Free Open Access Medical Education Research Articles

Weighing the gold standard: The breadth of emergency medicine core content covered by textbooks.

Textbooks are often considered the criterion standard in medical education, but there is a growing preference for free open-access medical education (FOAM) content among learners. Despite FOAM's appeal, these resources often fall short in covering core content as comprehensively as the American Board of Emergency Medicine's 2019 Model of the Clinical Practice of Emergency Medicine (MCPEM), thereby sustaining the recommendation for textbook use. However, textbooks have limitations, such as how quickly content can become outdated. Notably, there is no evaluation of the comprehensiveness of emergency medicine (EM) textbooks in the literature. This observational cross-sectional study compared Rosen's Emergency Medicine: Concepts and Clinical Practice 10th Edition (Rosen's) and Tintinalli's Emergency Medicine: A Comprehensive Study Guide 9th Edition (Tintinalli's) with the MCPEM subtopics. Each textbook chapter was reviewed for content alignment with MCPEM subtopics. The primary outcome was the proportion of MCPEM subtopics covered by each textbook. Secondary outcomes included the count of chapters covering each topic and their distribution relative to the core content weighting in the ABEM National Qualifying Examination (NQE). Rosen's covered 95.3% of MCPEM subtopics (837 unique subtopics), and Tintinalli's covered 94.5% (826 unique subtopics). Both textbooks overrepresented topics like toxicology and psychobehavioral disorders compared to their weighting in the NQE. Relatively underrepresented topics included environmental disorders, cardiovascular disorders, renal and urogenital disorders, and traumatic disorders in Rosen's and other core competencies and cardiovascular disorders in Tintinalli's. The textbooks varied significantly in coverage of certain topics. Both Rosen's and Tintinalli's comprehensively cover MCPEM subtopics, with some discrepancies in topic representation compared to the NQE. While textbooks offer depth and breadth, they may not fully align with the NQE content distribution. A diversified approach to EM education, combining traditional textbooks and FOAM resources may be required for comprehensive learning.

The utilization of podcasts and other free open access medical education resources in vascular surgery

Vascular surgery is a dynamic and complex specialty that requires many years of training and lifelong learning. Traditional education methods may not be sufficient to meet the needs and preferences of learners in this field. Podcasting and other free open-access medical education online materials may provide innovative tools to deliver up-to-date, evidence-based information in an accessible and entertaining format. Many free resources have been developed in the past few years and are now available to vascular surgery learners. The Audible Bleeding podcast is the first and largest podcast in the United States dedicated solely to vascular surgery education. The Society for Vascular Surgery is the leading professional organization for vascular surgeons, with a mission to advance excellence and innovation in vascular health. The Society for Vascular Surgery and the Audible Bleeding podcast have established a successful collaboration that enhances the podcast's quality and promotes the society's mission and vision.

Use of Social Media and Free Open Access Medicine (FOAM) for Continuing Education in Emergency Nursing: A Scoping Review

Objective: Emergency nurses are responsible for ensuring that they have up-to-date knowledge and skills to deal with any situation that may present in clinical practice. As an emerging trend for learners to obtain and discuss evidence-based medical education, social media, Free Open Access Medical education (FOAM) and Free Open Access Nursing education (FOAN) could be used for continuing education in emergency nursing. This scoping review aims to discover what is known about social media and FOAM in continuous emergency nursing education. Methods: This scoping review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Extension for Scoping Reviews (PRISMA-ScR). The review searched three databases (Medline, CINAHL, and Web of Science) for any paper that discussed social media or FOAM in the context of continuing education in either general or emergency nursing published in any year. Of the 346 records screened, 12 studies were reviewed for their description of social media for continuing education use and any reported challenges or outcomes. Results: The current state of literature is limited in describing the use of social media with continuing education specifically in emergency nursing. Rather than as a primary educational intervention, social media has been used to enhance other educational strategies or as in-the-moment forms of learning. Studies that utilized social media showed favorability to its use, but there were often challenges to the methodology of these studies. Despite papers describing the elements of FOAM, papers within the nursing literature did not use this term. Conclusion: Although the literature on social media in emergency and general nursing literature is growing, it is superficial and broad. More studies are needed to see the overall effects of social media in continuing education in emergency nursing. Keywords: continuing education, emergency nursing, nursing education, social media.

