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

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!

4 thoughts on “The Path to developing F.O.A.M (Free Open Access Meducation) #FOAMed”

  1. Hello Damian,
    I’m very interested in this too of course. It strikes me that FOAM has elements of a social movement- the tech has been around for a few years now but what has changed is that it is now socially acceptable in some fields, particularly emergency medicine, to share what you have learnt. It’s not just seen as acceptable it is seen as contributing to a community. It’s worthwhile. It is increasing the assets of the community and possibly your standing within it. This is all good!

    With regards to the steps I’d make a plea that we exhort the value of public curation- this, I believe, will allow us to see the value of content to ‘people like us’.

    I think that your step ‘collaboration’ is closer to connection. In Howard Rheingold’s great book, NetSmart he distinguishes between connection, cooperation and collaboration. Collaboration is definitely the hardest, but the other two have value as well.

    Many thanks for sharing your thoughts. This also makes me think about one of my other favourite posts on why smart people sometimes don’t share


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