Educational resources discussing lifestyle, public policy, and wellness relevant for all healthcare providers
Calling all who read or listen to emergency medicine/critical care (EM/CC) blogs or podcasts. In 2014, we helped to publish the master inventory of free open-access medical education (FOAMed) resources spanning the period of 2002-2013 . In that publication, we demonstrated an exponential rise of both blogs and podcasts with 141 blogs and 42 podcasts (total 183 sites). In 2019, the Life in the Fast Lane (LITFL) team identified 251 active sites. But where are we at now?
Why create an EM/CC master list of sites?
Most of the time, we encounter new resources by word-of-mouth or through Google search engines. There are, however, so many more quality sites that are available for teaching and learning. We aim to find them all. Are the numbers like 50 or more like 500? So far, we have reviewed the 2019 LITFL list and identified 119 and 9 still-active blog and podcast sites, respectively. But we likely have missed some, especially those sites launched after 2019.
Why the rush on updating the master list now?
Since 2014, we have prided ourselves in running the Approved Instructional Resources (AIR) Series, which identifies quality blog posts and podcast episodes, specifically to help residency programs award asynchronous learning credit to their residents . Posts and episodes are identified from the top 50 sites, based on our validated Social Media Index (SMI) score  and are selected from a modified version of the 2019 LITFL list. The SMI formula incorporates the Alexa rank, which unfortunately just retired on May 1, 2022. So we are working towards an updated SMI score, using Ahref’s Domain Rating as well as new platform followerships that includes not only Twitter and Facebook but also Pinterest, Reddit, YouTube, Instagram, and LinkedIn.
Call to action: What sites did we miss?
We want to get as comprehensive a list as possible. If you don’t see a blog or podcast on these lists, fill out the Google form below! Thank you for your help.
- Cadogan M, Thoma B, Chan TM, Lin M. Free Open Access Meducation (FOAM): the rise of emergency medicine and critical care blogs and podcasts (2002-2013). Emerg Med J. 2014;31(e1):e76-e77. doi:10.1136/emermed-2013-203502. PMID 24554447
- Lin M, Joshi N, Grock A, et al. Approved Instructional Resources Series: A National Initiative to Identify Quality Emergency Medicine Blog and Podcast Content for Resident Education. J Grad Med Educ. 2016;8(2):219-225. doi:10.4300/JGME-D-15-00388.1. PMID 27168891
- Thoma B, Sanders JL, Lin M, Paterson QS, Steeg J, Chan TM. The social media index: measuring the impact of emergency medicine and critical care websites. West J Emerg Med. 2015;16(2):242-249. doi:10.5811/westjem.2015.1.24860. PMID 25834664
If you’re like most people, your mind wanders. You may be sitting down to finish your charts, make that presentation (or write that blog) and your mind is off thinking about what you’re making for dinner or the fact that you need to call the plumber. Our minds wander and lose focus more often than we think. A study by Harvard psychologists Matthew Killingsworth and Daniel Gilbert showed that our brains spend 46.9% of our waking hours in wandering mode, focusing on something other than the task at hand. That leaves only 53.1% of your attention going to what it’s actually supposed to . We all know though the less attention you devote to a task, the more time it takes to complete it. So that hour it would take to finish your charts, just turned into two with your favorite Netflix show on.
Given the fact we are living in a distraction economy, with new technological advances vying for our attention on a daily basis, it is important as ever to talk about how we can maintain our focus. This is part 1 of a 3-part series on achieving precision focus. I use the word precision, since I want you to think about focus refined and adapted to you and your life, rather than the generalized concept. There are 3 ingredients that go into achieving precision focus: attention, deliberateness, and energy. In this post we are going to tackle attention and discuss 3 tips for strengthening your attention muscle so you can achieve precision focus. Stay tuned for future posts on making sure you are deliberate with the items you choose to focus on and how to boost your energy levels to help you achieve precision focus.
Productivity isn’t about doing more, it’s about doing the right things, deliberately and with intention.
Many of us bask in the glory of “multitasking.” Checked off 10 emails while on that zoom call or responded to some Slack messages while at our kid’s baseball practice. Many of you likely already know this: multitasking is a myth. Dr. Eyal Ophir, a Stanford University neuroscientist, showed that our brains are simply not capable of focusing on 2 things at once. Rather our brain rapidly “task switches” its attention between the 2 items. This process of task switching causes performance to suffer, leaving you ultimately working less efficiently on both tasks. A Harvard Business Review article entitled “How (and Why) to Stop Multitasking” quoted a 40% loss in productivity when we attempt to multitask. Scientist Harold Pashler showed that when people do two cognitive tasks at once, their cognitive capacity can drop from that of an MBA to that of an 8-year-old [2, 3].
You can’t execute more than one conscious task at a time without impacting accuracy.
Are you looking to remember the tasks you’re working on?
If so, don’t divide your attention. A study by Madore et al showed that giving partial attention to your tasks limits the ability of the information to go from short-term to long-term memory. Subjects that attempted to multi-task had attention lapses and poor memory . So if you want to remember the information from your department faculty meeting, don’t surf the web during the research updates.
My advice, stop doing it all and do ONE thing. How refreshing will it be to sit down and just concentrate on the task at hand? Here are some ways to try to single-task this week:
- For this week’s Zoom meeting/lecture, don’t have your web browser open, don’t text, and don’t check email. Say “no” to any Zoom call you’re not willing to single-task for. The partial attention you are giving to both tasks is not worth your time.
