using newer technologies in medical education and healthcare communications
TRANSCRIPT
Workshop in Communicating Science
Using Newer Technology
Lawrence Sherman, FACME, CCMEP
Stony Brook University November 6, 2010
Who Am I And Why Am I Here?
16+ years in medical education Ahead of the curve using new media and
technologies Use new and old media in my teaching
and lecturing
Overview
Nature of the practice of medicine Social media tools and technologies Use of SoMe in medicine and public
health Speculations on future directions
There Are Many Audiences to Consider
There Are Many Audiences to Consider
There Are Many Audiences to Consider
Workshop Mode: Interactivity!
Did you come here today with a specific question or opportunity?
What can I tell you today? What do you hope to get out of this session? What has been your experience using new
technologies? Professionally Personally
When Considering New Technologies
Remember, professional and personal often merge
New technologies are fast, sometimes accurate, and very accessible The evening news on TV usually lags
Remember 2.0 – people interact Whether they want to or not You select your level of participation
Make sure that you use them correctly!
When I Say Social Networks
What do you think of?
Most People Say
Facebook LinkedIn Twitter MySpace Sermo*
*Physicians regard Sermo highly as a Social Networking platform
My Thoughts:
Facebook – about people you used to know (but changing)Many untapped uses in healthcare
Twitter – about people you want to know betterMicroblogging is an art
LinkedIn – about people you want to work withBest professional resource
But…SoMe Can Be Overwhelming!
What About Web 2.0 in Healthcare Communications?
Web 2.0 is a term describing new collaborative Internet applications
Primary difference from the original World Wide Web is greater User participation in developing and managing
content, which changes the nature and value of the information
Increasing role in providing health information "any time, any place"
McLean, R., Richards, B. H., & Wardman, J. I. (2007). The effect of Web 2.0 on the future of medical practice and education: Darwikinian evolution or folksonomic revolution? Medical Journal of Australia, 187(3), 174-177.
Web 2.0 Tools
Blogs – own content; to describe new trends Wiki – participatory content; to share knowledge Google, Gmail, maps, Ajax
Enriching the user experience MySpace – social networking Flickr, del.icio.us – photo sharing,tagging Youtube – video, tagging, social network Really Simple Syndication (RSS) – rapidly disseminate
awareness of new information Podcasts – make information available "on the move"
McLean, R., Richards, B. H., & Wardman, J. I. (2007). The effect of Web 2.0 on the future of medical practice and education: Darwikinian evolution or folksonomic revolution? Medical Journal of Australia, 187(3), 174-177.
Don’t Forget the Patients!
ePatient phenomenon Society for Participatory Medicine Involvement in care
Qualify informationAppropriate resources
The new generation of patients and providers!
The Leader
Workshop Mode: Communicating With The Public*
What resources are available? What have you done? What would you like to do? What are best practices
*It is imperative to consider the physician as consumer as well
Media and Web 2.0 in Public Health and Healthcare Communications
You Can Definitely Find What You Are Looking For!
You Can Definitely Find What You Are Looking For!
Mass. State Dept of Health Blog
CDC on YouTube
Use of CDC YouTube Site During H1N1 Pandemic
CDC had less than 1,000 Twitter followers in March. They now have over 500,000
23
CDC had <1,000 Twitter followers in March 2009—now they have >1,000,000 for @CDCEmergency
CDC’s H1N1 video has over 2,100,000 views!
"Web-based mapping, search-term surveillance, "microblogging," and online social networks have emerged as alternative forms of rapid dissemination of information."
-New England Journal of Medicine on May 7, 2009
Use of CDC YouTube Site During H1N1 Pandemic
CDC had less than 1,000 Twitter followers in March. They now have over 500,000
24
CDC had <1,000 Twitter followers in March 2009—now they have >1,000,000 for @CDCEmergency
CDC’s H1N1 video has over 2,100,000 views!
"Web-based mapping, search-term surveillance, "microblogging," and online social networks have emerged as alternative forms of rapid dissemination of information."
