Write Medicine

Every Word Must Count

June 07, 2021 Alexandra Howson PhD Season 1 Episode 9
Write Medicine
Every Word Must Count
Show Notes Transcript Chapter Markers

Adrienne Stevens, EdD, MBA, Vice President and Head of Scientific Strategy at Healio Strategic Solutions shares how her passion for dance, and her interest in the mechanics of movement, physical therapy, anatomy, and physiology has translated into a career as a medical communicator. Dance requires precision, and that’s what Adrienne practices in her work. 

Welcoming Adrienne Stevens, PhD in physiology, to the podcast 

[00:02] Some of the things Adrienne  learned in the process of writing her dissertation that fuel her approach in healthcare communication.

[00:04] Some of the key differences Adrienne sees between scientific writing and business writing. 

 [00:09] Key types of communication that work with physicians and other healthcare workers.

 [00:13:25] The importance of motivational interviewing.

[0015:29] Differences in the kind of education strategy and format that MSLs respond to compared with clinicians. 

[00:18:22]  Are we interactive enough in the education we design?

[00:20:36] Communication in obesity education.

Healio Strategic Solutions
Performing Health
Motivational interviewing 

Connect with Adrienne: LinkedIn
Connect with Alex: Thistleeditorial.com

Podcast Team
Host: Alexandra Howson PhD
Sound Engineer: Suzen Marie
Shownotes: Anna Codina

Alexandra Howson 00:00 

Hello and welcome to Write Medicine here today with Adrienne Stevens, Vice President and Head of Scientific Strategy at Healio Strategic Solutions and founder of Performing Health, a nonprofit organization that supports young athletes through Wellness Education. Welcome, Adrienne. 

Adrienne Stevens 00:36 

Thank you. Thank you, Alex. It's a pleasure to be here. 

Alexandra Howson 00:40 

It's good to see you. Let's talk a little bit about how you found your way into this wider medical world and the wider world of education and medicine. 

Adrienne Stevens 00:55 

Sure. Well, as you know, I started my life, the first part of my life as a professional dancer, growing up in New York City and in Manhattan, and being exposed to all the wonderful things that New York City has to offer, as well as the fine teachers. And I was always interested in the mechanics of movement, physical therapy and anatomy, physiology. And I started teaching dancers at a very young age and non dancers, and through that it developed into physical fitness and training, because at that time, as the fitness boom was occurring, it was dancers that were leading the exercise and the fitness regimens. And once I started exploring more with certifications, as they became more standardized, I found exercise physiology. And through that, it fueled my interest in, in movement in physiology, and writing up my own dissertation, it was picked up by the new services by the AP. And through that way, I learned about medical communication and writing and editing, and found that I did not want to be in a lab for the rest of my life studying a very small aspect, and really found that medical education and communication provides a rewarding experience. 

Alexandra Howson 02:40 

That's a beautiful description of your path into the medical education world, which is pretty wide. And you talked about writing your dissertation for your doctorate in exercise, physiology, what were some of the things that you learned in that process of writing that affected your approach to communication and education, because writing a dissertation is a pretty lonely and sometimes an isolating experience? 

Adrienne Stevens 03:22 

Yeah, I liked writing, I was working, I was very productive with my professor, he had taken me on as his associate at the College of Physicians and Surgeons at Columbia University. And we were a highly productive team. He was foreign, and his writing skills were, you know, less than desirable, put it that 

way. And I found that number one in the dissertation process, you have to communicate, and I liked researching and unearthing new areas to supplement the principal line of thinking for the dissertation. And the other was being able to write clearly and succinctly. And I think anyone who's been in this business and who's written abstracts, I can appreciate the fact that you've got 200 or 250 words, and every word has to count. And I've translated that into the educational material that I've developed, whether it be slides or monographs or what have you the simplicity of the words and effectively communicating a message that is paramount. 

Alexandra Howson 04:37 

Are you a writer that writes the abstract first or at the end of the process? 

Adrienne Stevens 04:44 

Ah, that is a good question. I am now finishing my MBA and in this kind of business writing, one has to write executive summaries. So whereas in scientific writing, I might have done the abstract last on finding business writing, and I'm weaving, business writing and scientific communication. The executive summary is coming first, because it frames up how much I want to elaborate on certain topics. 

