CLINICIAN'S CAPSULE
What is known about the topic?
Podcasts are used broadly by emergency clinicians for education.
What did this study ask?
How and why podcasts are used by emergency medicine and critical care clinicians?
What did this study find?
Participants most frequently listened to medical podcasts to review new literature, learn core material, and refresh memory; few utilize active learning strategies, and most conduct other activities while listening.
Why does it matter to clinicians?
Learners may consider utilizing active learning techniques while listening to podcasts; podcast producers may encourage the use of active learning techniques.
INTRODUCTION
Educational podcasts have become popular platforms for teaching and learning in medical educationReference Cadogan, Thoma, Chan and Lin1,Reference Cho, Cosimini and Espinoza2 and are one of the most-utilized educational resource among emergency medicine residents.Reference Purdy, Thoma, Bednarczyk, Migneault and Sherbino3,Reference Riddell, Swaminathan and Lee4 However, it is unclear how they are used or if they could be used most effectively for learning. The educational literature provides broad support for the superiority of active learning.Reference Prince5 The inherently passive nature of podcasts may limit their effectiveness.Reference Zanussi, Paget, Tworek and McLaughlin6 Few studies have explored nuanced listening behaviours such as whether listeners use active learning methods such as note-taking, pausing, or repeating segments for processing.Reference Hargis, Schofield and Wilson7,Reference Scutter, Stupans, Sawyer and King8 Given the scant work done to characterize the use of podcasts by a broader group of practicing clinicians and the uncertainty around the active use of podcasts, we sought to characterize usage patterns and listening behaviours of an international cohort of emergency medicine and critical care clinicians.
METHODS
We performed a cross-sectional survey to determine how podcasts are used by emergency and critical care clinicians recruited through a multimodal online sampling strategy. The study was exempted from ethical review by the Research Ethics Board at the University of Saskatchewan (BEH 17-170).
Our international authorship team aimed to recruit an international sample of participants. After a literature review, two authors (BT and SG) developed survey questions in accordance with current best practices in survey design.Reference Artino, La Rochelle, Dezee and Gehlbach9 Five other study authors with experience in medical podcasting reviewed and edited the questionnaire to ensure relevance to the constructs of interest. The survey was piloted by the authors of FluidSurvey software in August 2017. The pilot resulted in minor modifications to the survey, including adding questions, shortening the number of questions per survey page, and refining of the wording of existing questions.
We followed the Medical Education Translational Resources: Impact and Quality (METRIQ) Study's participant recruitment process to recruit a cohort of emergency clinicians who listen to podcasts.Reference Thoma, Paddock and Purdy10 This included sharing an infographic (Appendix A) on email, Facebook, and Twitter; using the #FOAMed hashtag on Twitter to target a virtual community of emergency and critical care clinicians; and recruiting from our personal networks using email. We also invited collaborators from a previously published series of METRIQ studies using email.Reference Thoma, Paddock and Purdy10
Recruitment material directed prospective participants to an intake form (Supplemental Material Appendix B) hosted at https://METRIQstudy.org. The intake form collected the name, email, profession, and level of training of prospective participants. Its completion was considered an expression of interest in the study. A link to the study survey was sent to prospective participants within 24 hours of completing the intake form. Reminder emails were sent every 1–2 weeks, up to a maximum of four times. The initial email was sent by SG, and follow-up emails were sent by BT. To incentivize participation, participants who completed the METRIQ podcast study were acknowledged as collaborators.
Participants formally enrolled in the study by completing a form at the beginning of the survey (Supplemental Material Appendix C) that contained the study consent. Raw survey data were exported from FluidSurveys, and descriptive statistics were calculated using Excel (Microsoft Corp., Redmond, WA, USA).
RESULTS
Recruitment occurred between September 10 and December 9, 2017. The survey remained accessible until March 8, 2018. Four hundred fifty-seven health care professionals expressed interest: 394 (86.2%) formally enrolled, and 390 (85.3%) completed the survey. The average age of the participants was 33.3 years (standard deviation [SD] 8.8), with a slight male predominance (54.8%) (Supplemental Material Appendix D). While most were from North America (68.7%), participants represented 34 countries. A majority (59.4%) of study participants (attending physicians, nurses, paramedics, and physician assistants) represented populations whose use of medical podcasts had not been described previously. Non-physicians (nurses, paramedics, and physician assistants) comprised 31.7% of the population. A minority (9.7%) of participants managed, owned, or operated their own podcast. Most listened to podcasts at least monthly (79.0%).