-New England Journal of Medicine on May 7, 2009
Alabama Dept of Public Health on Facebook
Hospitals Are Using SoMe
As of October 19, 2010
871 Hospitals total 421 YouTube Channels 679 Facebook pages 648 Twitter Accounts 417 LinkedIn Accounts
94 Blogs 2,259 Hospital Social Networking Sites
http://ebennett.org/hsnl/#ixzz13rK4eQXx,
Hospitals Are Using SoMe
As of October 19, 2010
871 Hospitals total 421 YouTube Channels 679 Facebook pages 648 Twitter Accounts 417 LinkedIn Accounts
94 Blogs 2,259 Hospital Social Networking Sites
http://ebennett.org/hsnl/#ixzz13rK4eQXx,
Hospitals That You Know Are Using SoMe
Hospitals That You Know Are Using SoMe
Community Contributions: The Wiki
Medical Wikis
AskDrWiki.com FluWikie.com Ganfyd.org Just The Facts PubDrug Wikisurgery.com
Web 2.0 & medicine, Giustini – April 2007
Blog Discourse in Medicine
Blogs stimulate discussion, self-directed learning & reflective practice
Useful educational tools Clinical Cases & Images,
Ves Dimov, M.D. Kidney Notes blog, Joshua
Schwimmer, M.D. Over!My!Med!Body!,
Graham Walker,MD
Medical librarian search blogs To help find medical
information, rapidly
Web 2.0 & medicine, Giustini – April 2007
Blog Discourse in Medicine
Blogs stimulate discussion, self-directed learning & reflective practice
Useful educational tools Clinical Cases & Images,
Ves Dimov, M.D. Kidney Notes blog, Joshua
Schwimmer, M.D. Over!My!Med!Body!,
Graham Walker,MD
Medical librarian search blogs To help find medical
information, rapidly
Web 2.0 & medicine, Giustini – April 2007
Clinical Cases & Images blog
Web 2.0 & medicine, Giustini – April 2007
Workshop Mode: Using Tech to Communicate With the Public
Are there examples that you can think of where you have seen this occur?
Are there places that you can envision technologies assisting in healthcare communication with the public?
Adult Learning Principles for Physicians – Application? Achievement and competency Active engagement in a supportive learning process Management of their own learning experience Ability to utilize what is learned in practical setting Ability to interact with peers Immediate feedback regarding their performance Use of self-evaluation
Educational Effectiveness Adult Learning Principles
Application-focusedKnowledge-focused
Active engagementPassive participation
Personalized contentGeneralized content
Multiple media methodsOne media method
Multiple interventionsOne intervention
Learner-centeredFaculty-centered
MORE EFFECTIVELESS EFFECTIVE
Sources: AHRQ, Grimshaw et al, and many others
Communications – Integrated Approach
Standalone eCME can be more effective when integrated into an educational curriculum
Permits evaluation of individual activities Comparisons can me made Multiple interventions can be measured Aggregate outcomes can be evaluated
Addresses various learning style preferences
How Do You Measure Success Of Various Online Formats? Isn’t just about the delivery Use of 2.0 technologies for
Needs assessments Interactive Credible Gaps identified? Multiple components
Audience Generation Quantify those participating solely as a result
of social network invitation Outcomes measurements
Compare educational impact measurement with controls from outside network
Post-activity dialog related to impact of education
Faculty planning and training Sharing of data/information
Just the Tip of the Iceberg
Satisfaction Surveys
Evaluation of faculty / activity Content Delivery Practice Relevance Handouts and AV
“To what extent were you pleased with… ?” “How can we improve in the future ?”“Other speakers / topics to suggest ?”
Going Below the Surface
Self-Assessed Learning Surveys To what extent was ___ learning
objective met? To what extent are you more
[aware of, prepared to, confident about, proficient at] ___?
To what extent are you [planning to, prepared to, committed to] apply this learning in your practice?
