An Evaluation of Emergency Medicine Core Content Covered by Free Open Access Medical Education Resources

Ann Emerg Med. 2016 May;67(5):649-653.e2. doi: 10.1016/j.annemergmed.2015.12.020. Epub 2016 Feb 11.


Study objective: Emergency physicians are using free open access medical education (FOAM) resources at an increasing rate. The extent to which FOAM resources cover the breadth of emergency medicine core content is unknown. We hypothesize that the content of FOAM resources does not provide comprehensive or balanced coverage of the scope of knowledge necessary for emergency medicine providers. Our objective is to quantify emergency medicine core content covered by FOAM resources and identify the predominant FOAM topics.

Methods: This is an institutional review board-approved, retrospective review of all English-language FOAM posts between July 1, 2013, and June 30, 2014, as aggregated on The topics of FOAM posts were compared with those of the emergency medicine core content, as defined by the American Board of Emergency Medicine's Model of the Clinical Practice of Emergency Medicine (MCPEM). Each FOAM post could cover more than 1 topic. Repeated posts and summaries were excluded.

Results: Review of the MCPEM yielded 915 total emergency medicine topics grouped into 20 sections. Review of 6,424 FOAM posts yielded 7,279 total topics and 654 unique topics, representing 71.5% coverage of the 915 topics outlined by the MCPEM. The procedures section was covered most often, representing 2,285 (31.4%) FOAM topics. The 4 sections with the least coverage were cutaneous disorders, hematologic disorders, nontraumatic musculoskeletal disorders, and obstetric and gynecologic disorders, each representing 0.6% of FOAM topics. Airway techniques; ECG interpretation; research, evidence-based medicine, and interpretation of the literature; resuscitation; and ultrasonography were the most overrepresented subsections, equaling 1,674 (23.0%) FOAM topics when combined.

Conclusion: The data suggest an imbalanced and incomplete coverage of emergency medicine core content in FOAM. The study is limited by its retrospective design and use of a single referral Web site to obtain available FOAM resources. More comprehensive and balanced coverage of emergency medicine core content is needed if FOAM is to serve as a primary educational resource.

Publication types

  • Evaluation Study

MeSH terms

  • Access to Information
  • Clinical Competence*
  • Curriculum*
  • Emergency Medicine / education*
  • Humans
  • Internet
  • Internship and Residency*
  • Program Evaluation
  • Retrospective Studies