SAEM systematic online academic resource (SOAR) review: Gastrointestinal illnesses.

Free open access medical education (FOAM) has become an essential tool for emergency medicine (EM) education and can be valuable to clinicians as a point-of-care resource. The development of the revised Medical Education Translational Resources Impact and Quality (rMETRIQ) tool provides a standardized means of quality assessment. Previous entries of the Society for Academic Emergency Medicine systematic online academic resource (SOAR) series have focused on renal, endocrine, and sickle cell disorders. In this iteration, we strive to identify, curate, and describe FOAM topics specific to acute gastrointestinal (GI) illnesses. We searched 389 keywords across 11 GI topics that were modified from the 2019 Model of the Clinical Practice of EM (EM Model) using the search engine Google FOAM and within the top 50 websites listed on Academic Life in Emergency Medicine's Social Media Index. The sites underwent preliminary screening to eliminate resources that were not relevant to EM or GI illnesses. Identified resources were evaluated with the rMETRIQ tool by five board-certified EM physicians who received rMETRIQ tool rater training. After duplicates of the initial 39,505 resources were eliminated, 8059 remained. Primary screening resulted in a final 1202 resources. The most common categories were large bowel (18%), small bowel (13%), stomach (11%), esophagus (11%), biliary (11%), and liver (10%). Many resources covered multiple topics and subtopics. The final mean intraclass correlation coefficient among the five physicians was 0.95 (95% CI 0.92-0.98) for rMETRIQ scoring. We identified 256 sites considered "high quality" with a rMETRIQ score of 16 or higher as designated in prior reviews. This iteration of the SOAR review resulted in the highest number of high-quality resources compared to other SOAR reviews, with 21% of resources thus far scoring ≥ 16. A final list of high-quality resources can guide trainees, educator recommendations, and FOAM authors.

Systematic online academic resource (SOAR) review: Pediatric respiratory infectious disease.

Free open access medical education (FOAM) resources have become increasingly popular in graduate medical education. Despite their accessibility, the assessment of FOAM resources' quality is challenging due to their decentralized nature and the diverse qualifications of their authors and distribution platforms. In this first pediatric systematic online academic resource (SOAR) review, we utilized a systematic methodology to aggregate and assess the quality of FOAM resources on pediatric respiratory infectious disease topics. We searched 177 keywords using FOAMSearch, the top 50 FOAM websites on the Social Media Index, and seven additional pediatric emergency medicine-focused blogs. Following a basic initial screen, resources then underwent full-text quality assessment utilizing the revised Medical Education Translational Resources: Impact and Quality (rMETRIQ) tool. The search yielded 44,897 resources. After 44,456 were excluded, 441 underwent quality assessment. A total of 36/441 posts (8% of posts) reached the high-quality threshold score (rMETRIQ ≥ 16). The most frequent topics overall were pneumonia and bronchiolitis. A total of 67/441 posts (15% of posts) were found to have a rMETRIQ score of less than or equal to 7, which may indicate poor quality. We systematically identified, described, and performed quality assessment on FOAM resources pertaining to the topic of pediatric respiratory infectious disease. We found that there is a paucity of high-quality posts on this topic. Despite this, the curated list of high-quality resources can help guide trainees and educators toward relevant educational information and suggest unmet needs for future FOAM resources.

‘SurgTalk’: The Educational Outcomes Associated With Development of a Surgical Podcast for Undergraduate Medical Students

Educational podcast series are becoming increasingly popular as free open access medical education (FOAMed) resources, however, the educational benefit associated with their use is unclear. The aim of this study was to assess the educational outcomes associated with the implementation of a surgical podcast series for undergraduate medical students. Two conversational case-based podcast episodes were recorded covering 2 common surgical presentations. Final-year medical students were recruited prospectively in January 2023 and underwent a baseline multiple choice question (MCQ) test covering the material within the podcast episodes. Participants were then provided with the episode files through encrypted Google Drive links. Two weeks following baseline assessment, students repeated the initial MCQ test and completed a postpodcast reaction survey. Data were analyzed using a paired t-test, multivariable regression analyses, and simple descriptive statistics. Fifty students were enrolled in the study. All participants undertook the baseline assessment. About 98% completed the postpodcast MCQ, while 94% completed the postpodcast reaction survey. All participants who undertook the reaction survey (n = 47) found the podcast helpful in explaining surgical concepts, 92% of participants found the podcast enjoyable to listen to. The most commonly reported activity undertaken while listening was "commuting/driving" (n = 24, 48%). The mean baseline MCQ score was 44.6%. The mean postpodcast MCQ score was 65.51%. There was a mean absolute increase in test score of 20.2% from baseline which was statistically significant (95%CI 14.67-25.6, p < 0.001). Implementation of this podcast series was associated with a statistically significant improvement in mean test score from baseline, reflecting knowledge acquisition. There was a positive user reaction and students were able to listen while performing other activities. Further evaluation of the educational outcomes associated with podcast use, particularly the effects on knowledge retention and clinical competence, is required.

