about how you actually learn from this stuff. Because I don't know if you guys knew this about the internet. I just found this out myself. That you can spend a lot of time on the internet and not learn a thing. You can go down these rabbit holes, but you'll find that you've just spent two hours of your life and you know you're actually dumber than when you started. But we're going to start trying to talk about how we can actually get some real learning here. So my only disclosures are, like Tim mentioned, I'm the co-host of a podcast. I'm a FOMED creator, essentially. I have a website that I put up initially just to share stuff that I came across that I thought was helpful for my students. And instead of just emailing them every time I came across something, I decided to start this blog. And then I thought, well, other people might like it too. And then I am the co-host of the podcast Critical Care Scenarios. So basically, at the end of this talk, I want you to be able to develop a plan for how you're going to use social media, foam, the internet, whatever you want to call it, to have a personal education plan for yourself. Okay? We're going to look at a couple of different ways to do that. We're going to look at structured learning. We're going to look at sources and how we evaluate and identify sources. And then finally, just be able to put it all together for what you need. So before you get started with this, you need to establish what's your goal, right? Because this is really going to inform how you do things. Maybe you want to supplement your training, right? You're a student or a resident or a fellow. You're in a program already getting some training, and you want to add on to that. Right? We don't have time to teach you everything in school. We don't have time to teach you everything in postgraduate. Or maybe there's something that you're just really interested in and you want to add to it. Maybe you're out of training for a while, and you're trying to figure out how do I stay on top of stuff. I think that's why a lot of folks come to SCCM, right? Is to, how do I stay on top of things? Maybe it's something else entirely. Who knows? But this is really key because it's going to inform your strategy for moving forward. So you really need to know, like, what's my goal here? All right. So the next thing you need is, we're going to get started. You need two main things. You need curriculum, and you need some content. Okay. So half of you fell asleep, and the other half got on Twitter when I mentioned curriculum. But curriculum is just a fancy word for a plan. Right? We all got here from our homes because we had a plan. We didn't just go to the airport and say, I would like to be in California, please. Right? So you have to have a plan. I'm on the faculty of the nurse practitioner program at Georgetown University in Washington, DC. And when I first took this job, I thought, I don't know anything about being a professor. Is there a professing class that I can take? And, hey, there was. So Georgetown offers a postgraduate certificate in medical education. So I did this postgraduate certificate. And one of the first things we talked about was curriculum design. And initially, I thought, okay, this doesn't apply to me because I'm just teaching. I don't design curriculum. That's for other people. But I learned that this is really important because without a curriculum, well, everything is awesome online. Right? It's amazing. It's cool. And you're going to find all sorts of stuff. And you're going to come away with going, I don't know what I learned. So my first degree is in history. And I had this professor my freshman year of college in history taught world civilization and European history from the French Revolution to the present. And sorry, there will be no content from that class in the talk today. But he was this fascinating professor, mostly because I think he had lived through most of that history. But he would lecture for like an hour and you'd just sit there and go, well, that was so amazing. And then you would look down at your notebook to see what pearls of wisdom did I glean from this. And I looked in and I had written today's date. Okay. I don't know. I mean, I didn't really learn much. It was super entertaining. And so was the internet. So I can watch cat videos and debate politics and read memes all day. But that's not an efficient use of my time. So a curriculum, like I said, is just a plan. And the best thing about this curriculum is it's your curriculum. So it's personalized for you. So all of us have experience with curricula, right? You're in school. You're in postgraduate training. Someone developed a curriculum for you, but not really for you, right? They developed it for you, right? Whatever they decided, people in my program, when they leave, should know this. But this is the chance that you get to sort of say, what do I need to know? What do I want to know? And where do I go and how do I get there? Now, your curriculum is going to be a balance between a couple of things. There's the fundamentals versus latest and greatest, right? And this is going to play into a little bit to your goals and where you are in your career. If you're early on, you know, maybe you really need the fundamentals more. If you're somebody who's been doing this for 10 or 15 years, you're like, that's boring. I need the new cool stuff. But I would say there's always room for that balance, right? I've been doing this six years, so I'm, I guess, early to mid-career. And I still have things that I would consider fundamentals that I don't understand well, because I just don't do them very often. There is definitely a balance, and especially online, between the cool and the mundane. I am also a POCUS enthusiast, and you can read lots of stuff about POCUS online. I can read tweets and blogs and watch videos about POCUS all day long. But in reality, that's a real small