Participants cited multiple reasons why they listened to medical podcasts. There was significant overlap in those who used them to review the literature (75.8%), learn core material (75.1%), and refresh memory (71.8%). Inspiration (45.5%), entertainment (40.7%), and connecting with the community (36.4%) were also cited as reasons for listening by a minority of participants.
Most (93.6%) participants performed other activities while listening. Driving (72.8%), exercise (39.7%), and chores (39.2%) were the most frequent activities (Table 1). The use of active learning strategies was variable. Few participants took notes while listening (69.5% never; 23.1% “about one-fourth of the time”). Many (60.3%) reported pausing podcasts at least one-fourth of the time, but this was most often because they were interrupted (72.5%) and only rarely to allow processing of content (45.3%) or memorization (16.0%). Replaying parts of podcasts was more common than replaying entire episodes.
Table 1. Podcast listening habits
Despite the finding that most (61.8%) of the participants were aware that they could change the listening speed of podcasts, just under one-quarter of participants (23.1%) did so, with most (76.1%) opting to listen at 1.0× (normal) speed.
DISCUSSION
This study aimed to focus future research by understanding how and why emergency and critical care clinicians consume podcasts for education. It is unique among the few descriptive studies on related topics that have been published both because of its international and interprofessional participant pool and its investigation of how clinicians are using podcasts.
Our findings may help medical educators and podcast producers to understand their learners and listeners better in the domains of demographics, concurrent activity, motivations for listening, frequency of consumption, and active learning strategies employed. The results suggest that medical content focused on reviewing and learning clinical material is extremely important. Consistent with developing theories on the role of educational entertainment,Reference Moyer-Gusé11 a subgroup of participants endorsed a desire to be inspired and entertained. The finding that greater than one-third of participants listened to podcasts to foster a sense of community may have been inflated by our recruitment methodology, which specifically sought out participants in a community of practice. However, it is consistent with qualitative explanations of the listening motivations of residents.Reference Riddell, Robins and Brown12
While most participants listened with the goal of learning from podcasts, this contrasted with their behaviours while listening. It is likely that unrecognized inattention while conducting other activities is detrimental to retention. Only a minority used active learning strategies that could aid retention (e.g., note-taking, pausing, repeating segments, and repeating episodes).Reference Prince5–Reference Scutter, Stupans, Sawyer and King8 Research exploring the impact of concurrent task completion and active learning techniques on the retention of podcast content is needed. For now, listeners could consider trying these techniques while podcast producers could encourage them within their recordings.
As a survey-based study with a social media–based recruitment strategy, our results have numerous limitations. This is the largest study to date on this topic and the only one to include multiple professions and an international sample. However, we could not calculate a traditional response rate because of the recruitment methodology,Reference Thoma, Paddock and Purdy10 and the characteristics of the population of interest (emergency and critical care clinicians who listen to podcasts regularly) were not available to compare with our sample. As 9.7% of our participants managed, owned, or operated their own podcast and a significant proportion were recruited from the authors’ personal networks, the sample might not have been representative of this group. Finally, our sample was limited to those with English-language proficiency who resided in countries with enough internet bandwidth to allow for podcast downloading or streaming. This likely contributed to the high proportion of participants from developed, English-speaking countries.
CONCLUSION
Emergency clinicians use medical podcasts predominantly for learning. Most perform concurrent tasks, and few utilize active learning strategies. Several active learning techniques were used by a minority of participants that could be adopted more broadly and encouraged by podcast producers. Further exploration of the effectiveness of these techniques should be explored.
SUPPLEMENTARY MATERIAL
The supplementary material for this article can be found at https://doi.org/10.1017/cem.2019.427.
Acknowledgement
The authors would like to acknowledge Annet Alenyo Ngabirano and Katie Knight for their assistance with participant recruitment.
