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I recently learned of something in educational theory that lead me to a small epiphany: threshold concepts.

Critical care specialties are full of threshold concepts.

What is a threshold concept?

The idea of a threshold concept in learning was first introduced by Meyer and Land¹, focusing on economics education. They described this as concepts that "...once understood, transform perception of a given subject."

A threshold concept provides a gateway to a greater, more in-depth understanding of an area – but is often difficult to master. Meyer and Land described a threshold concept as having:

"...the notion of transformation (in which students change the way they perceive and practice aspects of their discipline), irreversibility (once learnt rarely forgotten or 'unlearnt'), integrative (whereby connections are made to concepts or knowledge of previously unknown or concealed areas), bounded (in that they help define the boundaries of a subject area) and potentially troublesome." K. Connan (2014)

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Anesthesia and Analgesia's companion journal Anesthesia and Analgesia Case Reports is now indexed by metajournal, after being requested by our users.

A & A Case Reports has only been around since October 2013, after spinning off from the prestigious Anesthesia & Analgesia. It is now a standalone publication "...devoted exclusively to publishing cases that are educational and unusual."

You can jump in a browse the latest from A & A Case Reports among our indexed journals.

UPDATE:

Anesthesia & Analgesia has now evolved A & A Case Reports into A & A Practice – naturally, also indexed by metajournal!

Wow. Last week metajournal quietly indexed it's 500,000^th article!

We now track over 100 journals related to critical care specialties: anesthesiology, emergency medicine, intensive care and pain medicine.

Everyday metajournal indexes, qualifies and assesses new articles published not just in these journals, but also the highest quality articles that are related to articles from these journals, regardless of where they are published.

This ensures that if a quality, significant and personally relevant article is published outside the core specialty journals that you follow, metajournal will still recommend the article to you.

Incredibly, only 9 months ago metajournal was celebrating indexing it's 50,000^th article. Grow on!

To welcome in the new year, metajournal quietly rolled-out a big update to the machine learning magic that is the foundation for recommending quality, significant and personally relevant papers to you based on your professional medical interests.

The metajournal Collective Intelligence Engine, is the secret sauce that integrates evidence with your own interests, along with topics that other clinicians in your specialty are following and interested in.

Not only does metajournal look for quality articles that are relevant to the Topics and Journals that you follow – metajournal is now smart enough to follow your article reading behavior.

As you read and favorite papers and abstracts, metajournal learns more about the types of articles that you find most interesting and relevant – the topics, the authors, the journals, and many many more features. Metajournal will even recommend particularly relevant papers that are outside your followed journals, reducing the chance that you miss something truly important.

Metajournal is also smart enough to understand which articles you do not find interesting – simply click the not interesting... link under an abstract and metajournal will grow a little wiser by understanding what is not relevant to you.

The best way to get the most out of metajournal's growing intelligence is simply to teach metajournal more about what interests you: follow interesting Topics, click through to Read interesting abstracts and Favorite the most interesting papers, and when metajournal suggests Not interesting... articles – click the link to tell it!

When browsing your articles page you may have noticed a new link: trending articles.

Trending articles gives you a glimpse into which papers the rest of the metajournal community, with similar clinical interests to you, are reading, sharing and studying.

These are not necessarily the latest or most recent articles, but rather those that currently most interest metajournal users who follow the same journals as you.

Next to the trending tab, you will also find a link to the latest articles - showing the newest articles published from all the journals that you follow in your metajournal account. This is a great way to dip your toe into the waters of the latest published research in your field, browsing through the freshest and newest papers.

Between metajournal's article suggestions, trending and latest articles, you will be certain to find something that not only interests you – but also improves your practice.