portion of what I do in the ICU. We had a guy on a podcast not long ago, an EM doc, and he said, one of the things I love about you guys in the ICU is you're the master of the incremental gains. He's serious. This wasn't a joke. It wasn't a dig at how uncool we are compared to EM. But that's a lot of what we do, right, is these little things that are not super exciting, but that's what makes differences in patient outcomes, right? So if you're going to go and just go out there and start consuming content, you're going to read a lot about POCUS. You're going to read a lot about ECMO. You're going to read a lot about proning, and you're never going to read a thing about VTE prophylaxis or antibiotic stewardship. But those are things that make difference in patients' lives, right? So there is definitely a balance between the cool, exciting stuff that you're going to not have to look for. It's going to be in your face, and the more mundane stuff that you're going to have to dig a little bit. And then probably the best question you can ask yourself is, what are my weaknesses? It's the best and the worst question, right? It's the most valuable question, but it's the one that sucks the most, right? I hate my weaknesses. I don't like talking about them. But I tell my students, when I was, years ago, when I was studying for my NP boards, I would do flashcards for some of you in the room. Flashcards used to be these things with, they're called paper, and you write on them with these things called pencils. But I would love to go over flashcards about hemodynamics, because I was a CTIC nurse for 10 years. I knew hemodynamics backwards and forwards, right? It made me feel super great studying those things, but it was not a very good use of my time. I needed to study things like antibiotics, which I still don't have a firm grip on, and thank goodness I work with great pharmacists, so I can just be like, can you just tell me what to do here? But so you have to identify, like, what are the things that I need? Because otherwise, it's just a feedback loop, right? You're just going out and reading about things that you are already knowledgeable about. We do that here. I was telling somebody, I come to conferences, and I make out this plan of the sessions I'm going to go to, and I end up going to all these sessions that I probably have given the talk, right? Because it's stuff that I know real well. Maybe I should go to the ones that would challenge me more, okay? So it's really important that you're looking at what are your weaknesses and what are the areas that you need to brush up on. So once you have a plan, you need some sources, right? You need some information. Again, in our training programs, this is provided for us, right? We just show up, and people come and lecture. People tell us, buy this book, read this book, okay? But now this is all up to you. You've got to find sources. So where do you find these sources? Well, we've already heard about Twitter, and we've heard about Instagram, blogs, podcasts, websites, YouTube, you name it. There's tons of stuff out there. So if you can't find a source, you're just not looking very hard. But I would classify all these sources into kind of two broad and one small category, so formal and informal. And then the smaller one is what I would call quasi-formal or semi-formal. So what's a formal source? Well, a formal source is, frankly, it's a big organization like SCCM. This is a formal source. SCCM, if you go to their website, has tons of educational modules and books and things like that that you can get, journals, chests, critical care medicine, JAMA. They all have tons of stuff like that. There's some upsides and some downsides to formal sources. The biggest upside probably is these are well done, right? These are organizations who spend a lot of time, effort, and money to make these things really, really nice. In a lot of cases, they have maybe people who are professional educators weigh in on pedagogy and things like that. They're very well vetted, right? Lots of sourced stuff. You know, where's the data for this? Oh, it's from this study and this study. And they're cited, you know, pages long. You can trust the stuff. The biggest downsides? Well, the biggest downside is cost. This stuff is expensive, typically. It just is. I tried to figure out a way to say that where I wouldn't sound like I was offending the organization that brought me here to speak. But I don't think it's offensive, right? It is what it is. SCCM puts a quality product together. These journals put a lot of effort into this. And that stuff costs money, which is great. But maybe you're new, and you don't have a lot of money to spend. So that's a big downside. Another downside, I think of a downside, some people might like this, is it's more of an academic tone, right? I'm for somebody who likes real casual stuff. That's why I like Twitter. That's why I like podcasts. Maybe that's an upside for you. But a lot of people, that's sort of off-putting. It's like, I don't want to read textbooks anymore. And that's kind of what these things feel like sometimes. And then the other big downside is big organizations move at an institutional pace. And so it's real hard to get super bleeding-edge stuff from these formal sources. And that could also be an upside, right? Because sometimes bleeding-edge stuff turns out to not work so well. I think we can think of a couple of things that have come out in the last couple of years that maybe in hindsight proved to not be so great. Then you have informal sources. This is the opposite end. These are usually individuals. Twitter accounts, podcasts, some podcasts are formal, some are more informal, blogs, stuff like that. The big benefit for these is low bar to entry, right? Literally, you could be out here right now, you've never done this before, but you were inspired by the previous two talks. And now you have a Twitter account