Effect of Interpolated Questions on Podcast Knowledge Acquisition and Retention: A Double-Blind, Multicenter, Randomized Controlled Trial

A Randomized Trial Assessing the Effect of Exercise on Residents' Podcast Knowledge Acquisition and Retention

PURPOSE

Podcasts are commonly used by residents as part of their learning, with many listening concomitantly with other activities (e.g., driving and exercise). The effects of exercise on learning are controversial, with some suggesting potential benefit and others suggesting impaired learning. This study examined whether exercise influences knowledge acquisition and retention among resident physicians listening to a podcast while exercising versus those with undistracted listening.

METHOD

This multicenter, randomized, crossover trial assessed emergency medicine residents across 5 U.S. institutions from September 2022 to January 2023. Residents were randomized to a group that listened to one 30-minute podcast while seated or a group that listened to a 30-minute podcast while engaging in 30 minutes of continuous aerobic exercise, with stratification by site and postgraduate year. Within 30 minutes of completing the podcast, they completed a 20-question multiple-choice test. They subsequently crossed over to the other intervention and listened to a different 30-minute podcast followed by another 20-question test. Each podcast focused on emergency medicine-relevant journal articles that had not been covered in journal club or curriculum at any sites. Residents also completed a 40-question delayed recall test with separate questions on both podcasts at 30 days.

RESULTS

Ninety-six residents were recruited for the study, with 95 (99.0%) completing the initial recall portion and 92 (97.0%) completing the delayed recall tests. No statistically significant differences were found between the exercise and seated cohorts on initial recall (74.4% vs 76.3%; d = -0.12; 95% CI, -0.33 to 0.08; P = .12) or delayed recall (52.3% vs 52.5%; d = -0.01; 95% CI, -0.22 to -0.19; P = .46).

CONCLUSIONS

Exercising while listening to podcasts did not appear to meaningfully affect knowledge acquisition or retention at 30 days when compared with listening while seated and undistracted.

'SurgTalk': The Educational Outcomes Associated With Development of a Surgical Podcast for Undergraduate Medical Students

OBJECTIVE

Educational podcast series are becoming increasingly popular as free open access medical education (FOAMed) resources, however, the educational benefit associated with their use is unclear. The aim of this study was to assess the educational outcomes associated with the implementation of a surgical podcast series for undergraduate medical students.

METHODS

Two conversational case-based podcast episodes were recorded covering 2 common surgical presentations. Final-year medical students were recruited prospectively in January 2023 and underwent a baseline multiple choice question (MCQ) test covering the material within the podcast episodes. Participants were then provided with the episode files through encrypted Google Drive links. Two weeks following baseline assessment, students repeated the initial MCQ test and completed a postpodcast reaction survey. Data were analyzed using a paired t-test, multivariable regression analyses, and simple descriptive statistics.

RESULTS

Fifty students were enrolled in the study. All participants undertook the baseline assessment. About 98% completed the postpodcast MCQ, while 94% completed the postpodcast reaction survey. All participants who undertook the reaction survey (n = 47) found the podcast helpful in explaining surgical concepts, 92% of participants found the podcast enjoyable to listen to. The most commonly reported activity undertaken while listening was "commuting/driving" (n = 24, 48%). The mean baseline MCQ score was 44.6%. The mean postpodcast MCQ score was 65.51%. There was a mean absolute increase in test score of 20.2% from baseline which was statistically significant (95%CI 14.67-25.6, p < 0.001).

CONCLUSION

Implementation of this podcast series was associated with a statistically significant improvement in mean test score from baseline, reflecting knowledge acquisition. There was a positive user reaction and students were able to listen while performing other activities. Further evaluation of the educational outcomes associated with podcast use, particularly the effects on knowledge retention and clinical competence, is required.

