Tag: textbooks

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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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Free Onconephrology text book

Awesome, current resource on onconephrology from the ASN. Nineteen chapters with everything you need to be a superior consultant nephrologist

Chapters

  1. Onco-Nephrology: Growth of the Kidney-Cancer Connection
    Mark Perazella, MD, and Mitchell Rosner, MD
  2. Why Do We Need an Onco-Nephrology Curriculum?
    Mark Perazella, MD, and Mitchell Rosner, MD
  3. AKI Associated with Malignancies
    Amit Lahoti, MD, and Benjamin Humphreys, MD, PhD
  4. Tumor Lysis Syndrome
    Amaka Edeani, MD, and Anushree Shirali, MD
  5. Electrolyte and Acid-Base Disorders and Cancer
    Anushree Shirali, MD
  6. Glomerular Disease and Cancer
    Divya Monga, and Kenar Jhaveri
  7. Hematologic Diseases and Kidney Disease
    Ala Abudayyeh, MD, and Kevin Finkel, MD, FACP, FASN, FCCM
  8. Clinical tests for Monoclonal Proteins
    Nelson Leung, MD
  9. Hematopoietic Stem Cell Transplant-Related Kidney Disease
    Sangeeta Hingorani, MD, and Joseph Angelo, MD, MPH
  10. Radiation Nephropathy
    Amaka Edeani, MBBS, and Eric Cohen, MD
  11. Chemotherapy and Kidney injury
    Ilya Glezerman, MD, and Edgar Jaimes, MD
  12. Pharmacokinetics of Chemotherapeutic Agents in Kidney Disease
    Sheron Latcha, MD, FASN
  13. CKD as a Complication of Cancer
    Laura Cosmai, MD, Camillo Porta, MD, and Maurizio Gallieni, MD, FASN
  14. Hereditary Renal Cancer Syndromes
    Katherine Nathanson, MD
  15. Work-up and Management of Small Renal Masses
    Susie Hu, MD Anthony Chang, MD
  16. Cancer in Solid Organ Transplantation
    Mona Doshi, MD
  17. Cancer Screening in ESRD
    Jean Holley, MD
  18. Ethics of RRT, Initiation and Withdrawal, in Cancer Patients
    Michael Germain, MD
  19. Palliative Care in Patients with Kidney Disease and Cancer
    Alvin H. Moss, MD, FACP, FAAHPM

The more you learn the cheaper that ASN membership looks.

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What is the role of UpToDate in medical education?

I wrote the following tweetorial last week and the response was amazing. Seems like everyone had an opinion.

The poll at the end of the tweetorial had over 1,500 votes with 90% split between “Definitive source” and “Equivalent to other textbooks”

A recurring thought among commenters was that textbooks are great for providing overviews and UpToDate is a more practical reference that will be both up-to-date and provide specific recommendations for your clinical question. I remember talking to Burton “call me Bud” Rose when he was hawking a still incomplete UpToDate in the halls of ASN Renal Week in the 90s. One thing he drilled in on was that his cards (a card is a single entry in UptoDate) always finish with a specific recommendation. He viewed this as a critical differentiator for UpToDate. He made his writers not just provide the data but pick a side.

One great comment was by Poonam Sharma

I think this might be the source of some physicians distaste for UpToDate. When we have a resident give a presentation to teach the rest of the team or residency, or fellowship program we want people to dig deeper than summarizing UpToDate.

Additionally people kept commenting on the importance of going to the primary literature. This is great in principal, but in practice the volume of primary literature is overwhelming. The KDIGO 2012 blood pressure recommendations have 453 references on blood pressure alone. If you seek to be an expert, going down the rabbit hole of primary literature is essential, but if you want to put all of that training to use taking care of patients, it is best to stick with guidelines, review articles, and, yes, UpToDate.

One final note, the villain of the initial tweet, Dustyn Williams, contributed to the conversation.

This is a model with how to deal with this type of hullabaloo. He avoided any ad-hominem defensiveness. He stated that this was a long time ago and he is no longer the same person. His thoughts on the topic have evolved. Nicely done. God knows what inappropriate and emotional things I have typed out in the past. And I am sure most of us will, in the future, need to deal with years-old statements returning zombie-like to chase us down. Dr. Williams provides an admirable model to follow.

COI: I am the author of a medical textbook.