Read by QxMD Community Spotlight: Clay Smith
This is the fifth instalment in our new Community Spotlight series. If you missed the first four, you can find it here, here, here, and here.
We recently reached out to some of our users to understand how they’re using our Read app. We learnt so much about their struggles in keeping up with the medical literature and how they’ve integrated Read into their workflow to simplify their workload. There were many great stories that came in so we thought we’d share a few of our favourites. Hopefully, you can pick something up from these Q&A sessions to further optimize your practice!
This interview has been edited and condensed for clarity.
Hi Clay, please tell me a bit about who you are and what you do.
Sure, so I am an emergency physician and I work in both adult and pediatric emergency departments at a tertiary care hospital. And I also have an administrative role as a medical director for some of our local retail clinics and pharmacy chain. So kind of two different hats.
As our readers may know, you run this blog called JournalFeed, so tell us a bit about that and what inspired you to start it and run it?
Yeah so when I was in residency, I had the desire to keep up with the medical literature but I just couldn’t find a way to do it and I couldn’t seem to figure out a way to make that happen. And I asked one of my attending physicians if he might send me an article a week or something like that because even when reading just a little bit would help. But he kind of wisely said, “No, that would take way too much time”.
I had the desire to have a way to easily learn what the current literature was saying but I just didn’t have a way to make that happen. And so as I was trying to think up a lecture idea for some of our residents, I thought, “Well, I’ll summarise maybe the top 10 articles of the year in a certain field.”. Anyway, I put together a lecture on top 10 articles in trauma for a year and it was well received. So I initially started a podcast a number of years back and from one reason another, that iteration didn’t work.
But I still had the desire to keep up with medical literature. So I initially thought I would make something called ’EM Topics’, where I would take different topic areas in emergency medicine like stroke, acute coronary syndrome, etc. then compile sort of the best of the best literature from the year in those topic headings. But as I got into that, I started realising there are so many key current articles that I couldn’t just do summaries of either landmark or guideline type articles and that I really did need to delve into the current literature as well. So I had the idea to just do a monthly big list of ALL of the key articles. But even I didn’t wanna read it, it’s just too much! And so that kind of shunted me more toward doing these spoon-fed type articles because it’s so much easier to learn when you do it little by little.
I go back to the med school years where you are given this ream of paper that you have to memorise and it’s just too much. But if you break that down into bite sized pieces then you can do it. It’s the same with the medical literature, there’s just a ton of stuff coming out but if you can take it little by little then it’s doable and it’s learnable. So that kind of led to JournalFeed and the concept of spoon feeding the literature.
How do you decide on which papers you want to review in JournalFeed?
So I have the really smart people at McMaster in Canada to thank for helping me find a search algorithm that reduces the workload. The main way that I do it is I use PubMed and the McMaster people have some great search algorithms to limit your search to the types of articles that you’re interested in like clinical trials, trials associated with a diagnosis/prognosis, key review articles, etc. And so I have 32 journals that I’ve chosen to follow and then I use the PubMed search strategy to take it from a total of about 3,000 articles a month down to about 1,500. So then I still manually search and skim through the 1,500 abstracts in PubMed. And then pull out about 30 that I think are the most relevant and the most important to emergency medicine. And then I usually call that down to about 20 or so. And then I go and pull the full-text and start writing furiously.
What kind of feedback have you received then from the recipients or readers of JournalFeed?
Well, I’ve done some surveys of the subscribers and I think the majority would recommend it to a friend and find the summaries to be helpful. And I think most of them also find the articles to be practice changing and enjoyable to read. So that’s really my goal, is to help give better care to patients by exposing physicians and clinicians at the bedside to the latest medical literature that’s really practice changing. So there you go.
We’ve noticed that you’ve been including Read links on each post on JournalFeed. What has the feedback been like for that?
Yeah so as you know, in areas of online learning, you tend to have a very dedicated fan base and so there are lots of the readers of JournalFeed who also use Read. And who love having the convenience of the full-text link at the end of the article. So I have gotten good feedback because it’s just another way that we can make things easier for really busy clinicians and to provide a shortcut.
JournalFeed’s providing a shortcut in that, instead of having to skim through 1,500 articles, we give you a curated list of the best of the best and a short summary. So that you don’t really have to delve in and get into the weeds of the full-text. But if you do wanna delve deeper, if the readers do wanna delve deeper, then it’s really convenient. And Read creates a shortcut by a single click to then open on their mobile phone in the app and get the full-text immediately. So it’s a great way for us to shorten the knowledge translation process and give readers good information at their fingertips.
