The hashtag refers to the concept of Free Open Access Meducation (medical education), or FOAM, first promoted at the 2012 International Conference on Emergency Medicine in a lecture by Mike Cadogan, an emergency medicine physician, educator and digital media enthusiast from Australia. Frustrated by the resistance of many physicians and medical educators to the serious potential of social media, he decided to rebrand what he and others were doing online as a form of continuing education.
"I'd always seen blogging and podcasting as an amazing medium to use for medical education," Cadogan said in a Skype interview. He saw the rebranding as a way to "get people on board with something they felt was very beneath them."
The past year has seen proliferating use of the hashtag and specialty-specific variants on it (such as #FOAMcc for critical care doctors). While the Twitter feed itself, with its 140-character limit, doesn't lend itself to in deep exploration, it's acting as a carrier wave for broader conversations a click away in blogs, podcasts, videos and video chats. While this information has not gone through the same peer review filters as an article in a medical journal, enthusiasts say it is often more current and useful -- not necessarily for major research findings but as a way to share practical tips on techniques for the everyday practice of medicine.
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"We've actively managed to engage a large group of researchers and significant academics who are moving away from writing textbooks and journal articles to doing more in the online arena," Cadogan said. "That's lending a sense of credence to what we're doing."
"The journals are still an essential part of the culture we work in," he allowed, but medical education is starting to be influenced by the open source and open content trends on the Internet, where "you take all the simple stuff, all the basic knowledge, and make it free." As an author of medical textbooks himself, Cadogan has decided it is more productive for him to spend his time blogging than to produce a new edition of one of those books.
Textbooks tend to be "outdated and expensive," whereas information gleaned from blogs and wikis can be better for fostering a "lifelong learning habit," said Michelle Lin, an associate professor of clinical emergency medicine at the University of California San Francisco and a contributor to the Academic Life in Emergency Medicine blog. Many FOAM enthusiasts will start a blog and use links posted to Twitter as "a means of directing people to their grander thoughts." Because of the growing number of clinical experts participating on Twitter, it can also be a powerful research tool, she said.
FOAM is distinct from the uses of social media for marketing or patient communication. Instead, the focus is on peer-to-peer networking of doctors.
Considered as education, FOAM mirrors what has been going on in other sectors of higher education with open educational resources (OERs) such as free digital textbooks and massive open online courses (MOOCs). At the undergraduate level, OER textbooks and other course materials are often promoted as a tool for lowering the cost of education, but also as a way of keeping instructional videos up to date by making them modular and digital. Although healthcare has some open textbook type projects of its own -- such as WikEM for emergency medicine -- most of the open education momentum is taking place outside of medical school.
While medical blogging and online activity is not new, it has a new focus.
"Really in the last year, it has just sort of exploded," said Haney Mallemat, an assistant professor and member of the department of emergency medicine at the University of Maryland School of Medicine. While medical blogging is not new, the hashtag is useful because doctors use it exclusively for subjects related to medical education, as "a sacred temple" where personal tweets or even discussions of healthcare politics should not intrude, he said. Longer term, he sees potential for the conversation to migrate to Google+, which supports longer posts and other useful features like video Hangouts.