Trends in online learning: #FOAMed

In recent months RSS feeds and Twitter have been overflowing with mentions of MOOCs, as Cousera, Udacity and EdX continue to attract new university partners and launch growing numbers of courses.  As these big guns have entered the world of MOOCs they’ve attracted lots of attention from the mainstream press, whilst MOOC participants are blogging about their experience as learners on these MOOCs and some of the issues they’ve encountered.

So how about MOOCs and medical education?  Back in January I blogged about an open online anatomy course that Stanford were due to be running in March.  Out of curiosity, I signed up along with a few colleagues, but the course was postponed and it’s not one of the 24 Coursera offerings listed under medicine so who knows if it’s going to go ahead.  I’m sure we’ll see more medical themed MOOCs come on stream from the big players running what are now being referrred to as xMOOCs.  Overall though in terms of online medical education I think there’s another emerging trend that’s more interesting than MOOCs and that’s free open access medical education (#FOAMed).

#FOAMed resources are typically being delivered via blog sites and much of the credit for the emergence and growth of #FOAMed is down to Mike Cadogan and Chris Nickson of Life in the Fast Lane fame and the growing band of emergency medicine bloggers that are following in their footsteps such as the team at St Emlyn’s.

It’s not just all about emergency medicine though, there are growing numbers of clinicians using blogging platforms to support and deliver medical education and particularly at postgraduate and CME level that can be branded as #FOAMed.  One example that’s been gaining momentum over the past year is  #gasclass set up by Sean Williamson and colleagues on Teeside.  #gasclass uses a WordPress blog and Twitter to support case based discussion for trainee anaesthetists.  Set up originally to  support weekly face to face training and discussion of local trainees it now attracts an international audience and is a great example of #FOAMed.  Another example is #ecgclass run by Heather Watherell and her Keeping ECGs Simple blog.  There are other sites and related twitter chats springing up around different medical specialties including urology and public health and a growing list of #FOAMed supporters.

More recently it’s been great to see undergraduate medical students getting involved with #FOAMed activities.  There’s the Twitter Finals Revision Group #twitfrg set up by Faye Bishton.  Each week Faye posts up notes for revision topics for medical students and hosts a Twitter chat on Thursday evenings at 8pm (UK time) and doctors are joining in to provide additional support to this student led initiative. Another student example is Anatomy Zone.

I don’t think the #FOAMed approach is just relevant to medical education, tools such as blogs, twitter and social media are open and accessible to anyone and in essence it’s perhaps another way of describing open educational recources (OER).  Last week I was interested to see some posts in my Feedly feed from Clive Shepherd on Kineo’s Learning Insights 2012 report and one in particular in which he highlighted that elearning is changing and said:

If you want to know about, say, photography – one of my current interests – the first thing you do is go to Google and YouTube. Your search doesn’t lead you to slide shows full of bullet points and multiple-choice questions, but to blogs, Wikipedia articles, screencasts and lots and lots of videos.

You know the detailed information will always be available online so you don’t bother trying to learn any of that. You want the big picture, the important ideas, lots of tips and tricks, and demonstrations of the key skills. If you have questions, you go to the forums. If you want to benchmark your progress against that of your peers, you join groups, share your work and provide helpful critiques to others. We are completely accustomed to learning in this fashion and very satisfied with how well it works. We cannot see why things should be so different at work.

So e-learning design is changing because, more often than not, it’s not traditional e-learning that people want. They’re looking for resources not courses. They want these resources in all sorts of forms – plain text will often do, graphics are nice, but they particularly like video. They are not expecting these resources to be fully-functioning learning objects, that take a learning objective through to its conclusion. Rather they want to pick and choose from a range of materials that can each make a contribution to whatever evolving goals they may have.

We’re looking for a new breed of digital learning content designers. Yes, they will be able to analyse a need and understand an audience but, most importantly, they will be great communicators in a wide variety of media.

It used to be that we turned to text books for resources, but as Clive suggests we’re all increasingly looking online for resources and when we find them we share them.  One of the roles of the doctor is the doctor as teacher and with the advent of #FOAMed what we’re seeing is a new generation of digital medical educators. Educators (or digital learning content designers as Clive describes them) who’ve engaged with technology and used it to create learning resources and enhance learning and create new opportunities for social learning that can both complement and supplement face-to-face and on the job learning.

