When a new podcast episode reaches iTunes, a Tweet goes out. When someone gives a talk and posts it on YouTube, a Tweet goes out. When someone finds an interesting paper and wants others’ opinions, a Tweet goes out. But it does not end with an announcement into the ether.

This is where the game change is: As far as FOAM use goes, Twitter can best be described as a 24-hour-per-day conversation by and for people who care and are well-informed about emergency medicine. Twitter is where FOAM became a community of people, constantly interacting and educating each other, all in the same place, playing by the same rules. Ideas come at all levels, from medical students, to residents, fellows, and attendings all the way up the line to the most influential thought leaders in the field. The 140-character limit stifles diatribes and monologues while facilitating genuine conversation. Amazingly, this process is how I came to have pancakes in Denver with Dr. Scott Weingart (yes, he teaches in my residency, but I’m the only one with this claim to fame) and a handful of FOAM giants.

If research is organized curiosity, FOAM is asynchronous learning on steroids. Why? Because virtually every person consistently contributing content is available and willing to answer questions from anyone, defend positions, and – dare I say it – admit it when they are wrong.

People are learning from each other and unlike in the past, FOAM means that asynchronous learning no longer has to be a solo endeavor. And the central locale increasingly is Twitter. People still write emails to authors and content creators, and still post on message boards on blogs. But if you want a vast array of opinions on any topic, one Tweet can reach thousands of people in an instant.

The replies come in faster than you could get to the bibliography on uptodate.com and often contain direct links to evidence-based medicine papers. Twitter has replaced many users’ journal watches. The ensuing debates happen months before letters to the editor can be published in the Annals.

Why do people create FOAM content? For the same reason they give talks. But unlike live talks, FOAM in any of its forms can be accessed anytime, anywhere, by anyone for as long as the link works. And the audience is the type that educators want. People utilizing FOAM do so because they have genuine interest.