Issue: December 2019

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December 06, 2019
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Podcasts Driving a Revolution in Rheumatology Medical Education

Issue: December 2019
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When journalist Ben Hammersley coined the word “podcast” in 2004, he was attempting to put a name to the phenomenon resulting from the timely convergence of widely available MP3 player technology, inexpensive audio software and weblog culture — a renaissance of radio programs that could be downloaded and played at the listener’s convenience, anytime or anywhere.

Today, following a decade-long boom in the medium, podcasts have dramatically transformed the way in which listeners absorb information while keeping up with the demands of 21st century living: Always on-the-go. Podcast listenership continues to grow across the United States, with an estimated 51% of Americans having listened to at least one podcast, including 32% who listened in the past month, and 22% in the past week, according to Edison Research.

As the majority of listeners (74%) report they listen “to learn new things,” this uniquely flexible medium continues to grow its educational offerings — an opportunity for which a new generation of rheumatology providers are taking full advantage.

Podcasting has become mainstream in the medical field, valued as a resource to help filter through the vast amount of new research and topical issues physicians are bombarded with on a daily basis, as well as a medium for physicians to share their own experiences in the field, offering advice to others on how to manage the various stresses of the job. The move by several major medical journals — including The New England Journal of Medicine and the Journal of the American Medical Association — to launch their own companion podcasts has lent validation to this new educational venue.

 
Podcast listenership continues to grow across the United States, with an estimated 51% of Americans having listened to at least one podcast, including 32% who listened in the past month, and 22% in the past week, according to Edison Research..
Source: Adobe

Unique among the medical specialties, rheumatology providers have embraced this new medium, with dozens of rheumatology-focused podcasts now available to listeners. As the rheumatology workforce shortage hinders much of the one-on-one discussion among rheumatologists, podcasts may have provided an ideal way for isolated providers to stay abreast of the literature while fostering connections with the larger rheumatology community.

From bite-size chunks of current news to historical cases unraveled as medical mysteries to longform interviews, rheumatology podcasts are taking shape to meet the needs of listeners who want to keep learning and growing in the profession.

Education On the Go

Healio’s own rheumatology podcast, Rheuminations, is meant for a broad audience and does not require an extensive knowledge of the field, according to its host, Adam J. Brown, MD, associate staff physician in the department of rheumatic and immunologic diseases at Cleveland Clinic. Since its launch in July 2018, Rheuminations has garnered more than 25,000 unique downloads of its episodes.

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Adam J. Brown, MD
Adam J. Brown

“The podcast is designed to make it an easy listening experience so a rheumatologist or health care worker can listen to it on a drive, on the treadmill or wherever they go because time is valuable and it is becoming harder for people to read the journals and keep up to date with the field,” Brown said.

Rheuminations also offers a few different types of episodes. Scattered throughout are some history episodes — recent topics include rheumatic fever, gout and steroids — and interviews with experts on specific diseases, such as IgG4-related disease and inflammatory eye disease. However, the bulk of the episodes focus on interesting cases of rare diseases, framed as a medical mystery with Brown walking listeners through the case and then explaining the diagnosis and how it was reached.

Brown has grown to appreciate the storytelling aspect of these episodes and said he has been able to relax a bit over time and share more of his personality in the episodes to make them more engaging for listeners (on display in episode titles such as “Hypophosphatasia: One of the 4 Hs of bonepocalypse” and “An Inflamed Eye-Opening Interview”).

“There are not many rules for medical podcasts at this point so you can have more fun with it, make jokes, make it more engaging and entertaining, and that is what I like about podcasts,” he said.

Interaction and Discussion

The BMJ has been producing podcasts for the past several years, with a companion podcast to Annals of the Rheumatic Diseases a more recent addition in 2017, bearing the same name as the journal. The podcast format is used to highlight recent articles in the journal to give listeners a taste of the findings reported and use them as a jumping-off point for a broader discussion, Letícia Amorim, multimedia editor for BMJ, said.

“People will be invited to read the article more in detail if they want to, but the idea is that the podcast [episode] complements the article in a way,” she said. The target audiences are physicians studying or working in rheumatology, but Amorim noted that episodes are published with an awareness that anyone could come across them on a podcast app, so keeping a patient’s perspective in mind is important, particularly as self-education of patients has been on the rise in recent years.

Paul Studenic, MD, PhD, of the Medical University of Vienna, is a social media advisor for the journal and podcast who frequently contributes to episodes. He said that the Annals of the Rheumatic Diseases podcast allows the BMJ to reach a wider audience than the journal can do alone, because different people have different learning styles.

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“Some people are very much into reading, and reading is efficient for them. Others like discussions or highlighting certain areas either in a visual way or an audiovisual way,” he said. “With a podcast, you have the option to educate and train yourself on the run.”

Annals of the Rheumatic Diseases episodes typically focus on a topic that is covered in some way in multiple recent journal articles and then features a roundtable discussion of authors.

“Ideally, [episodes] should not just include one author and one interviewer but authors of several papers that have mutual data or conflicting data,” Studenic said.