Embracing the (r)evolution of social media and digital scholarship in pediatric nephrology education.

Free Open-Access Medical Education (FOAMed) has transformed medical education in the past decade by complementing and substituting for traditional medical education when needed. The attractiveness of FOAMed resources is due to their inexpensive nature, wide availability, and user ability to access on demand across a variety of devices, making it easy to create, share, and participate. The subject of nephrology is complex, fascinating, and challenging. Traditional didactic lectures can be passive and ineffective in uncovering these difficult concepts and may need frequent revisions. Active teaching methods like flipped classrooms have shown some benefits, and these benefits can only be multifold with current social media tools. Social media will inspire the involvement of students and allow them to create and share educational content in a "trendy way," encouraging the participation of their peers and thus building an educational environment more conducive to them while promoting revision and retainment. FOAMed also promotes asynchronous learning, spaced learning, microlearning, and multimodal presentation with a meaningful variation. This article discusses the evolution of digital education, social media platforms, tools for creating and developing FOAMed resources, and digital scholarship.

Emergency Medicine Procedures: A Review of Approved Instructional Resources from the World of Free Open Access Medical Education.

The Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) Series was created in 2014 to address the Free Open Access Medical Education (FOAM) movement's decentralized nature and lack of inherent peer review. The AIR series provides a topic-based, curated list of online educational content vetted by academic emergency medicine (EM) faculty that meets individualized interactive instruction criteria for EM trainees. Relevant FOAM resources were identified from the top 50 FOAM websites using the Social Media Index and then scored by EM faculty using a validated instrument to identify the highest quality posts related to a topic. This article reviews FOAM resources pertaining to EM procedures that were labeled as an "Approved Instructional Resource" or "Honorable Mention" using the AIR series methodology.

The rebel, the professor, and the entrepreneur: Qualitative study to explore creator stories of FOAM.

The free open access medical education (#FOAMed, or FOAM) movement creates educational content intended to inform medical education and clinical practice and is distributed in an unrestricted fashion (e.g., open access website). The who, what, and in particular the how of FOAM has raised important questions about the sustainability of the movement. We recruited a diverse research team that included educational researchers, FOAM contributors, a business academician, and medical trainees to design and conduct a qualitative study exploring the work of FOAM creators. We analyzed the transcripts of interviews with 11 participants from top FOAM websites in emergency medicine and critical care. The team met frequently to iteratively identify and discuss emergent themes (major and minor) until saturation of concepts was achieved. Creators of FOAM could be categorized using three archetypes: the rebel, the professor, and the entrepreneur. The rebel was categorized as distinctly rejecting "traditional academic structures" yet was compelled to deliver educational content via alternative routes. The professor retained a traditional academic role, instead creating FOAM to supplement academic activities (teaching courses, disseminating scholarship, promotion). Entrepreneurs focused on creating a sustainable entity in an effort to supplement their income and reduce clinical obligations. While all FOAM creators appear unified in their passion to create, promote, and distribute educational material with unfettered access to educators, their motivations for creating content could be differentiated. Given the grassroots nature of FOAM, creators share concerns related to financing, time commitments, and threats to sustainability of these businesses. The longevity of FOAM and what business models are best suited to support them are uncertain. Further exploration of the implications could investigate the best ways to engage with and support the different FOAM creator archetypes and develop models of sustainability.

Trainee Love and Breakup Letters to NephSIM: A Free, Mobile-Optimized, Nephrology Teaching Tool.