Competing interests
SG received a Dean's Summer Research Project Grant from the University of Saskatchewan to support his contributions to this work. Several of the authors currently or previously contributed to emergency medicine podcasts. None were compensated for their work on these podcasts.
APPENDIX: The METRIQ Podcast Study Collaborators (in alphabetical order by last name)
Peter Agaba, Mohammed M Aldawood, Mohammed Makki Aldawood, Mathew Alex, Salma Ali, Laura Allan, Mohammed Almuhanna, Ashwini Amaratunga, Jeremy Amayo, Natalie Anderson, Omar Anjum, Mads Astvad, Arden Azim, Patrick Bafuma, Michelle Bailey, Steve Baker, Kimberly Baldino, Joanna Banaszek, Alex Barber, David Barton, Alan Batt, Rachel Baumgartner, Jared Baylis, Taylor Bechamp, Stéphanie Beckett, Chris Bell, Antônio Felippe Benini, Temesgen Beyene, Meghan Bhatia, Richard Biedermann, Märta Björling, Jessica Blackbourn, Michael Blanchard, Iria Miguens Blanco, Brandon Blondeau, Bryan Boling, Andrew Bowman, Emma Bradshaw, Victoria Brazil, Ian Breden, Page Bridges, Joshua Britton, Robert Bruce, Ineke Brummer, Wisarut Bunchit, Kevin Burns, Mike Butler, Alan C. Taylor, Avery Callahan, Federico Carini, Christina Castillo, Ryan Chadwick, Christie Wing Long Chan, Kathryn Chan, Teresa Chan, Alvin Chin, Rachel Christian, Alex Christiansen, Alyssa Cocchiara, Isabelle Colmers-Gray, Joe Colucci, Roberto Cosentini, Stefan Cowtan, Avery Crocker, Henry Cullen, Andrew D'alessandro, Bagonza I Kenneth Daniel, Aaron Danielson, Christi Denton, Alixe Dick, Susana Garcia Diez, Tatjana Dill, Matt Dionne, Anthony Doherty, Danielle Donoghue, Maia Dorsett, Dr Doug Lynch, Hugo Dowd, Philippe Dubuc-Gaudreau, Taylor Duda, Justin Dueweke, William Dunkerley, Kevin Durr, Marcia Edmonds, Sylvia Egels, Kirsty Ellis, Elaine Erasmus, Rebecca Erker, Caley Flynn, Mark Frederikse, Ushira Ganas, Joe Ghorayeb, Siew Pei Goh, Mark Goichman, Amanda Goodfellow, Puja Gopal, Michael Gottlieb, Paul Grinzi, Andrew Grock, Tanner Gronowski, Catriona Gunn, Adrianna Gunton, Andrew Hall, Benjamin Hardy, Lukas Hashem, Erfun Hatam, Philip Hehn, John Heisler, Chloe Henley, Suelin Hilbert, Sakura Hingley, Amy Ho, Nicholas Hochfelden, Brenden Hoff, Caroline Hoogerheide, Dirk Houtman, Lamont Hunter, Qasim Hussain, Elizabeth Namugaya Igaga, Pholaphat Charles Inboriboon, Aaron Inouye, Irene Ostapowich, Palbha Jain, Jesse Jamieson, Pieter Jan, Suneth Jayasekara, Dayna Jaynstein, Maria Jirwe, Levi Johnston, Will Johnston, Kalanzi Joseph, Clint Kalan, Kelly Kaley, Drew Kalnow, Annika Kamberelis, Ramya Kancherla, Aravind Kashyap, Gerben Keijzers, Catherine Kerr, Jaasmit Khurana, Jerry Kim, Katie Knight, Lisa Knijnenberg, Justin Koh, Melodie Kolmetz, Daniel Korpal, James Kozak, Alexander Krois, Ivanna Kruhlak, Natalia Krupin, Michael I Kruse, Stephen Kydd-Hindelang, Simon Lainh, Chip Lange, Bryan Laviolette, Jacqui Le Geyt, Andrew Leach, Jennifer