From Hippocrates to Osler to FOAM

As many know Free Open Access Med(ical Ed)ucation (FOAM) is a concept that was developed in June 2012 at a pub in Ireland. Since its creation FOAM has developed into a collection of constantly evolving, collaborative, and interactive resources and tools with one main objective…to make the world a better place. At the heart of FOAM is the philosophy that high-quality medical education should be free and accessible to all who care for patients and to those who teach the art and science of medicine. Recently, I watched a video from the 2013 Social Media And Critical Care (SMACC) Conference given by Joe Lex that made me realize although the acronym only came into being recently, maybe the concept had historical origins (From Hippocrates to Osler to FOAM).

FOAM Fallacies [1]

1. FOAM = Social Media: Social media refers to the creation and exchange of content via virtual platforms that are internet based. FOAM uses these platforms to disseminate information, but the ideas are created independent of this medium.
2. No Peer Review = Bad: FOAM is not a scientific publication, but instead a means of dissemination, discussion, and deliberation of research in a post publication open peer review forum to bridge the gap between research and practice.
3. Variable Degree of Scholarship: Physicians should use critical thinking skills and appraise the merits of whatever information they are using as they would for research publications.

Real-Time Knowledge Translation

Everett Rogers, a professor of communication studies, wrote a book called Diffusion of Innovations, first published in 1962 that stated diffusion is the process by which innovation is communicated through certain channels over time among members of a social system. He emphasized four main components that influence the spread of a new idea: the innovation, communication channels, time, and a social system.

1. The Innovation: New research, concepts, and practices
2. The Communication: FOAM (Twitter, Blogs, Podcasts, etc…)
3. The Time: Real-time translation
4. The Social System: Medical education and clinical practice

From Hippocrates to Osler to FOAM

Quotes from Hippocrates:

• “Make a habit of two things: to help; or at least to do no harm.”
• “Cure sometimes, treat often, comfort always.”
• “Wherever the art of medicine is loved, there is also a love of humanity.”
• “Many admire, few know.”
• “Science is the father of knowledge, but opinion breeds ignorance.”
• “There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance.”
• “To do nothing is also a good remedy.”

Quotes from Osler:

• “We are here to add what we can to life, not to get what we can from life.”
• “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.”
• “One of the first duties of the physician is to educate the masses not to take medicine.”
• “To have striven, to have made the effort, to have been true to certain ideals — this alone is worth the struggle.”
• “The young physician starts life with 20 drugs for each disease, and the old physician ends life with one drug for 20 diseases.”
• “Medicine is a science of uncertainty and an art of probability.”
• “The value of experience is not in seeing much, but in seeing wisely.”
• “The first duties of the physician is to educate the masses not to take medicine.”
• “The greater the ignorance the greater the dogmatism.”
• “Observe, record, tabulate, communicate. Use your five senses. Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you can become an expert.”
• “One special advantage of the skeptical attitude of mind is that a man is never vexed to find that after all he has been in the wrong.”
• “I desire no other epitaph than the statement that I taught medical students in the wards, as I regard this as by far the most useful and important work I have been called upon to do.”
• “There are only two sorts of doctors: those who practice with their brains, and those who practice with their tongues.”

In the end just realize:

• 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 conference.
• If you want to know how we will practice medicine in the future, listen in the hallways and use FOAM.
• Joe Lex

And finally:

FOAM is the concept and FOAMed is the conversation.

References:

1. Nickson CP et al. Free Open Access Medical Education (FOAM) for the Emergency Physician. Emerg Med Australas 2014. PMID: 24495067

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