It is not known how learners feel about free open access medical education (FOAMed) as they progress through their training from medical school to fellowship. Love and breakup letter methodology (LBM) is a technique that has been used extensively in user experience technology-based research but has not previously been used in evaluating medical education tools. LBM asks participants to creatively write a "love" or "breakup" letter to a product under study to capture their thoughts and emotions when engaging with it. We conducted qualitative analysis of data from focus groups to explore how attitudes toward a learning platform change at various training stages and to broaden our understanding of how we meet learners' needs through a nephrology FOAMed tool, NephSIM. Three virtual, recorded focus groups were conducted with second-year medical students, internal medicine residents, and nephrology fellows ( N =18). At the start of the focus group, participants composed and read their love and breakup letters. Semistructured discussions were then led by facilitator-driven questions and peer comments. After transcription, inductive data analysis was conducted using Braun and Clarke's six-step thematic analysis. Four main themes were seen across all groups: attitudes toward teaching tool, perception of nephrology, learning needs and approach, and application to practice. Preclinical students positively viewed the opportunity to simulate the clinical setting and unanimously wrote love letters. Reactions from residents and fellows were mixed. Residents were interested in brevity and speed of learning, preferring algorithms and succinct approaches to meet their practice-based learning needs. Fellows' learning needs were driven by a desire to prepare for the nephrology board examination and review cases uncommonly seen in practice. LBM provided a valuable methodology through which to identify trainee reactions to a FOAMed tool and highlighted the challenges of meeting learning needs of a continuum of trainees with a single learning platform.

Investigating Social Media to Evaluate Emergency Medicine Physicians’ Emotional Well-being During COVID-19

Emergency medicine (EM) physicians experience tremendous emotional health strain, which has been exacerbated during COVID-19, and many have taken to social media to express themselves. To analyze social media content from academic EM physicians and resident physicians to investigate changes in content and language as indicators of their emotional well-being. This cross-sectional study used machine learning and natural language processing of Twitter posts from self-described academic EM physicians and resident physicians between March 2018 and March 2022. Participants included academic EM physicians and resident physicians with publicly accessible posts (at least 300 total words across the posts) from the US counties with the top 10 COVID-19 case burdens. Data analysis was performed from June to September 2022. Being an EM physician or resident physician who posted on Twitter. Social media content themes during the prepandemic period, during the pandemic, and across the phases of the pandemic were analyzed. Psychological constructs evaluated included anxiety, anger, depression, and loneliness. Positive and negative language sentiment within posts was measured. This study identified 471 physicians with a total of 198 867 posts (mean [SD], 11 403 [18 998] words across posts; median [IQR], 3445 [1100-11 591] words across posts). The top 5 prepandemic themes included free open-access medical education (Cohen d, 0.44; 95% CI, 0.38-0.50), residency education (Cohen d, 0.43; 95% CI, 0.37-0.49), gun violence (Cohen d, 0.37; 95% CI, 0.32-0.44), quality improvement in health care (Cohen d, 0.33; 95% CI, 0.27-0.39), and professional resident associations (Cohen d, 0.33; 95% CI, 0.27-0.39). During the pandemic, themes were significantly related to healthy behaviors during COVID-19 (Cohen d, 0.83; 95% CI, 0.77-0.90), pandemic response (Cohen d, 0.71; 95% CI, 0.65-0.77), vaccines and vaccination (Cohen d, 0.60; 95% CI, 0.53-0.66), unstable housing and homelessness (Cohen d, 0.40; 95% CI, 0.34-0.47), and emotional support for others (Cohen d, 0.40; 95% CI, 0.34-0.46). Across the phases of the pandemic, thematic content within social media posts changed significantly. Compared with the prepandemic period, there was significantly less positive, and concordantly more negative, language used during COVID-19. Estimates of loneliness, anxiety, anger, and depression also increased significantly during COVID-19. In this cross-sectional study, key thematic shifts and increases in language related to anxiety, anger, depression, and loneliness were identified in the content posted on social media by academic EM physicians and resident physicians during the pandemic. Social media may provide a real-time and evolving landscape to evaluate thematic content and linguistics related to emotions and sentiment for health care workers.

A case for lifelong learning in emergency medicine: The perspective from a rural state.

