Write Medicine

Getting Comfortable with Uncertainty

September 06, 2021 Alexandra Howson PhD
Write Medicine
Getting Comfortable with Uncertainty
Show Notes Transcript Chapter Markers

Karen Overstreet EdD, RPh, FACEHP, CHCP, Vice President, Scientific and Educational Affairs for Medical Learning Institute, Inc. is here to talk about her journey into educating health professionals and some of the things she thinks are important to support effective communication in the education field. 

These include:

* Skills you need for staying power in CME/CPD
* The science of learning
* Creative ways to measure outcomes
* Formats for delivering education to clinicians
* How to build interactivity into text
* Parsing education materials for specific kinds of clinicians
* The pressing need for wider professional development

 

Resources

Medical Learning Institute, Inc
Facebook: @mliace
Instagram: @medicallearninginstitute
LinkedIn: @medical-learning-institute-inc
Twitter: @mli_ace

Accreditation Council for Continuing Medical Education (ACCME) Standards

Health and Human Services Office of the Inspector General (HHSOIG) Guidance

Connect with Karen: LinkedIn
Connect with Alex: ThistleEditorial.com 

Breath Awareness Audio File
Newsletter

Podcast Team
Host: Alexandra Howson PhD
Sound Engineer: Suzen Marie
Shownotes: Linzy Carothers

Alexandra Howson  00:00

Hello and welcome. Today I am with Karen Overstreet, Vice President, Scientific and Educational Affairs for Medical Learning Institute, Inc. We're here today to talk about her journey into educating health professionals, some of the things she thinks are important to support effective communication in the education field. Welcome, Karen. 

Karen Overstreet  00:32

Thank you, Alex, it's a pleasure to talk with you today.

 

Alexandra Howson  00:36

You've had a long career in print and virtual education. And I know that you did your doctorate in education at Temple University, maybe you can share with listeners how you find your way into education generally, and what pulled you there?

Karen Overstreet  00:57

Well, I stumbled into medical education, medical communications, as so many of us do. I don't know anyone who went to college and intended to work in medical communications or medical education, we all sort of just stumble into this field. And it started for me when I was working on my master's degree in drug information in New York. And one of my professors ran a small med comms company, and he knew I was a good writer from being in his class. And so he hired me to do some freelance work from him, for him. And so I didn't even know the medical communications field existed, I had no idea I could apply my skills in writing my light for writing with my scientific background, starting out as a pharmacist. So it was just a natural marriage of those two things, those two parts of my skill set that I really enjoyed, and started out working in a couple of different med comms companies back in the days when you could do continuing medical education and med comms in the same company was fortunate enough to take a job in Philadelphia with the first med ed company that became triple accredited, back in the early 90s. I hate to say that it makes me feel really old. But the first company that was ever accredited for physicians, nurses and pharmacists, and along about that time, I was offered the opportunity to get a doctoral degree in adult education, and just jumped on it because I was jumping into CME with both feet without really knowing what I was getting into or what the company was getting into.

 

Alexandra Howson  02:47

And that's so interesting. And, and I am conscious, I did use the term long career in education. And that's not an age comment. I think that's, for me, that's more about staying power. And so a couple of things I want to follow up on there. And one is, what are some of the skills that people who work in the medical education space need to sustain that staying power? And the other question is, you know, how you think adult education has changed over the last couple of decades? So maybe that's the place to start, you know, looking at your, your clinical background, and how you brought that into a very theoretical world of, you know, education, looking at how that's changed. And then what that tells us about what content creators need to, you know, create that sustain sustaining power? 

 

Karen Overstreet  03:52

Well, that's a great question Alex, and a very multifaceted one. The communications world and the education world have changed so much over the last few decades. I mean, just since you and I started in this business, there's been evolving regulations, the ACCME standards for commercial support have changed several times and they're changing again, the pharma code the HHSOIG guidance, they add the med code. The Senate Finance Committee hearings on CME all of these things have shaped what we do. The certification of CPD professionals, the certification of medical publication, planners, on both sides of the business have really evolved and best practices are changing all the time, the evidence base that underlies communication and education continues to evolve, just like the clinical evidence base for all of the different therapeutic areas that we work in. And it's challenging to be able to keep up with the science of medicine as well as the science education and communication. It's growing all the time. But that's what's kept me in it. It's fascinating to be able to learn different things. A supervisor of mine years ago used to say this, and it used to drive me crazy. And now I quote her all the time. If we did, yeah, if we do today, what we did yesterday will have nothing to do tomorrow. And I think that's, that's true, we live that every day, the world is changing so quickly. And the COVID pandemic is a perfect example, we have all had to adapt and come up with new strategies in the blink of an eye. So being nimble, planning ahead, looking for contingencies. All of those things are critically important, as well as the science and the evidence base that underlies what we do.