An Evaluation of Emergency Medicine Core Content Covered by Podcasts

INTRODUCTION

Podcasts are used broadly for learning in emergency medicine (EM); however, there is concern about the potential for knowledge gaps for learners who rely on podcasts for their learning. The extent to which EM podcasts cover the core curriculum of EM is not known; thus, we sought to quantify the extent to which podcasts represent the core content of our specialty.

METHODS

We performed a retrospective review of all EM podcast episodes published in 2019. All podcasts were given credit for the content they covered as it related to the 2016 American Board of Emergency Medicine (ABEM) Model of Clinical Practice in Emergency Medicine (EM Model). The primary outcome was a description of how podcasts represented the ABEM EM Model content topics compared to the topic representation of the ABEM Qualifying Exam.

RESULTS

We included 54 unique EM podcast programs and 1,193 podcast episodes. They covered 2,965 total EM Model core content topics. The topics most covered were "other" (which includes interpersonal skills and professionalism), procedures, and signs and symptoms. Musculoskeletal, hematology, and environmental each accounted for less than 1% of all topics covered. Almost three-quarters of podcast episodes covered other core competencies of the practice of EM.

CONCLUSION

Podcasts had a broad yet imbalanced coverage of the ABEM EM Model core content subtopics in 2019, with a notable coverage of other core competencies of the practice of EM. Learners, educators, and scholars should be mindful of these gaps and focus future work on exploring how podcasts should best be used in EM education.

How podcasts teach: A comprehensive analysis of the didactic methods of the top hundred medical podcasts

PURPOSE

Medical podcasts have grown in popularity, but little is known about their didactic methods. This study sought to systemically describe the pedagogical approach employed by the 100 most popular medical podcasts in the United States. This study also aimed to assess factors related to quality control and conflicts of interest in podcasting.

METHODS

The authors averaged the rank positions for Apple podcasts in the Medicine category in the United States from 06/01/18 to 09/30/20 to generate a list of the 100 highest-ranked medical podcasts. They developed and validated a categorization system of didactic methods based on Bloom's taxonomy and collected data on didactic methods, as well as podcast affiliation, target audience, format, advertising, continuing medical education (CME) offerings, and presence of a reference list or review process.

RESULTS

Of the 100 most popular medical podcasts, 91 are educational. Of those, 51 are podcasts intended for physician education (PIPEs) while 40 are intended for other audiences, including the general public, nurses, and physical therapists. Compared with podcasts intended for other audiences, PIPEs engage higher levels of Bloom's taxonomy (p < 0.001). Among PIPEs, 18 (35.2%) are affiliated with an individual, 16 (31.4%) with a company, and 12 (23.5%) with a professional journal. 38 PIPEs (74.5%) are targeted toward all levels of medical learners. PIPEs are significantly more likely to list references or have a peer review process in place (n = 37, 72.5% vs. n = 15, 37.5%, p = 0.001) and offer CME credits (n = 20, 39.2% vs. n = 2, 5.0%, p < 0.001) than podcasts intended for other audiences.

CONCLUSIONS

Medical podcasts employ a variety of didactic methods, including those ranked highly on Bloom's taxonomy. Unlike traditional medical education, PIPEs are commonly produced by individuals or companies and targeted to all levels of medical learners.

Enhancing Psychiatry Education through Podcasting: Learning from the Listener Experience

OBJECTIVE

Podcasts have recently been introduced into psychiatry education, despite limited evidence evaluating podcasting in medical education. PsychEd is an educational, publicly available podcast targeting junior learners in psychiatry. This study characterized PsychEd's listeners and the podcast's role in their education.

METHODS

The study involved a mixed-methods survey, followed by semi-structured phone interviews with respondents. There were 97 survey responders in total, of whom 9 participated in a telephone interview. Survey responses were coded as interval data and analyzed descriptively using statistical software. Interviews were transcribed and coded for emergent themes using a grounded theory model.

