Information overload…staying up to date with new medical journal publications

As physicians, some of us love to read the latest journal publication while some of us don’t give a s@#!. Those in the latter category are more than happy to get the information at conferences or journal clubs in due time. There’s nothing wrong with these people…in fact, it could be argued this is a healthier approach than being addicted to your wireless device or computer waiting for the newest publication!

But for those of us who do get turned on by reading then talking about the newest publication the day it comes out “Epub ahead of print”, it can be a daunting task to stay up to date.

In our world where we’re exposed to up to the minute Twitter feeds, blog posts or push notifications, we can easily become overloaded and inundated with how to manage this information. The challenge is particularly difficult with journal publications. I admit, that I really enjoy reading the latest research data and while that doesn’t make me a bad person…it arguably makes me a less attentive husband (one woman’s opinion).

Are there any strategies for improving information intake and staying up to date with recent research? I don’t think this area is well taught in medical school or residency, partly due to the fact it’s a brand new method of information acquistion. Also, it’s rapidly changing with new sites and apps coming all the time.

I follow a few different journal topics including emergency medicine related, critical care, general medicine and medical education. Overall, this probably results in about 15-20 journals per month. I don’t read every article, nor do I read every abstract but I routinely read through table of contents or titles to make sure I’m staying up to date.

I’ve been thinking about this recently and while this post isn’t intended to be comprehensive, it does offer a few strategies that I’ve used to ensure I’m reading the newest evidence (any mention of a product/app below is only because I’ve found them helpful…I take no money from anyone). The following are in no particular order of preference. And if there’s an app or strategy I’m missing, please comment and I’ll add it to the post!

Here we go.

QxMD “Read”: I just started using this app and I really like it and I highly recommend it for any physician trying to keep up with the medical literature. And it’s FREE!  Anyways, it’s a Canadian company that “provides a single place to discover new research, read outstanding topic reviews and search PubMed“. It allows you to sign up through your library Proxy account and access PDFs for any medical journal that your library has available. If your university isn’t supported, email them, I believe they are really working hard to add new institutions. The key component for this app is the user can select which journals they want to receive regular updates from and easily access. Here’s a great review of the product.  For those using Android/non-Mac products I don’t think its available for any other platform than Apple (I only use Mac so I can’t confirm this).

Settings page for "Read"

Settings page for “Read”

Main interface used when reading articles

Main interface used when reading articles

Feedly: I also highly recommend this! and it syncs with GoogleReader which inexplicably is getting shut down. This program provides regular updates to any journal you wish to add to your list. The benefit to this approach is that it syncs well across platforms (both mobile and desktop) and it also houses all of your non-medical blogs and news sites. The difference between Feedly and QxMD is the latter offers a much easier route to read the PDF. Feedly simply provides you with the abstract then its up to you to figure out your own access method.

Screen Shot 2013-04-21 at 11.40.53 AM

Subscribe to a journal’s table of contents (TOC): Most journals allow you to provide your email so that every time a new volume is published, the TOC arrives in your inbox. This is how I started following journals though depending on the number of emails you receive (and the number of journals you follow), this process can easily overwhelm.

Example of "The Lancet" Table of Contents email

Example of “The Lancet” Table of Contents email

Subscribe to programs such as Journal Watch or InfoPOEMs (from Cdn Med Assoc): Essentially these organizations review the literature (typically 1-2 months behind) and send brief summaries of selected articles. This isn’t comprehensive and they’re not always free (e.g. Journal Watch) but it does help you find out about papers that maybe you wouldn’t have read. I use these methods then I download the article myself using my University library account. But it is a bit more labor intensive than Feedly or QxMD.

Follow an up to date medical blog. For those in emergency medicine/critical care, lifeinthefastlane.com is a must. The authors of this blog provide high quality, regular, up to date information about new publications that will interest EM physicians. Sign up to their LITFL review and they outline some of the newest journal articles out there. In addition, they link you up with all the most recent blog posts from around the EM world.