The expansive practice of emergency medicine cannot be fully taught or learned in 3 or 4 years. Lifelong learning, self-assessment,1 and ongoing skill acquisition and retention are necessary. How do we teach and acknowledge this during residency training and how do we support our isolated, rural colleagues? Importantly, there is a growing shortage of rural emergency physicians and many of our trainees may work in these environments.2 As educators, we must study potential solutions and bridge these gaps for our trainees entering independent practice and for our colleagues far removed from formal training. Recent cases, and many like them, illustrate this point. A rural emergency physician expertly places a small-bore chest tube for an atraumatic pneumothorax, the pneumothorax resolved, they requested transfer to a larger center for ongoing management. The tertiary care center is at full capacity. A phone consultation with a specialist recommends removal of the chest tube in the emergency department (ED) and discharge home if a follow up chest x-ray shows sustained resolution. The emergency physician has never removed a chest tube before and the patient is transferred to a larger regional ED for uncomplicated removal. In a second case, a patient is transferred from an hour away, during a snowstorm, for a peritonsillar abscess. The procedure is within an emergency physician's scope of practice. The referring physician had never performed this procedure in their decades of practice. The patient is transferred to the tertiary care center where it is drained by the attending emergency physician and emergency medicine resident. On a winter night, an emergency physician intubates a patient with a head injury in their critical-access emergency department. They request lifesaving medications and the respiratory therapist to set the ventilator. It is nighttime; there is no respiratory therapist or pharmacist. The physician must assist in mixing the medications and setting up the ventilator. The skills required for an emergency physician are ever expanding, particularly as access to tertiary care becomes more difficult. Lifelong learning and practice development to best serve our patients is a necessity in our specialty. Solutions may include regional conferences, collaborative case reviews, real-time peer-based decision support with telemedicine, maintenance of board certification, asynchronous, self-directed learning through free open-access medical education (FOAM), podcasts, textbooks or journal articles, and academic–rural partnerships that create shared faculty positions between rural and tertiary sites and rural rotations for trainees. Each of these has its limitations and time represents a major barrier.3-5 The American Board of Emergency Medicine requires continuous learning for maintenance of certification; this is beneficial but is not tailored to the physician's practice environment.6, 7 Our own work in the rural state of Vermont and upstate New York has led us to offer high-acuity, low occurrence (HALO) courses at the regional academic center twice a year for both residents and practicing emergency physicians within our region and create a rural-specific simulation lab at one of our critical-access sites. Additionally, we established a tele-emergency medicine program to offer a virtual resource from the tertiary care center in times of high-acuity, high-complexity care, or volume surge. The skill of delivering and accepting tele-emergency medicine assistance must also be learned and taught. Our education must continue to adapt to meet the needs of our unique and evolving practice environments. We must also acknowledge that many scenarios cannot be predicted. Instilling the motivation for lifelong learning, self-assessment1 and exposure to resource limited settings during training may help prepare trainees for these challenges. Although these issues are not unique to emergency medicine, we are a specialty that prides itself on adaptability. We must confront this challenge with creative solutions. Skyler Lentz, Ashley Weisman, Jordan Ship, and Matthew S. Siket conceived the idea for this manuscript and contributed substantially to the content, design, writing and editing of the commentary. The authors declare no conflicts of interest.

Engagement in Free Open Access Medical Education by US Nephrology Fellows.

As free open access medical education (FOAMed) use increases, it is important to characterize how and why learners are using this educational material in nephrology. We describe the frequency, purpose, and type of FOAMed usage across US nephrology fellows. In this cross-sectional survey, items were emailed to all US adult and pediatric nephrology fellows via the American Society of Nephrology (ASN) Fellow Survey in May 2022. The eight-item survey, developed to measure FOAMed engagement, had previously undergone instrument validation. The results were analyzed by descriptive statistics. In total, 43% (359/842) adult nephrology fellows and 51% (45/88) pediatric nephrology fellows completed the survey. Seventy-four percent (300/404) of fellows reported using FOAMed, and 72% (215/300) started using FOAMed within the past 2 years. Of FOAMed users, 41% (122/300) reported viewing FOAMed and 33% (99/300) reported applying knowledge gained from these resources daily or weekly. Common purposes for FOAMed engagement included searching Twitter to learn about others' opinions in the field (43%; 130/300), reading blogs to answer clinical questions (35%; 105/300), and listening to podcasts for the most up-to-date information (39%; 116/300). Compared with traditional educational resources, fellows preferred using FOAMed for staying up to date on nephrology topics (75%) and answering clinical questions (37%). Among all fellows, the greatest barriers to FOAMed use were unfamiliarity with FOAMed (27%; 111/404), validity concerns (22%; 90/404), and a lack of a local community of FOAMed users (22%; 87/404). Seventy-four percent of nephrology fellows used FOAMed resources in a variety of ways, and of them, 33% of fellows clinically applied knowledge gained from these resources. Reasons for engaging with FOAMed varied across resources.

