Introduction

Medical trainees have traditionally relied on textbooks, classroom teaching, and review questions to acquire medical knowledge. More recently, online blogs, social media websites, and podcasts have become popular among trainees through the Free Open Access Medical Education (FOAM) movement.^1,2 These digital resources are increasingly used within, or as supplements to, formal medical education curricula.^3–9

Prior literature demonstrated that learners may prefer podcasts, as they allow asynchronous engagement, which can reduce stress and anxiety and provide accessibility to learners with different studying habits and learning styles.^10,11 Other studies demonstrated podcast learning increased student and resident knowledge and engagement compared with traditional text-based learning.^12–15 While there are multiple podcasts available in other disciplines, there are currently few podcasts specific to obstetrics and gynecology (Ob-Gyn) residents.^1,3,6,13,14 This report aims to describe the development of “CREOGs Over Coffee,” an Ob-Gyn medical education podcast by Ob-Gyn residents, and demonstrate its feasibility, sustainability, and acceptance.

Methods

The podcast was created at a large, urban, academic medical center with 32 Ob-Gyn residents. Two postgraduate year 3 (PGY-3) residents created the podcast during their own time. Podcast content was based on the Council on Resident Education in Obstetrics and Gynecology (CREOG) educational objectives, which are the main drivers of Ob-Gyn resident curricula (provided as online supplemental material).¹⁶ Podcast recording was performed in a single take, capturing a conversation between the cohosts, or the hosts and an invited subspecialist guest from our program. The hosts took turns interviewing each other or the guests.

Each podcast episode was reviewed by a board-certified Ob-Gyn or subspecialist, depending on the topic. The identified audience for the podcast was Ob-Gyn residents. The goal of each podcast was to cover a specific Ob-Gyn topic in 10 to 20 minutes. This length of time was chosen to keep listeners engaged and to allow for the podcast to fit into busy lifestyles.

We disseminated the podcast through public hosting via Podbean (http://www.podbean.com), which allowed for synchronous upload to “podcatchers,” which are standard podcast-hosting applications such as Apple Podcasts, Google Play, or Spotify. Listeners accessed episodes on podcatchers by searching for CREOGs Over Coffee or via http://www.creogsovercoffee.com. Refer to the online supplemental material for more details on the podcast implementation framework.

Feasibility markers were measured by the ability to produce weekly podcasts and offset costs through Patreon (http://www.patreon.com) online donations. Sustainability was assessed through Podbean podcast downloads, allowing for tracking of geographic distribution of downloads and number of downloads per episode and month. Podbean did not allow for tracking of download retention, defined as the same user downloading multiple episodes, or repeat downloads, defined as the same user downloading the same episode multiple times. Acceptance was measured by the number of reviews publicly seen on Apple podcasts and the number of followers on Twitter.

This study was declared exempt from review by the Women and Infants Hospital Institutional Review Board, as no human subjects were involved.

Results

Feasibility

We released 60 episodes of the podcast from September 30, 2018, to July 28, 2019, a period of 43 weeks, exceeding our parameter of 1 podcast episode per week. Episodes ranged from 10 to 30 minutes in length. Each episode, from research to publication, took approximately 3 to 4 hours for completion (breakdown provided as online supplemental material). Most podcast episodes involved the 2 PGY-3 hosts as well as their board-certified Ob-Gyn reviewer, and a few podcasts also involved a subspecialty board-certified guest.

Initial startup costs amounted to $3,180, with maintenance costs of $29 per month (table). After 10 months, 58% of these costs were offset by monthly Patreon crowdfunding (15 patrons; $200 per month income). If current funding trends continue, we anticipate that all costs will be fully covered approximately 1.5 years from startup.

table Podcast Expenses

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Sustainability

The podcast generated 173 995 downloads with listeners from more than 100 different countries, all 50 states in the United States, and 11 of Canada's provinces and territories. The United States (161 205; 93%), Canada (3475; 2%), and Australia (1504; 0.9%) had the most downloads per country. California (13 216; 8%), New York (12 444; 8%), and Texas (11 068; 77%) had the most downloads per state. Downloads increased from 39 per month in September to 31 206 per month in July, with demonstrated sustainability over time (figure).

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Discussion

To our knowledge, this is the first report regarding the feasibility of development of an Ob-Gyn medical education podcast by residents. We demonstrated that a weekly medical education podcast focused on CREOG guidelines was feasible, sustained over 10 months, and acceptable to an international audience.

Our findings support the existing literature with regard to learners' interest for accessible, digestible learning material.^1,3,7–17 Emergency medicine, in particular, has led the charge in FOAM,^3,14,16,17 and we demonstrate there is an interest for this in Ob-Gyn. Our findings also support the larger role that social media now plays in disseminating medical knowledge. A study of emergency medicine residents showed that almost 98% used some sort of social media for learning at least 1 hour per week.¹⁷

While podcasts and other FOAM learning tools seem to be readily accepted by learners, the literature is sparse on their effectiveness versus traditional forms of learning. One systematic review looking at multiple FOAM mediums (including blogs, Twitter, and podcasts) showed that in general, FOAM interventions did not improve knowledge, and participants using FOAM had equivalent test scores compared with those who did not use FOAM.¹⁸ One study reported higher knowledge scores on postintervention tests, but it did not compare participants' scores with those from nonintervention groups.¹⁹ However, these studies may suggest that FOAM is not inferior to traditional forms of medical education while being accessible and enjoyable for learners.

Limitations of this study include an inability to assess acceptability from all listeners. Only a limited number of listeners gave ratings and reviews or followed our Twitter account. Those listeners who responded may have been biased toward more favorable opinions about the podcasts. We were also unable to use established implantation design frameworks, such as PRECEDE, due to the difficulty of assessing impact from a podcast that is widely disseminated.²⁰ While the target audience of the podcast was PGY-1 to PGY-4 Ob-Gyn residents, specific download data were not available; thus, we do not know if we reached our target audience. Generalizability of the podcasts' usefulness for other disciplines or health professions is also unknown. Whether listeners learned from the podcasts also was not assessed.

We aim to continue the podcast after residency and to update the website with new materials. Our next steps include a survey for our residency program to assess resident learning and attitudes after listening to our podcast.

Conclusions

A resident-created Ob-Gyn weekly podcast based on CREOG guidelines, with faculty expert review of content, was feasible over a 10-month period. The podcasts appeared highly acceptable and were downloaded nearly 175,000 times by individuals from 100 countries and all 50 states.