Tag: FOAMed

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Moving from Traditional Medical Education to FOAMed

Recently, when talking about social media and medical education I have been comparing it to traditional medial education. Some media is locked into one camp or the other. Textbooks are a bastion of traditional medical education. The complexity of writing and publishing a physical book results in a cost structure so high that it can’t given away. Textbook costs for some corners of medicine have risen to absurd prices.

But I have a text book that has crossed over from traditional medical education to FOAMed. By making the Fluid, Electrolyte, and Acid-Base Companion a free download from this site I can get an idea of how much the price of a textbook is a barrier to wide adoption. The Companion went through one print run of 1200 books. We never did a second printing. All of them were sold. Any copies now available on Amazon are only available because of a robust secondhand textbook market. But since September of 2017, I have made the “Whole Enchilada” available for free on this site. The Companion is available as a simple PDF for anyone to download, redistribute, mark-up, and copy.

We sold 1200 printed copies. So how do we do with downloads? We get about half that number every month and have been averaging that for the last 5 years.

Download numbers from WordPress. I have been on WordPress for 46.5 months.

The Free in FOAMed is important. But I also think providing the document in a flexible, universal format like PDF that doesn’t require a specific reader app is also important. Remove as many barriers for the user as possible.

Why this post? Because I need a reference for a chapter I’m writing. I know it sounds circular, but a reference to a blog post seems better than “personal communication.” Look for this chapter on nephrology and social media to be published in a textbook in the next year or two.

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Mistakes in medical education social media

I am in page proof hell.

The two year slog from from gleefully saying “Wow, that sounds like fun” to a published book is wrapping up. I am working with Edgar Lerma and Matt Sparks on Nephrology Secrets fourth edition. It is an amazing amount of work.

Yesterday I was proofing a chapter and found a pretty profound error.

Not a typo.

Not a misspelling.

Not an awkward turn of phrase.

This was a hardcore, error-of-fact that would have confused readers that didn’t know better and cause significant loss of authority for the book by the readers that did.

This error had travelled a long and perilous editing river to finally arrive intact at the final page proof.

I don’t know how the authors proofed their own chapter, but I assume it went through multiple drafts and rewrites. Then the chapter was sent to the editors and for Secrets, each editor read and commented on each chapter. After each editor the chapter was sent back to the authors for revision. This rinse, wash, and repeat went through three cycles. One with each editor. Then the text was turned over to Elsevier and they converted it into a book. The publisher returned proofs to the authors with specific questions that came up during the page layout. Another independent set of eyes. And then the authors signed off on the proofs.

And after all of that I found the error. A significant error.

This error came within one-step of being a permanent, written-in-ink error in the book. That chain of revisions and proofs is what makes books as good as they are. What type of checks are there in social media delivered medical education? How do we assure that the lectures and pearls we push through our blogs and tweets do not contain subtle (or not so subtle) errors. Very little social media has anywhere close to the editorial infrastructure that an Elsevier textbook enjoys.

In my post about Kidney Week I received three different DMs and @s notifying me of 3 different typos and misspelling. Fix and move on.

Typos are easy. There is more embarrassment than ego in those mistakes. Mistakes of content are harder to accept. The instinct is to defend our work, push back against the unsolicited peer reviewer. But we need to keep our ears to the crowd and our minds open so that…

If we are wrong

It is not for long.

Because the strength of social media is using Linus’s Law to uncover mistakes and then it is up to us to put away our egos and make it right.

given enough eyeballs, all bugs are shallow

I really feel the success of FOAMed depends on the crowd notifying authors of mistakes and then the authors fixing those mistakes. A failure on either side of that equation (either side means that if you are reading FOAMed and see a mistake you have an obligation to point it out. Noticing a mistake in medical education material and moving on without notifying the author is like seeing a discarded pistol by the playground and not telling the authorities. That dead seven-year-old is on you) and FOAMed becomes a joke as it morphs into a minefield of crappy, error filled resources.