Captain Question Strikes Again!


Sit back, relax, and remember. You’re at a conference and a speaker has just given a reasonably interesting talk on something relevant to your speciality. You’ve listened and learned a few new things, heard a couple of surprising facts that you’re going to go away and think about. You’re just pulling out the conference program to see what’s up next and then the moment happens. The session chair invites questions…….


Captain **&*%%&&ing Question puts his hand up again and you can’t quite believe it. He’s asked some form of stupid, irrelevant, annoying, self-focused question to every speaker in the session thus far. You scan the room for another hand, you pray that someone else, anyone else will think of something to say, to ask, something interesting relevant and useful to you or anyone else in the audience. You meet the session chair’s eyes as they scan past yours and in that brief moment you realise that you are on the same search, but neither you nor he find a palm of hope in the auditorium. Slowly, sadly, reluctantly the chair turns to the raised hand and utters the request for the microphone to be handed to Capt. Question. He take it in his raised hand, brings it to his lips and utters the immortal words that dishearten all hypo-caffeinaemic delegates..

‘Thank you for that talk. I have 3 questions and a comment. Interestingly, in my experience, and based on a study I did 2 years ago I think you will find that……….’

Lightning_in_ArlingtonAt that moment a bolt of lightning defies the laws of physics and appears in the auditorium striking from the rafters to the very spot where Capt. Question sat. As the smoke clears the audience cheer and moves rapidly for the exit and coffee. Capt. Q has demised, perhaps by divine intervention and as the crowd leave they discuss the paradoxical feelings of relief and shame inherent in their Schadenfreude.

Do you know a Captain Question? I’m sure you do, I certainly do and in all honestly I suspect that there have been times when I’ve worn that uniform myself (weekends only) but we should be able to do better. Conference questions are a tradition in medicine and it’s unlikely that we will be able to abandon them at any time in the near future, so let’s think about how we might do better.

I recently embroiled Rob Rogers and myself in a bit of a viral episode on twitter when I tweeted a tongue in cheek guide to asking conference questions.

It was clearly designed to be an amusing aside between friends, but it clearly hit a chord with the world. To date the algorithm has been retweeted, modified and retweeted again over 1000 times nearly burning out Rob’s twitter account in the process. An updated version of the algorithm is shown below and please feel free to use this in any talk or conference you attend, it may get a laugh and perhaps it might stop Captain Question in his tracks.

Screenshot 2014-05-09 10.50.21

So, that’s a bit of fun around a serious point. Time is precious for all of us and time in conferences where we can learn, interact and network is precious, too precious for it be wasted by irrelevant self centred questions, but it’s not enough for us to just complain and poke fun. We need to do this differently. We need to find a way of making sure that everyone has an opportunity to ask questions, that they are relevant, that they can be managed as part of a conference program and for us to hope that they will add value for everyone and not just to the person asking the question.

Is social media the bullet to fell Capt.Q?

SMACC have led the way in incorporating social media into conference questions. I’ve used their ideas as a speaker, questioner and as a session chair and I’m a big fan. Here’s how it works.

  • 1. Session chair announces in advance that questions will only be taken via twitter.
  • 2. A session hashtag is announced (this allows questions specific to the session to be easily found). e.g for a session on cooling post arrest at the CEM conference you might choose #CEMTTMQ
  • 3. You need a separate ‘twitter monitor to assist the session chair. It’s too much for the chair to do both.
  • 4. The twitter monitor selects questions for the chair to ask.
  • 5. The chair asks the question on behalf of the questioner, ideally also identifies individual in audience so the speaker an direct the answer to them (that’s polite).

There are clear advantages to this approach. It allows a degree of control and avoids the truly irrelevant conversations but there are potential disadvantages such as these.