For those interested in medical education – I highly recommend a new blog “Medical Educator 2.0” that compiles medical education (and general education) related topics from sources around the world. Ali Jalali is a medical educator at the University of Ottawa (and happened to be a professor of mine in med school) and he puts together a very high quality site. If you subscribe then you’ll get regular emails when a new version/updates are posted.

Download each journal’s app: Great if you only read 1-2 journals but not sure how useful this is if you’re looking for regular updates from a broad range of journals. Here’s a list of journal apps for download.

Twitter: Either sign up and follow a journal’s twitter account (e.g. @EmergencyMedBMJ) or follow individuals that often retweet or post comments about new articles. This approach really maximizes the power of crowds and can make reviewing new articles much easier. On Twitter, you can also follow hasthtags like #meded and #FOAMed.

So those are a few strategies that I use. I welcome feedback and suggestions that I’ve missed. I’m happy to update this post with any ideas that you feel should be included.

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A reflection on SMACC (Social Media and Critical Care Conference) in Sydney!

The past 3 days has been a whirlwind experience in Sydney, Australia where I attended the Social Media and Critical Care Conference (@smacc2013).

smacc-big

I joined a group of several of my colleagues at Auckland HEMS to participate in the inaugural conference. It combined two seemingly unrelated things – social media & critical care. Making it probably the among the first (if not the first) medical conference to have social media as a key theme. Over the past few years, physicians in critical care, emergency medicine and prehospital medicine have become leaders in social media and using the internet as a learning tool. The creators of the conference started the innovative website Lifeinthefastlane which is a blog read by thousands of acute care physicians around the world. They decided to extend their scope and create a conference which in my opinion was a huge success! This conference was a natural extension of the relatively new concept that highlights “medical education for anyone anytime, anywhere” – this concept is known as FOAM or “free access open meducation” (#FOAMed on twitter). I won’t describe it fully here as others have already done so. But it’s the way in which we use social media and the internet to share, disseminate and collaborate within medical education.

As a reflection on the conference I’d like to share a couple highlights and concepts that emerged. What was unique about the conference was the use of Twitter. There was heavy emphasis on live tweeting during each session with a designated twitter coordinator who would pose questions to the speakers directly from those asked on Twitter. There was constant discussion on Twitter with both conference attendees and even those clinicians half-way around the world. Let me provide a brilliant demonstration of this in action. In one session about coagulation in trauma, the session facilitator (Dr. Minh Le Cong from the blog PHARM) tweeted asking for comments from those in the twittersphere. Within minutes there were comments coming in from Dr. Karim Brohi, a trauma surgeon in London, England who is a world expert in coagulation in trauma. A discussion among the speaker and the audience resulted based on his comments. Never before had I seen such interaction at a global level occur during a conference. The power in capturing ideas and facilitiating live discussion among both those attending the conference and leading experts sitting in a room across the world is amazing!

When I would look around the room in each session, there was a barrage of tweeting with many sending out comments made by conference speakers as they happened. This is incredibly powerful. It allowed for an immediate online commentary for those not attending the conference. But it also allowed those of us in other sessions to hear some highlights and really get an idea of what was happening especially if there were controversial topics being discussed.

Every talk was videorecorded and posted online for free viewing by anyone in the world. This represents a huge step in promoting free open access medial education (FOAM). Why we restrict education to those who can afford or arrange travel to these conferences is mindboggling. Our business is to improve patient care and if we can collaborate and share ideas that emerge from great meetings like this then our patients will definitely benefit.

Imagine a speaker says something quite controversial. Previously it might never really be discussed again. Or perhaps it might be misrepresented several weeks or months later in a report. At this conference, speaker comments could be disseminated rapidly with the opportunity for rapid responses and discussion.

Unlike many academic conferences, speakers were introduced based on their blog (and not their publication count or number of academic achievements). While the merits of publications should not be diminished, it highlighted that an online presence where your ideas are shared, exposed and subject to review from people around the world is a new way to gain status within the medical world.