 

Alexandra Howson  05:55

So, one of the things I find interesting about that, which takes me to how adult education might have changed, or might not have changed in the last couple of decades is and you mentioned this, the science of learning the science of education. What do you see, as core elements of that science, that haven't, haven't really changed, maybe tinkering at the edges? And what do you see as new pieces of knowledge that have been identified, as part of, you know, the new science of learning? Another two pronged question?

 

Karen Overstreet  06:46

Absolutely. Well, I don't think when you really boil it down, I don't think there's, there's so much new, but it's more applying what we know and coming back to the pandemic. Being practical, being just in time, giving clinicians what they need to know, and giving them expert guidance on how to use it. I think so much of education and communication, whether it's CME or a journal article, or an advisory board, so much of that content historically has just been a parade of P values in a data dump. And I think we're well beyond the point when that's enough, clinicians are so busy keeping up with the literature in their field and practicing medicine in a different way than they did before the pandemic, we've got to take it a step further and give them, interpret the data for them, give them expert advice on what to do with that data. You know, just knowing the results of a clinical trial are good enough. What do they mean? How do they use that for an individual patient? So that's one piece of it and outcomes of courses. Another really important piece and commercial supporters are getting more sophisticated about outcomes, providers are getting more sophisticated about outcomes. And just being able to come up with creative ways to assess the effectiveness of what we're doing cost effectively, is really a challenge. You know, it's great to talk about patient level outcomes or population health outcomes, but very few people have the time and the resources and the money to put towards measuring those sorts of metrics. So how can we be more creative, given time constraints, budget constraints, the realities that we're all living?

 

Alexandra Howson  08:47

What are some of the creative ways that you see people measuring outcomes, whether we're talking about CME or whether we're talking about other kind of educational vehicles?

 

Karen Overstreet  09:00

People I think a lot of times are still relying on pre and post tests, and that's fine. I think sometimes getting less volume of data through qualitative means can be more meaningful just talking to learners, or readers or participants in an advisory board and asking them, what are you going to do differently based on the discussion we just had or based on what you just read? I think sometimes we get hung up on trying to assess a whole population of learners or readers or participants. And that gives some valuable information, of course, but there's a limit to that. So perhaps looking at a smaller subset of those learners or readers or participants and really getting some meaty information about what surprised them from what they learned what they're going to do differently, what questions they still have and how are they going to address them those. I don't think we do enough of that.

 

Alexandra Howson  10:04

Well, as a qualitative researcher, of course, that that speaks to, to my, you know, one of my passions. You know, I see a little bit of that. Are you seeing some of that in the work?

 

Karen Overstreet  10:15

A little bit, but not enough, I think.

 

Alexandra Howson  10:19

And one of the other things that you mentioned, you talked about print, creating, you know, content for print, do you think that's something that, you know, sometimes there's a lot of angsts within the CME world, in particular around the value of print? And I'm wondering, given where we are, we're speaking, you know, in the fall of 2020, after six or seven months of living with Coronavirus. What's your sense of how the vehicles the formats for delivering education to clinicians might change and, and will print see a resurgence as a consequence?

 

Karen Overstreet  11:08

Interesting question, Alex. I think print will always have a place. journals, some journals are hugely credible. And there are still a subset of clinicians that want to get that copy of the journal in the mail and flip through it when they have opportunities. But beyond that, so much content is available online now, even before it comes out in print. So, when we say print, I always think about the online version of that, as well as the old-fashioned paper that comes in the mail. And a lot of those print publications are adding enhanced features. They're adding video elements, podcasts, webcasts, interactive posters, there's lots of creative things going on to make content that used to be static, much more interactive, to engage learners. And a lot of that has happened because of all of the conferences being cancelled, because of the pandemic, with oral sessions and poster sessions being done virtually. People are trying to find creative ways to make them more interactive to give learners a chance to interact with the presenters in a new way. And I think that's exciting. I don't think that will go away. Even when the meetings business comes back. If it ever does, I think the use of virtual technologies and being able to interact with content will change. And that's a very positive thing.

 

Alexandra Howson  12:44

And presumably, this is something you're seeing not just in medical education, but across a whole range of medical communication types.

 

Karen Overstreet  12:54

Absolutely, yes, yes. With advisory boards being done virtually, most appraisal presentations being done virtually with videos of the presenter and live Q&A sessions done online, it's really interesting to see how the industry has had to adapt very quickly.

 

Alexandra Howson  13:12

We talk about interactivity, a lot. And I think the kind of default, or what I hear is when we talk about interactivity, we very quickly move from print to multimedia forms and formats. But I'm a writer. And so and I know you're a writer, too. And so I'm interested in how can we talk about writing in a way that builds that interactivity into the words themselves and the way that we use the words?