Leckie, Charles Lei, Edgar Lei, Vivian Lei, Haakon Lenes, Nilantha Lenora, Mason Leschyna, Tim Leung, Ian Lewins, Resa E Lewiss, Winny Li, Kelly Lien, Brodie Lipon, Andrew Little, Jonathan Little, Steve Liu, Megan Loucks, Stephanie Louka, Jessica Gy Luc, S. Luckett-Gatopoulos, Kristopher Maday, Sonali Mantoo, Paige Mason, Rebecca Maxwell, Cian Mcdermott, Michael Mcdonnell, Jonathan Mcghee, Sean Mcintosh, Susan Mclellan, Amy Mcnaughtan, Carolyn Mcquarrie, Katie Mcpadden, Therese Mead, Patrick Meloy, Maartje Melse, Donna Mills, Brendan Moore, Justin Morgenstern, Lee Morissette, Sarah Mott, Pinaki Mukherji, Lisa Murphy, Victoria Myers, Vanessa Naidoo, Gabriel Najarro, Meera Nariadhara, Annet Alenyo Ngabirano, Dan Nguyen, Taylor Nikel, Anton Nikouline, Mais Nuaaman, Sean Nugent, Dayle Ostapiuk, Nadine Ouderkirk, Rob Paquin, Alim Pardhan, Ravi Parhar, Quinten Paterson, Christine Patterson, Caroline Chandler Pedrozo, Gina Pellerito, Brock Phillips, Sarah Plante, Zoe Polsky, Dawn Prall, Michael Prats, Joel Privé, Gregor Prosen, Henrique Alencastro Puls, Vishal Puri, Chichen Qiu, Tanis Quaife, Md, Salim R. Rezaie, Dillan Radomske, John Reagan, Elissa Remmer, Jeff Riddell, Milan Ridderikhof, Jamie Riggs, Brendan Riordan, Doreen Rivera, Isabel Rizor, Genevieve Robinson, Damian Roland, Kaye Rolls, Stuart Rose, Keith Rosenberg, Kyle Roshan Wong, Paul Ross, Brenda Ruberto, Evan Russell, Mackenzie Russell, Syed S Ahmed, Abdul Sattar Abdul Safras, Eleni Salakidou, Erin Sandilands, Michelle L Santos, Alan Sazama, Owen Scheirer, Rebecca Schulman, Paul Schunk, Makamu Sebakeng, Ashley Selvig, Cornelius Sendagire, Alex Senger, Parisa Shahrabadi, Julia Sheffield, David Sheps, Jack Shier, Seyara Shwetz, Mansoor Siddiqui, Teresa Siefke, Sarah Simons, Adam Singer, Gabilan Sivapatham, Shyam Sivasankar, Sarah Skolfield, Sam Smith, Paula Sneath, Cassandra Sobkiw-Kurtz, Robert Soegtrop, Peter Speare, Jan Spicer, Anna Spinaze, Adrienne Stedford, James Stempien, Britni Sternard, Brittany Stewart, Katie Stuart, Danielle Swart, Colleen Sweeney, Henry Swoboda, Andrew Tagg, Christopher Tait, Nikhil Tambe, Elisha Targonsky, Michael Taylor, Robert Taylor, Luis Eduardo Vargas Téllez, Brent Thoma, Brent Thoma, Megan Thoma, Adam Thomas, Gareth Thomas, Liam Thorley, Gerhard Tiwald, Sydney Todorovich, Meriel Tolhurst-Cleaver, Luz-Patricia Torres, Max Tory, Charlene A Traynor, Seth Trueger, Troy Turner, Amol Utrankar, Italo Vasquez Vargas, Christopher Velasquez, René Verbeek, Femke Verbree, Jacqueline Vulto, Sonja Wakeling, Ateshia Walker, Gregory Wanner, Kevin Webb, Brittni Webster, Kristen Weersink, Hao Wei Chen, Meghan Wentzell, James Werbicki, Scott J Wieters, Gabby Wilcox, Penny Wilson, Nelson Wong, Mark Woodcroft, Jason Woods, Rob Woods, Nichole Woodward, Fred Wu, Craig Wylie, Kevin Wyne, Lisa Tai-Ling Ying, Louise Hammer Yndigegn, Heinri Zaayman, Leah Zhao, Katina Zheng, Alex Zozula