RESULTS

PsychEd listeners represented an interprofessional audience, with 46 respondents (48%) being physicians or physicians in training, and 34 (35%) being allied mental health professionals. All respondents (100%) rated the podcast as "helpful" or "very helpful" for general knowledge. Listeners were attracted to PsychEd for the auditory learning format, the opportunity to review existing knowledge, the focus on core topics, the Canadian expertise, and the presentation of "clinical pearls." Respondents highlighted valuable qualities of a psychiatry podcast: conversational, case-based, narrative approach, longer episodes (i.e., 30-60 minutes) as compared to other medical specialties, and a clinical focus. Furthermore, they identified podcasts as an opportunity for shared interprofessional curricula.

CONCLUSION

This study is the first to examine the motivations and experiences of listeners of a psychiatry educational podcast. The findings support existing literature on the benefits of podcasts in medical education. Future studies should explore the impact of podcasts on learning and behaviors.

Pediatric Emergency Medicine Podcasts: Current Status

Background: Podcasting has become a primary delivery model for medical content among various specialties. Although this model is still growing, it has become an essential tool for many learners, educators, and institutions. Because of this rapid growth, there is an unknown availability of podcasts for each specialty.

Objectives: This paper aimed to evaluate the podcasts currently available in the subspecialty of pediatric emergency medicine (PEM).

Methods: The investigators sought to evaluate the prevalence of PEM podcasts from the end-user's (medical students, residents, etc.) perspective. This was completed by performing a simple internet search using the term “podcasts in pediatric emergency medicine.” Using Google Search, the first 50 results were analyzed.

Results: For PEM, there were only eight podcasts found, five of which were active.

Conclusion: PEM podcasts in comparison to other specialties are currently underrepresented and lacking in this important resource. The authors call on PEM physicians, educators, and organizations to consider creating content in this educational space.

Learning Through Listening: A Scoping Review of Podcast Use in Medical Education

PURPOSE

To improve understanding of podcast use in medical education by examining current research on descriptive attributes and educational outcomes, highlighting implications of the current evidence base for educational practices, and identifying research gaps to guide future investigation.

METHOD

The authors conducted a scoping review, searching PubMed and Embase databases in June-July 2020 for English-language studies of audio-only medical education podcast use in undergraduate, graduate, and continuing medical education. The authors excluded studies without original data or with nonphysician data that could not be separated from physician data. From included studies, the authors extracted data regarding descriptive outcomes (e.g., podcast use, content areas, structure) and educational outcomes (classified using Kirkpatrick's 4 levels of evaluation).

RESULTS

Of 491 unique articles, 62 met inclusion criteria. Descriptive outcomes were reported in 44 studies. Analysis of these studies revealed podcast use has increased over time, podcasts are a top resource for resident education, and podcasts are being incorporated into formal medical curricula. Educational outcomes were reported in 38 studies. The 29 studies that assessed learner reaction and attitudes to podcasts (Kirkpatrick level 1) showed learners value podcasts for their portability, efficiency, and combined educational and entertainment value. The 10 studies that assessed knowledge retention (Kirkpatrick level 2) showed podcasts to be noninferior to traditional teaching methods. The 11 studies that assessed behavior change (Kirkpatrick level 3) showed improved documentation skills in medical students and self-reported practice change in residents and practicing physicians after listening to podcasts. None of the studies reported system change or patient outcomes (Kirkpatrick level 4).

CONCLUSIONS

Future research should focus on the optimal structure of podcasts for learning, higher-level outcomes of podcasts, and the implementation of podcasts into formal curricula. Podcasts may prove to be essential tools for disseminating and implementing the most current, evidence-based practices.

The Role of Educational Podcast Use Among Otolaryngology Residents

OBJECTIVE

Medical podcasts are becoming increasingly available; however, it is unclear how these new resources are being used by trainees or whether they influence clinical practice. This study explores the preferences and experiences of otolaryngology residents with otolaryngology-specific podcasts, and the impact of these podcasts on resident education and clinical practice.

