2014_03The folks at SUNY Downstate Emergency Medicine program have been hard at work contributing to the field of #FOAMed over the last few years (ClinicalMonster.com). Dr. Mark Silverberg, the program’s Associate Residency Director, has also been busy with an EKG website featuring 100 interpreted EKGs. And now he’s busy at it again, introducing the newest contribution to EM – an online visual atlas: www.kchemimage.wordpress.com. While the website is still in development, I wanted to discuss further with Dr. Silverberg the nuances of obtaining images and creating an EM website with it.

Why did you decide to create a blog dedicated to visual images?

The blog was built for educational reasons. Clinical images are not often used for education, although they should be. Most (the better ones) lectures have good images in them, but most lectures are not totally based on them. There have been many studies that show imagery is a superb way to educate because images are linked to material retention.  There are photo atlases out there (I have participated in writing 2 of them –  Greenberg’s Text Atlas of Emergency Medicine and The Atlas of Pediatric Emergency Medicine) but they are expensive. You need good paper and ink to reproduce good images. However, blog sites are free and open to all, making it a much better/affordable mechanism to disseminate knowledge. Plus electronic images can be very high quality.  

How do blogs compare to regular textbooks as a platform for visual atlases?

Both use images to teach/disseminate knowledge. However blogs can capture feedback/questions from learners and have their questions answered. Chances are, if one person has a question, others will think the same thing but be shy/unwilling to ask the question as well. Blogs also are dynamic and can change rapidly. If something is “hot” in the media or academics, that topic can be presented in the blog while a text book once written never changes. 

What are the ethical considerations of obtaining images for blogs and visual atlases?

Images should never be obtained without a patient’s consent. If the image is going to be able to identify an individual, then signed paper consent must be obtained. Verbal consent from the patient is usually adequate if you are going to shoot a single body part such as a toe or elbow that does not identify the person. But caution with tattoos and other identifiable features on the body!

What kind of equipment do you use to obtain the images?

I have a simple point and shoot camera that I can keep in my pocket or bag while working. A lot of people use big, bulky SLR cameras but I find that it is not necessary. As long as the point and shoot has a good macro lens that is all you need. I find that Nikon and Canon are my two favorite brands of cameras. They are the most reliable and take the best images in my opinion. I have no relationship with either of these companies and get nothing back from them. I just like their color saturation and ability to focus sharply. 

What to expect from the blog?

The clinical image of the month will come out on the 1st of the month, every month. Answers will come out 7 days later. There is also going to be a radiograph of the month coming out on the 15th and similarly the answers will come out 7 days later.  Future expansions are to come up with a CAT scan image of the month and EKG of the month to end up making it a weekly system.

Further Reading: 

Nikita Joshi, MD

Nikita Joshi, MD

ALiEM Chief People Officer and Associate Editor
Clinical Instructor
Department of Emergency Medicine
Stanford University
Nikita Joshi, MD


Emergency Medicine Doctor Associate Editor of ALiEM Gun Sense Advocate #FOAMed #Docs4GunSense #MomsDemandAction Tweets represent my own views and opinions