Walker Redd

Emily Gutowski

Next Generation is a Brigham Clinical & Research News (CRN) column penned by students, residents, fellows and postdocs. If you are a Brigham trainee interested in contributing a column, email us. This month’s column is written by Walker Redd, MD, an Internal Medicine resident, and Emily Gutowski, a fourth-year medical student, the co-creators of the “Run the List” podcast.

Our podcast began with a conversation: We had both been wondering if there was a way to help supplement traditional clinical learning for medical students during clerkships.

A Podcast in the Making

We remember feeling overwhelmed early in our medical training by the amount of new information we needed to absorb while learning how to care for patients. Despite having memorized countless details and using popular learning resources to study for standardized exams, we often found these less helpful for learning how to manage a patient presenting with a particular medical problem. Educating medical students during rotations is often achieved with “chalk talks” — short lessons given by residents or attending physicians on high-yield topics in medicine. However, whether or not these are given is highly variable, depending on factors such as patient load and the amount of free time on any particular day. This can quickly lead to a disparity in the quality and quantity of education that medical students receive throughout their training. We felt that a resource was needed to even the playing field.

Just Getting Started

Last fall, we sat down with Navin Kumar, MD, an attending gastroenterologist at the Brigham who is very involved with the pre-clerkship and clerkship curricula at Harvard Medical School. We discussed potential ways to help fill the need for clinically focused resources for medical students. Since internal medicine podcasts designed for trainees and attendings were increasingly available and widely used, we decided to design a podcast for medical students.

We named our podcast Run the List, a callback to the colloquialism referring to updating the medical team about patients’ statuses and plans throughout the day. Each episode is a one-on-one conversation between Walker, Emily, or Navin, and a Brigham attending physician or fellow. Together, we talk through common topics that students are likely to encounter while learning to take care of patients. These episodes are short and engaging and represent the “chalk talks” that would be given in an ideal world.

We chose podcasting as our medium because of the rising popularity of this form of learning. We knew medical students often lack the time to read about patient management guidelines, especially after a long day in the hospital. In contrast, we found podcasts to be an easily accessible way of transmitting information to these busy students. In our view, podcasts allow students to listen at their own convenience, for example while at the gym, doing laundry or on their daily commute, and their short duration make them easy to consume.

Guests for Run the List are experts in their respective medical fields who also have an interest in medical education. After accepting an invitation to be interviewed, they are sent a basic script written by one of us and reviewed by Dr. Kumar. We meet at the Brigham Education Institute to start recording. Part of the beauty of these episodes is that although they cover important topics in medicine, they have a highly conversational feel. Once recorded, episodes are edited down to under twenty minutes and uploaded here on a weekly basis. We love getting the word out about each episode and interacting with our listeners through Twitter, which has, along with podcasts, been growing in its impact on medical education. Our podcast team — Emily, Walker and Dr. Kumar — meets monthly and communicates often to discuss goals, timelines and new developments. Having three team members at different levels of training (attending physician, resident and medical student) allows for a comprehensive perspective on the creation and evaluation of Run the List.

Through helping build upon the foundation of practical guidance about inpatient management, we hope Run the List can help medical students become more confident in the clinical setting and facilitate growth as they prepare for residency. We also imagine that the podcast may help flatten the medical team hierarchy and help students participate more actively in the model of the flipped classroom.

A Vision Realized

One afternoon in early October, we both witnessed how our podcast has been a resource for one of our colleagues. Our general medicine team piled into our workroom as the clock struck 4 p.m. One of the medical students, Sarina Madhavan, led the session. Although she had only started her clerkship year a week earlier, she had listened to our podcast episode about cirrhosis, a type of liver damage, and volunteered to teach about that topic.

Rather than standing at the whiteboard as is typical practice during these “chalk talks,” Sarina took a seat at the large table with the rest of the team and started a conversation with the question, “What is cirrhosis?” During the discussion, fellow students were quick to offer responses to their peers, even if they were uncertain of the answer. Likewise, the interns, residents and attendings contributed based on their own understanding and clinical experience. By the end of the session, we had compiled a list of interesting questions that would require us to review the relevant literature. With this reversal of the more traditional teaching structure, the learning was fun, interactive and high-yield for all participants — much like our podcast strives to be. Sarina listened to the podcast and then loosely structured her own teaching around that format — she went through the topic in a similar order and made it interactive for participants.

“Exactly What I Needed”

As is often the case in education, our students recognized an even greater potential for its use and were ready to take the next step by teaching the material themselves. We are encouraged by the fact that students and trainees have found the episodes to be a helpful, enjoyable learning tool that they can use on their own time despite busy schedules. Similar feedback has come from others, including reviewers on the Apple Podcast page. One reviewer, in a review titled, “Exactly What I Needed,” stated that the podcast was at the “perfect level for med students.” Another wrote, “Especially ideal for a clinical med student and rising interns. High-yield topics for both diagnosis and management presented in an easily digestible format. Especially enjoy the short-length that allows me to listen to a whole episode during my commutes.”

As the practice of medicine remains ever-changing, the way we think about medical education should continue to evolve. It will be important to design learning tools based on student needs and empower students to shape their own learning environment. Such efforts can spark a passion for clinical curiosity and learning, helping shape the next generation of physicians into wise clinicians and educational innovators.

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