SMACC: Flipping the Medical Conference

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Social media-driven conferences like SMACC may represent a fundamental shift in how medical education meetings will be conducted in the future.

Emergency providers are gearing up for another American College of Emergency Physicians (ACEP) Scientific Assembly in DC, looking forward to lectures by prominent emergency medicine figures, touring the exhibition hall and innovation zone, and packed social events each night. That’s how EM conference culture has always been. However, there are signs that the framework for medical meetings may be changing completely.

Professional dancers and acrobats took over the stage in the center of an auditorium. At one point they balanced one another using only tools in their mouths while the audience turned on their flashing lights in coordinated fashion. No, this wasn’t a performance of Cirque du Soleil. It was the opening of the Social Media and Critical Care conference (SMACC) that took place in Berlin, Germany in June 2017. That’s right, moments after a stunning, acrobatic opener, a speaker shared clinical pearls on sickle cell disease and insights into the unconscious bias providers bring to clinical encounters.


Most, if not all, attendees were prepared for this non-traditional amalgam of entertainment and medical education. Its blend of entertainment, celebrity status, and profanity is perhaps the most common association people have with SMACC – and the source of its controversy. The flash and fanfare of acrobatics, choreographed music, and elaborate simulation, deemed by some as “rock star styling” let all attendees know that this isn’t your grandfather’s medical conference. However, the most innovative machinations of SMACC lay in the content and the mechanism of delivery.

Talk Like Ted
Unlike most conferences, SMACC conference delegates did not peel off into separate rooms following the plenary. The delegates stayed in the same auditorium, gazing at a single stage for the entirety of the conference. There were no parallel sessions and no choice of speakers or topics. This “single track” conference consisted mostly of short twenty minute talks with a few panel sessions and short interviews. This was quite a departure from the traditional medical conference schedule of multi-track sessions and 50-60 minute lectures.

Historically, lectures have functioned as a foundation to the medical education – from medical school to continuing medical education. Yet lectures are an inefficient way to transfer large amounts of knowledge and the efficacy of this model of medical education has been challenged. Medical conference lectures traditionally span 30-60 minutes despite controversial literature that shorter lectures may keep learners attention [2]. Although not studied specifically, if one believes in stereotypes, it’s possible that this shorter attention span applies even more to the emergency physician.


Lectures at conferences are getting shorter; even the Society for Academic Emergency Medicine conference has moved to truncated lectures. The Ignite! presentations at ACEP’s Scientific Assembly are shorter presentations designed to showcase junior presenters. Similarly, AAEM has included whirlwind Pecha Kucha talks in which presenters are constrained to 6 minutes and 40 seconds.

The University of Vermont College of Medicine recently announced that they have discontinued lectures and moved to a “flipped classroom” model of instruction [1]. This model, popularized by the Khan Academy and adopted by emergency medicine residency training programs across the country, involves students watching lectures or reading at home and then doing homework or discussing concepts in the class setting [3].

Unlike the University of Vermont, however, conference lectures are unlikely to disappear completely. This is not necessarily a bad thing. Presentations at SMACC may be perceived by some as being too “soft,” as they often revolve around clinical stories. Presenters are gifted the book “Talk Like Ted” as inspiration for their talks. While some presenters had traditional crowded PowerPoint slides, most presenters shared stories and pearls with a backdrop of simple, crisp slides with minimal text. This is intentional as the purpose of these lectures is not the traditional aim to transmit as much information as possible but rather to inspire audience members to become intrigued in a topic. The lectures are a springboard for future independent learning rather than a one stop shop for definitive information. It is likely that we will see lectures at medical conferences evolve and potentially be partially replaced by other activities.

Social Media-Driven Brands
SMACC was born out of the social medial movement in emergency medicine and critical care. Thus, it is not surprising that the social media drives the conference, from choice of speakers to audience participation during the conference. Dr. Salim Rezaie, emergency physician and founder of the emergency medicine blog REBEL EM has also started a conference based on his blog, which is slated to occur in May 2018. The creation of these conferences are responsive to the communities they serve. For example, Dr. Rezaie of the Rebellion in EM Conference noted a void in the continuing medical education circuit in Texas and decided to fill this using his social media prowess and brand he has established as a blogger and social media educator. Further, many of the individuals speaking at his conference were recruited, at least partially, due to their significant roles in the Free Open Access Medical Education (FOAM) social media movement.


Free and Open
Another novel aspect of the flipped conference is the content is often freely available to all online. At SMACC, the content from the lectures, rather than being proprietary, is released for free as FOAM throughout the following year. Thus, although the conference is expensive to attend, over the course of a year, individuals from around the world can access the same information without a fee. This is not surprising given the FOAM roots of SMACC but runs contrary to the model of most major medical conferences whereby virtual conference packages run more that $400. At the American Diabetes Association conference this year, audience members were asked to refrain from tweeting certain content from the conference, which caused a national frenzy regarding censorship and restriction to medical knowledge [7]. In contrast, ACEP organizes a team of emergency physicians with social media prowess to tweet to the point of De Quervain’s tenosynovitis, hoping to spread the innovation, research, and clinical pearls that presenters bring to the conference.

Loosen Your Tie, Make a Friend
The new breed of medical conferences doesn’t short shorten lectures – it substantively changes how they are delivered. There is no doubt that SMACC is designed to be entertaining and informal. Afterall, one lecture was titled “Endocarditis will also f&*k you up.” There was a clear sense of intimacy and familiarity among the delegates from around the world despite most people never meeting in person previously. This sense of closeness despite geographic disparities or virtual propinquity provided an easier avenue for networking. The delegates and presenters extended across the spectrum of medicine – physicians from anesthesia, critical care, and emergency medicine, social workers, nurses, and prehospital providers. This allowed networking and idea exchange across populations that work together daily but often do not learn and process together in the educational arena. This integration echoes recent trends in medical education to focus on the entire team of medical providers.

SMACC is deservedly a conversation piece, particularly for its party-like atmosphere. But it represents a new breed of social media-driven medical events that are fundamentally challenging mainstream continuing medical education. Some of these changes – like the use of dancers and acrobats – may not last. But other innovations on display are indicative of global trends in medical education. So, it seems that despite its reputation as an outlier, perhaps SMACC isn’t that far out.


  1. “Medical Student Education.”The University of Vermont. Available at: Accessed September 7, 2017
  2. Wilson K, Korn JH. Attention During Lectures: Beyond Ten Minutes. Teaching of Psychology. 2017; 34:2, 85-89.
  3. Lew EK. Creating a contemporary clerkship curriculum: the flipped classroom model in emergency medicine. Int J Emerg Med. 2016;9(1):25.
  4. Rose E, Claudius I, Tabatabai R, Kearl L, Behar S, Jhun P. The Flipped Classroom in Emergency Medicine Using Online Videos with Interpolated Questions. J Emerg Med. 2016;51(3):284-291.e1.
  5. Young TP, Bailey CJ, Guptill M, Thorp AW, Thomas TL. The flipped classroom: a modality for mixed asynchronous and synchronous learning in a residency program. West J Emerg Med. 2014;15(7):938-44.
  6. Heitz C, Prusakowski M, Willis G, Franck C. Does the Concept of the “Flipped Classroom” Extend to the Emergency Medicine Clinical Clerkship? West J Emerg Med. 2015;16(6):851-5.
  7. A Perfect Twitter Storm: Why Is the ADA So Anti–Social Media? June 11, 2017. Available at


Dr. Westafer  is an emergency physician and research fellow at Baystate Medical Center. She is the author of The Short Coat.

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