Using electroencephalography to explore neurocognitive correlates of procedural proficiency: A pilot study to compare experts and novices during simulated endotracheal intubation.

The objective of this study was to explore the use of EEG as a measure of neurocognitive engagement during a procedural task. In this observational study, self-reported cognitive load, observed performance, and EEG signatures in experts and novices were compared during simulated endotracheal intubation. Twelve medical students (novices) and eight senior anesthesiology trainees (experts) were included in the study. Experts reported significantly lower cognitive load (P < 0.001) and outperformed novices based on the observational checklist (P < 0.001). EEG signatures differed significantly between the experts and novices. Experts showed a greater increase in delta and theta band amplitudes, especially in temporal and frontal locations and in right occipital areas for delta. A machine learning algorithm showed 83.3 % accuracy for expert-novice skill classification using the selected EEG features. Performance scores were positively correlated (P < 0.05) with event-related amplitudes for delta and theta bands at locations where experts and novices showed significant differences. Increased delta and frontal/midline theta oscillations on EEG suggested that experts had better attentional control than novices. This pilot study provides initial evidence that EEG may be a useful, noninvasive measure of neurocognitive engagement in operational settings and that it has the potential to complement traditional clinical skills assessment.

A novel approach to operating room readiness for airborne precautions using simulation-based clinical systems testing.

BACKGROUND: The emergence of the COVID-19 disease as a global pandemic caused major challenges and strained busy operating room environments. This required institutions to rethink current system functioning and urgently develop safe medical practices and protocols. PURPOSE: To use a novel approach combining simulation-based clinical system testing with rapid cycle deliberate practice concepts for identifying latent safety threats presented by newly developed operating room COVID-19 protocols and collecting frontline staff recommendations for mitigation. METHODS: This study design combined a training/education approach with probing the systems function. The primary outcomes were the number of latent safety threats and staff evaluations of this approach for feasibility and utility on immediate and four-month post surveys. Participants started the simulation which took place in the operating room, in the assistant role before graduating to the primary airway manager. Simulation staff members observed the simulations and noted whether elements in the protocols/checklists were followed and whether latent safety threats were present using an observation form. Solutions to latent safety threats were sought during the debriefing period. RESULTS: This approach identified 17 latent safety threats not foreseen during the planning stages and allowed for corrections to the protocols prior to impacting patient outcomes. Post-simulation surveys indicated that the program was well received and all who responded agreed that it was worth the time it took. Fifty-seven percent of respondents to four-month follow-up survey reported using the work products to care for an actual COVID-19 patient. CONCLUSIONS: This study demonstrated a flexible methodology that effectively integrated simulation-based training and systems tests to train staff and detect latent safety threats in the new workflows and provide recommendations for mitigation. While COVID was the specific prompt, this approach can be applicable in diverse clinical settings for training medical staff, testing system function, and mitigating potential latent safety threats.

Practice what you teach: An approach to integrate airway education for experienced anesthesia clinicians.

BACKGROUND: The COVID-19 pandemic has disrupted clinician education. To address this challenge, our divisional difficult airway program (AirEquip) designed and implemented small-group educational workshops for experienced clinicians. Our primary aim was to test the feasibility and acceptability of a small-group, flexible-curriculum skills workshop conducted during the clinical workday. Secondary objectives were to evaluate whether our workshop increased confidence in performing relevant skills and to assess the work-effort required for the new program. METHODS: We implemented a 1:1 and 2:1 (participant to facilitator ratio) airway skills workshop for experienced clinicians during the workday. A member of the AirEquip team temporarily relieved the attendee of clinical duties to facilitate participation. Attendance was encouraged but not required. Feasibility was assessed by clinician attendance, and acceptability was assessed using three Likert scale questions and derived from free-response feedback. Participants completed pre and postworkshop surveys to assess familiarity and comfort with various aspects of airway management. A work-effort analysis was conducted and compared to the effort to run a previously held larger-format difficult airway conference. RESULTS: Fifteen workshops were conducted over 7 weeks; members of AirEquip were able to temporarily assume participants' clinical duties. Forty-seven attending anesthesiologists and 17 CRNAs attended the workshops, compared with six attending anesthesiologists and five CRNAs who attended the most recent larger-format conference. There was no change in confidence after workshop participation, but participants overwhelmingly expressed enthusiasm and satisfaction with the workshops. The number of facilitator person-hours required to operate the workshops (105 h) was similar to that required to run a single all-day larger-format conference (104.5 h). CONCLUSION: It is feasible and acceptable to incorporate expert-led skills training into the clinical workday. Alongside conferences and large-format instruction, this modality enhances the way we are able to share knowledge with our colleagues. This concept can likely be applied to other skills in various clinical settings.

