This piece is an interview by Teresa Chan with Dr. Brent Thoma of the CanadiEM blog. Brent started the #FOAMed blog BoringEM in December, 2013. In January of 2016 it amalgamated with the Frontdoor2Healthcare blog, bringing on a bunch of new talent to become CanadiEM.
The blog has 6 primary editors and a 9 member advisory board. Over the past few years there have been more than 20 reviewers and more than 30 writers; however, most of them have not been regularly active. The CanadiEM team is run by a small group of enthusiastic editors that range from residents (Eve Purdy, S. Luckett-Gatopoulos, Shahbaz Syed) to practicing physicians (Ed Kwok, Brent Thoma & Teresa Chan). There are a number of advisors from around the world.
Q: How would you describe your blog?
A: Our blog aims to be a community of practice for Canadian emergency medicine healthcare practitioners that provides both a forum for the discussion of important national issues as well as freely available medical education resources without conflicts of interest.
Q: How would you describe your audience?
A: Our audience consists of emergency practitioners from around the world. While there is certainly a focus on issues of relevance to Canadian physicians, we regularly host content that is important in the international context and to other emergency medicine providers (e.g. nursing, respiratory therapy, pharmacy, etc).
Q: Are you able to give us some stats on how many people access your site per month and for what purpose?
A: CanadiEM only launched on January 1st, but as of January 15th we have received >40,000 page views. It is always difficult to know why people access our information. However, popular content includes our stockpile of posts on emergency medicine topics from BoringEM, our mentorship series that covers everything about the CaRMS residency match, and our opinion section, which features discussions of important topics in emergency medicine.
Q: Can you describe your process for generating content?
A: This depends to some degree on what section the content is published under and who wrote it. However, everything posted on CanadiEM is submitted to one of our editors and undergoes a review and copyediting process.
We are quite proud of the “Coached Peer Review” process that was developed by our editorial team (specifically Teresa, Eve, and S Luckett) and will be described in an upcoming innovation report in Academic Medicine. This process involves iterative feedback from a copyeditor and attending-level reviewer to learner-generated content until it meets a level of quality sufficient for publication on our site. The reviews of the attendings are posted on the same page openly for everyone to read. We find that this process is more positive than traditional peer review that often seems to be focused more on whether an article should be accepted or rejected than on making it better.
Q: What’s your technology stack (i.e. how do you host your site, how do you code it, do you have a CMS, do you use any integrations e.g. Facebook, Twitter, Google etc…)?
A: CanadiEM is the fourth website that I have built and it has benefited enormously from my previous experience. It is built on a wordpress.org platform and hosted by a relatively high-end WordPress-specific host (WordPress Engine). The widely acclaimed “X” theme is used as its skin with only minor modifications. A minimal number (<20) plugins are used to preserve loading speed while adding features such as image optimization (EWWW Image Optimizer Cloud), search-engine optimization (Yoast SEO), analytic data (Google Analytics), social media integration (NextScripts SNAP Pro), a comment system (Disqus), and academic support (Academic Blogger’s Toolkit and co-author plus).
Q: What’s one interesting thing you have learned through the process of developing a MedEd blog / website?
A: I think the most important thing that I have learned is the unexpected value of contributing to an expanded online community of practice. I spend a lot of time working on CanadiEM that could be devoted to other pursuits that are more immediately and tangibly rewarding. However, CanadiEM has helped me become part of a community that rewards me with unexpected opportunities that lead to professional growth.
Q: How do you deal with issues of ownership / copyright? i.e. Does the material belong to the PERSON or INSTITUTION?
A: In terms of intellectual property, we’re still learning along with everyone else. This is a question that I suspect will be getting substantially more airtime as the potential of online resources like blogs and podcasts for medical education is realized. Previously, nobody seemed to care about issues of ownership because it was thought that these resources had no value. However, while they have not been well publicized, I know that some of the major players in the FOAM world have had a lot of difficulty with this as their websites became more influential and valuable.
I have kept a close eye on these developments. I am working to insulate CanadiEM from similar issues. I believe that the shift from BoringEM to CanadiEM helped to make it explicit that the website is operated by a collective rather than an individual. Moving forward with that theme, I am exploring the possibility of creating a non-profit organization to own and manage CanadiEM.
Of course, all of this costs money and, at present, the only funding that CanadiEM has comes out of my pocket. As we enter the era of “Funded Open Access Medical education” I hope to be able to comprehensively address the concern of ownership.
In terms of copyright: the CanadiEM team and I strongly believe in making our resources freely available to those that wish to use them for their own education. However, we are not interested in others selling or benefiting financially from the work that we have done. As such, we have placed a copyright on our website indicating that our resources are available for non-commercial use. We use CreativeCommons.org to identify the license restrictions that we feel are appropriate for our resources and values. The license we chose (allows others to adapt and distribute our content for non-commercial purposes as long as it is attributed to us and any derivative products that are created from it are shared using the same license.