Alexandra Howson 05:20 

It's interesting. So can we talk about that a little bit in terms of what some of the key differences are, that you see between scientific writing and, and business writing, because I, I work in certain kinds of reports that have an executive summary. But for me the process, that's always the last thing that I do, because I have to work through the material first and get a feel for the content and the shape. And then, and then it's a more iterative process, you know, sometimes I write the executive summary, and then I go back to the material and I restructure things a little bit. How do you approach that process? 

Adrienne Stevens 06:04 

Well, with business writing, it's a little bit newer to me. So there, I outline first what I want to write very, very broadly, topics that I might want to cover certain references that I want to cover. And then I make sure to flesh them out in a more collaborative process and bring my own experiences to it. And I think that, that makes the writing come alive when you put some type of personal experience to it. And this 

holds true with the medical communication, I think, is that we're all consumers. At the end of the day, we all have family members. And I think it takes those key points about how the common people are navigating a medical world, bringing that back to the physicians who, you know, may lose sight of the 

most basic functions that patients consumers people have, for example, just going out and getting their medications or the cost of medications, or some aspect like that. 

Alexandra Howson 07:23 

So what I'm hearing there is that sometimes foolish physicians lose sight of. Yeah, and I see this in some medical education materials as well that the content is a million miles away from what actually goes on in the clinic. And what the patient brings to the clinic. And it's often that there are lofty goals, which are good goals. But starting the learning process, or the education process at a level that doesn't really deal with the nitty gritty that clinicians usually have to wade through first before they get to, you know, what is really important for the patient or they encounter. So that wasn't really a question. It was more of a reflection, but you've worked across a lot of different types of organizations with a different 

relationship to education in healthcare and medicine. What are some of the key differences that you see are different types of communication that you see that really work with physicians and other health care workers as well? 

Adrienne Stevens 08:44 

I think you're correct. I've worked across many aspects of medical communication from early in my career medical advertising, to continuing medical education CME to developing training materials for medical science liaisons, and communicating those messages as well as purely academic writing. And I think that, you know, the first step is having an engagement of, of thought leaders come together and discuss a topic. And of course, that is very high level, it's very high level, they are very much interested in mechanisms of action. Alternative aspects for a molecule whereas communication to a community level leader is not going to focus that much on a mechanism of action. They want to assume that it works and should work and should be safe and tolerable and efficacious. But they are the ones who are dealing with whether the drug needs to have prior authorization before it can be prescribed or picked up by the consumer. I haven't done much on the patient education aspect. But I think that translates to everything that I do and it is having that component with the physician and in medical writing is how do you have the communication? How do you have the dialogue with the patient so that they understand this was drilled very well into me when I was working in the obesity space launching a new product in the market. And obesity really hadn't been considered a disease up until that point. And there was a lot of shame, put on patients, if they were overweight, the terminology was patronizing. And how we kind of changed the industry so that it was accepted as a disease, of course, by the AMA, and how physicians should start those initial conversations with their patients by finding out what was important to them, and what were their life goals. And then backtracking into why taking care of their health and their weight would affect the longevity of the things that they like to do. And so from a medical writing perspective, you know, that was built right in about easily identifying the science, you know, making sure that that was down pat and solid. And then following through with data from research studies, to really highlight that point. And then the clinical aspects about how physicians might recognize patients that commonly came in their offices, and how to help them, you know, navigate their own health. 

Alexandra Howson 11:55 

And so there's a really important cultural aspect to writing there, and you touched on the kind of degree of shame that is associated with and I think, is still so associated with obesity, I'm curious how much you think that's shifted in, in your field and the work that, that you do, whether it brings me to a kind of wider point around when we're writing, or creating materials for, you know, learners and healthcare, you do have the clinical aspect and the scientific aspect, but that cultural piece is really important, because that informs the kinds of words that patients used to describe their experience to clinicians, and also the clinicians on you know, cultural experiences and form those kinds of encounters. How, how important do you think it is for people who are creating education for clinicians to have a good grasp of cultural differences? 

