Engagement in Free Open Access Medical Education by US Nephrology Fellows

Abstract

Background: As free open access medical education (FOAMed) use increases, it is important to characterize how and why learners are using this educational material in nephrology. We describe the frequency, purpose, and type of FOAMed usage across US nephrology fellows.

Methods: In this cross-sectional survey, items were emailed to all US adult and pediatric nephrology fellows via the American Society of Nephrology (ASN) Fellow Survey in May 2022. The eight-item survey, developed to measure FOAMed engagement, had previously undergone instrument validation. The results were analyzed by descriptive statistics.

Results: In total, 43% (359/842) adult nephrology fellows and 51% (45/88) pediatric nephrology fellows completed the survey. Seventy-four percent (300/404) of fellows reported using FOAMed, and 72% (215/300) started using FOAMed within the past 2 years. Of FOAMed users, 41% (122/300) reported viewing FOAMed and 33% (99/300) reported applying knowledge gained from these resources daily or weekly. Common purposes for FOAMed engagement included searching Twitter to learn about others' opinions in the field (43%; 130/300), reading blogs to answer clinical questions (35%; 105/300), and listening to podcasts for the most up-to-date information (39%; 116/300). Compared with traditional educational resources, fellows preferred using FOAMed for staying up to date on nephrology topics (75%) and answering clinical questions (37%). Among all fellows, the greatest barriers to FOAMed use were unfamiliarity with FOAMed (27%; 111/404), validity concerns (22%; 90/404), and a lack of a local community of FOAMed users (22%; 87/404).

Conclusions: Seventy-four percent of nephrology fellows used FOAMed resources in a variety of ways, and of them, 33% of fellows clinically applied knowledge gained from these resources. Reasons for engaging with FOAMed varied across resources.

Graphical abstract

Figure 1

Self-reported frequency of various types of free open access medical education (FOAMed) engagement by fellows who reported FOAMed use (n=300). As difficulty of engagement increases (from simply viewing a FOAMed resource to creating and posting original FOAMed content), the frequency with which fellows are engaging in that way decreases as expected.

Figure 2

Self-reported reason for FOAMed use by type of FOAMed resource among fellows reporting FOAMed use (n=300). Notably, games and cases were used less frequently overall. Fellows used Twitter with high frequency for many different reasons, whereas podcasts were specifically used for fellows' ability to multitask, and blogs were popular for seeking answers to clinical questions.

Figure 3

Reasons why fellows preferred using FOAMed resources instead of traditional learning resources, among fellows who use FOAMed (n=300). Fellows were allowed to select more than one reason. Those with no preference for FOAMed did not select any of the reasons above.

Figure 4

Fellow-reported barriers to FOAMed use stratified by self-identified FOAMed users (white) and FOAMed nonusers (gray). Fellows could select multiple barriers, and percentages displayed are reported within their respective group (user versus nonuser), hence the sum may be >100%. Nonusers had a greater relative percentage of unfamiliarity with resources and concerns regarding the lack of data for FOAMed as an educational tool. Overall, contextual factors, including difficulty with technology, a lack of familiarity with FOAMed resources, and no local community of FOAMed users, comprised the greatest proportion of perceived barriers.