Dr. Damian Roland (@damian_roland) - #FOAMed supporter

What I learnt this week: The frustrating advantage of being difficult #WILTW

In #WILTW on October 20, 2014 at 7:02 pm

This is the 22nd #WILTW (and a little delayed due to my attendance at #EAPS2014)

This week I took our family car into be serviced and have an MOT. I dropped it at the garage just before work and was told it would be ready later in the afternoon. However  I had an answer-phone message at about 4pm to say that the service had been done but they hadn’t got around to doing the MOT so could I please leave the car with them overnight or come back the next morning.  I was a bit frustrated by this assumption as I either

i) I couldn’t get home or

ii) would be without an appropriate car for the school run.

I suspect, in fact know, I am a bit soft in these situations and although I was frustrated I tend not to let emotions get the better of me. So surprisingly, and probably because I missed the call and didn’t get put through to the person who had initially made it, I was able to be a little more ‘robust’ in my annoyance. I felt a little uncomfortable when I put the phone down having expressed my disappointment at the service I had received. However 5 minutes later I got a phone call back saying that manager had found someone to do the MOT…

There are often times when parents, carers or relatives of children become frustrated by hospital processes. Often they are scared and emotional and outbursts can be tolerated in the context of the situation they see their children in. But sometimes it does appear the smallest thing can be blown out of all proportion and you find yourself expending energy ameliorating the parents anger at the expense of care to other patients. Conversely in my experience parents are often very humble about things they could and should be annoyed about!.

My learning last week was reflecting on whether bad behaviour gains you rewards? My small outburst with the garage sorted a problem (which probably shouldn’t have occurred in the first place). What of the families or patients we see? When is strongly challenging the care they feel their child has received appropriate? and when is it simply a method of gamesmanship?

I hope I am never in a place where I assume the latter and will always do my utmost to facilitate the former.

What did you learn this week? #WILTW

Compassion in Emergency Care: More than a cup of coffee?

In General on October 14, 2014 at 5:24 pm

As part of series of interviews with my consultant colleagues I have been chatting to Dr. Pro Mukherjee. Pro is an avid advocate of compassion in healthcare and shared with me a great example of how powerful re-framing your view of something can be.

“Compassion” is a word of the movement. But do we really understand its context in healthcare?


And an audio file

Click here to get an audio download

The Path to developing F.O.A.M (Free Open Access Meducation) #FOAMed

In FOAMed on October 12, 2014 at 7:10 pm

I’ve often felt a slight dissonance between the world I inhabit as a clinician and the world I inhabit as part of the FOAM community. This shouldn’t be the case but the disconnect appears to persist. This is partly caused by myself, “I’m not sure anything I produce will be accepted in my workplace” and partly re-inforced by my environment, “Oh FOAM stuff! Don’t really do it. Go and talk to Damian, he’s interested in it.”

When I started as a consultant I made a conscious effort to try and avoid these stereotypes. Why can’t FOAM material be produced as part of my clinical work? So with the support of colleagues I have gone about doing this; reflected by a number of recent blogs:

Leading an Emergency Department

Listen – Look – Locate: An approach to the febrile child #tipsfornewdocs

As a result I’ve begun to notice a common trend in the way others have been getting involved in creating their own FOAM:



I have not based this construct in any form of theory, it’s much more back of the napkin type stuff.  However I think I have taken some inspiration from Mike Cadogan (who else!) in terms of how FOAM networks have been created and also some brilliant analogy on ‘blogging’ ecosystems. I also recently came across the concept of rhizomatic learning which I think is very akin to the philosophy which has sustained the FOAM community of practice.   I am hoping though those more widely read than myself will be able to apply some theory to my approach.

The idea is as follows:


Young girl watching a fishbowl1. Curiosity

The initial spark is formed when an individual hears a conversation or reads an article that is FOAM related (or  FOAM-esque). This may need to happen a couple of times and, more often than not, is re-inforced by knowing a FOAM-ite who can explain in more detail. Often the first leap is into a social media domain (i.e twitter/google + etc.)



2. CurationCuration

The interaction with social media and then through to FOAM resources often begins with ‘hoarding’ of content. The available information can feel quite overwhelming to begin with and so web-links of blogs and podcasts are saved religiously . This phase may be brief, or prolonged, and is clearly aided by good filing systems!






3.  Celebration 

As confidence grows, sharing material which has been enjoyed or has resonated with the person’s own beliefs and practice, becomes more frequent. This may simply be by word of mouth (leading to increasing “curiosity” in others) or via social media channels.





4. CollaborationColloboration

Increasingly active participation in the FOAM community then leads to discussions with that community. Sharing material naturally leads onto constructive criticism of the subject. Often many of those involved in FOAM will remain at this junction of the path. However for some ‘collaborations’ with others lead to a desire to participate further…


"The Beginning" Road Sign with dramatic blue sky and clouds.5. Creation

Having immersed themselves in FOAM some will decide to then produce their own content. This may simply be in the form of a blog posting, perhaps with a “collaborator” or a review article. Increasing ease of access to recording equipment has seen ever more podcasts being released and the influence of SMACC on raising awareness of PK type presentations has led to a variety of video-cast style short talks.

6. Cultivation

The development of new FOAM material is only really the beginning as its creation gives the author deeper understanding of the advantages and limitations of the medium they have chosen. New insights lead to new understanding and increased collaboration, not only cultivating others interest, but leading to new skills sets in the individual themselves.

Path to FOAM




I have spent time pondering whether it is a path or a cycle. It probably doesn’t really matter but as always would be grateful for feedback!


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