Since 2014, we have been writing and producing FOAMcast, a podcast on a mission to bridge the cutting-edge content frequently favored in popular blogs and podcasts with essential emergency medicine core content that tends to get less attention in the world of free open access medical education (FOAM). We started small. At first, we were just a couple of EM residents armed with our smartphones, a couple of microphones, Skype accounts, some shared Google docs, and a handful of dusty textbooks. Now, we are… Wait, nothing has changed.

The format of our podcast is simple. In each episode of FOAMcast, we summarize a recent FOAM blog or podcast for a few minutes. We then spend the remainder of the show on related “bread-and-butter” topics covered by the major EM textbooks—which we fondly refer to as “Rosenalli” (a word we unabashedly made up as an amalgam of Rosen and Tintinalli, though we refer to other major texts as well).

In our first 40 episodes, we’ve covered the EMCrit podcast, SMART EM podcast, the EM Literature of Note blog, the Skeptics’ Guide to Emergency Medicine, The St. Emlyn’s podcast, and many more. Finally, we end our show with a boards-style multiple-choice question, which is donated to the show by the Rosh Review. In this recurring ACEP Now column, we’ll highlight some of the best material from our most recent episodes of FOAMcast (which can be downloaded for free on iTunes or at www.foamcast.org). We’ll also discuss what’s going on in the world of FOAM and occasionally interview each other on emergency medicine and medical education topics. Let’s start with that for this inaugural entry.

JF: From an educational perspective, what has been the most surprising part of making FOAMcast?

LW: Definitely that the stereotypes about the different formats of medical education just don’t hold up. I think there’s this misconception that textbooks are old, out-of-touch fossils that are hard to use and are basically dying a slow death. On the other end, I think some people still think of blogs and podcasts as thrown-together shoddy resources that can’t be trusted. And I’d say that neither of those misconceptions is remotely true. Let’s look at textbooks. If you ask people how far behind textbooks are, you’ll get a range of answers. Five to 10 years? But in reality, the textbooks are surprisingly inconsistent. Some things in Rosenalli sound like they came right out of a podcast. Very progressive and current. Other times, you’re wondering, “OK, how long until they update this thing?”

JF: We recently covered thoracic trauma algorithms on the show, and since then, I often ask interns and medical students to guess, “What do you think Rosen’s says about routinely getting a rib series X-ray in cases of mild blunt trauma to the chest?” And they just assume that the textbooks are conservative and recommend to get that rib series. But in truth, they don’t. Rib series films are a pretty unhelpful test in most situations, and the so-called old-school textbooks are on it.

LW: That’s called pimping, my friend.

JF: I prefer to call it enhanced medical interrogation techniques. There’s no actual torture involved.

LW: Then on the other hand, there’s the misconception that podcasts and blogs are these thrown-together things that have not been researched or are presenting knowledge that is somehow inferior to what’s found in Rosenalli.

JF: What we find is quite often the opposite. The most popular FOAM resources are often quite rigorously researched. And, in fact, the bibliographies are not only thorough, the quality of the papers cited is consistently excellent.

LW: One of my favorite things is to notice the studies that are cited in Rosenalli. If you look, some of it is frankly not strong. Some borders on hilarious, as we’ve covered on the show. But of course, some of it is high quality. But then take something like SMART EM podcast—the literature cited in the bibliography is uniformly superb. Another misconception is that using FOAM is some kind of shortcut. The appeal of FOAM for many is that the products are slick, refined, entertaining, and, above all, brief (SMART EM podcast notwithstanding). I know you recently had a chance to sit and talk with Lewis Goldfrank, MD, Herbert W. Adams professor and chair of the department of emergency medicine at New York University, about FOAM versus traditional medical education, and he expressed concern over the perceived shortcut to excellence by using FOAM.

JF: Thanks for dropping Goldfrank’s name in there so I didn’t have to.

LW: No prob.

JF: But yes, he’s a methodical, deliberate, and truly intellectual person. My argument to him was that FOAM, when done correctly, is not a shortcut to learning but actually a springboard to deeper learning. It’s actually a long cut! Instead of reading a chapter on, say, ENT emergencies and being done, our hope is that they’ll listen to our show for 20 minutes and then be inspired to go read some of the chapters in Rosenalli or even some of the primary literature. Instead of one-and-done, now the learner is checking in with multiple resources and platforms.

LW: The reason this works is that people are actually attracted to things that they already find familiar. Our approach is to clue people in to what’s hot in FOAM and then highlight what the texts say or what the boards want you to know. That way when they go to open that intimidatingly large textbook, it already seems friendly and familiar because we’ve taken a bite out of it already. Nice plug for our recent episode where we covered ENT emergencies after discussing the hotly debated recently published FELLOW trial that assessed the role of apneic oxygenation during rapid sequence intubation.

JF: Definitely a topic that got tons of attention in the FOAM world. Ultimately, though, I agree. We use FOAM, and you and I specifically create our brand of FOAM in an attempt to try to get ourselves—and, of course, our listeners—to do more work and studying, not less. That’s probably our main motivation for even doing the show. We’re not experts on very much, but I often refer to us as “public learners.”

LW: I thought you mainly do the show as a platform for promoting your collection of made-up words. Rosenalli and SIRSycardia [heart rate between 90–99 bpm], come to mind.

JF: That’s merely a fringe benefit.

LW: In all seriousness though, our motto is that people should not “FOAM it alone.” Which is another way of saying: “Here’s what’s out there now. Here’s what’s hot. Now go and check it out for yourself and draw your own conclusions. Dig in to it.”

JF: Because that’s what all the “cool” kids are doing.

Next time, we’ll delve into some recent episodes of FOAMcast. In the meantime, feel free to catch up on back episodes on iTunes or at FOAMcast. See y’all online.

Follow FOAMcast @FOAMpodcast.

Dr. Faust is a senior emergency-medicine resident at Mount Sinai Hospital in New York. He tweets about #FOAMed and classical music @jeremyfaust.

Dr. Westafer is chief resident at the Baystate Medical Center at Tufts University in Springfield, Massachusetts. Follow her @LWestafer.