The interesting thing is that this approach hasn’t emerged out of an institutional top down approach or beacuse of funding calls.  It’s being led by individual doctors who want to improve and enhance medical education and have grasped that technology can help to make resources openly accessible and support online learning.  There are also doctors who’ve started blogging who’s blog posts are also being used to support learning and in turn #FOAMed resources.  Two recent cases that spring to mind include Laura Jane Smith’s post on the Human touch which was posted up on our respiratory teaching blog and shared with our 1st year students and also Jonathan Tomlinson’s post on Shame which medical students were sharing and resharing via the Twitter sphere.

When I took up my current post, Life in the Fast Lane was one of the few medical education blogs around and Mike Cadogan was one of the first doctors I started following on Twitter.  Together with Alan Cann’s MicrobiologyBytes, Sam Webster’s blog and  Jim Groom’s work at University Mary Washington, Mike got me thinking about using blogs to support our undergraduate teaching and that led to an interesting journey for us at Dundee with our VLE.  Four years on it’s clear to see that Mike and his Life in the Fast Lane team are continuing to inspire growing numbers of doctors to embrace free open access medical education.  I hope this a trend that continues.  The future’s bright, the future’s #FOAMed!


  1. Thanks Natalie for the great overview of #FOAMed principles, and for all the support of the last 4 years.
    There are myriad free online medical education resources – and although this is exciting and encouraging – it can also be overwhelming for new users and intrepid explorers of the online space.
    Now we have the technological advances, the altruistic drive, broadband accessibility and global awareness…the next stage of development will be to harness the power of folksonomic and ontologic semantic search – always have to stay one step ahead of the detractors

    1. Thanks Mike. I agree we need to keep a step ahead of the detractors! I’m particualrly interested in how we can harness the technogy to support adpative learning – perhaps something along the likes of Zite, an app that could deliver #FOAMed resources based on an individuals interests and specialty. Meantime there’s a lot we can be doing around curating resources and signposting newcomers to what’s available.
      P.S. Sorry for the delay in getting your comment published, for some strange reason Askimet sent it to the spam folder 😦

  2. Really interesting post Natalie in several ways. I’m in veterinary medicine and am keen to get the vet world to move to using blogs and other social media for CPD. I even submitted a proposal to present on the topic at the national conference but was unfortunately turned down. I was also very interested in the VLE changes at Dundee. Bring on Free Open Access Veterinary education!
    Your post has inspired me to blog on the topic myself in the next couple of weeks – I’ll link back to your post if that’s OK.

    1. Thanks Rachel. I think this approach can apply to all the healthcare professions and related areas like veterinary medicine. It’s disappointing to hear your presentation proposal was turned down, I think the issue is that some people don’t quite understand this concept of open education and using open tools to develop it. You just need to keep chipping away, let me know know if I can help in any way. Let me know when your blog post is up, I’ll look forward to reading it.

  3. Great post – and I completely agree with the Clive Shepherd quote – especially:

    “So e-learning design is changing because, more often than not, it’s not traditional e-learning that people want. They’re looking for resources not courses.”


    “We’re looking for a new breed of digital learning content designers. Yes, they will be able to analyse a need and understand an audience but, most importantly, they will be great communicators in a wide variety of media.”

    That’s the FOAM approach in a nutshell I think.


  4. Hi Natalie
    A few weeks after I was planning but I’m finally getting around to thinking through my post about open veterinary education resources. One thought I had was wondering how you defined FOAMed resources – do you specifically mean interactive Web 2.0 rather resources rather than static pages like lists of radiology cases to work through?



    1. Hi Rebekah
      I think a FOAMed resource is any resource that can be freely and openly accessed online. This might be a video on youtube, an interactive resource but yes could also be a static webpage with a radiology case to work through. The St Emlyn’s Blog has some examples of this sort of FOAMed resource as does Life in the Fast Lane.
      Let me know if you fancy a Skype or Google hangout chat sometime about any of this.

      1. Thanks so much for taking the time to reply Natalie. As always the medical sphere is way ahead of the veterinary even in resources considered fairly static by today’s standards.

        I would love to have a Skype or Google + chat if you have the time but I really don’t want to impose. It’s very generous of you to offer. I could do ether early morning or evening my time whatever suits you best (the time change is currently 11 hours).

        Thanks again

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