METHODS

An 18-question survey was distributed anonymously to a representative junior (up to post-graduate year 3) and senior (post-graduate year 4 or greater) otolaryngology residents at most programs across the US. Along with demographic information, the survey was designed to explore the preferences of educational materials, podcast listening habits and motivations, and influence of podcasts on medical practice. Descriptive statistics and student t-tests were used to analyze the results.

RESULTS

The survey was distributed to 198 current otolaryngology residents representing 94% of eligible residency programs and was completed by 73 residents (37% response rate). Nearly 3-quarters of respondents reported previous use of otolaryngology podcasts, among which 83% listen at least monthly. Over half of residents changed their overall clinical (53%) and consult (51%) practice based on podcast use. Residents rank-ordered listening to podcasts last among traditional options for asynchronous learning, including reading textbooks and watching online videos.

CONCLUSIONS

While other asynchronous learning tools remain popular, most residents responding to this survey use podcasts and report that podcasts influence their clinical practice. This study reveals how podcasts are currently used as a supplement to formal otolaryngology education. Results from the survey may inform how medical podcasts could be implemented into resident education in the future.

Maximizing the Morning Commute: A Randomized Trial Assessing the Effect of Driving on Podcast Knowledge Acquisition and Retention

STUDY OBJECTIVE

Emergency medicine residents use podcasts as part of their learning process, often listening while driving. It is unclear how driving while listening to a podcast affects knowledge acquisition and retention. This study evaluated the knowledge gained from listening to podcasts while driving compared to that gained from undistracted listening.

METHODS

This was a multicenter, randomized, crossover trial among postgraduate year (PGY) 1 to 4 emergency medicine residents at 4 institutions. Residents were randomized with stratification by site and PGY level to listen to podcasts while driving first or sitting undistracted in a room first. Within 30 minutes of listening, they completed a 20-question test. They subsequently crossed over to the alternate intervention, serving as their own controls, and listened to a different podcast before completing a second 20-question test. Each of the podcasts was professionally recorded and based on 5 emergency medicine-relevant journal articles that had not been covered in a journal club or curriculum at any of the institutions. One month later, participants completed a delayed recall test composed of 40 new questions based on both podcasts. Questions were derived and validity evidence was collected prior to use. Data were compared using a paired-sample t test and ANOVA.

RESULTS

A total of 100 residents completed the initial recall tests, and 96 residents completed the delayed recall test. There was no statistically significant difference between the driving and undistracted cohorts on the initial recall (74.2% versus 73.3%) or delayed recall (52.2% versus 52.0%).

CONCLUSION

Driving while listening to a podcast does not meaningfully affect knowledge acquisition or retention when compared with undistracted podcast listening among emergency medicine residents.

Medical Podcasting in Low- and Middle-Income Countries: A Needs Assessment and Vision for the Future

Phenomenon: Physician shortages in low- and middle-income countries (LMIC) have led to increased interest in using e-learning tools for training. Organic digital education (ODE)-digital scholarship largely created outside of formal medical curricula-has increased in popularity over the past decade. Medical podcasting has become one of the most prominent asynchronous ODE sources for learners in high-income (HI) countries; there have been no previous attempts to characterize their use in LMIC. Approach: Listener data from a 2-year period from three major internal medicine podcasts-Bedside Rounds, Core IM, and The Curbsiders-were aggregated, 188 episodes in total. These data were subdivided into country by top-level domain, normalized by population, and grouped together by World Bank income levels and English-speaking status. This methodology was also repeated to compare individual episodes on topics more versus less relevant to learners in LMIC. Findings: Over a 2-year period, the three podcasts had a total of 2.3 million unique downloads and were listened to in 192 of 207 countries worldwide. Overall, 91.5% of downloads were in HI countries, with 8.2% in LMIC. A total of 86.1% of listens were in countries with English as an official or unofficial listed language, whereas 13.8% were in countries without. Normalized for population, listeners in HI countries represented 970.5 listens per million population compared with 12.4 per million in LMIC. An analysis of individual episodes by topic showed that material more relevant to learners in LMIC had significantly more listeners from these countries. Insights: Compared with other forms of ODE, medical podcasting has much lower uptake in LMIC. However, there are considerable opportunities for growth. Medical podcasters in HI countries should be aware of a potential global audience and should take concrete steps to ensure a diversity of content and to periodically audit their data. Medical educators in LMIC should consider podcasting as a potentially powerful form of teaching. International medical educational organizations as well as podcasting organizations should provide resources for educators in these countries.

