One of the most difficult parts of residency and medical education is coordination and communication. Often residents and faculty alike can be found drowning in a never ending onslaught of emails, with chains of projects getting buried amongst reply-all’s and attachments. Over the course of the past year, our residency program at Doctors Hospital-OhioHealth in Columbus, Ohio has been using a newer form of communication to facilitate the dissemination of information and collaboration as a group.

After some initial exploration into technology and apps, it was decided to try out the program called Slack . Designed to help large groups work together as well as separately on projects simultaneously, we felt this may be our solution to the clunky and at times unbearable onslaught of emails. For those of you interested in taking your residency or group to the next level, below are our observations from the past year in a simple do’s and dont’s fashion.

Do

• Do get some beta-testers on board first. Let them feel out the program, get used to the nuances, and set up some primary channels. Once they feel comfortable, these people can become your initial “super-users” to help people new to the process get settled in.
• Do make this a primary form of communication. Often people resist change because it is strange and unfamiliar. So from day 1, we had the primary information deliverers on board, using this as the main form of residency communication. Upload documents, announcements, reminders to Slack. This minimizes the extraneous use of other forms of communication (e.g. email, paper mail, carrier pigeons, etc.).
• Do set up an initial “introduction” presentation on how to use Slack. Using the beta testers, you can give them real time examples so people can see how Slack is supposed to work. Once they can see examples, have the invitation ready to go and do breakout sessions right then and there to have people join and start exploring.
• Do explain how to leave and join channels, how to create channels, and probably most importantly silence channels. Just like the ventilators and alarm fatigue in the ICU, if people are constantly bombarded with message tones eventually they learn to ignore it.

Don’t

• Do not forget to have people set up the app on their mobile phones/tablets. While the desktop app is great, having access via the mobile app does increase usability and reach.
• Do not force people to follow every channel on the Slack team. We had a large amount of pushback from people when they had their phones vibrating constantly as every channel had people commenting in it. Designate a minimum number of required channels to follow for residents and faculty. While we want there to be a central place for all communication and projects, too much information at one time can cause people to feel overwhelmed and reject the program. We found the most success when we implemented only 2 required channels for residents (announcements and the weekly didactic channel). All other channels were optional.
• Do not restrict use or creativity. Allow users to create channels and expand the environment. Over the course of the year, our most active channels have been #announcements and #foam-links, however #wildmed is picking up the pace. We also have channels that are more social than work related to foster friendship, work-life balance, mentorship, and team building. We have also established “private channels” for committee work including “virtual meetings” which allows for engagement regardless of work schedules or personal commitments.
• Do not be discouraged if some learners are slow to embrace Slack. As content and relevance grows, more will engage with the team for fear of being left behind.

Our experience thus far

This resource has provided a platform for continuing discussions that started in didactic conferences or on shift, initiating new conversations on various topics, and providing real-time interaction. This experiment over the past year has been great; however, we believe the upcoming year will be the pivotal time frame for engraining Slack into our residency. Our current interns are the only class to have used Slack as their main form of communication since day 1 of them joining the program. As they progress and a new class starts, we anticipate an expansion in their use. This will be the true telltale sign of how well this technology will work. Even now we are seeing increasing levels of participation, creation, and utilization. This expanded participation combined with a larger pool of users having only known the world of Slack will likely flesh out the capacity to which we will eventually be able to utilize program for our residency communication.

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