INTRODUCTION

I was born into a generation where communication included flicking the wheel of a rotary phone at my grandmother’s house to order pizza. Over 20 years later, I can use an app on my phone to order one without having to utter a single word. As the technological arts evolve, medical residency programmes with modern learners can evolve in ways that best utilise these advancements. Residency programmes can enhance its teaching and recruitment through these modern modes utilizing collaborative application such as Slack, Stitch and Mattermost.1^–3

Slack is a cloud-based team collaboration application that is commonly used in the business world for communication and better workflow. It allows the upload of documents and images, and it archives all direct messages and group conversations.1

On August 2016, our emergency medicine residency programme of over 70 residents and staff incorporated Slack as our main form of communication, coordination and information exchange. Unlike e-mail, discussions are organised into ‘channels’ that can include different members of the same group. Very quickly we found that this application allowed residents to share interesting cases, announcements and numerous documents. The application further allowed private channels, which we used for communication amongst residents only, chief residents and those involved in other committees.

As the medical student recruitment season approached, we looked to Slack to provide us with innovative and creative ways to recruit the best class of residents. A medical student channel allowed residents and staff physicians to communicate directly with all of the rotating students. In partnership with our robust medical student curriculum and social events, Slack enabled us to build relationships with the students while evaluating their competency through their discussions on the channels.

In the end, a brief survey of every medical student’s rotation allowed us to gauge how well this application was functioning as a recruiting tool. Of the 34 total responses collected, we found that the majority of students rated their experience with Slack as a 4 or 5 on a scale of 1–5 (1 being worst and 5 being best). The response rate was 85% (34 of 40), and comments included:

Slack is a nice app, it takes some time to learn, but once you do so it is a nice way to organize different threads.

Slack was interesting in seeing how residents and faculty interacted outside of work.

It seemed expedient for communications.

Yes, shows great relationships between attendings and residents/students. Open venue for conversations from medicine to fun.

SLACK was pretty helpful. I’m glad I had an opportunity to use it and see the discussions and would rather have access than not as a rotating medical student. It’s a very cool resource for bringing the whole department together to follow the flow of cases and questions that come through the ED. Only down side was that I’d never used it before so it took some getting used to.

It was great to see the threads on practice variations and interesting cases to hear about residents and attending’s experiences.

Despite the numerous advantages of Slack, our programme did encounter some challenges with implementing this system to visiting medical students. The major drawback was that all rotating students shared one account. This created some confusion regarding which medical student was posting messages. Another student felt intimidated asking or answering questions on Slack since the Programme Director and Assistant Programme Directors could view all messages.

Matching into a residency programme is becoming increasingly competitive. Students look to match into a programme that feels both like an inclusive community and challenges them academically. Building a community involves a sense of identity, trust, participation and reward.4 Slack allows medical students to participate fully in conversations involving interesting cases, medical management and practice variation. This past medical student recruiting season, our Emergency Medicine Residency Program successfully integrated a novel communication technology into academic activities with the use of Slack. We encourage other residency programmes to optimise their use of technology in order to attract the best applicant in a pool of modern learners.