An anesthesia education success story:
I was administering a mock oral board exam to a Stanford first-year anesthesia resident in November 2022, and the young man aced the test. He exceeded the knowledge base and judgement of his peers by a significant margin. After the exam, my co-examiner and I asked him how much medical training he’d had to date. He answered that he’d graduated from medical school, completed a one-year internship, and had been an anesthesia resident for (only) 4 months.
“How do you know so much about anesthesia already?” I asked.
“Almost everything you asked me I knew from keeping up with ACCRAC,” he said.
“What’s ACCRAC?” I asked.
He answered, “I was at Johns Hopkins for an anesthesia rotation, and I met Dr. Jed Wolpaw, one of the Critical Care faculty, who has a website called ACCRAC, which is a collection of anesthesia podcasts.”
ACCRAC stands for “Anesthesia and Critical Care Reviews And Commentary.” Our Stanford resident had listened to the podcasts on Dr. Wolpaw’s website for over one year, and as a result he was wise beyond his age concerning anesthesia information and decision making.
I accessed the ACCRAC website and found a wealth of information, with more than 240 podcasts pertaining to anesthesia. The majority of the podcasts were Dr. Wolpaw interviewing experts from different aspects of anesthesia or critical care. The podcasts varied from #1 (June 14, 2016) “Properties and laws of volatile anesthetics” . . . to #247 (January 30, 2023) “Kali Dayton discussing her work helping ICUs around the country learn how to get their intubated patients awake, up and walking, by implementing the ABCDEF bundle.” The podcasts are audio only. Continuing Medical Education (CME) credit is available from the website. I found ACCRAC to be the most extensive and comprehensive array of anesthesia podcasts on the internet.
I contacted Dr. Wolpaw and told him the Stanford resident’s success story. I queried him about his website and his podcasts. These were his answers to my questions:
- What was your impetus for initially starting ACCRAC? What void in anesthesia education did you identify?
“When I was an intern in Emergency Medicine, I listened to EMRAP (Emergency Medicine Reviews And Perspectives) as did every resident I knew, and many attendings as well. It was a fabulous source of information and learning. When I switched into Anesthesiology, I looked for the equivalent podcast but it didn’t exist. I always had in the back of my mind that someday I might try to start one. When I became an attending and heard our residents asking for audio resources, I knew it was time.”
- Why did you choose podcasts rather than a website of written words?
“I wanted something that people could listen to while commuting or working out, something that wouldn’t add a burden to their already busy day. Audio only podcasts are really the only way to do that.”
- How do you select your guests?
“I look for interesting articles, or approach people who give talks I find intriguing. I also get lots of proposals from people who are doing interesting things and are interested in coming on the show. And I get tons of emails from listeners requesting certain topics. I can’t do them all, but I try to get to as many as possible.”
- What percentage of your guests are from Johns Hopkins?
“I’m not sure of the exact number but certainly a fair amount, I’d guess maybe 70% or so.”
- Is your target market residents and fellows? How about university professors, or community anesthesiologists?
“I certainly think we have a lot of content that is useful to trainees, but we also have a large number of practicing anesthesiologists, both academic and private practice, who listen (and some use it for CME) as well as nurses, CRNAs, AAs, medical students and others.”
- Is any aspect of ACCRAC directed toward laypeople?
“Not really, but I have done some episodes that are accessible to the lay public like a review of the book The Obesity Code, and an interview with Dr. Richard Harris who helped rescue the Thai Boys Soccer Team from a flooded cave in 2018.”
- You trained at UCSF, arguably the nation’s finest anesthesia program. How does Hopkins compare to UCSF? Is there a West Coast-East Coast difference?
“I think they are both fabulous programs. I honestly find more similarities than differences and apart from the weather haven’t noticed much of a coastal difference.”
- What are 5 or 6 of your favorite podcasts, to direct my readers to?
“I really enjoyed my conversation with Dr. Harris about the rescue of the soccer team. The interview with Dr. Bobbie Sweitzer was also great because she pokes holes in so many assumptions we have. I think the episode with Christian Meyhoff is also a great one since we talk about his surprising findings and why they might have come out that way. And the same is true of my talk with Mark Neuman about his New England Journal of Medicine (NEJM) paper. And my conversation with Wes Ely about his book Every Deep Drawn Breath was really compelling.”
- How labor-intensive is it to maintain and add to ACCRAC? I notice six other individuals on your home page who assist you.
“It’s a fair amount of work, but I really enjoy it. I’m lucky to have volunteers who handle the social media accounts and help with the website. For now the preparation, interviews, recording, and editing is all me but it’s manageable.”
- I see that you published “Podcasting as a Learning Tool in Medical Education: Prior to and During the Pandemic Period,” a reference regarding podcasting. To what extent do you see podcasting growing in medical anesthesia?
“I think we’ll see significant growth. Emergency Medicine is a great example where there are podcasts covering all sorts of sub-specialty topics and niche interests. We’re already starting to see some growth in Anesthesiology with great podcasts like Depth of Anesthesia and I think we’ll continue to see more.”
Googling the topic of “anesthesia podcasts” reveals Dr. Wolpaw’s website on the first page. Other leading sources of anesthesia podcasts include:
The American Society of Anesthesiology (ASA) presents four categories of podcasts, including (1) ASA’s Central Line, which “features leaders in our field discussing a wide variety of challenges and opportunities vital to our practice and our profession.” (2) Residents in a Room, “a podcast series for residents, by residents, featuring anesthesiologists-in-training from across the country, putting it all out there, discussing their hopes, fears and expectations for residency and beyond.” (3) ANESTHESIOLOGY featuring the “Editor-in-Chief of Anesthesiology and his monthly overview of new journal content (translated in multiple languages) and featured author podcasts that highlight research through author and editorialist interviews; (4) Summaries of Emerging Evidence (SEE), featuring “a sneak peek of the most interesting studies covered the latest edition of the popular continuing education program.”
The International Anesthesia Research Society/OpenAnesthesia presents a link to hundreds of podcasts, including interviews from anesthesia experts from 2009 – present.
Great Britain’s Association of Anesthetists, and their journal Anaesthesia, have a website which includes 38 podcasts to date.
Harvard’s Massachusetts General Hospital presents Depth of Anesthesia, a collection of 38 podcasts to date.
Podcasts present a significant means of communication, information, and entertainment in the United States. Per The Infinite Dial report by Edison Research and Triton Digital, “As of 2021, 41% of Americans ages 12 or older have listened to a podcast in the past month, . . . up from 37% in 2020 and just 9% in 2008. Additionally, 28% of those 12 and older said they have listened to a podcast in the last week, up from 24% in 2020 and 7% when this was first measured in 2013.” Per Pew Research Center, “About a quarter of U.S. adults (23%) say they get news at least sometimes from podcasts.
Dr. Wolpaw’s 2022 publication, “Podcasting as a Learning Tool in Medical Education: Prior to and During the Pandemic Period,” makes the following important points about medical podcasts:
- “By entering a query for the term “podcast” in PubMed, a year-by-year breakdown of the number of publications with this term in the title shows an increasing trend from 2006 to 2022.”
- “For the creator, podcasting is a relatively low-cost endeavor, allowing for a low bar for entry into the podcasting space.A feasibility study conducted for the creation of an ophthalmology podcast revealed that start-up costs were just $212.18 with $29 monthly expenses.”
- “One review found that listeners find learning from podcasts to either be equivalent to, or better than, classroom learning.”
- “Multiple studies have found that listeners of medical education podcasts felt more motivated to learn.”
- “Rather than waiting on peer-reviewed literature, which could take several months to begin to show up, the rapidly evolving nature of the early pandemic required a faster means of propagating information to clinicians. Podcasts were a way by which-as early as February and March of 2020-anecdotal experiences from physicians across the world could be shared before peer-reviewed literature could be published.”
I find the primary advantage of podcasts is that one can listen to them while multitasking. I find a disadvantage in that, unlike a written article, one cannot skim over the content looking for the most pertinent sentences or paragraphs. If a podcast lasts 20 minutes, you’re committed to listening to every word, or to utilizing an available fast forward button for a 30 second leap to a later time. Another disadvantage is the inability to visually display internet links to references. With a written article, one can click on links to other published articles mentioned in the text. Dr. Wolpaw’s publication states that “many podcasts in medical education also utilize show notes-summary documents that accompany podcast episodes. These documents outline the episode’s main points and contain references to resources discussed in each episode.”
Podcasts are mainstays of 21st century media. The freedom to educate yourself while driving a car, doing chores, or exercising is a terrific opportunity for medical professionals. Until I discovered ACCRAC, I was not a podcast listener. Now I am, and I recommend the same to you. Podcasts won’t replace the written words of anesthesia textbooks or journals, but podcasts can be enjoyable and informative, and they have a definite role in supplementing medical education.
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