Habits of Lifelong Learning

Brad Gordon, MD ('02)

There is no denying that the nature of connections between people is changing.  With my grandma, it is best to send a handwritten card.  But my elementary age nephew and niece text me from their iPods.  One of our current residents wouldn’t mind getting all communication through Facebook status updates.  In some ways, even writing this ‘essay’ seems old school.  Yet, print is not dead, and adaptation to new technology is the name of the game.

As such, the residency is working to adapt (and possibly even lead the way) to the new tools and methods of connecting to our community.  While the current residents are always the core of our community, we have a big group of you out there that have a personal connection with the program.  The non-exhaustive list includes applicants, alumni, former faculty, non-EM faculty, affiliated community physicians, nurses, hospital staff, and residency benefactors.  Beyond this circle, we have our community in which we serve: the patients of the east metro area and western Wisconsin.

So, since our residency serves so many, we must work to reach out and try new things. During 2010, the residency has focused on social media to expand its outreach.  While our email list, EMRes, has been active for over 10 years, with 312 subscribers, we now also have 393 people who ‘like’ us via Facebook.

How many of you are connected with the residency on Facebook? Or are following our tweets (@regionsem)? While these tools are definied as ‘social’, it is amazing how much medicine you can learn from social media.  Our status updates and tweets frequently contain clinical content, not just the latest residency curling outing.

In the true sense of social media, many individuals have gotten into the act.  Our Trauma Director, Michael McGonigal, has shared much of his wisdom and opinion through his blog, The Trauma Professional’s Blog (regionstraumapro.com). Our Tox service has a nice blog at Twin Cities Toxicology (twincitiestox.tumblr.com)  Stephanie Taft has maintained the print version of the EM Shorts newsletter, still posted in EDs around the state by some of our alums.  We’re experimenting with also putting this information into a blog.

With regard to your personal habits of lifetime learning… how are you doing?  Do you have a habit?  Have you found a way to keep your clinical edge sharpened?  Really, it is all about finding that optimized combination of content and tools to keep you efficiently and continuously processing the tsunami of information that washes upon us daily.  How to do this? Here’s my suggestion.

First, define your ‘tiers of knowledge’.

To review, these were The Cutting Edge: a core 10-20 percent of clinical information where you would call yourself ‘expert’; Standard of Care:  This is material you should know for your practice without having to look it up; and The Limits: As in: I need to know something exists and how to pronounce the word, but I would need to look up anything beyond that.

Second, for each tier, identify a strategy for information monitoring.

For the cutting edge, I believe you should be monitoring for and reading primary work from peer reviewed journals.

For the standard of care, I’d use a mix of EM journals and some digest service (EM Abstracts, Journal Watch, etc)

For the limits: watch blogs, non-EM high-impact journals (JAMA, New England Journal, BMJ, etc)

Third, identify a tool to manage this constantly updating information.

This ideally is something you’re going to use every day.  For me, it is my home email and RSS subscriptions via Google Reader.  It is separate from work email, where I deal with a different deluge of information (e.g. can Epic trim toenails?)  For others, it may be audio digests and paper journals.  For the new generation of MDs, it may be Facebook and Twitter.  (As an aside, I enjoy imagining what is next: downloading and 3D printing your own central line simulator? Sim lab on your XBox with Kinect?  How far are we from direct download of knowledge into our brain?)