  • 1. You have to have a twitter account! Not everyone has an account and that may disenfranchise some delegates (though this is a diminishing problem).
  • 2. The chair may paraphrase the question and get it wrong. Having said that questions should be clear if confined to 140 characters. If they are not clear then they are probably not a great question.
  • 3. The chair/monitor choose questions that ‘they’ think are important and that may not reflect the views of the audience. I don’t worry too much about this as it’s progress over an unfiltered approach from the random questioner. Consider it peer review 😉
  • 4. Twitter attracts lots of questions and they cannot all be asked, but that’s no different to a real audience and that’s what the coffee break is for!

So, there are potential disadvantages, but on balance and having experienced the twitter solution to Capt. Question I’m a fan, and if like me you have experienced the burning hate of the irrelevant questioner you should really give it a try.

Simon Carley

How to Make Journal Club Work

As part of a drive to create asynchronous learning resources for the SMACC Education Workshop, Chris Nickson talked to Simon Carley to find out ‘How to make Journal Club work”. It also ties in nicely with the SMACC EBM Workshop that Simon is running. They cover the objectives, structure and setting, the people involved, content and conduct, tech and resources to help with journal club and what the oucomes should be.
Check out Simon’s St. Emlyn’s post on Journal Clubs for an introduction.

Key Journal Club references

  • BMJ Careers, 2011: Are journal clubs an essential tool for postgraduate education? Yes by Sophie Cook [Free Full text] No by Helen MacDonald [Free Full Text]
  • Deenadayalan Y, Grimmer-Somers K, Prior M, Kumar S. How to run an effective journal club: a systematic review. J Eval Clin Pract. 2008 Oct;14(5):898-911. doi: 10.1111/j.1365-2753.2008.01050.x. Review. PubMed PMID: 19018924. [Free Full Text]
  • Patil P. Establishing an Effective Journal Club: A Postgraduate Educational Tool.Education In Medicine Journal, 2013 5(3). doi:10.5959/eimj.v5i3.134 [Free Full Text]
  • Pitner ND, Fox CA, Riess ML. Implementing a successful journal club in an anesthesiology residency program. F1000Res. 2013 Jan 16;2. doi: 10.12688/f1000research.2-15. PubMed PMID: 24358844; PubMed Central PMCID: PMC3752701.

Also, this is the iTeachEM post on NB that was mentioned in the podcast for collaborative document annotation: NB Helps Flip the Classroom

Free websites with journal club archives

Useful critical appraisal resources

Come meet Simon and the iTeachEM team at smaccGOLD.

Vive la FOAM!


Carley on FOAM and Education

Simon Carley (@EMManchester), Professor of Emergency Medicine in Manchester and fearless leader of the StEmlyn’s blog team, is an education powerhouse. Regular iTeachEMers will know that he gave two profoundly interesting talks at SMACC last March.

Here is the video footage of these two inter-related talks. In the first, Educational Leadership and Subversion he explores the emergence of FOAM as a way of learning, focusing on the role of Leadership. In the second talk — Anarchy in the UK — he praises the virtues of anarchy as he talks about his, and the StEmlyn’s, journey into FOAM from a UK perspective.

Educational Leadership and Subversion

Anarchy in the UK


Slides and audio for the latter talk are here on StEmlyn’s.

The Future of Education at SMACC


All the talks from SMACC are being released on the SMACC podcast and we’ve finally reached the end of the first of the three days. Day One finished with a fascinating plenary session on the ‘Future of Education’. From my point of view, it was awesome to be able to get a bunch of brilliant people together and have them talk about stuff I wanted to hear about.

If you’re into medical education and FOAM, you won’t want to miss out on any of the plenary:

I should also mention that even before the plenary began there was this two hour session on FOAM as it is, including its challenges and pitfalls:

  • SMACC FOAM Q/A — a bunch of hardcore FOAMers got together for a Q&A session on all of its facets — with audience participation, of course. It features Scott Weingart of EMCrit, Joe Lex of Free Emergency Medicine Talks, Simon Carley of StEmlyns, Minh Le Cong of PHARM, Oli Flower of ICN as well as Mike Cadogan and yours truly from LITFL and iTeachEM.

Subscribe to the SMACC Podcast on iTunes. Vive la FOAM!