SGEM Global

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Date: September 8th, 2015

Today was the first day back to school for my children so what better time to launch Season#4 of the SGEM. We had a great summer that included white water rafting on the Ottawa river, a visit to Niagara Falls, catching a Toronto Blue Jays game, watching a few outdoor movies, a trip to Halifax and many more adventures. I hope all the SGEMers had some great time off  with family and friends.

Listeners know that the goal of the SGEM is to cut the knowledge translation window down from over ten years to less than one year. We use social media to accomplish this goal.

Today I have one of the most exciting announcements ever made on the SGEM. It has been hinted about in past episodes but today is the day. Today I am announcing the SGEM Global project.

SGEMers have come to expect a weekly dose of medical skepticism. It is typically delivered as an evidenced based review of a recently published paper. The critical appraisal is performed using a validated and reliable method. The review is then is uploaded to the SGEM blog and podcasted for free on iTunes.

The SGEM is part of the FOAM movement. FOAM stands for Free Open Access to Medical Education. FOAM was started in 2012 to provide medical education for free to anyone, anywhere and anytime. It’s goal …to make the world a better place.

FOAM is a wonderful initiative. You might be wondering how SGEM Global could make it even better? How could it be possible? What could SGEM Global do to improve on such an amazing concept?

Before I spill the beans, let me remind everyone that it can take an average of 17 years for 14% of high quality clinically relevant information to reach the patients’ bedside.

It was Pathman and company who created a beautiful model to illustrate the problem visually. He called his model the leaky pipe. Pathman et al described seven leaks in a pipe between the reservoir of knowledge and the patient. The seven leaks all started with “A” and include:

SGEM Global will focus in the first of the “A’s” – Awareness.

How can patients get the best emergency care if their providers are not even aware of the literature? Patients deserve excellent emergency care from the time they call 911, during transportation, in the emergency department, in-patient (ICU/CCU) and to discharge. It takes a team (EMS, PA, NPs, RNs, MDs, Pharmacist, administration) all working together based on the best information for patients to get the best care.

However, the SGEM blog is published in English and I podcast the SGEM episodes in English. Do you see the problem? It reminded me of a Simpsons episode where Homer says ” ? Who needs that? I’m never going to England”.

The FOAM world has some great resources like Life in the Fast Lane out of Australia and Academic Life in Emergency Medicine. But a limitation of these great resources is that they are provided in English.

The SGEM often does critical appraisals of systematic reviews. One of the things we look for in the methods section is any language restriction. A weakness of these systematic reviews is the search strategy. They will often only include studies published in English. They specifically exclude non-English papers.

So turning that skeptical/critical eye on my own project, I realized the SGEM only disseminates in English. This represents a major limitation, barrier or leak in the KT pipe. How can emergency medicine and critical care providers be aware of the high quality reviews we do every week if English is not their first language?

When presenting at QuebecBEEM last year I realized I was providing all high quality clinical relevant information in English to a French audience. Now this is not a criticism of the audience. Their English was much better than my rudimentary French.

Again, it dawned on me, how could I expect these skilled providers to appreciate the nuances of EBM, methodology and critical appraisals, when it was not in their own language.

Dr. Marcel Emond was the conference lead at QuebecBEEM. We did a podcast on blunt trauma the traditional way. Then in one of those “Eureka” moments we decided to have Marcel record the exact same episode but in French. That is where the idea for SGEM Global came from.

The next step was to reach out to some people, some friends, some FOAMed friends and ask them if they would help with my knowledge translation project. I invited them to be part of SGEM Global.

I am proud to announce the SGEM Global project. This initiative will try to eliminate language as a barrier to knowledge translation by providing the SGEM in a number of international languages.

SGEM French: Dr. Marcel Émond specializes in emergency medicine; he practices as an emergency physician at a Level-1 trauma center, the CHU Hôpital de l’Enfant-Jésus in Québec City, Canada. He holds a master’s degree in clinical research and is currently the director of a Canadian research team (CETI) which aims to address geriatric trauma issues.  When not working saving lives in a trauma bay or doing research he enjoys carpentry.

Listen to a short interview with Marcel about SGEM Global French and his first Podcast SGEM#91 on Blunt Trauma.

SGEM Portuguese: Dr. Bianca D. Bertuzzi is a Brazilian emergency medicine physician who graduated in 2009 at the first emergency medicine residency in the country. She did a fellowship in Emergency Medicine Ultrasound at the Massachusetts General Hospital in 2010-2011, and has worked with point of care ultrasound since 2008, specifically with Winfocus (World Interactive Network Focused On Critical UltraSound). Bianca is part of a Brazilian commission to try to make emergency medicine a specialty in Brazil. She works as an emergency physician and as an ultrasound instructor at Hospital de Clínicas de Porto Alegre, in Brazil. Bianca also loves music, working out and trying to play musical instruments.

You can listen to an interview with Bianca and her husband (SGEM Global Portuguese) and her podcast SGEM#1, SGEM#92 and SGEM#94 .

SGEM Spanish: Dr. Manrique Umana, Dr. Alejandro Moya and Dr. Wilfredo Gomez are emergency medicine (EM) physicians from Costa Rica with a huge interest in medical education. The three are professors of the only EM Residency Training Program in Costa Rica. In their spare time, they try to post frequently in their Spanish EM blog (www.viamedem.com) and support the FOAM movement.  Pura vida!

Listen to Manrique discuss how he got involved in SGEM Global Spanish and three podcasts in Spanish SGEM#70,  SGEM#92 and SGEM#93 (to be uploaded shortly).

Each team has agreed to podcast one episode a month in their own language based on the four podcasts I produce each month. This should encourage people to listen to podcasts in general, the SGEM specifically and bring them into the FOAM world.

I hope SGEM Global breaks down that first leak in the pipe, awareness and makes the SGEM more accessible to a wider audience. Hopefully it allows those providing emergency care regardless of the language they speak to better understand evidence based medicine, critical appraisal and skepticism. It’s ultimate goal is to facilitate patients get the best care based on the best evidence.

There you have the big announcement – SGEM Global! If this has knocked your socks off, please send me a tweet @TheSGEM with a picture of your bare feet with the #SocksOff.

If you are passionated about emergency care, FOAMed and want to be part of the SGEM Global project send me an email TheSGEM@gmail.com.

This Sunday will be the first critical appraisal of Season#4. This will be a SGEM Hot Off the Press.

Remember to be skeptical of anything you learn, even if you heard it on the Skeptics’ Guide to Emergency Medicine.