A question asked at the 2009 ACEM Winter Symposium following our presentation on ‘The Web 2.0 Rollercoaster‘ was:

How can emergency physicians deal with information overload?

Fear of information overload is a barrier preventing doctors from using web resources. But, given that humanity has been experiencing information overload since the invention of the Gutenberg press, ignoring web resources to avoid confronting this daunting problem is a maladaptive, self-defeating strategy.

Here are some ‘Life in the Fast Lane’ pointers to help ‘Web 2.0 laggards’ pull their heads out of the ground and off-load the stress of information overload:

#1. Relax!

You’ve been doing fine so far. The information storm will rain down around you regardless of whether or not you are aware of it – so nothing has changed. So relax, OK! You are still going to get on with the job of being a doctor. A lot of the published medical literature verges on recycled trash anyway and no one will die because you haven’t read everything ever written…

“… staff of the journal Evidence-Based Medicine… hand-search about 60 000 articles from 140 journals annually, including the five highest-rating general medical journals and a variety of other specialty journals… the “number needed to read” to find one valid study is about 18 articles.

- Glasziou PP. Information overload: what’s behind it, what’s beyond it? MJA 2008; 189 (2): 84-85

Nevertheless, effective use of Web 2.0 tools will make you more efficient at handling the raging torrent of information. This will enable to meet your knowledge needs more easily, and may ultimately improve your effectiveness as a clinician. After all, ‘the times they are a changing‘.

#2. Know your knowledge needs

Know your knowledge needs. This is a key step in dealing with information overload. There are so many exciting information sources out there – on every subject imaginable – it is easy to get distracted from your core needs. Define your needs and only use information sources that contribute to meeting them. How can you determine what your knowledge needs are? If you are a student or trainee then focus on aspects of your exam syllabus, if you are a busy clinician then focus on your day-to-day practice and on clinical questions as they arise.

Don’t be afraid to cull an information source that is low yield – whether that be someone you follow on Twitter, a blog, a podcast, a journal, or some other information source. This might mean that you will miss an occasional useful bit of information. Don’t worry, relax (Tip #1). So long as you remember to ‘be social’ (Tip #3) and ‘follow the leaders’ (Tip #4) then although you may miss the primary information source, the important gaps will be filled by secondary sources.

#3. Build a one-stop shop

Do you fill your email inbox with journal table of contents updates that you resent having to file? Do you find that you hardly ever get to read these anyway because they turn up at an inconvenient time and you forget to go back to them later? Do you waste time repeatedly visiting your 31 favo(u)rite websites to see if anything new has been e-published since the last time you checked?

If you answered yes to any of these questions you need to start using a feed aggregator (aka reader). An aggregator means that you don’t have to constantly “pull” information, it is “pushed” to you instead. Best of all, use a web-based aggregator so that you can access it anywhere – on computers at work or at home, or on your ‘smart’ phone so that you can ‘go mobile’ (Tip #9). Once you have chosen an aggregator, you need to subscribe to the feeds of your favo(u)rite websites, whether they be blogs, journal webpages, podcasts, Pubmed or Medworm searches, or any other continuously updated webpage. The aggregator then collects the incoming stream of information that is automatically pushed to you, storing and categorizing it for you to read at your convenience. Aggregators also let you label or tag your favorites to revisit later, make it easy to discard the dross, and enable you to share your discoveries with your friends and colleagues.

If you use Google Reader and Twitter with the Firefox web browser, consider using Feedly. Feedly provides an eye-friendly magazine-style interface that that integrates these tools, and also makes sharing with other Web 2.0 services a breeze. If subscribing to RSS feeds scares you, then check out the new and impressive clinician-friendly web-based aggregator Clinical Reader (try the emergency medicine section, the critical care section, or the medical students section) or Webicina.com‘s PeRSSonalized Medicine.

Read RSS Really Simple Syndication and Health Feed Aggregation to learn more about feeds and aggregators for physcians.

#4. Search selectively

By learning to search effectively you can increase your search ‘hit rate’ so that you’re not left wading through a sea of worthless information slime. Time and effort spent learning how to search properly will reap you massive rewards in the long run. Effective searching is essential to “pull” information to meet your foreground knowledge needs.

For tips on how to improve your searching skills read Medical Search for Physicians and Laika’s MedLibLog: 10+1 PubMed Tips.

If in doubt ask a librarian (someone like @laikas)!.

#5. Be smart, be social

Having a robust social network of highly intelligent people with similar interests means that high yield information is ‘pushed’ to you effortlessly. The key is to build a network of people that will help you meet your knowledge needs. This is why the team at ‘Life in the Fast Lane’ are so enthusiastic about encouraging our medical colleagues to embrace Web 2.0 tools – the symbiosis of synergistic sharing is incredibly powerful. The more people interested in emergency medicine, toxicology, retrieval, critical care, and acute medicine there are that start tweeting, social bookmarking, blogging, and podcasting the greater the flow of information, but there will also be more filters (Tip #7) resulting in a higher signal-to-noise ratio for important information as becomes retweeted, virally blogged and bookmarked.