When / how will you measure the impact on your … [practice or patients]
ACCME Accredited Providers:Trends in Total # Activities by Modality
ACCME Report, 2006-2009
41,898 40,284 40,342 35,990
23,939 26,763 28,72331,213
5,902 4,6996,581 6,866 7,714
6,821
10,427 11,803 11,40711,830
3,8353,127
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,000
2006 2007 2008 2009
Courses Internet (Enduring Materials) Manuscript Review
Other Enduring Materials Regularly Scheduled Series
Facebook in Healthcare
Facebook in Healthcare
Twitter in Healthcare
Twitter in Healthcare
Twitter in Healthcare
LinkedIn in Healthcare
LinkedIn in Healthcare
LinkedIn in Healthcare
Another Medium
Talking Medicine
How do physicians communicate? Formally
Journal articles, print and e-books, conferences
Informally Conversation, ‘on the wards’, online, with residents
Community of practice (Lave & Wenger)
Web 2.0 & medicine, Giustini – April 2007
Doctors are Social
Web 2.0 creates conversations Tools, ‘social-software’
Blogs, wikis, podcasts, video, RSS feeds Socialization
Conversation, ‘on the wards’, online, rounds with residents
Knowledge begins with conversations*
* Kenneth Megill. Thinking for a living: the Coming Age of Knowledge Work. 2004
Web 2.0 & medicine, Giustini – April 2007
Maximizing Physician Participation Goes Beyond Just Attracting an Audience
RIGHT CONTENT
New Science
Updates to Guidelines
Patient Education
Engage physicians with education that will improve their competence and performance in practice
RIGHT CLINICIAN
Degree
Patient Population
Practice Demographic
RIGHT EDUCATION
Channel
Format
Design
Today, A Confluence of Factors Are Complicating the Physician’s World
PHYSICIANClinical Practice GuidelinesPatient Inquiries
Technology Enablement
Pay for PerformanceQuality Improvement
• Point-of-Care software• Self-Assessment tools
• Guides treatment decisions based on evidence-based medicine• Published by med associations, payors or gov’t
• Payment model • Rewards physicians for meeting certain performance measures of quality and safety
• Improve practice performance• Analyze records, implement an intervention, report results for re-certification
• DTC Growth • Health information online
60% of Physicians Interested in Social Networks
Physicians participating in such online communities are more likely to:
Be primary care physicians Be female Own a PDA or Smartphone Go online during or between patient
consultations Be slightly younger than the average
physician
Results are based on a Q1 2008 telephone and online survey of 1,832 practicing U.S. physicians conducted by Manhattan Research
References: Casebeer L, Bennett N, Kristofco R, Carillo A, Centor R. Physician Internet medical
information seeking and on-line continuing education use patterns. J Contin Educ Health Prof. 2002 Winter;22(1):33-42.
Bennett NL, Casebeer LL, Kristofco RE, Strasser SM. Physicians' Internet information-seeking behaviors. J Contin Educ Health Prof. 2004 Winter;24(1):31-8.
Casebeer L, Brown J, Roepke N, Grimes C, Henson B, Palmore R, Shanette Granstaff U, Salinas GD. Evidence based choices of physicians: a comparative analysis of physicians participating in Internet CME and non-participants. BMC Medical Education 2010, 10:42.
Wutoh R, Boren SA, Balas EA: eLearning: a review of Internet-based continuing medical education. J Contin Educ Health Prof 2004, 24:20-30.
Fordis M, King JE, Ballantyne CM, Jones PH, Schneider KH, Spann SJ, Greenberg SB, Greisinger AJ: Comparison of the instructional efficacy of Internet-based CME with live interactive CME workshops: a randomized controlled trial. JAMA 2005, 294:1043-1051.
Casebeer L, Engler S, Bennett N, Irvine M, Sulkes D, DesLauriers M, Zhang S: A controlled trial of the effectiveness of internet continuing medical education. BMC Med 2008, 6:37.
Peabody JW, Liu A: A cross-national comparison of the quality of clinical care using vignettes. Health Policy Plan 2007, 22:294-302.
Peabody JW, Luck J, Glassman P, Jain S, Hansen J, Spell M, Lee M: Measuring the quality of physician practice by using clinical vignettes: a prospective validation study. Ann Intern Med 2004, 141:771-780.