Adrienne Stevens 13:07 

There's a lot of literature on this now from motivational interviewing to, you know, the science about different areas where education can occur. And, and how patients use different medications, for example, alternative and complementary modalities and herbal therapies, how patients are looking about pricing, you know, if they're getting generics, or prefer to use an alternative, that's not really FDA approved. And and it's very, very important dialogue, because you can alienate a reader right away by using the wrong terminology and the way that, that literature used to describe hypertensive patients or diabetic patients and, and that's a pet peeve of mine, it's that no one is characterized by their disease. 


So now, I think we do see more patients with obesity, patients with hypertension. It's not unilateral. But I think there has been a shift so that the language is a little bit more fair. And you're not putting blame on somebody or shame because they have a given condition. And I think it holds true. And if you can substantiate all of this with literature, which there's always a wealth of literature to find. I think that's key. And I think it comes back to one of your earlier questions about scientific writing: whether it's promotional advertising, or writing up an abstract, it's all about selling the science. Right? And it has to help you understand what the hook is. Maybe it's a mechanism of action, maybe it's patient care. cost. But what is the key point? And why should people know about it? 

Alexandra Howson 15:07 

That's good. That's a good point. You talked about MSL (Medical Science Liaison) earlier. Do you see differences in the kind of education, strategy and format that they respond to compared with clinicians? And is that something that really needs to be rethought? Reshaped? I mean, where are we educating? 

Adrienne Stevens 15:36 

Well, from my experiences, I've been fortunate to lead three groups of three MSL teams for three different companies, from smaller to very large pharma, and the trainings invariably, and especially with the larger companies is solid, you know, if it's a more mature agent, there's a wealth more of a wealth of educational materials and training materials. But I think it comes down to how people learn, and everyone learns different and adult learning principles really come into play here. It's, it's not just enough by reading, you have to have some interactivity so that it sticks. And it's very much like the model of positions is learn one do one teach one that you've got to be able to verbalize that and ask questions and I was told the MSL is you just need that one question that the physician asks that you don't know. And you find the answer to that you will never forget. And I think that is key to the way we all learn. And so from my experiences, they get a tremendous amount of reading material, which is supplemented with journal clubs and role playing, as well as interactivity, interactive activities, that are part of their training materials. And as well as by leading promotional programs for dinner meetings, for example, and then having the one to one dialogues with physicians, because they really have to show their value. And it's not just what they can get out of a thought leader, but it's what value they bring to the thought leader to educate them about the science and the field in which they're practicing. 

Alexandra Howson 17:41 

You mentioned interactivity a number of times there, and I'm wondering, are we interactive enough in the education that we design? And I'm, and as I asked that question, I'm thinking about the work that you do with Performing Health and your passion for movement and exercise physiology? Do we need to get more creative about the kind of interactivity that we bring into medical education, whether we're talking about accredited education, or whether we're talking about educating medical science lays on other people in the field? 

Adrienne Stevens 18:23 

Well, I think we are starting to see some of that, like at the medical conferences, a lot of the booth activities were becoming more interactive, taking people through mazes and touching things. And virtual reality. My work at Healio Strategic Solutions, for example, is developing educational materials that the users will continually come back to and what does that mean? So gamification, tactics are very popular. The world is obsessed with video games, and this translates into medical communication. Now that because of the pandemic, when people are not getting out, it has become more challenging to get physicians to stay in front of their computer, which they already are because of not being able to see patients in the way that they may have before and how to keep them active. So it is a challenge, I have to say. And I think we're constantly trying to come up with new ways and new tactics to keep people's attention so that they understand that there's a site or resource that they can come back to, to get not only quality education, but have it fun, and have a venue that they can engage with their colleagues to discuss something. I think that the piece that might be lacking is how do you maintain that thought leader interaction when you can't go to a Congress, so I can't run down the street for coffee. And I actively think about ways that we can bring these groups of people together in a validated way that's impactful and compliant for legal ramifications of these companies. 

Alexandra Howson 20:30 

Right? Yeah. Can you talk a little bit about your work with reforming health? And how the kind of education and training you do there might differ or be similar to your work in, in medical education? 