and you're live tweeting. And that's that, right? So there's no barrier to entry. So if you're somebody who is smart and a good clinician and has a lot of experience who wants to share their wisdom, you can just start doing it. And finding those people are like finding gems, right? Because it's like having an experienced mentor, you know, who's right there with you. They tend to be more casual in tone, if that's your thing. Like I said, that's my thing. I like that. The downsides, though, kind of are the flip side of that coin, right? Because it's so easy to get started and it's so easy to post. I mean, I could sit out here and be posting stuff right now and put hashtag SCCM on it and nobody knows if I'm making stuff up, right? A lot of times these things are not sourced. They're not, nobody's citing sources. Twitter's a horrible place to do that because you have a character limit. So who wants to spend half of your 280 characters citing a reference? I'm just going to tell you stuff I know. You know, this is sort of the equivalent of if you, I got here yesterday and was walking around downtown and, you know, there's some guy out on the street ranting about the government. And that's the guy, right? That's the informal source. Now, is that guy wrong? Not necessarily, right? He could be spot on. But it's a little hard to trust him versus if the San Francisco Chronicle published it, automatically there's trust, right? So the big downside to the informal sources, I think, is there's just not necessarily this built-in trust, built-in security that this is valid. And that's where I think quasi-formal or semi-formal sources really come into play. And these are usually groups of people or organizations, but not like SCCM, not journals, not research. These are like Critical Care Now, Haney Malomet's group. It's just a group of intensivists who get together and write these posts. And because there's a group of them, they can pool their resources. They can verify each other. They actually do some peer review. Life in the Fast Lane, the Australian side, if you're not familiar with that, look it up. It's fantastic. It's another great one. They can do the same sort of thing. So a lot of the upsides of the formal with all the upsides of the informal as well. So when you're picking a site and picking a source, who do you trust? This is the big question. Anytime I talk about the internet, anytime I talk about social media, people say, well, how do I know who to trust? How do I know what to believe? Well, how do you know what to believe about anything, right? Hopefully, you're not just reading stuff and accepting at face value. One of the best talks I ever heard was one of the former chairs in my department gave a talk to some med students, and I got to listen in, on how to read the medical literature. And he took a paper from JAMA and a paper from the New England Journal, arguably the top two, or at least two of the top five medical journals in the world. And he dissected these articles, and he looked at their methodology, and he looked at their biases, and he looked at their conclusions. And at the end of those, I didn't believe a thing either of those papers said. They weren't worth anything to me. I'm not saying that JAMA and the New England Journal publish junk, but you know, sometimes stuff gets through. We all have biases. So hopefully, you're not reading anything and accepting it at face value. So what's your system for evaluating any material, right? If it gets published in JAMA, I probably am going to give it more weight because it's JAMA. Same thing here, right? If I follow somebody, if I follow Tim on social media enough, I know that when he posts, it's good stuff. So he has a little bit of reputation with me. Referral, right? What do your friends read? What do they listen to? You know, if I talk at work with my colleagues, and they tell me, oh, did you read the latest blog post by so-and-so, and we're all talking about it? Okay, good. That's another good way to check things too, right? If there's 10 of you reading the same article or following, listening to the same podcast, it's a lot less likely all 10 of you are going to miss some big glaring errors, right? This is basically how Journal Club works. And then trial and error is all going to come down to this, right? You're going to have to do a little bit of trial and error. I don't like trial and error because I feel like the trial and the error part are wastes of my time, right? I want to just have the definitive stuff right away and go. But sometimes you're just going to have to pick some people, and you're going to go like, you know what? I listened to this podcast, and she was just really easy to listen to, and I really like it. And I'm going to have to do a little fact-checking. And maybe I follow somebody on social media, and he just makes everything so simple. But I'm going to have to do some fact-checking and make sure that he's right. And after you do that a while, you'll get a feel for, okay, yeah, this person, everything they put up is good. I don't have to vet everything they say. So if you want more resources, this is a people always want to know, well, how do I get started more? What do I need more? So full disclosure, this goes to a page on my website, which is basically just the fancy way of saying it is curated content. I just repost a lot of social media stuff that I think is good. But this is a list of some of my favorite stuff. It is a completely biased and non-exhaustive list, but it gets you started, okay? And then you can see there's my email address and my Twitter if you want to continue talking about this stuff. I'm happy to talk about how to do this more, what are good sources, how do I start a podcast, why do you still do that podcast, all that stuff. So thanks. Thank you.

personalized education plan

social media

online resources

curriculum design

formal and informal sources