Risk, probability and decisions in Emergency Medicine. St.Emlyn’s

This week we have released the first e-book from the St.Emlyn’s team. You can get the book in two different formats.

  1. Download the book from iTunes by clicking on this link
  2. Download the book in pdf format from Research Gate using this link.

Why have we done this?

Like many bloggers in the #FOAMed world we have found that content naturally falls into themes. For St.Emlyn’s these are clinical topics, the philosophy of EM, Evidence Based Medicine and Wellbeing. Within those major themes we also find topics that naturally fit together as is the case with this first book on metacognition for the emergency physician. Arguably this book started way back in 2013 at the first SMACC conference when I spoke on how we wrestle with risk in emergency medicine. That talk led to a series of blogs on clinical decisions in a probabalistic world. Those original topics work well with others from the St.Emlyn’s team who have a keen interest in the practice of emergency medicine, especially in the information light and time critical world of the resus room.

Where do e-books fit in the digital and social age of #FOAMed?

The simple answer is that we don’t really know as yet. One of the main attractions of blogs is the immediacy and relevance of their content. We believe learners increasingly use them (and they do) because they are accessible, relevant and interesting. That’s great of course, but books still have a permanence and connectivity with the reader, and within themselves (between chapters and sections) that is sometimes difficult to deliver using social media based platforms. I still read and treasure books in a way that is different to electronic resources (if you could see me now I am literally surrounded by hundreds of books). Marshal McLuhan famously said that the media is the massage and so as we repackage our content from blogs into e-books it will be interesting to hear whether the message and the experience changes. We think that it inevitably will change the experience, and it may even enhance it. Although we have based the book on our blogs we have edited the content in style and such that it flows better between sections.

We are not the first to this party, and we’ve been inspired by others such as the ALiEM and Simulcast teams who have led the way (and others too).

What’s this book about?

This first book focuses on decision making, arguably one of the most important core skills of medicine. In the acute specialities such as Emergency Medicine, Acute Medicine, Critical Care and Prehospital Care the complexities of clinical decisions are amplified by the time critical nature of our practice. We are often required to make decisions quickly, and also at a point in the patients journey when there may be significant uncertainty as to what the underlying cause of the patient’s injury or illness is. Those of us who operate in the time critical, information light world of the resuscitationist know that we are judged by the quality of these complex decisions. This is both an immense challenge, but also a huge privilege as those decisions can transform a patient’s clinical course. If you follow the St.Emlyn’s blog and podcast then you will already know this, but I would challenge you to stop and consider how much of your formal time in training has been spent on understanding risk, uncertainty, decisions and dilemmas? I suspect relatively little, which is arguably surprising, considering its importance. How do we learn these skills, and how did others develop them? A useful exercise is to stop and think about a colleague or teacher who exhibits that elusive quality of ‘great clinical judgement’. How do you think they developed those skills? It’s likely a combination of practice, reflection, feedback, review and time, but it did not come without effort or study. At St.Emlyn’s we’ve always believed, that by thinking about thinking (meta-cognition), we can improve our understanding of clinical practice and thus become better clinicians. This book is an introduction into how we do this.

If you want to go right back to the beginning then you can watch this presentation from SMACC in 2013. It covers some of the content from chapter 1.

How do I cite this book?

Carley S, Beardsell I, Body R, May N, Carden R, Gray C. Risk, probability and decisions in Emergency Medicine. [Internet]. Carley S, Liebig A, editors. Available from: https://itunes.apple.com/us/book/risk-probability-and-decisions-in-emergency-medicine/id1312424398?ls=1&mt=11

What next?

We have several other books planned around the four themes of St.Emlyn’s. We hope you read them, enjoy them and please do share them with friends and colleagues who may not be engaged in the #FOAMed world, but who may want to read in another format. It’s a lot of work to put these together but we think it’s going to be worth it. Of course if you have ideas that you’d like to share with us for future titles then please get in touch and let us know.




Before you go please don’t forget to…

Cite this article as: Simon Carley, "Risk, probability and decisions in Emergency Medicine. St.Emlyn’s," in St.Emlyn's, November 16, 2017, https://www.stemlynsblog.org/risk-probability-decisions-emergency-medicine-st-emlyns/.

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