Mastering the New Mediums of Continuous Medical Education
By Nathaniel Hundt & Jeffrey Levick. Illustrations by Gerre Mae Barcebal.
How do we learn? Where do we share what we know? These questions have fascinated me since 2010, when I was an instructional designer at Apple University. I helped my team reinvent corporate education by distilling multidisciplinary lessons from Steve Jobs, Jony Ive, Tim Cook and others into in-person courses for new Apple employees, managers, and leaders. I had fabulous mentors, like Kim Scott, Richard Tedlow, Joshua Cohen and David Ruben, who taught me how to leverage extended metaphors, extract teaching moments, and use media to make education fun and immersive.
When I got to business school, I couldn’t shake the storytelling bug. Yale School of Management was pioneering video-based “raw cases,” and it was there I met Jeff Levick, who previously had served as the first lead producer and instructional designer on Open Yale Courses. Jeff and I would go on to create several cases that made their way into the Yale MBA curriculum.
Soon after founding Dr. Katz, Jeff and I reconnected. We began exchanging ideas regarding online education and envisioning an opportunity to reshape clinical upskilling for mental health providers.
Nate: Hey Jeff, what’s going on?
Jeff: You know, just trying to keep my kids focused on school. There’s been lots of Zooming over the past couple of years. I have been thinking a lot about how video and conferencing has changed our lives. Do you realize that compared to 2018, we’re watching twice as much online video per day? As much as nineteen hours per week!
N: It’s the new normal. I’m on video calls all day long and then we stream Netflix to wind down in the evening.
J: It’s really transformative. For fifteen years, I used to capture video in-person. You and I filmed interviews together in New York, Washington, D.C., Florida and Connecticut. I have an elaborate traveling video kit. But over the past two years, I’ve produced and edited dozens of panel discussions, lectures and other educational content recorded on Zoom. The amount of content that I’ve seen institutions create is staggering.
N: I’ve seen it create opportunities for live, as well as on-demand video learning from peers, educators, and experts who wouldn’t have had time to travel to attend conferences in person. We’ll look back at this time period as the pivot to a hybrid world.
J: I agree. Every year I help produce a global conference for educators that usually brings 400–500 people to a single location. That conference has been held virtually over the past two years and each time, it’s attracted 2000 attendees. If you think about knowledge-sharing at scale, that’s a 4–5x increase in reach.
N: I’m sure you could attract speakers and thought leaders that typically have very restrictive schedules.
J: We did. What makes it possible is the ability for a subject matter expert to be recorded or live-streamed from the comfort of a home office. It’s not just conferences. For academic medical centers, talks, such as Grand Rounds, can bring in more guest speakers, capture content more easily and distribute more widely, well beyond the four walls of the lecture hall. YouTube has helped usher in democratization and open access. So it cuts both ways–easier to capture content and better platforms for distribution.
N: It’s great for the mental health providers with whom we’ve been talking. They have to obtain a certain number of continuing education (CE) credits to maintain their license. They have other requirements from their employer, malpractice insurance provider, and membership associations that necessitate CE. It’s complicated by the fact that many providers have extended their coverage area during the pandemic. But more online content and better distribution creates opportunities for streamlining this whole process.
J: Social workers, doctors and others have been telling me that they also want this content brought to them in a way that feels personalized and accessible, and “in their pocket.” I see Dr. Katz simplifying the provider experience for them.
N: To take it even further, in addition to viewing a Grand Rounds or one-off video talk, we’ve heard those users want easy access to hundreds of courses from the same platform, in just a few clicks.
J: I’ve been to some incredible remote talks in the past year. But as you’re implying, I think the key is organizing information so it is easily available on-demand. Busy providers don’t always have the time to book an hour for a live event. So you have to make content available very soon after an event or talk is finished. There’s a lot of power in organizing content in one place, too. YouTube pioneered gathering creators on one platform. Netflix and Hulu have connected studios and film distribution to respond to their audiences and expand offerings. In higher-ed, Coursera convenes learning communities by leveraging and curating content from dozens of institutions. Ultimately, creators, organizations and content managers all benefit from this integrated, platform approach. But it’s the end users that are really empowered. We are continuously learning from users and their wants and needs drive the evolution of modern platforms.
