
during prolonged laryngoscopy in
obese patients: a randomized, controlled
trial of nasal oxygen administration.
J. Clin. Anesth. 2010; 22: 164–8.

Levitan RM. NO DESAT! Nasal
oxygen during efforts securing a
tube. Emergency Physicians Monthly.
2010. Available from URL:
WimalasenaY, Burns B, Reid C,Ware S,Habig K.
Apneic oxygenation was
associated with decreased desaturation
rates during rapid sequence intubation
by an Australian helicopter
emergency medicine service.
Ann. Emerg. Med. 2015; 65: 371–6.
He was interviewed later and thought he was in Moscow getting beat up by a Mr. Spongebob and Master Mickey Mouse and "Friends",
after "they cut me off in traffic."
What about kids?
adultis peiores
Liberi non parva

Define and explain the concept of FOAM / FOAMed (Free Open Access Medical Education) and the ongoing FOAM paradigm shift in Medical Education.

Discuss & Evaluate FOAM scientific veracity, FOAM motivations of the authors, and various FOAM resources so that attendees can implement FOAM into their practice.

Describe & Evaluate Delayed Sequence Intubation (DSI), and its evolution as a FOAM concept, from its inception to research study with implementation into practice.

Introduce Social Media and Critical Care (SMACC) as a FOAM web resource and annual medical conference.

Discuss FOAM truthiness (a.k.a. scientific veracity) and Impact Factor

Introduce SMACC - Social Media and Critical Care

Mention the word "FOAM" more times in one hour than the listener cares to ever hear.


(If audience behaves, lecturer will reward with video at the end)
Actively pursue opportunities to
deliver supplemental oxygen throughout the process of difficult airway management.

Opportunities for supplemental oxygen administration include (but are not limited to) oxygen delivery by
nasal cannulae
, facemask or laryngeal mask airway, insufflation: and oxygen delivery by facemask, blow-by, or nasal cannulae after extubation of the trachea.

Summary of ASA Difficult Airway Management Guidelines
Hagberg, M.D. 2014 © ASA
Emerging Scoring Tools:

ALiEM AIR Series
AIR Score
Full transcript