Over the past couple of weeks myself and others (Michelle Lin, Todd Raine, Lauren Westafer, Minh Le Cong, Javier Benítez , Simon Carley, Nadim Lalani, etc!) have tweeted, mused and, in the case of Michelle Lin, even experimented with the idea of peer-review for FOAM. My thoughts are summarized in blog posts here and here. Those posts, along with Todd Raine’s Storified version of the twitter conversation and Michelle Lin’s post on her experiment provide a reasonable overview of the conversation so far.
To summarize briefly in black and white: FOAM skeptics argue that it lacks peer review and therefore has no quality control. FOAM supporters argue that its peer review is crowd-sourced through comments and traffic (good content gets linked to, bad content does not). Michelle Lin created a feedback form for her posts on ALiEM that allowed peer-review of the posts. Unfortunately, while the posts were of high quality (in my opinion) and got view counts that my site daydreams about (as does everything on her high-quality site), few people filled out the forms. While there was much speculation about why this might be (form fatigue, took too much effort, nothing controversial was said, etc), the review mechanism was not as robust as one would hope.
I was disappointed.
Then this conversation happened:
And it got me thinking along another path.
Certainly, the observation that FOAM is not recognized academically is not new. Skeptics would argue that it shouldn’t be recognized using the same refrain they use to criticize it: “It’s not peer-reviewed” they cry. Peer-reviewed medical journals would generally not consider publishing any FOAM content because it is already available freely. However, there are exceptions. For example, Open Medicine and the Public Library of Science, perhaps among others (I didn’t do much of a search), are free, open-access online journals that peer-review their content.
During the twitter conversation on this topic Minh Le Cong suggested peer-groups review FOAM content. Why not a peer-review group under the auspices of an online open-access journal? One that, rather than accepting manuscripts and reviewing them, flipped the journal paradigm on its head and picked through the best FOAM published each month and peer-reviewed it. The author could be contacted and asked if they would be interested in having their content reviewed for publication in the currently non-existent Journal of Free Open-Access Medical Education. If they agreed, an editorial team would comb through their contribution (be it a text review, procedural video, podcast or anything else [podcasts might be difficult to edit...]) and provide feedback along with acceptance, suggested changes, or rejection.
It would bring peer review to some FOAM content
It would provide the best FOAM to the masses of skeptics with quality control
It would support the academic careers of those creating the best FOAM content by allowing them to cite some of their online work
It would promote publication-worthy FOAM and the authors that produce it
It would utilize the work already done through crowd-sourced review to find the best work. This would also reduce the editorial burden as only great work would be reviewed
It would encourage FOAM content producers to create publication-worthy content
It would maintain the free open-access spirit of FOAM
It is better than what we have now
The journal would be republishing content
I am not academically experienced enough to know for sure, but I suspect open-access journals are less prestigious than other journals, decreasing the benefit to the author
Not enough content could be published to make a difference to the potential academics that put tons of hours into this
Academic rigor would take the fun out of FOAM
We’d be giving in to the critics
Multiple other reasons I’d love you to tell me about
Having written this out I’m not even sure that I want to post it. Creating a Journal of FOAM is out there in a way that could make me the “crazy, unrealistic FOAM resident with stupid dreams that everyone points at and laughs.” Regardless, I look forward to the feedback and the possibility that someone will read this and come up with an idea that helps FOAM to grow in the eyes of the academic world from a rambunctious toddler into a polite teenager.
Please encourage my posting and help to develop this conversation by leaving a comment, tweeting about it, retweeting tweets about it, following me on twitter @boringem, following my blog through e-mail (right column) or following my blog through an RSS feed (top right corner).
Next week I promise to quit posting about the Canadian residency match and FOAM and get back to the boring medical topics that are the original purpose of this site. Thanks so much for reading!