SGEM#42: Don’t Panic

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Date: June 30, 2013
Title: Don’t Panic

Welcome to the Skeptics’ Guide to Emergency Medicine. Meet ’em, greet ’em, treat ’em and street ’em. This will be the final podcast in Season #1 of TheSGEM. It seems like a natural place to pause at Episode #42 given the references to The Hitchhikers Guide to the Galaxy.

The plan is to take the summer off and return in the fall with a new batch of critical reviews done by the Best Evidence in Emergency Medicine Group. BEEM is the project started by Dr. Andrew Worster from McMaster University about eight years ago. He had a vision and process of taking the tsunami of publications, filtering them down to those clinically relevant papers and critically appraising them. These critical reviews are then packaged into a 12 hour BEEM course taught by the BEEM Dream Team around the world.

Here are just 5 reasons why BEEM is amazing:

BEEM has the ONLY validated instrument to distinguish the signal from the noise in order to identify EM-relevant, practice-enhancing evidence for your clinical practice based upon YOUR input — no other CME products seeks pre-appraisal input from the end-user bedside clinician.
BEEM publishes our critical appraisals in the world’s leading peer reviewed journals and authored multiple books and textbook chapters about the practice of EBM.
BEEM faculty have been awarded national teaching awards from CAEP and EMRA based upon their work in EBM and KT.
BEEM faculty are also faculty on leading EBM courses like the McMaster EBCP workshop and the UCSF Evidence Based Diagnostics course.
BEEM faculty hold Chair positions in the SAEM EBM Interest Group (the leading EM society section for Evidence Based Medicine).

Despite the success of the BEEM project I felt we could reach a wider audience by using social media. The BEEM content was excellent but the distribution was traditional (conferences). Hence The Skeptics’ Guide to Emergency Medicine was created. Using a weekly podcast on iTunes, Twitter, Facebook and YouTube to reach a global audience of EM practitioners interested in providing the best care for their patients based on the best evidence.

To make the idea even better TheSGEM is free. It is part of the Free Open Access to Meducation (FOAMed) movement also started last year. “FOAM is the movement that has spontaneously emerged from the exploding collection of constantly evolving, collaborative and interactive open access medical education resources being distributed on the web with one objective — to make the world a better place. FOAM is independent of platform or media — it includes blogs, podcasts, tweets, Google hangouts, online videos, text documents, photographs, facebook groups, and a whole lot more.”

Dr. Joe Lex 2012:
If you want to know how we practiced medicine 5 years ago, read a textbook.
If you want to know how we practiced medicine 2 years ago, read a journal.
If you want to know how we practice medicine now, go to a (good) conference.
If you want to know how we will practice medicine in the future, listen in the hallways and use FOAM.

Let us look back at the first year of using social media to cut the knowledge translation window from an average of 10 years down to less than one year. TheSGEM was launched in the fall of 2012 as a knowledge translation/dissemination project. The first few episodes were recorded in Algonquin Park while volunteering as a camp doctor. It was a learning curve for sure with one of the most important lessons to use a good microphone.

I then had the amazing opportunity to attend Oxford University to take their EBM Teaching course. Spending a week at Oxford learning was surreal. Surrounded by history, beauty and wonderful people interested in EBM.

After traveling across the Atlantic ocean guess who one of my group leaders? Dr. Worster my EBM guru and the founder of BEEM. It was in Oxford where he taught me that when it comes to an EBM question the answer is always “it all depends”. And who could ever forget the first PUBcast with Group 7 doing a critical review of the BMJ article whether Orthopedic surgeons were as strong as an ox and almost twice as clever over a few pints.

TheSGEM hit its stride early with great guests like Dr. Tony Seupaul who is part of the BEEM Dream Team and Chairman at the University of Arkansas. With his smooth style and quick wit TheSGEM was up and running. More and more episodes followed and many had cheesy 80’s theme music. And no, the topic is picked first not the music.

Another great guest was Captain Cranium Dr. Chris Carpenter from Washington University in St. Louis. He literally wrote the book on Evidence-Based Emergency Care. Having access to such a brilliant physician was an honour and privilege.

It was not all Ivory Tower academics who came on TheSGEM. There were also bright and talented medical students from across Canada and the USA. Lauren Westafer from the blog The Short Coat was on a couple of times. We also had a panel of generation Y’ers (Bethany, Jimmy and Alia) on an episode called We Are Young to balance out the Baby Boomer episode called My Generation.

TheSGEM was not afraid to tackle difficult and controversial issues such as the Dogma of Wound Care, mandatory flu shots for health care workers (Hit Me with Your Best Shot), thrombolysis in acute stroke (Stroke Me, Stroke Me), proton pump inhibitors for upper GI bleeds (Ho, Ho, Hold the PPI) and even birth control (Papa Don’t Preach).

There were also skeptics and critics who kept providing great constructive feedback. These people all had great input and made TheSGEM much better. One skeptic stood out from the rest so much Dr. Katrin Hruska was invite to discuss her questions on Episode #25: Who Are You.

The BEEM Dream Team got together at the annual SkiBEEM conference. It was a great chance to tap into the EBM expertise in the group. We used the opportunity to do another PUBcast and reviewed the BMJ article on speed bumps in diagnosing appendicitis (A Bump Up Ahead).

There were some low points during the year. Being a witness to the tragedy at the Boston Marathon was a profound experience. The episode discussing the bombing was one of the most popular and downloaded shows. I am not sure if it was more of an emotional impact because it happened when I was physically exhausted. Standing in the road, 480m from the finish, hearing the reports of death and injury and not being able to do anything. Time passes, scars heal and people move on. There were thousands of us who did not finish (DNF) due to the horrific act of two young men. The Boston Athletic Association has decided to give all the DNFers a chance to run in the 2014 marathon. To me DNF now stands for Do Not Forget Boston 2013.

There were some really fun times doing TheSGEM as well. Any podcast done with our BEEM Peds expert Dr. Anthony Crocco (Honey, Honey) is worth a listen. He was a great co-presenter at CAEP for our BoB (not TED) Best of BEEM talk. To get an idea how cool Anthony is check out his RANThony on fever fear. Another very funny show was the Bob and Doug McKenzie spoof The Great White North (CanFOAMed). Brent, Chris, Elisha, Eve and Stella were great hosers to have on TheSGEM.

The year was capped off for me this month when I received two teaching awards. One was from Western University for excellence in teaching by an adjunct faculty member. The other award was the Canadian Association of Emergency Physicians Teacher of the Year Award. These were given in part due to the work done on TheSGEM.

The project started as an idea, grew in concept and finished with accolades. TheSGEM might be free but after 42 episodes it has made me a rich man in many other ways. Thanks to everyone who has supported the project, provided inspiration, given feedback, and listened to the podcast. Clearly you are interested in cutting that KT window from 10 years to less than 1 year so you can provide your patients the best care based on the best evidence.

The most important person I would like to thank is my wife Barb. She has put up with all the crazy ideas, tolerates the cheesy 80’s music, rolls her eyes at my jokes and has always believed in me.

KEENER KONTEST: David Savage was last weeks keener kontest winner. He knew that PRISMA stands for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. It is a list of items that should be reported in a systematic review or meta-analysis.

Listen to the podcast to hear this weeks Canada Day themed keener kontest.

Follow the SGEM on twitter @TheSGEM and like TheSGEM on Facebook.

Have a great summer everyone and remember to be skeptical of anything you learn, even if you heard it on The Skeptics’ Guide to Emergency Medicine. Talk with you in the fall.