Free Open Access Meducation (FOAM)—medical learning shared online without a paywall—grew rapidly in emergency medicine and critical care. A 2014 study charted this expansion from two blogs and one podcast in 2002 to 141 blogs and 42 podcasts in 2013, describing it as an “explosive growth” that would anchor future research [1]. The scale is striking, but growth is not the same as educational impact. A blog or podcast may be easy to access and widely discussed, yet those features alone do not show how well it teaches, changes clinical practice, or affects patients. This article follows FOAM from that early act of documentation toward harder questions: who uses it, what they value, how quality is judged, and what remains unknown about this evolving educational format.
That distinction makes the 2014 study by Cadogan, Thoma, Chan, and Lin a useful starting point. Rather than testing a single lesson, course, or educational intervention, the authors mapped the emergence of an online ecosystem for emergency medicine and critical care (EMCC). They gathered data prospectively—from 2002 through November 2013. “Prospectively” means that the information was collected as the period unfolded, allowing the study to describe the field’s expansion over time rather than offering only a later snapshot [1].
The paper documented a marked increase in EMCC websites. In 2002, the field included two blogs and one podcast; by 2013, it included 141 blogs and 42 podcasts [1]. These figures are not measures of learner improvement or clinical change. They are a record of how many publicly available online sources had emerged within the scope of the study. That difference matters: the paper’s contribution was to establish the size and trajectory of a developing communication and education environment, not to demonstrate that FOAM produced better learning or patient care.
The authors framed this growth within continuing professional development—the ongoing learning associated with professional practice—and described disruptive technologies as reshaping that activity. Most importantly, they presented the study as a foundation for future research in the field [1]. In that sense, the paper serves as a baseline: it captured FOAM at an early stage, making later questions about use, quality, and educational impact possible without answering them itself.
Adoption soon became visible in learner behavior. In a Canadian survey, residents reported using free online resources extensively for general emergency medicine education, procedural-skills training, and interpreting diagnostic tests; podcasts were among the most frequently used formats. Residents placed more importance on entertainment than program directors did, while some residents considered literature references less important than all directors did . A U.S. survey found that most emergency medicine residents listened to podcasts at least monthly, preferred episodes shorter than 30 minutes, and used them to keep up with current literature and learn core content. Many also reported that podcasts changed their clinical practice, although this was self-reported rather than independently measured .