Andrew Tagg. The sweet bird of truth, Don't Forget the Bubbles, 2016. Available at:
The use of social media has yet to hit the mainstream of medical education and, as such, those of us that spend our time online are often asked to explain exactly what we do. I was given the opportunity to speak to the Melbourne Paediatric Emergency Medicine trainees about the whys, hows and the so whats of social media as a medical education tool.
We’ve all seen the doctors, disillusioned with their lot, coming in to work as if they are in a factory. They clock in, do their job, then go home – perhaps unaware of the impact they have on those patients and colleagues around them. I want you to think of those excellent doctors you have worked with, no matter what field, and reflect on what made them excellent. Certainly they are all great communicators, empathic listeners, decisive in a crisis, but…and it is a most important but, they also know their stuff. I’m going to cover the hidden curriculum in the next few months as it is an area that fascinates me but now I want to focus on knowing stuff.
Even the best clinicians – the Scott Weingart’s, the Cliff Reid’s, the Haney Mallemat’s – had to start somewhere. They did not come out of medical school with brains leaking knowledge.
Like Daniel-san* they have slowly progressed through four key stages of knowledge/skill acquisition
- Unconscious incompetence
- Conscious incompetence
- Conscious competence
- Unconscious competence
We know that at the start of their careers most clinicians play it safe and are risk averse but after a couple of years they think they know more than they do. As they ascend Mount Stupid on the Dunning-Kruger curve they are blind to the things they do not know. Traditional textbooks are vital to provide the map, to help unwary travellers avoid the chasms of missed diagnoses. But they do have their problems.
The current edition of Cameron’s Textbook of Paediatric Emergency Medicine, for example, (one of the core textbooks recommended by the Australasian College of Emergency Medicine in order to cover the curriculum) was published 5 years ago in 2011. No doubt authors wrote their chapters well before then. That means the information it contains may be at least 6 years out of date. A lot can change in that time. In fact studies have suggested it can take up to 17 years for information to disseminate from researcher to clinician. Social media, in the form of blogs, podcasts and Twitter, can shorten this knowledge translation gap to days.
Blogs – short for weblogs – are not just the on-line confessions of a teen drama queen, but are immense on-line repositories of knowledge. It is very easy to be overwhelmed by all of the material out there and so a number of erudite people have created some handy guides on getting started. It would be impossible to keep up to date with all of the published literature so you need to create some filters to make your life easier.
- Information overload by Chris Nickson on Life in the Fast Lane
- Drinking from the firehose – keeping up to date with the published literature by Nat May on St Emlyn’s
- The path to insanity by Scott Weingart on EmCrit
- Got FOAM? by Salim Rezaie on R.E.B.E.L.E.M
Now that Google Reader is defunct I use an RSS feed aggregator called Feedly to pull the latest articles from the blogs I read as well as the latest journal articles from the published literature. With such a large number to review I scan through them to identify those that would be of interest to me and save them to a program called Pocket so that I can read them at my leisure on a device of my choosing. If you use this approach you must remember to check in with your feeds on a regular basis or you fall foul of a pile of knowledge waiting to be read, like so many plastic-wrapped journals sitting on the desk.
Some of you may be familiar with the behemoth 4 hour production of Mel Herbert EM:RAP which, along with Emergency Medical Abstracts, have been leading the way of paid audio digests for years. Since the current inception of the Free Open Access Medical Education movement there many more podcasts to enjoy. Whether you use the native podcast app on your iPhone or have moved on to Overcast there is something for everyone out there. Rather than list the contents of my podcast feed I thought I would just highlight three that every paediatrician aspiring to excellence should listen to.
And so on to my favourite way of cutting the knowledge translation window. Twitter is a microblogging platform with a limit of 140 characters in which you need to get your point across. You could absolutely use it to tell people what you had for breakfast but a professional account can be so much more than that. Everyday educated clinicians tweet out pearls of information, highlight great journal articles you might not have spotted and an answer questions. We recently highlighted an exciting initiative by the Journal of Paediatrics and Child Health to tweet out a free article a day for a month – a great way of bringing the latest papers to the masses.
Here are some great guides to getting started with Twitter for professional development.
The so what?
A number of criticisms have been levelled at social media. I think this paper by Vic Brazil and Damian Roland answers pretty much all of them.
Roland D, Brazil V. Top 10 ways to reconcile social media and ‘traditional’education in emergency care. Emergency Medicine Journal. 2015 Oct 1;32(10):819-22.
Concerns have been raised about the potential cult of celebrity surrounding some medics on Twitter but most of their audiences have discerning tastes. Remember Donald Trump has 14M followers but that doesn’t mean he speaks the truth. Just as in real life you need to be critical of what you hear and read, read the show notes, and look at the primary literature. The best podcasts, such as PEMPlaybook contain so much more than what you hear. If you just listen to 30 minutes of Dr Horeczko talking about GI bleeds in kids you’ll miss out. Read the show notes and the comments posted on-line to delve deeper.
Beyond the knowledge gap
There are so many more benefits of getting involved with social media for medical education. You can use it to create your own personal learning network. You can use it to ask questions of experts. And if you are lucky you can use it to spread knowledge.
If I give a talk about neonatal resuscitation to our local registrars, at one of their regular teaching sessions, it might be seen by 20-30 people. If I do the same thing at a regional training day I might influence 100 people. If I write a journal article on the same subject it might reach 5000 people. But if create a blogpost it might get to 20,000.
And so many more opportunities may arise. If it wasn’t for Twitter I wouldn’t be running the paediatric workshop at dasSMACC. Or helping run this…
One day, I hope, I wont need to give this talk as everyone will be using online resources as freely as they use textbooks.
*Please only watch the amazing 1984 classic starring Ralph Macchio