1301. ID Fellows Cup: Developing Confidence Through Content Creation

Abstract Background The ID Fellows Cup (IDFC) is a multiple-choice question set delivered via the Kaizen Education software, which uses gamification to enhance engagement. Questions are directed to ID fellows worldwide, but all learners can participate. In the inaugural year, 541 individuals (344 fellows) played in ≥1 of 3 rounds. Content creation by learners is known to enhance knowledge and confidence with material. We hypothesized that inviting trainees to author questions would enhance their perceived ID knowledge and confidence in creating Free Open Access Medical Education (FOAMed) content. Methods We invited trainees to write questions for the 10/2021 and upcoming 5/2022 games (105 questions) through an online volunteer call. They received a brief lecture and outline on question development. Mentors (early faculty or other fellows) reviewed their content and gave constructive feedback. We developed a 22-item survey targeted to writers and mentors using input from the literature and involved educators. Items included demographics, prior experience, perceptions of benefit, and areas to improve. We distributed it by email after question submission. Results Thirty-eight of 54 (70%) writers and mentors completed the survey. 1 asked to remove their responses from research. 35 (94.6%) participants answered all survey questions. Table 1 shows their demographics. Before the IDFC, 18 (48.6%) respondents had never written a board-style ID question; 21 (56.8%) had never created FOAMed content, and 23 (63.9%) had low confidence in creating it. 35 (97.2%) found that writing a question was an effective use of their time, and 36 (100%) felt it increased knowledge of the assigned topic. 33 (91.7%) found it increased their confidence as near-peer educators, and 31 (86.1%) that it increased confidence in creating future FOAMed content (Table 2). Conclusion Crowdsourcing questions through a mentored process allows for an enhanced educational experience for trainees and early faculty. Authoring board-style questions was felt to increase ID knowledge and was rated as effective use of time. Many authors had limited experience in FOAMed content creation but gained skills and confidence from the process. Similar initiatives may support and empower early educators to step into the global digital education platform. Disclosures All Authors: No reported disclosures.

Fifty Years of Critical Care Medicine: The Editors' Perspective.

Fifty Years of Critical Care Medicine: The Editors' Perspective.

Free Open Access Medical Education in India: The Stage Is Set.

Free Open Access Medical Education in India: The Stage Is Set.

Using an OSCE/OSTE as an Innovative Skills Assessment for Faculty Development in Diversity, Equity, and Inclusion.

