Swarm-based Medical Swarm-based Medical EducationEducation

Knowledge Translation Knowledge Translation TimeTime

Known ————> used in practiceKnown ————> used in practice

TimTimee

10 years -> 10 years -> weeksweeks

Mike CadoganMike Cadogan

PodcastsPodcasts

BlogsBlogs

TwitterTwitter

Google PlusGoogle Plus

Advantages of FOAMAdvantages of FOAM

MultimediaMultimedia

Listen to podcasts while biking or kayakingListen to podcasts while biking or kayaking

Great for people with short attention spans. Check Great for people with short attention spans. Check Twitter on the looTwitter on the loo

Short KT TimeShort KT Time

ExampleExample

Apnoeic oxygenationApnoeic oxygenation

Nasal prongs oxygenation during rapid sequence Nasal prongs oxygenation during rapid sequence intubation to reduce risk of hypoxia.intubation to reduce risk of hypoxia.

Article in Journal of Emergency Medicine Feb 2010 Article in Journal of Emergency Medicine Feb 2010 and EP Monthly Dec 2010, quoting anaesthetic and EP Monthly Dec 2010, quoting anaesthetic research.research.

March 2011 EMCrit Podcast -> Put into practice in March 2011 EMCrit Podcast -> Put into practice in our ED that month and probably within a year was our ED that month and probably within a year was standard practice in all EDs around the worldstandard practice in all EDs around the world

Example 2Example 2

Targeted Temperature ManagementTargeted Temperature Management

NEJM Dec 2013 Post cardiac arrest cooling to 36˚ as NEJM Dec 2013 Post cardiac arrest cooling to 36˚ as effective as cooling to 33˚effective as cooling to 33˚

Discussions via various FOAM mediaDiscussions via various FOAM media

Practice change Dec 2013 in many hospitals (not Practice change Dec 2013 in many hospitals (not this one :-( this one :-(

But there’s all this But there’s all this dubious stuff on the dubious stuff on the

internetinternet

Who can you believe?Who can you believe?

What can you trust?What can you trust?

Swarm intelligence (SI) is the collective Swarm intelligence (SI) is the collective behavior of decentralized, self-organized behavior of decentralized, self-organized

systems, natural or artificial. systems, natural or artificial.

The swarm, the online medical community, is choosing who to The swarm, the online medical community, is choosing who to listen to. listen to.

Meritocracy, cream floats, good blogs and podcasts become Meritocracy, cream floats, good blogs and podcasts become popularpopular

Opinion leaders quickly change opinions based on feedback from Opinion leaders quickly change opinions based on feedback from the swarm e.g. Anand Swaminathan on EM:RAP re calcium the swarm e.g. Anand Swaminathan on EM:RAP re calcium gluconate vs calcium chloride jan 2014gluconate vs calcium chloride jan 2014

Swarm based critique and feedback Swarm based critique and feedback

e.g. possible foreign body on a Wanganui X-Ray picked up by a e.g. possible foreign body on a Wanganui X-Ray picked up by a doctor in Venezuela last year (coarctation stent)doctor in Venezuela last year (coarctation stent)

e.g. Dr Minh Le Cong edits the whole of FOAM. Corrected a dose e.g. Dr Minh Le Cong edits the whole of FOAM. Corrected a dose of ketamine in one of my tweets within a few minutes of ketamine in one of my tweets within a few minutes

• + a smattering of several other + a smattering of several other good podcastsgood podcasts

Niche: new docs, small hospitalsNiche: new docs, small hospitals

Helps attract good quality doctorsHelps attract good quality doctors

Most importantly helps orientate Most importantly helps orientate and up-skill our new docsand up-skill our new docs