Free Open Access Medical Education (FOAM) for the emergency physician

Journal Club Summary

Free Open Access Medical Education (FOAM) for the emergency physician

23 April 2014

Facilitated by Victoria Brazil


Social media and online learning platforms have enormous potential to shape current and future medical education and literature. But should or can they replace traditional medical journals and textbooks, or revolutionise the peer-review process?  Victoria Brazil discussed free open access medical education (FOAM) and highlighted the potential uses of social media tools such as Twitter.

Paper presented

An avid user herself, Victoria started the journal club by introducing Twitter, tweets, hashtag and handle, and then went on to present a paper about FOAM for the emergency physician1. FOAM resources are blogs, podcasts, tweets, Google® hangouts, Apps, online videos, text documents, photographs, graphics and even anything you can create with a pen and paper and share online with the medical community. Since the FOAM concept was coined in 2012, over 240 blogs and podcasts in emergency medicine and critical care alone have been created. One such blog,, has had 5 million visits since 2010.

The paper discusses how and if FOAM compares to traditional medical journals and textbooks, and how it could influence medical education.

Twitter is a powerful tool for the rapid dissemination and debate of new scholarly work and has indeed been central to the development of the FOAM community. A good example is the discussion that happened after the publication of the targeted temperature management trial in November 2013.2 Social media and FOAM therefore have the potential to play an important role in knowledge translation and post-publication peer review, but they complement medical journals rather than clash with them.

With regard to medical textbooks, FOAM does currently not replace the need for every emergency trainee to read at least one traditional textbook cover to cover. FOAM content is too heterogeneous and biased – “sexy”, trendy topics get a mention on blogs and Twitter but other important topics such as hand hygiene are not covered. Therefore, FOAM should not have its own curriculum. However, many FOAM resources provide the most up-to-date and highest quality information. This is certainly something that could be integrated into a textbook of the future: it should be instantly updatable, include multimedia elements and be accessible through a cloud. In the meantime, FOAM can function as an adjunct to existing medical education during preparation for lectures and group discussion.

On a related note, Victoria also presented an analytical tool called Symplur ( that can be used to provide amazing analytics of hashtags and Tweet activity.


She finished her presentation with a few recommendations and warnings:

  1. Recognise effective use of social media. The same things that work on social media are those that work face-to-face.
  2. Develop and adapt your critical appraisal and evidence based medicine (EBM) skills – same principles, different tools
  3. Exert caution to avoid a return to eminence or celebrity-based medicine rather than EBM
  4. A curriculum must be comprehensive and cannot be replaced by popularity of choices


The discussion focused mainly on the use of Twitter.

Victoria has used Twitter in a class of 80 students to gather questions and opinions in real-time.

At the recent Social Media and Critical Care (SMACC) conference on the Gold Coast, a “Twitter moderator” collected questions from the audience during talks (tweeted in by conference participants) and selected the 3 most important questions to ask the speaker.

Victoria noted that the Twitter community is generally very positive; people rarely openly criticise. Nevertheless, you need to think carefully about what you tweet, also in terms of your own and other people’s privacy.


  1. Nickson CP and Cadogan MD. Free Open Access Medical education (FOAM) for the emergency physician. Emerg Med Australia (2014) 26, 76-83.
  2. Cadogan M. All in the lather over TTM.


 (Summary provided by Michele Weber)

An interesting blog posted 21 April 2014 regarding social media and sharing evidence: