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Featured Article: Peter J. Fabri, MD, PhD, FACS ACS Presentations RRC Procedures for Granting Duty Hour Exceptions
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Podcasts deliver on-demand material to today's surgical resident
William B. Jeffries, PhD, Associate Dean for Medical Education Introduction Providing a synchronous didactic curriculum for residency and fellowship programs can be challenging, especially as these programs encompass additional inpatient locations and ambulatory sites. While the concept of recording lectures is not new, recent developments have made it much easier to develop an on-demand lecture series without advanced technology skills or a tremendous investment in hardware. In this article, we will introduce the basic concepts of providing recorded lectures and podcasts to residents, outline the steps needed to implement such a program, and discuss some early experiences in one of our residency programs. What is podcasting? Podcasting has come to be understood as the on-demand delivery of a recorded media file via the World Wide Web for playback on a media player. Several of these terms need qualification. “On demand” implies that the user is asking for the file to be downloaded either individually or through a subscription process known as syndication (explained below). The term “podcasting” is more properly restricted to syndicated delivery, but the term is now used for all recorded files delivered on demand. As we will see, the media file is typically a sound file, but could also be a video file. “Media player” originally implied a handheld device such as an iPod® (hence, the name podcasting) but can include any device, such as a personal computer. The lure of podcasting in education is the ability to automatically deliver lectures and other content that can be used by learners when they need it and in a style that best suits them. Educational uses of podcasting Many medical schools use podcasting to distribute recorded lectures and most of their experience is in podcasting in undergraduate medical education. At Creighton University School of Medicine (CUSM), the audio portion of each lecture presented to first and second year students is recorded and uploaded to a server shortly after presentation. Students can download individual lecture files or subscribe to the entire lecture series. Such subscriptions enable automatic downloads of files to the student’s computer. The corresponding handout is also available electronically, which allows review of the entire lecture, with the ability to annotate the presentation while reviewing the presentation. Further, the playback speed can be varied, which enables students to review the material more quickly than originally presented. Playback can also be slowed to discern difficult concepts or decipher the presenter’s accent. Recently, podcasting has found application in graduate medical education (see Table 1). At CUSM, we began to present recorded lectures online for our 24 family medicine residents in July of 2007. We have a three-year curriculum for the residents that is designed to provide a complete board review over the course of a three-year period. Our conferences are held on Friday afternoons from 1:00 to 5:00 pm in a seminar room that is equipped with audiovisual and audio-recording equipment. Due to the duty-hour policy, residents who are post-call cannot attend these conferences, yet they are responsible for the material for their rotations, their in-service exams, and for their boards. In the past, residents who missed the lectures could review the PowerPoint® slides for each lecture but they would still miss the explanation and nuances of the speaker. We started using podcasting on July 1, 2007. Our residents are now able to access not only the PowerPoint® slides for the lecture but listen to the lecture as well. In our early reviews of this program, we have recognized three primary benefits of podcasting:
How to set up a podcast If you want to set up your own podcast, it is important to speak the language of Web-audio delivery. Table 2 defines some of the common terms encountered in podcasting. The process of establishing podcasting at your institution can be broken down into discrete steps, each of which can be accomplished by someone with little information technology (IT) training. Figure 1 illustrates the steps required.
1. Recording. There are two options to record a presentation. The first option is to use a microphone that is plugged into a computer as an input device (Windows® and Macintosh® computers both enable this feature). The second option is to use an inexpensive digital audio recorder, which may be used with (better) or without a microphone. The former option captures the sound as a WAV file and saves it onto the hard drive of the computer. The latter option records sound as a MP3 file that is saved onto a digital media card. Good quality unidirectional microphones can be obtained from most consumer electronics stores. To record onto a computer, you will need to use your operating system’s recording utility or a third-party program. A great program for audio recording is Audacity®. Using Audacity®, you can record your sound files directly onto your computer. The same program can convert WAV files into MP3 files (necessary for posting files as podcasts) and can be used to edit the files as well. Editing is sometimes desired to remove dead space at the beginning and end of a file or to create excerpts. The best part about Audacity® is that it can be downloaded for free from the Audacity® Web site. The site (http://audacity.sourceforge.net) also contains a step-by-step tutorial that can have novice users podcasting in no time. A word of caution: if you are capturing audio on the same computer from which you are running a PowerPoint® presentation, the computer may not be able to keep up. Your PowerPoint® presentation could be slow to respond, especially if you have large images embedded. Also, the quality of the audio file may be affected. If you use two computers or a separate audio recorder, this will not be an issue. This brings us to the second recording option. In this case, a portable data recorder is used to record the lecture as a MP3 file. A portable data recorder can be handy because it can be used in rooms that are not computer ready. At Creighton, we use the Sanyo ICR S700RM Digital Voice Recorder (which costs about $250). This device allows a microphone input and records MP3 files onto a digital media card. The card is removed and can be subsequently plugged into a computer for audio file processing and editing. Newer devices can eliminate some of the steps described above. Some recorders render files directly in the MP3 format (eg, Marantz PMD660-Portable Compact Flash Digital Recorder, $450) and some can directly upload from the device to the server (eg, Echo360, see vodcasting below).
2. File conversion and uploading. Once you have recorded your event, it will be in a WAV file format. For a one-hour lecture, this format is much too large to be sent over the Internet. It must be compressed into an MP3 format (using Audacity® or another audio editor), which will be significantly smaller. This file type can be readily played by computers and handheld media players. The MP3 file is now ready for uploading to a Web server. At this point, links to the uploaded audio files can be catalogued as links on your curriculum Web site. At Creighton University, we load our files into the New Innovations Residency Management Suite (http://www.new-innov.com). Here learners choose files that they want to download directly onto their computers. The advantage of this approach is students only download content they have chosen. The disadvantage is they need to continually return to the curriculum Web site to determine if new content has been added. The solution to this problem is to syndicate the podcasts as a RSS feed. 3. Syndication. Syndication allows learners to have new audio files “pushed” to their computers automatically if they subscribe to the service. This is accomplished by the creation of a RSS file, which is uploaded to the server at the same time as the audio file. To the uninitiated, the RSS file looks complicated (Figure 2). However, the creation of a RSS file can be automated and managed by someone with little IT experience (eg, a curriculum coordinator or department secretary). Using inexpensive or free software (eg, FeedForAll, http://www.feedforall.com or Podifier, http://www.podifier.com), you can produce RSS files without knowing computer languages.
The RSS file contains information (metadata) about the audio file (course and lecture title, date of recording, etc.). Most importantly, the RSS file contains the Web address of the audio file so that the user’s computer can find the podcast. Once created, the RSS file is uploaded to a Web server and the URL for the RSS file is posted on a Web site that the learners have access to. The learners can then navigate to that Web site to obtain the link to the RSS file (they need only the link to the file, not the actual file). 4. Obtaining a RSS feed. For residents to obtain podcasts automatically, they need software to read RSS files and to direct the MP3 file download to their computer. This software is refer-red to as a podcast receiver or podcatching client. The easiest way to handle RSS feeds is through the iTunes® program, which can be downloaded free (http://www.apple.com/itunes). In iTunes®, students establish an account into which they simply paste the URLs of all subscribed podcasts. The program then regularly visits the URLs of all subscribed RSS feeds and automatically downloads new podcasts to the user’s computer. Other free podcatching clients are also available, such as Juice (http://juicereceiver.sourceforge.net), Zune™ Marketplace (http://www.zune.net), and Winamp (http://www.winamp.com). Most of the newer Web browsers (Internet Explorer® 7, Firefox®) have RSS integrated into them. While these don’t automatically download the files, they do give a listing of audio available and will update the list as the feed is updated. Once the residents download the file onto their computers, they can either listen to it from there or copy it onto their portable MP3 player (eg, iPod®). 5. Using a learning management system (LMS) with podcasting. If you are fortunate enough to have access to a learning management system (eg, Blackboard® 7 (http://www.blackboard.com) or ANGEL® (http://www.angellearning.com), podcasting is made much simpler. In such systems, the upload of audio files is facilitated and your materials can be organized in folders that pertain to courses or curricular modules. Both types of LMS also feature automatic RSS file generation that can be enabled in the course management menus. Online residency management systems such as New Innovations allow storage of audio files but do not yet support RSS. Thus, the LMS can automate and catalog your podcasts with little technical expertise. There is another advantage: the hand-outs and supplemental learning material can be organized along with the podcast, allowing the learners to obtain and review all the materials at once. Two caveats pertain here. First, these features may be customized for individual institutions, so it is best to check with your institution’s IT administrators to determine if podcasting is enabled and how it is managed in your LMS. Second, audio files are large and there may be limits on the number and size of files that can be uploaded into the system. If this limitation applies, you may have to upload audio files to a third party server and just put links to the files into the LMS instead of the actual files. 6. Video podcasting: vodcasting. Podcasting is not restricted to audio media files. Thus, video files can also be catalogued and syndicated using the same techniques described above. There are now automated capture programs such as Echo360 (http://www.apreso.com) and Camtasia Studio (http://www.techsmith.com) that can capture images from PowerPoint® presentations, SMART Boards, document cameras, etc. and synch them with the accompanying audio. Other systems are available that can capture full video of the lecturer (which is especially useful for patient examination or surgical techniques, etc.). The creation of video files for educational purposes creates some unique challenges. First, the file size is much larger, which creates storage and file delivery problems. Large video files can take a long time to download, which may limit their utility. A solution to this is to stream the video, which is the delivery of the file in small packets as they are needed for viewing. This method requires special software and server technology. Another challenge with vodcasting is efficient note taking. With separate handouts and audio files, it is easier to take notes within a presentation (especially PowerPoint® files). It is not possible to annotate a video file. Final thoughts During our experience with podcasting, several observations have arisen that are worth sharing.
Due to its versatility and ease of use, podcasting can be a valuable tool in graduate medical education. Podcasting promotes the ability to review materials in ways that best suit the learner. We anticipate growth in the use of podcasting and forecast that sharing of curriculum among institutions will be the next major advance in this area. Links for further reading How to create your own podcast:
How to use Audacity®:
How to use/make RSS: Podcasting in Blackboard®:
Online March 7, 2008 |
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