Purpose: In response to the twin pandemics of COVID-19 and racial inequity, our health professions have awakened to the impact of structural racism on health care. While the current generation of trainees is facile with cultural humility, the generation of faculty lags. 1,2 Faculty development programs aimed at closing this gap are essential. 3 Most studies of cultural competency training focus on outcomes limited to practitioner knowledge acquisition and attitudes, not skills. 4 In implementing a year-long faculty development program in diversity, equity, and inclusion (DEI), we asked ourselves: Is it possible to assess faculty’s skills of antiracism and allyship to engage learners using an OSCE (observed structured clinical examination)? Method: Our faculty development in DEI, grounded in longitudinal community of practice, uses appreciative inquiry, critical reflection, and skill building. We designed a mid-program OSCE and OSTE (observed structured teaching examination) to assess skill acquisition. In the OSCE, participants conduct an advising session with a trainee underrepresented in medicine who is experiencing stereotype threat. In the OSTE, participants facilitate a teaching session on COVID-19 vaccine hesitancy. Fourth-year students, trained as standardized learners, completed behavioral checklists. Faculty participants self-assessed using the same behavioral checklists. Faculty development leaders served as observers and led global feedback discussions with the faculty and learners who then completed surveys for reflection. Results: In the advising OSCE, faculty demonstration of the 8 core skills ranged from 17% to 100% (average 63%). While 17% of the faculty named stereotype threat, 100% implemented one strategy to mitigate it. While 50% elicited a personal narrative from the learner, 67% were able to disclose their own “location of self.” While 58% inquired about experiences of bias, 83% responded with empathy after hearing them. The standardized learner reported comfort with 58% of the faculty as an advisor. In the vaccine hesitancy OSTE, faculty demonstration of the 12 core skills ranged from 33% to 100% (average 78%). Only 33% named their “location of self” yet the standardized learners reported comfort with 100% of the faculty as small-group leaders. Ninety-two percent of the faculty taught the sociopolitical construct of race and connected historical racism to vaccine hesitancy. Seventy-five percent of the faculty used one core skill of establishing psychological safety, and 67% created ground rules distinguishing safe from brave spaces. The kappa coefficient ranged from 0.26 to 0.88, depending on the learners involved. One hundred percent of the faculty and standardized learners agreed that the OSCE/OSTE was valuable, the stations were relevant and appropriate, they were able to identify strengths and weaknesses, and the experience made them feel positive about efforts to improve the learning environment. One hundred percent agreed that logistics went smoothly. Discussion: We discovered that OSCE/OSTEs for the assessment of DEI skill acquisition are not only feasible but also valuable, to faculty participants, program leaders, and standardized learners. We identified gaps in the curriculum and a need for better training for interrater reliability. We also identified potential future facilitators. Finally, our student participants were impressed with the quality of the curriculum and assessment. This message, organically shared among all students, was an unintended benefit to the school. Significance: To our knowledge, this OSCE/OSTE is the first of its kind to formatively assess DEI skills. While success on a behavioral checklist is still a proxy for how faculty behave in the actual learning environment, it goes a long way toward identifying skill acquisition. We plan to refine this assessment mid-program and implement an end-of-program OSCE/OSTE for skills of apology, upstanding and leveraging privilege. We will make our materials available as a free open-access medical education resource. Acknowledgments: The authors wish to thank Treisha Green and Kelly Conlon for their assistance with this project, as well as all the ZSOM students who volunteered their time to play standardized learners.

Systematic online academic resources (SOAR) review: Sickle cell disorders.

Free open-access medical education (FOAM) resources have become highly utilized resources in emergency medicine education. However, FOAM content often lacks the traditional peer review process, leaving quality assessment to the readers. In this systematic online academic resource (SOAR) review, we apply a systematic methodology to assess the quality of FOAM resources on sickle cell disease (SCD). We searched keywords for SCD using FOAM Search and the top 50 FOAM websites listed on the Social Media Index. Resources found were screened using inclusion/exclusion criteria, and a total of 53 resources underwent full-text quality assessment using the revised Medical Education Translational Resources Impact and Quality (rMETRIQ) tool. The search yielded 520 resources, of which 53 met the criteria for quality assessment. A total of eight posts (15.1% of posts) were identified as high quality (rMETRIQ ≥ 16). The most commonly addressed topics within SCD topics included acute chest syndrome, acute pain crisis and general review of SCD. A total of 11 posts (21% of posts) were found to have an rMETRIQ score of less than 7, which may indicate poor quality. The most commonly identified type of resource was personalized reading (64%) and a number of posts were deemed to not have an appropriate use due to poor quality (15%). We were able to systematically search a wide range of resources to identify, appraise, and organize FOAM resources on the topic of SCD. A final list of eight high-quality resources can guide trainees, educator recommendations, and FOAM authors.

Nephrology Trainee Education Needs Assessment: Five Years and a Pandemic Later

Seventy-four percent of nephrology fellows reported exclusively receiving virtual didactics during the early part of the coronavirus disease 2019 (COVID-19) pandemic.1 In response to this rapid shift to online instruction, we sought to describe usage of novel digital educational resources, including free open access medical education (FOAMed; eg, online journal clubs, podcasts, and blogs), by current adult and pediatric nephrology fellows through a research survey. Observed utilization rates were compared with rates reported from a prepandemic study.

A Framework for Creating a FOAMed Organization in Gastroenterology: Lessons Learned from the Liver Fellow Network

With the exponential growth of information technology in the 21st century, the landscape of medical education has changed dramatically. One such example is the free open access medical education (FOAMed) movement, which allows for dissemination of material in a digital format that facilitates ease of access and open sharing.1 FOAMed resources can take various forms (eg, blogs, podcasts, tweets, and videos) and typically rely on social media for dissemination. Importantly, FOAMed differs from traditional learning by being asynchronous, accessible on mobile platforms, and digestible.