Adrienne Stevens 20:46 

Sure. Well, this came about when I was doing work with obesity. And not only was I working with top level thought leaders, but I was educating the population. And the general population, you know, is struggling to maintain weight, and every couple of years, couple of months, there's a new therapy, a new diet, and a regimen that comes out and I thought, you know, how, how should dancers be learning or eating, and we've all heard rap, and stories of crazy things that dancers have done, you know, I grew up in New York City, and in a very high period of balancing when dancers were starving themselves. And I took that insight to the dancers to really highlight mindfulness and tell them that and, and there was very little research and literature at that period of time, why dancers need to eat, how they what they should eat, how they can pack things, and be more self reliant to whether it's on tour in their boarding school, or in their regular days, where they're going nonstop, from school to the studio, how to take care of themselves, the importance of sleep, the importance of maintaining blood glucose levels that are stable, so it doesn't trigger hunger pangs and take care of themselves that they're not excessively drinking or smoking. And this was received very well, I had been asked to, to, to lecture in Europe, which then sparked the whole eating and mindfulness into perfectionism, into changing body types and being more accepting of body types. And back in the studio is how to strengthen one's body and whether it's with using bands and changing the philosophy that using weights and will not build muscles, to the contrary of what dancers might think they need to do, and, and why common exercises are important for the dancers to maintain their physiology. I mean, back in the day, when I danced, we were told never to ice skate, or never to horseback ride or no one jog. Because it was, we were told that it was going to build different muscles. And that's not the case anymore. And dancers do need to be aware of their environments, they do need to read. I tell the dancers go watch a football game of your peers, you know, see what other people are interested in? Because the world is big, and you need to have as an artist, a bigger view of the world. 


Alexandra Howson 23:59 

Right? No, I think that's a really interesting shift that's occurred in that, you know, I've seen it in my own kids over the years, they're in their in their 20s now, but even in the years that they were in dance, there were some changes in how all of those things were discussed and talked about. And it's also kind of making me think I'm curious to know what your perspective is on the role of movement and mindfulness in educating clinicians. Because it seems that this is an area that if we're talking about supporting clinicians and the work that they do, whether we're talking about nurses or doctors or other health care workers, then self care, as you noted, probably needs to be part of that. Is there a role for continuing education to play there in terms of supporting self care for health care, work? 

Adrienne Stevens 25:01 

That is a very good suggestion. I have not touched on it, per se. But it's important, you know, when we're all at these protracted medical congresses and the data are going and going and going, and you're sitting there, all j, you know how wonderful it is when you finally have a chance to strike. And I think there are data to support that when you move while you're learning it's more likely to stick. And I have not seen any kind of movement towards that. But it's certainly very important. 

Alexandra Howson 25:45 

I think Mayo Clinic actually includes treadmills and its board prep courses to allow people to move while they're, you know, reading material or breaks in between sessions. But yeah, the kind of movement piece is one of the things that I think is starting to emerge as not just an adjunct to learning but actually a critical piece of reinforcing. 

Adrienne Stevens 26:13 

Same thing with music, right? So if you sing something, you're more likely to remember it. And the same principle I would imagine holds true. 

Alexandra Howson 26:23 

Well, we'll need to look into that. Before we wrap up. Is there anything else that we haven't touched on that you'd like to talk about today? 

Adrienne Stevens 26:32 

I think we're at a very interesting period now with medical education. And it's exciting to see what new developments may arise. There's certainly a lot of competition among companies, but companies that really have loyal, engaged audiences, and you yourself know that when physicians find a place that they are comfortable going back to because the information is credible, and not skewed towards one perspective or another, they come back to it. And I think there's a lot of competition potentially in the field. And we constantly have to strive to, to cater to the audiences for them to come back. 

Alexandra Howson 27:25 

100%. Thank you so much for your time, Adrienne, it was great talking to you today. 


Adrienne Stevens 27:29 

Thank you so much. 


How the process of dissertation writing has fueled Adrienne's approach to healthcare communication.
Key differences between scientific and business writing.
Motivational interviewing
Medical science liaison education
Communication in obesity education
Key Take Aways