 

Karen Overstreet  13:48

Another great question, Alex, you're obviously very adept at interviewing people. I think it's an important. It's an important consideration. And I think we've got to think in writers need to think in smaller chunks. And we're those of us who started writing a long time ago, we're used to writing 5000-page manuscripts that might have a few tables and figures. And we have to think a little bit differently. How can we get across the key messages in a way that will draw readers or learners in and keep their attention when they're so busy trying to keep up with the volume of stuff that they have to maintain to take care of their patients? So, how can we be succinct? How can we be practical? How can we give them an opportunity to relate to a piece of content or only subsets of that content that are meaningful to them? So, thinking about how to make the graphics more accessible, what can they download what parts of something they're looking at on the screen, can they blow up or download for their own use versus just reading a 10 page article.

 

Alexandra Howson  15:03

Agreed. I think that that succinctness, that brevity, shorter chunks, material is increasingly key. And part of that is, I mean, obviously, the volume of work that clinicians do, and the limited amount of time that they have to actually process, that kind of information, but also just I think there's something about neurobiology and neuroscience that suggests, you know, our attention spans are shorter and shorter. And this is going to take me into a rant about social media. Now, I'm not gonna go there. But I think, thinking about that it's not just the structure of work in a healthcare context that's shifting, it's also you there are some biological changes taking place in the human brain that make it incumbent on us to create content in a way that is, is more is more kind of accessible.

 

Karen Overstreet  16:09

Yes. And digestible. You're absolutely right. Our attention spans are shorter. Technology, in some ways, is a wonderful thing. In some ways, it's really a detriment to thinking and learning, but it is what it is. So, we have to continually think about being practical and relevant and helpful to learners when they've got so many opportunities and so many things pulling at their attention,

 

Alexandra Howson  16:33

Right. That practical piece, from your vantage point, how parsed out do you think education materials are for specific kinds of clinicians? So not just physicians, but also nurses, pharmacists, you're a pharmacist by trade, and specialty and training. Can we do a better job of making sure that or how can we do a better job, I think is a better question of making sure that the content that we were delivering an education, whether we're talking about CME, whether we're talking about the wider education field is just more targeted, what kind of audience analysis do we need to be doing in order to make sure that we're really getting to the people who need to use the material? And we're showing them how to use the material.

 

Karen Overstreet  17:26

I think that's a really important point. And there's been a tendency, at least in the CE CME space, and people tend to use CME broadly to mean all healthcare professionals to just certify activities for everybody without thinking about the needs of the community pharmacists, the clinical pharmacist, the nurse, the PA, the NP, right, at some levels, they all need to know some of the basic things, but what they do with that information is very different. So just certifying an activity for oncology pharmacists, without thinking about what is it? What are their needs that are different from the nurse or the physician? It's not going to be very effective, I think we've got to understand scope of practice. I think we need to have those different target audiences represented in the planning and the development of the content. And maybe there shouldn't be so much education, that's multi certified. Maybe we should go back to the days of designing education for physicians and nurses and advanced practice providers and pharmacists, separately, I think it's dependent on the scope of practice, and also the therapeutic area. In areas where advanced practice providers can prescribe, and they have more authority, their educational needs are probably closer to those of physicians, but in other areas. That's not the case. And state by state is different, too. So, I think it comes down to really knowing the scope of practice of your target learners and getting them involved from the beginning and planning, whether it's an article or an advisory board or CE activity.

 

Alexandra Howson  19:21

I think yeah, no, I that's, that's a really helpful way to think about this. I think one of the things that these last few months of living in pandemic have shown is well, let me backtrack there. You mentioned that, you know, we tend to use CME as a kind of shorthand for continuing education and for continuing professional development across different kinds of clinicians and in that continuing professional development piece, I think one of the things that we've seen more and more in the last few months of pandemic is that there are so many other things that clinicians have to think about in the context of their work. I'm thinking of, for instance, stress and anxiety as a consequence of working in a pandemic. And the American Medical Association, for instance, has an initiative at the moment on building resilience building resiliency amongst clinicians. From your vantage point, what are some of these wider professional development pieces that those of us who work in medical education, whether we're talking about CME, whether we're talking about continuing education more generally. And whether we're talking about the broader field of communications, what are some of the things we need to be thinking about to support clinicians that are not therapy base that are not disease specific, that are not about workplace organization, but are about self-care, and sustaining a career, you know, over a lifetime?

 

Karen Overstreet  21:13

That's a really important point. And I've seen sustainability and self-care be addressed in a number of different organizations, from professional organizations that you and I may belong to, to clinician organizations, I think that's key, everyone is stressed, everyone's having to do too much. Taking care of kids at home while they're working, those sorts of things. So those are important, but also, I think, somehow getting people or helping people to become nimble, to be comfortable with the fact that it's not going to go right all the time, that they unforeseen things are going to happen. Being comfortable in uncertainty. That's an uncomfortable place to be, but we're all living through it. And it's uncomfortable for people who make life and death decisions or who make decisions that support those people. But this pandemic has all taught us that we have to be flexible, we have to be nimble, we will get through it, we have to have a plan B and that's okay, we've got to get comfortable with uncertainty and finding ways to be resilient and work through that uncertainty.

