Free open access medical education (FOAM)

Adam C. Greenfield, PharmD

PGY-1 Pharmacy Practice Resident

University of Maryland Medical Center

“If you want to know how we practiced medicine 5 years ago, read a textbook. If you want to know how we practiced medicine 2 years 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.”1

Free open access medical education (FOAM) is a completely decentralized conglomeration of educational media including, but not limited to, social media, blog posts, podcasts, videos, tweets, and more originating and focused largely in the fields of emergency medicine and critical care.  In a world dominated by social media with information available at the click of a mouse, at its core, FOAM is an adjunct to traditional medical education that we are accustomed to seeing in textbooks, peer-reviewed journals and organizational guidelines and accompanying recommendations. FOAM, over the past decade and a half, has grown tremendously regarding the amount of blogs, websites, and twitter pages devoted to the dissemination of FOAM-related content and media. As of November 2013, over 140 blogs and over 40 podcasts were identified on over 175 different websites.2 However, these numbers are certainly conservative underestimates of the amount of FOAM content available today. (See embedded link below for examples of popular FOAM content)

Given the open-access nature of the educational material presented and published, opponents of FOAM argue that the lack of a peer-review process could potentially lead to the spread of misinformation or of information that is more opinion-based rather than fact-based. On the contrary, FOAM advocates, counter that FOAM is not scientific research, but rather a “useful way of disseminating, discussing, dissecting, and deliberating over the products of research.”3 Through navigating the post-publication analysis of studies, FOAM can aid in acting as a bridge between publication (research) and practice.3 It should be noted that various groups, including Academic Life in Emergency Medicine (ALiEM) in particular, have developed initiatives to increase the scholarship of asynchronous medical education. ALiEM established the Approved Instructional Resources (AIR) Series which uses a national expert panel to adjudicate asynchronous educational material available online through a peer-review process, creating assessment questions for high quality blog content.4

Although the idea of FOAM was born out of Emergency Medicine and Critical Care it is not a wild concept to think that medical education that is so readily available could branch out to a variety of disciplines. Because of the variety of media used and the open-access nature of the material, the use of FOAM could provide useful for teaching modalities such as the ‘Flipped Classroom’ approach. The availability of FOAM resources and educational platforms provides an avenue for learners to explore FOAM content prior to classroom experiences, allowing the majority of the time spent in the classroom being related to higher level analysis, problem-solving, and critical thinking. The concept of self-teaching and learning aligns most closely with the educational theory of andragogy which we have discussed at length previously throughout the year.

I believe that the concept of FOAM is very valuable and the ability to have resources that are extremely informative and timely is important for the continued growth of new practitioners and learners alike. However, all information that is presented should be vetted to some degree with critical thinking skills by the reader/listener/learner with particular attention paid to the sources of the information including experience and prior accolades. As social media continues to grow and evolve, it will be interesting to see how FOAM and traditional educational resources (e.g. textbooks, peer-reviewed journals) continue to evolve together.

Top FOAM Blogs and Websites

References
1. Lex JR.  International EM Education Efforts & E-Learning, recorded August 2012 in New York City.  Listen or download from http://freeemergencytalks.net/wp-content/uploads/2012/08/2012-08-21-08h00-International-EM-Education-Efforts-E-Learning.mp3
2. Cadogan, MD, Thoma, B, Chan, TM, et al. Free Open Access Meducation (FOAM): the rise of emergency medicine and critical care blogs and podcasts (2002-2013). Emerg Med J 2014;31(e1):e76-7; online first. Available at: http://emj.bmj.com/content/early/2014/02/19/emermed-2013-203502.abstract
3. Nickson CP, Cadogan MD. Free Open Access Medical education (FOAM) for the emergency physician. Emerg Med Australas 2014;26: 76-83. Available at: https://lifeinthefastlane.com/wp-content/uploads/2014/02/emm12191.pdf
4. Lin M, Joshi N, Grock A, Swaminathan A et al. Approved Instructional Resources Series: A National Initiative to Identify Quality Emergency Medicine Blog and Podcast Content for Resident Education. J Grad Med Educ. 2016 May;8(2):219-25. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857492/pdf/i1949-8357-8-2-219.pdf