- Single-task your deep work this week. This week when sitting down to do deep work, have only ONE tab/app open on your computer for the one task you are working on.
- For your next conversation with a friend or family member, be intentional about single-tasking conversations with a family/friend. Listen to them, and soak in the conversation. No phone, no doing the dishes, just be deliberate in listening to what they have to say.
You sit down to do deep work, and your phone lights up with a text message from a friend. Picking up your phone, you see you also have a new email notification. 20 minutes later you are surfing Twitter and wondering how you got here. While technology has had considerable benefits in our lives, it’s also made it so much easier to procrastinate. Attention is a currency, and we don’t have unlimited amounts.
Combat distractions and improve your attention by incorporating a “startup” ritual into your workday.
Do the 3 D’s:
- Declutter. Our brains don’t like disorganization. This is important not only for your physical environment, but your digital environment too. Clean off your desk and delete icons cluttering your desktop.
- Do not disturb. Make sure your phone and computer are on “do not disturb.” Put your phone out of your visual space. Put it at least 20 seconds away to really stop temptation. Go to your email and take all accounts offline so you’re not tempted to check your email.
- Design. Look over your planned design for the day. By reviewing what you intend to focus on, you will be less likely to get distracted.
I have a meditation confession. It took me some time to be convinced to try meditating. After reading countless attestations of the benefits of meditation, I gave it a try. The benefits of meditation go beyond reducing stress, generating kindness, and improving sleep. Mindfulness meditation affects various psychological outcomes. It can not only improve your cognitive performance but also enhance your attention. A meta-analysis done by Ofir et al., looked at 27 studies on mindfulness based interventions and found that meditation can reliably enhance attention and executive control .
You may think you don’t have the time to meditate. Your schedule is already so busy! Studies show that even a small “dose” of meditation has benefits. Moore et al. asked meditation-naive participants to meditate daily for 10 minutes. The results suggested that mindfulness meditation can lead to improved self-regulation of attention . Basso et al. studied non-experienced meditators and found that at 8 weeks, 13-minute daily meditation decreased negative mood state, enhanced attention, increased working memory, and decreased anxiety .
Don’t know where to start? Check out the free app Insight Timer. I also enjoy Headspace (also check out their amazing “Sleepcasts” that not only help your drift off to dreamland but also feature a “Nighttime SOS” section that provides guided meditations if you wake up in the middle of the night).
Summary Action items
- Try out single-tasking this week, be it a conversation with a friend or your next Zoom meeting. Do ONE thing and stop living a life of partial attention.
- Read my 3 Tips for Combating Distractions while Working From Home blog on preventing distractions. Start your day with the 3 D “startup” ritual every day.
- Try 10 minutes of meditation one day this week. Download the Insight timer (free) and pick one to do.
- Killingsworth M, Gilbert D, A Wandering Mind Is an Unhappy Mind. Science. 2010; 330, 932. DOI: 10.1126/science.1192439
- Rock D. Your Brain at Work. 2nd Edition. Harper Business. 2020.
- Pashler H. Dual-task interference in simple tasks: Data and theory. Psychological Bulletin. 1994; 116(2), 220–244. https://doi.org/10.1037/0033-2909.116.2.220
- Madore K, Khazenzon A, Backes C, et al. Memory failure predicted by attention lapsing and media multitasking. Nature. 2020; 587, 87–91. https://doi.org/10.1038/s41586-020-2870-z
- Yakobi O, Smilek D, Danckert J. The Effects of Mindfulness Meditation on Attention, Executive Control and Working Memory in Healthy Adults: A Meta-analysis of Randomized Controlled Trials. Cogn Ther Res. 2021;45, 543–560. https://doi-org.laneproxy.stanford.edu/10.1007/s10608-020-10177-2
- Moore A, Gruber T, Derose J, Malinowski P. Regular, brief mindfulness meditation practice improves electrophysiological markers of attentional control. Front Hum Neurosci. 2012; 6(18). https://doi.org/10.3389/fnhum.2012.00018
- Basso J, McHale A, Ende V, Oberlin D, Suzuki W. Brief, daily meditation enhances attention, memory, mood, and emotional regulation in non-experienced meditators. Behav Brain Res. 2019; 356:208-220. PMID 30153464.
As physicians we are managing many different roles in our lives: academician, researcher, clinical provider, spouse, parent, just to name a few. Despite our many roles, the amount of time we have in a day to complete the tasks of each role remains the same: 1,440 minutes. Is how you’re spending your 1,440 minutes in a day the way you want to spend them? By assessing your priorities, practicing time saving tips and being proactive and not reactive you can live the balanced life you’ve dreamt of. There are only 1440 minutes in a day. Are you utilizing them well?
The COVID-19 pandemic has placed incredible stress and strain on the personal work lives of emergency physicians. We have endured these almost 2 years of misinformation, PPE shortages, fear, frustration, grief, and death. So much going on in the world politically and socioeconomically, we at ALiEM wanted to share a message that WE SEE YOU. We’re with you, and we’re in this together.
Thank you for the tireless work on this video by animator Spencer Evans, who is a soon-to-be-emergency physician attending medical school currently at the University of Colorado. Also thanks to the entire ALiEM team for contributing to the message and storyboard, especially Drs. Al’ai Alvarez, Andy Little, Carl Preiksaitis, Chris Belcher, Christian Rose, Felix Ankel, Jason Woods, and Teresa Chan.