Feasibility, implementation, and outcomes of in situ simulation-based curriculum to manage common emergencies in the pediatric post-anesthesia care unit.

PURPOSE: Studies have shown that most critical events that occur in the post-anesthesia care unit (PACU), including cardiac arrests, are preventable and respiratory in origin. Admission to the PACU necessitates transfer of care from anesthesiology staff to PACU nurses. The aim of the study is to assess a) feasibility in implementing an in-situ curriculum for PACU nurses to manage common pediatric emergencies, b) the effectiveness of the curriculum in improving self-confidence of the PACU nurses in performing essential skills c) nurses'' perception of such an offering. DESIGN AND METHODS: This was a single center curricular evaluation study. Anonymous surveys were used to assess curriculum effectiveness by comparing self-reported confidence in the execution of key technical skills and application of knowledge in a real clinical environment at three time points: baseline, immediately post-simulation, and 3 months later. RESULTS: Of 50 PACU nurses, 80%, 98% and 58% responded to the targeted needs assessment, post-simulation and follow up (at 3 months) survey respectively. Self-reported confidence levels for most of the essential skills were significantly increased immediately after simulation and at 3 months. Most of the participants responded that the simulation training helped them improve care of hypoxic (83%) and hypotensive (62%) patients in the PACU. CONCLUSION: Implementation of in situ curriculum for PACU nurses was feasible. The self-reported confidence in performing essential skills increased significantly and the nurses could apply these skills in real clinical environment. PRACTICE IMPLICATIONS: Interprofessional simulation should be implemented in all high risk units to optimize safety of children.

Development of a scale for measuring physician attitudes toward interprofessional education and collaboration.

Interest has been increasing in interprofessional education and collaboration (IPEC) within health professional schools over the last two decades. Although a growing body of literature addresses the effects of IPEC on healthcare outcomes, psychometrically sound attitudinal instruments that measure concepts surrounding IPEC are still needed. The primary objective of this study was to develop a scale to measure the attitudes of attending physicians and residents toward IPEC. Based on a literature review, a set of questionnaire items was drafted to address all six domains outlined in a World Health Organization report for interprofessional learning outcomes. These domains are teamwork and collaboration, roles and responsibilities, communication, reflection and learning, the patient, and ethics and attitudes. A total of 379 physicians and trainees completed the questionnaire. A principal axis factoring with orthogonal varimax rotation of 20 items produced a 5-factor solution explaining 60% of the variance. Examination of the items in each factor led to the following labels: 'teamwork and communication,' 'ethics and attitudes,' 'roles and responsibilities,' 'reflective practice,' and 'patient-centered care.' A Generalized Linear Model provided initial evidence that the new scale might detect shifts in attitudes related to some of the emergent factors.

Training novice anaesthesiology trainees to speak up for patient safety.

BACKGROUND: Effectively communicating patient safety concerns in the operating theatre is crucial, but novice trainees often struggle to develop effective speaking up behaviour. Our primary objective was to test whether repeated simulation-based practice helps trainees speak up about patient management concerns. We also tested the effect of an additional didactic intervention over standard simulation education. METHODS: This prospective observational study with a nested double-blind, randomised controlled component took place during a week-long simulation boot camp. Participants were randomised to receive simulation education (SE), or simulation education plus a didactic session on speaking up behaviour (SE+). Outcome measures were: changes in intrapersonal factors for speaking up (self-efficacy, social outcome expectations, and assertiveness), and speaking up performance during four simulated scenarios. Participants self-reported intrapersonal factors and blinded observers scored speaking up behaviour. Cognitive burden for each simulation was also measured using the National Aeronautics and Space Administration Task Load Index. Mixed-design analysis of variance was used to analyse scores. RESULTS: Twenty-two participants (11 per group) were included. There was no significant interaction between group and time for any outcome measure. There was a main effect for time for self-efficacy (P<0.001); for social outcome expectations (P<0.001); for assertive attitude (P=0.003); and for speaking up scores (P=0.001). The SE+ group's assertive attitude scores increased at follow-up whereas the SE group reverted to near baseline scores (P=0.025). CONCLUSIONS: In novice anaesthesia trainees, intrapersonal factors and communication performance benefit from repeated simulation training. Focused teaching may help trainees develop assertive behaviours.

