CJEM and the changing landscape of medical education and knowledge translation.

The papyrus leaf. The Gutenberg printing press. The Internet. What do all of these technologies have in common? They all have disrupted the way that we communicate. The adoption of technology occurs along a predictable curve. Innovators lead the way, taking a new concept and introducing it to the world. Next come the early adopters, often opinion leaders, who engage in new practices. Eventually, the majority develops an increasing interest in the phenomena and makes it their own. Now, communication within the emergency medicine (EM) community is being disrupted by the Free Open Access Medical (FOAM) education movement. A trend that started with a few innovators at the beginning of the millennium has led to a veritable explosion of resources, such as blogs and podcasts over the past decade. These resources, which are promoted primarily via social media, have shifted the way that knowledge is translated into practice. Recent studies have demonstrated that new media are being used for education with 97.7% of American residents spending at least one hour per week supplementing their traditional academic curricula with podcasts and 99.5% of Canadian residents using free online resources for their general EM education. Tellingly, residents value entertainment and used wikis, podcasts, and screencasts significantly more than their program directors. The impact of social media and these online resources is demonstrated by their followership. CJEM-online.ca (CJEM’s primary website until 2015) received an average of 43,000 page views/month in 2014. BoringEM.org, a blog founded by an EM resident (Thoma), receives approximately 35,000 page views/month, 60% of which come from outside of Canada. Dr. Ken Mine (the Skeptic’s Guide to Emergency Medicine, theSGEM.com) and Dr. Anton Helman (EM Cases, emergencymedicinecases. com) have had similar success, regularly releasing podcasts that are downloaded between 5,000 and 10,000 times each. Some may argue that these resources do not possess the scholarly rigour to merit their notoriety, but they have grown to the point where they can no longer be ignored by the scholarly establishment. We believe that they are tapping into a niche that has been unfilled by journals by making it easier to consume and debate the literature. This trend toward convenience is likely attractive to busy clinicians trying to keep current with a constantly growing body of literature. We see social media and online resources as a complement to the static content of traditional medical journals. This growing synergy has been demonstrated by journals that have developed engaging online strategies. For example, The Journal of the American College of Radiology recently used Twitter “tweet chats” to increase online article views by >30% and Web page views by >25%. The Annals of Emergency Medicine and the EM blog, ALiEM.com, have organized online journal clubs that engage a diverse international population. A recent event had 1,401 readers and 313,229 Twitter audience impressions. With the rise of social media and online resources, academic journals are increasingly taking an active role in the translation of the research that they publish and have had varying levels of success. We believe that CJEM will benefit by embracing these evolving media and resources to become a leader in reader engagement.