And do you use Read yourself?
I do! I think one of the most effective uses that I have found for Read is when I come up with that final list of 20–25/30 articles each month. Then I love using Read to get the full-text. And so I actually use it on the desktop for this purpose and I’ll simply copy the PubMed ID number, paste it into the search box in Read and you don’t even have to click a button, it immediately starts searching. And it pulls up the full-text options through my institutional subscription to the academic institution where I work. And so it creates those links and it is by far the most efficient way for me to pull the full-text articles as opposed to having to go onto my institution’s library website, find the journal, find the issue, find the.. you know. And scroll through and then get the full-text and download the PDF. I click and copy the PubMed ID and Read takes me directly to links to the full-texts. I click my institutional login and immediately the full-text starts downloading. So that’s one way that I read it.
The other way that I use Read and that I find very helpful is I limit my searching to 31/32 journals but Read doesn’t. And so another great use for me is when I get the emails that say, “Most Read Articles in Read”. And it’s a curated list from Read of what other emergency physicians and people that are interested in the things that I’m interested in which are Emergency medicine, pediatric emergency medicine, critical care based stuff. It’s what are they reading and so it gives me a curated list and sometimes helps me to find articles that otherwise I wouldn’t have come across. And so that’s a great way for me to do it. And then finally another way that I use it is when I do want to get a full-text, I can just pull out my mobile phone, open Read, find the full-text. And then if I need to send that to a colleague, then I can just simply e-mail it to a colleague or save it (the full-text) into a Dropbox. It’s really convenient. And it’s just a great tool to provide speed, efficiency and to give me a shortcut.
Maintaining JournalFeed sounds like a lot of work. What keeps you going everyday?
Well first of all, I just love it. I just have a lot of fun doing it and I find it to be enjoyable. And I think second of all, it helps me as a physician to take better care for my patients. And also as an educator to do a better job in teaching our students and our residents.
So there’s one sense in which I just really enjoy it. There’s another sense in that it keeps me going because I’ve always had this desire to keep up with the medical literature. And I’ve found it to be a way that it forces me into engaging with that material because every month I have a deadline and I have people counting on me to get their email in the morning. And so it keeps me going and I think there’s a couple of other reasons that I still enjoy doing it. And I get a lot of really good feedback from some of the subscribers. I get emails periodically about articles that I’ve summarised and they say, “Wow! I saw a patient with this illness or this disease process and your article that you just published saved my bacon, and well, saved the patient’s bacon.”, and so that to me is incredibly gratifying to be able to touch lives not just in the US but literally around the world and improve patient care and to have that influence is really exciting and it keeps me going. And I think finally, I just have always had kind of an entrepreneurial spirit. As a kid I had a lemonade stand and so I always wanted to work on something that’s sort of a side hustle. So it scratches that itch for me as well.
What kind of impact do you think we might see if more healthcare providers started using JournalFeed and/or Read?
Well, I think the goal is to take the knowledge that’s flooding in from research and to put it into the hands of the clinicians that are at the bedside. And this process of knowledge translation is very time intensive and labour intensive. So tools like JournalFeed and Read help really busy people, really busy physicians and other clinicians to have a curated list of articles that are worth their time. And Read is so great in that it allowing them to put their hands on full-text resources more easily than anything that I have found so that they can dig deeper and really look into the article for themselves and make clinical decisions on the basis of those publications. And JournalFeed I think and Read have a similarity in that we’re both trying to make the process of knowledge translation quicker and easier for physicians. So we are the shortcut that lets them have a life outside of their shifts in the ED. And yet, quickly be able to keep up with this burgeoning medical literature. So I think we are shortcuts to improve efficiency and to provide an excellent curated list of articles worth their time.
Thank you for joining us, Clay. Do you have any final thoughts that you wanna share?
I am always open to feedback to make JournalFeed better. So anyone is welcome to go onto the website, there’s a contact page. They can always submit a form to tell me what they think and how to do it better. And the other thing that I think is good for people to know is that I really value their feedback and comments on the articles themselves. And so I think the more that the readers and subscribers to Read and JournalFeed can engage and go a little deeper and interact with the material and give feedback to those of us who are content creators, the better it’s gonna serve them and the other physicians. So feedback is key.
Clay Smith uses Read by QxMD, a personalized medical and scientific journal, to keep up with the latest medical research in his field and run his medical education blog, JournalFeed.