Finally, the conference started to address how FOAM, social media and asynchronous learning can be incorporated within medicine. There were enthusiastic talks that demonstrated the power of online education but also some excellent perspectives that online learning is not a learning panacea. These sessions were humbling since we must remember that despite all this technology, we still treat people. Our job requires human interaction and without reflection we can begin to forget this. Those on blogs and twitter drive the curriculum because topics are interesting, but sometimes the less sexy topics deserve discussion. There’s no curriculum to guide us online and this may not always benefit learners.

As long as we can appreciate these limitations we can maximize the potential of a asynchronous learning using an online platform. Never before can we collaborate, share, discuss and even criticize. It’s an exciting time for medical education and SMACC did a great job making it a reality!

How do you use Twitter in medical education? A new article outlines “how to” tips

This past week I posted my first tweet.

twitter

I feel like an old man writing “how I walked uphill both ways to school in 5ft of snow”. For many of you, I’m sure I sound like I may have just recently adopted electricity and the wheel…but I figured I should join the masses and test out this “new” technology.

I’m not sure what’s taken me so long to move to the Twitterverse but part of me was still trying to figure out its utility. I guess I wasn’t so sure how I could use something such as Twitter…especially since all my entire impression of the technology was that it existed as a bulletin board for the latest celebrity breakups, hookups or feuds. I figured a few episodes of Entertainment Tonight should suffice as a Twitter replacement and I wouldn’t need this new technology…

However, I thought that there must be some way this can be effective within medicine…I’ve come across some physicians in Toronto who’ve started to use it. So before joining I followed along for a little bit to see how they used it. They often tweeted about new articles or cutting edge technologies…it seemed quite up to date and a great way to follow all that was new in medicine!

Then I came across a great article that was just published in Medical Teacher by a few medical educators in Calgary. They summarized 12 Tips for using Twitter in medical education. For anyone who teaches or is involved in medical education I highly recommend reading this paper. It provides practical reasons for Twitter and nicely summarizes how it has been described in the medical literature!

Not trying to steal the thunder of the authors but wanting to share a few of their tips…In the spirit of the wiki mindset which now pervades our consciousness, I’ve posted a few below. Enjoy!

I’ve picked the ones I thought were best and added a few comments or paraphrased the authors.

  1. Use a twitter account for a specific class or group: be sure to set some ground rules so that learners will have a framework for the discussion
  2. Use a live Twitter chat in your next lecture: I’ve been to a few lectures recently where this was done and it’s really quite interesting. What’s especially cool is if people from outside the classroom tweet a comment! The beauty is that they can be anywhere else in the world. If you’re using it for questions, it might be best to only open it up near the end of the lecture or at least only post it on the projector during a dedicated time as it may serve as distraction rather than an effective tool.
  3. Tweet key resources or new literature for your students to use and read: This is an excellent way to flip the classroom. Have them follow along and get them the material before class so that they can read it, digest it then come to class or academic day and discuss & analyze it. Or simply provide a resource for them to access the latest articles that you’re reading.
  4. Use twitter for real-time feedback: If you can make it anonymous this could be pretty cool. It could be posted in real-time at the end of the lecture or course. Though the logistics of creating anonymous usernames may limit its utility…unless they’re ok with identifiable responses.
  5. Maximize the power of Twitter with emphasis efficient communication: Twitter’s benefits include having only 140 characters to post high yield information. Use this to your advantage in teaching your students concise summaries for case presentations, etc…
  6. Twitter as a tool for self & group reflection:  I love this idea. I think it presents a novel way to gather feedback and one which many learners are comfortable using.
  7. Informal polls & quizzes: I think this is a good option though there may be a better app out there called Socrative which I’ve blogged about previously.
  8. Use it as subject for further study: There’s little out there regarding this topic and could be an outstanding resident research project! I definitely agree with the authors that further study is needed. Most importantly the authors specifically state that valuable studies would not compare Twitter to no intervention but rather evaluate how best to integrate this powerful technology.

I’m looking forward to seeing Twitter become increasingly used and studied within medical education! How will you use it?

Source: SE Forgie et al. Twelve tips for using Twitter as a learning tool in medical education. Medical Teacher 2012 [Epub ahead of print]