 

Alexandra Howson  22:39

How much do you think that, you've mentioned the word nimble a few times and I it's a word I really like myself and links to the notion of, of pivoting and be able to, you know, think on your feet and all those kinds of things. How much of a generational issue, do you think that nimbleness is? You know, thinking about, you know, younger clinicians, Gen Z Gen Y. Compared to you know, I'm at the tail end of the baby boom. Do you see generational differences in how clinicians manage and perceive uncertainty?

 

Karen Overstreet  23:23

I think there definitely is a trend. I think people who have grown up with technology and are used to getting the newest version all the time are easier to adapt to changes in technology, they're easier. They're much more able to pick up a new teleconferencing system, a new video conferencing system easily whereas someone who has only used one system, it's going to be a lot tougher. So yeah, I think there are definitely generational differences and just that comfort level with technology and the changes in technology that are inevitable.

 

Alexandra Howson  24:05

So I'm, I'm conscious of our of our time, before we sort of wrap up are there any other issues that you know, we haven't covered that are really important to you in terms of thinking about creating education for clinicians?

 

Karen Overstreet  24:23

Well, just one last thought and coming from the perspective of someone who across my career has worked both on the medical communications part of the business, the industry, as well as the medical education side, we tend to think of them as two very discrete fields of work. And in some perspectives, they are they have their own regulations, their own sets of rules and guidelines. But at the end of the day, the processes of creating content and trying to inform clinicians are really the same good writing is good writing, whether it's for an activity certified for credit, or whether it's for a poster for a conference or an article going to the Lancet. Good communication good writing is the same, regardless of which playbook we're following.

 

Alexandra Howson  25:20

I love that. Karen, thank you so much for sharing your knowledge and your expertise with our listeners. And I hope to speak to you again soon. Thanks, Alex.

 

Alexandra Howson 25:33

All right,

 

Karen Overstreet  25:34

That was fun. Did you get what you wanted? I sometimes I can't tell if I'm babbling and going off on a tangent or if that was in any way coherent?

 

Alexandra Howson  25:43

No, no, that was good. In terms of process, what we'll do now is we'll create show notes, anything that you've mentioned, that might be a potential resource, so make sure to put in the in the show notes. And as I say, as I start to kind of gear up to launch, I'll let you know what that timeline looks or looks like. So that you know, if you want to you can you can, you know, share with your audience.

 

Karen Overstreet  26:09

Maybe I don't know we talking a few weeks, a few months, just know

 

Alexandra Howson  26:13

Probably a few months, I was hoping for late fall, I'm thinking I'm probably going to push it into early 2021. 

 

Karen Overstreet  26:20

Okay, good to know. And I will since Kayden and Syneos Health are mentioned I am going to have to run it by some PR person. But it's a it's a pro forma thing. I just need to let them see something and it's an automatic approval.

 

Alexandra Howson  26:36

Well, okay, so a couple of ways I can do that. I can share with you the edited version, if you like, and you can share that or we can just I can introduce you in a different way I can record over that

 

Karen Overstreet  26:48

They actually prefer for the company name to be in there.

 

Alexandra Howson  26:50

Actually they would. Okay. All right, then then that's good. I'll, I'll share with you the final kind of product and then you can or the edited version, so that you can you can pass that through whatever channels you need to. And yeah, no, I thought it was good. I knew it. I knew it would take us in a few different directions. And that's what I like. So, I wish we had longer.

 

Karen Overstreet  27:12

Oh, I know. I know. We had really insightful if we want to schedule some more time. I'm happy to.

 

Alexandra Howson  27:18

 Or maybe we can do a kind of follow up, you know, like a partner or something. You know, if you're if you if you like the first one, but no, that was that was great. I just wish we had more time. Yeah. I could keep talking all the time.

 

Karen Overstreet  27:34

All right, it was great catching up with you. And yeah, happy to do a part two, if that would be helpful.

 

Alexandra Howson  27:39

Yeah, no, I think that that could be good. You have such a wealth of expertise. And I I know you have a call, but I think it would be good to get into gender and women in education. So, I might do a themed series or season or something. Okay, great. All right, Karen. Thanks

 

Karen Overstreet 27:57

Thanks so much, Alex. Have a good one. Here.

 

Alexandra Howson 27:59

You too.

 


 

Skills you need for staying power in CME/CPD
What's new in the science of learning?
Creative ways to measure outcomes
Formats for delivering education to clinicians
How to build interactivity into text
Parsing education materials for specific kinds of clinicians
The pressing need for wider professional development
Summary