A Different Take on Patient Care

Suleman Bhana

ACR on Air, the official podcast of the American College of Rheumatology, is one of the newest rheumatology podcasts to arise with just five episodes so far. While the podcast will feature some episodes about research on rheumatic disease, it will also fill a niche with episodes that break down legislative policies and practice management issues that affect patient care.

Suleman Bhana, MD, FACR, rheumatologist at Crystal Run Healthcare in Middletown, New York, and chair of the ACR’s Communications and Marketing Committee, helps to plan episodes and sometimes joins as a guest. Bhana told Healio Rheumatology that one of the major issues that ACR on Air will focus on is the effect of nonmedical barriers to patient care and the ways legislation can improve these issues.

While conducting a thorough physical examination on a patient is important, Bhana said, he hopes ACR on Air will help students and health care workers to understand more deeply that some of the issues that affect patients the most are not directly caused by disease. Similar to ACR’s social media outreach, Bhana said the organization hopes the podcast will make advocacy more accessible.

Serving Patients

Education with the general public in mind is much different than that for specialists in a particular field, and the Boston MedTalks podcast has been offering just that since 2017. Erica Neufield, senior director of marketing at Boston Medical Center, said the two greatest challenges for the podcast are making episodes interesting and making them useful.

“It’s really important that the podcast not be so clinical that somebody is not going to understand it,” she said. “It needs to be actionable in some way, whether [the listener is] finding more information online or making an appointment. It needs to be balanced so that it’s not giving out medical advice ... Those are the things we think about the most.”

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Typical episodes are 15 to 20 minutes, focusing on digestible information. Topics typically come from general public news, such as a Zika outbreak or flu season, new or growing services at the hospital and services unique to the hospital. A recent episode focused on rheumatology care because several new rheumatologists had just joined the hospital.

“We know it’s a disease [that is] prevalent in our patient population, and so it made sense to help give some education about why it’s important to seek treatment,” Neufield said.

From a marketing perspective, Neufield said the popularity of episodes has been difficult to predict or understand.

“The most surprising thing for us is that our most listened-to episode in two-and-a-half years is about volunteer services. We never would have expected it,” she said. “The other surprise is there doesn’t seem to be a pattern of what people like. We can see just as many listens and clicks on a podcast [episode] about life sustainability as we can about flu. I can’t say we have come up with a perfect formula except to continue to make them vary.”

Podcasts – The New Textbooks?

According to a 2014 survey, U.S. medical residents now spend more time listening to podcasts (35%) than reading textbooks (33.6%) with a majority finding podcasts more beneficial — 70% endorsed them as a mode of learning compared to 54.3% who endorsed textbooks.

“I think that podcasts and YouTube videos are going to be the way that people are going to learn in the future because it’s more engaging, it’s more accessible and it’s easier to keep up to date with the latest news,” Brown said.

A major benefit podcasts offer over textbooks is immediacy, he said, noting that he can release a podcast talking about a landmark study or announcement within a few days. Brown added that while textbooks typically present information in a straightforward manner, podcasts can bring more nuance, offering a forum for different experts to share opinions on topics like new medications. “I think that podcasts allow for a more diverse outlook on newer things coming out,” he said.

At the same time, Brown said, textbooks are still crucial for providing vetted information from a credible source. Anyone can make a podcast, so listeners need to be discerning.

Representing both a journal and a podcast, Amorim said she does not see one completely replacing the other any time soon: “I think those formats have their place. While I think there is still a place for the article and for detail and in-depth information, you may have that break in your day that you want some digestive information, and that is the gap that the podcast is filling.” She added, “There is something that is added when you listen to your peer or a person [whose thoughts] you value in the field. Listening to that conversation is perhaps more engaging than reading the paper from beginning to end. They are complementary formats and one does not exclude the other.” 

For now, podcasts are simply an additional avenue to share information and expand the discussion for people who enjoy learning.

“I think that podcasts are a valuable mode of education in health care, and I hope that people continue listening,” Brown said.– by Amanda Alexander

References:

  • Mallin M, et al. Acad Med. 2014. doi: 10.1097/ACM.0000000000000170.
  • Edison Research and Triton Digital. 2019. The Infinite Dial. Retrieved from https://www.edisonresearch.com/wp-content/uploads/2019/03/Infinite-Dial-2019-PDF-1.pdf

For more information:

  • Leticia Amorim can be reached at BMA House, Tavistock Square, London WC1H 9JP; email: lamorim@bmj.com.
  • Adam J. Brown, MD, can be reached at 9500 Euclid Ave. #A50, Cleveland, OH 44195; email: browna22@ccf.org.
  • Suleman Bhana, MD, FACR, can be reached at 155 Crystal Run Road, Middletown, NY 10941; email: mmcdonald@rheumatology.org.
  • Erica Neufield can be reached at Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118; email: jazmin.holdway@bmc.org.
  • Paul Studenic, MD, PhD, can be reached at Medical University of Vienna, Spitalgasse 23; email: paul.studenic@meduniwien.ac.at.

Disclosure: Amorim, Bhana, Brown, Neufield and Studenic report no relevant financial disclosures.