N: One thing we’ve heard repeatedly is that it isn’t so much about overly-produced content. It’s about authenticity.
J: In the past few years, everybody has become accustomed to a lower bar in terms of video quality. We’ve all seen doctors Zooming into broadcast television shows from their webcams. I think it makes them more approachable.
N: What goes on behind the scenes with remote recording?
J: It’s a whole new world. The technology now is such that with the right setup and platform you can record in 4K remotely, while saving to the cloud. There are also ways of remotely controlling an iPhone or iPad so that a director of photography can adjust the depth of field or focus from thousands of miles away, in real time. The outcome is high-quality content without a studio. A process that once took weeks now takes a day.
N: And then there’s editing -
J: Absolutely. Content has proliferated in part due to video editing and collaboration tools becoming ubiquitous. It wasn’t so long ago that you would need dedicated computers and a team of editors that held refined acuity with a non-linear editing program. Now, virtually anyone can trim and edit clips with a touch of a finger using creator-friendly apps, like Kapwing. Furthermore, cloud apps like Frame have revolutionized collaboration with in-line commenting and reviewing, eliminating siloes and versioning nightmares. Anybody can participate, from anywhere. The same is true for audio and podcasting.
N: Digital education also benefits tremendously from the commoditization of the underlying distribution services. We’ve been able to weave these technologies into our foundation in a way that just wasn’t possible ten years ago.
J: Right again. It used to be that you would need a separate content management or file management system, and then that system would have a handshake with a separate, and often expensive content delivery network system, which would then serve up content through a third-party video player! Analytics were an afterthought. Now the expectation is that enterprise apps will be built with those capabilities included. The unification will yield a much better experience for content developers and managers and ultimately a better experience for the user.
N: I think what this means is that the learning systems of the future won’t have to be so disjointed. Instead, they will be integrated into things like clinical workflow. The real value-add will be the intelligence and personalization they provide to organizations and end users. That makes me think of something else that I know you are passionate about: the importance of audience targeting, but also the value of having content that is accessible across all audiences. Do I have that right?
J: You do. As a content creator, I want a platform that helps me do both of those things. For example, I’ll want to bundle content into programs or thematic collections, assign different content to different segments of an audience and configure view permissions. But in terms of accommodating learning differences, I always want to lower the barrier to entry. Things like closed captions can even be required by law, so platforms that offer this will help with compliance. They also help tremendously with accessibility, as well as search and discovery for that matter. It’s one of those experiences that is becoming a new standard.
N: As we’ve been developing Dr. Katz, we have been focusing on ways to give creators easy tools that improve the learning experience and keep people engaged. What have you learned about interactivity and feedback loops?
J: It all starts with having a platform that encourages collegiality, dialogue and interaction between the teacher and learner, the panelist and conference attendee. Streamyard, which I love, enables a producer to push comments and questions from social media into a live broadcast in real time. So imagine a doctor presenting Grand Rounds in the U.S. taking a live question from a colleague in Europe.
N: Makes me realize how much has changed since the days we spent at the Yale School of Management developing those case studies! When I think back, content creation was so static. Social media was ramping up and “mobile first’ was not in our vernacular. It’s quite a dramatic shift in a decade.
J: It’s been incredible to watch platforms and user behavior evolve in tandem. When we started Open Yale, we published videos in three different “flavors” to accommodate low-bandwidth users. A decade later, that administrative burden is obsolete with bit rate adaptation in systems like Dr. Katz. I couldn’t have imagined the extent to which we’d all be consuming video from mobile devices. But now, something like that is a necessity. It just goes to show you the importance of organizations embracing a forward-looking strategy. And it’s exciting to be part of a team that is partnering deeply with content creators like me.
N: Staying close to creators is essential. We wouldn’t be able to envision the future without you!