Learn more by reading Social Bookmarking for Physicians, Physician Social and Professional Networks , Is Social Media the Rock’n'Roll of HealthCare? and Medical twitter.

#6. Follow the leaders

Try to identify people who are innovators and have an enthusiasm for sorting, sifting, and filtering information. During their virtual travels searching the outer reaches of the info-verse, these explorers will collect and pass on only what they find useful or interesting, having panned out scarce golden nuggets from the information rapids. Pay close attention to these people – if they don’t Twitter, blog, or use social bookmarking tools then encourage them to do so so that we can all reap the benefits!

#7. Find fabulous filters

Instead of trying to sort the wheat from the chaff yourself, use ‘filters’ to keep your background knowledge up-to-date. There is simply too much information around for a practising clinician to sort themselves – indeed Clay Shirky has stated that information overload is not the problem, the real problem is ‘filter failure‘. Filters can be people in your social network (Tips #5 and #6), blogs (such as the Best Evidence in Emergency Medicine Investigator Group blog), journal summaries (such as JournalWatch , Richard Lehman’s entertaining weekly round up of general medical journals, and MedConnect Journal Summaries), review journals (such as Intensive Care Monitor or Current Opinion in Critical Care for intensive care, the Clinics of North America series and Emergency Medicine Practice), or the editorials, reviews, or “from other journals” sections of the major medical journals. Subscribe to the feed of a good medical news source like 6minutes.com.au if you want to keep your finger on the pulse of broader medical issues. Podcasts are also useful for accessing summarised and filtered information particularly if you ‘go mobile’ (see Tip #9).

Read Podcasts for Emergency Physicians to learn more about podcasts.

#8. Bathe in the flow

Let the ebb and flow of the information tide wash over you. You don’t need to read everything that is twitted or is fed to your feed reader. Just read what catches your eye – whatever looks like meeting one of your knowledge needs. Remember, that really important information tends to get repeated – whether syndicated by multiple blogs, retweeted by multiple tweeters, or featured in the “from other journals” section of the major medical journals.

#9. Go mobile

I’ve recently become more aware that while lots of doctors have smart phones, in Australia at least, they often don’t use the ‘smart’ part! I know doctors who freely admit that they have iphones but only use them for phone calls and text messaging. If you are one of these people, I strongly encourage you to start integrating your ‘smart’ phone with web 2.0 tools.

Transfer pdfs of articles to your ‘smart’ phone so you can read them sitting on the train, get the ‘Google’ app so you can skim through Google Reader while you languish in the queue for your coffee, and listen to podcasts so that going to the supermarket becomes an enlightening experience… ‘Going mobile’ lets you fill in the wasted moments of the day so that you can dance effortlessly through the information minefield.

#10. Find focus, time tasks, and “firewall” your attention

Multi-tasking is a myth. Constant interruptions hinder the assessment of the validity of information as well as its absorption. “Firewall” your attention. Prioritize your tasks and work from the top, one by one. If you are dealing with a high-priority information task then turn off the phone, your Twitter application updates, and any other technology they may distract you. Set yourself deadlines for tasks and give yourself a time limit for the minimum time for constant absorption in the task at hand before you are allowed to check email, Twitter or your feed aggregator.

…and remember, relax!

#10+1. Check this out…

Finally, Joshua Schwimmer’s (@KidneyNotes) stunning slideshow ‘Lifehacks for Doctors‘ is a must see.

Good luck going with the info-flow!

Further reading

Web 2.0 for Emergency Physicians

Efficient MD (aka Joshua Schwimmer) on Dealing with Information Overload, which discusses the approaches of medical blogger info-wizards Ves Dimov (@DrVes) (Clinical Cases and Images – How to deal with information overload from blogs, RSS, and Twitter?) and Bertalan Mesko (@berci) (ScienceRoll – Being productive online: Time management life hacks).

Smith R. What clinical information do doctors need? BMJ 1996;313:1062-1068 (26 October)

Other useful and interesting reads include:

• Altitude – Social Media Time Management: 9 Guiding Principles
• Dr Shock – When to check your e-mail?
• Harvard Business Blogs’ Tom Davenport – Why We Don’t Care About Information Overload
• Micropersuasion – Become a knowledge management ninja with Google Reader
• Shirky – Problem is filter failure, not info overload
• The New Atlantis -The Myth of Multi-tasking
• Think Simple Now – How to reduce Information Overload
• Wikipedia – Human multitasking and Information overload
• Zen Habits – Life coding: 9 ways to fight feature creep in our lives

Last updated: 27 November 2009

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