Morning report for all: a qualitative study of disseminating case conferences via podcasting

BACKGROUND

Despite its long-established importance, diagnostic reasoning (DR) education has suffered uneven implementation in medical education. The Clinical Problem Solvers (CPSolvers) podcast has emerged as a novel strategy to help teach DR through case conferences with expert diagnosticians and trainees. CPSolvers has 25,000 listeners in 147 countries. The aim of this study was to evaluate the podcast by eliciting the developers' goals of the podcast, then determining to what extent they aligned with the listeners' actual usage habits, features they valued, and perceptions of the podcast.

METHODS

We conducted semi-structured interviews with 3 developers and 8 listeners from April-May 2020, followed by qualitative thematic analysis.

RESULTS

Three major developer goals with sub-goals resulted: 1. To teach diagnostic reasoning in a case-based format by (1a) teaching schemas, (1b) modeling expert diagnostic reasoning, (1c) teaching clinical knowledge, and (1d) teaching diagnostic reasoning terminology. 2. To change the culture of medicine by (2a) promoting diversity, (2b) modeling humility and promoting psychological safety, and (2c) creating a fun, casual way to learn. 3. To democratize the teaching of diagnostic reasoning by leveraging technology. Listeners' usage habits, valued features, and perceptions overall strongly aligned with all these aspects, except for (1c) clinical knowledge, and (1d) diagnostic reasoning terminology. Listeners identified (1a) schemas, and (2c) promotion of psychological safety as the most valuable features of the podcast.

CONCLUSION

CPSolvers has been perceived as a highly effective and novel way to disseminate DR education in the form of case conferences, serving as an alternative to traditional in-person case conferences suspended during COVID-19. CPSolvers combines many known benefits of in-person case conferences with a compassionate and entertaining teaching style, plus advantages of the podcasting medium - democratizing morning report for listeners around the world.

Residents' Perceptions of Effective Features of Educational Podcasts

INTRODUCTION

Educational podcasts are used by emergency medicine (EM) trainees to supplement clinical learning and to foster a sense of connection to broader physician communities. Yet residents report difficulties remembering what they learned from listening, and the features of podcasts that residents find most effective for learning remain poorly understood. Therefore, we sought to explore residents' perceptions of the design features of educational podcasts that they felt most effectively promoted learning.

METHODS

We used a qualitative approach to explore EM trainees' experiences with educational podcasts, focusing on design features that they found beneficial to their learning. We conducted 16 semi-structured interviews with residents from three institutions from March 2016-August 2017. Interview transcripts were analyzed line-by-line using constant comparison and organized into focused codes, conceptual categories, and then key themes.

RESULTS

The five canons of classical rhetoric provided a framework for thematically grouping the disparate features of podcasts that residents reported enhanced their learning. Specifically, they reported valuing the following: 1) Invention: clinically relevant material presented from multiple perspectives with explicit learning points; 2) Arrangement: efficient communication; 3) Style: narrative incorporating humor and storytelling; 4) Memory: repetition of key content; and 5) Delivery: short episodes with good production quality.

CONCLUSION

This exploratory study describes features that residents perceived as effective for learning from educational podcasts and provides foundational guidance for ongoing research into the most effective ways to structure medical education podcasts.