Innovation in Education Research: Creation of an Education Research Core.

Within academic medical centers, there is increasing interest among physicians to pursue education as a promotion pathway. Many medical schools and universities offer professional development opportunities for these individuals such as workshops and certificate and advanced degree programs. However, there exists a need for a more personalized support for clinician-educators to be successful in educational scholarship in the health care setting. In 2017, a departmental level educational research community was established within Anesthesiology and Critical Care Medicine at Johns Hopkins University to support faculty, staff, and trainees in creating, completing, and publishing educational scholarship. The research infrastructure includes administrative and institutional review board submission assistance, internal grant support, database management, statistical analysis, and consultation with professional educators. Also, integral to the education core is monthly education lab meetings that allow an opportunity for education researchers to present work in progress, conceive new projects, discuss relevant literature, and cultivate and sustain a community of educational scholars.This innovation in education demonstrates feasibility at a departmental level to successfully support educational research. We have initiated education meetings with a cohort of core education faculty who are interested in an educational promotion track. We present several metrics that can be used to evaluate the effectiveness of the programs similar to this innovation.

Preliminary Development of a Performance Assessment Tool for Documentation of History Taking in Child Physical Abuse.

OBJECTIVES: This study aimed to develop a performance assessment tool for the history-taking components of the medical evaluation of physical abuse in young children by (1) determining the consensus-based injury history and social components for documentation, (2) identifying preliminary performance standards, (3) assessing current level-specific performance using the created tools, and (4) evaluating reliability and validity of the created tools. METHODS: The Physical Abuse Assessment Tool (PHAAT) was developed in 2 steps: (1) a modified Delphi survey was used to identify the injury history and social components for documentation in a medical evaluation for physical abuse, and (2) level-specific ("novice," "competent," "expert") practice standards (minimum passing scores) were created using the identified components via the Angoff method. To evaluate validity, reliability, and level-specific performance of the PHAAT, a chart review of 50 consecutive cases from each of the 3 levels was performed. RESULTS: Seventy-one child abuse pediatricians and 39 social workers participated in the modified Delphi survey, and 67 child abuse pediatricians and 27 social workers participated in the Angoff method. The resulting PHAAT included 2 checklists for use based on presence or absence of a history of an injurious event. One-way analysis of variance shows significant differences in performance based on team level (P < 0.001), indicating construct validity. Intrarater and interrater reliability evaluations showed strong (rs = 0.64-0.92) and moderate to strong (intraclass correlation coefficient = 0.81-0.98) correlations, respectively. CONCLUSIONS: Initial evaluation suggests the PHAAT may be a reliable and valid practice assessment tool for the medical evaluation of physical abuse.

Introduction of a formative assessment tool in a post-graduate training program in India: a mixed methods evaluation.

BACKGROUND: Our institution has longstanding post-graduate education and training partnership programs in Emergency Medicine (EM) across India. A programmatic challenge has been the integration and uptake of evidence-based medicine and lifelong learning concepts. Formative assessment (FA) is intended to enable learners to monitor learning, identify strengths and weaknesses, and target areas of growth. As part of a program improvement initiative, we introduced an online FA tool to existing summative assessments. This study investigates how the FA tool was used and perceived by trainees. METHODS: 246 trainees across 19 sites were given access to the FA tool. Usage metrics were monitored over 12 months. Semi-structured interviews were conducted in person with trainees using a purposive sampling methodology. A hybrid thematic analysis approach was used to determine themes. Interviews were coded independently by two blinded researchers using NVivo software. The study was deemed exempt by our institutional review board. RESULTS: There was high variability in trainees' utilization of the FA tool. Trainees who used the FA tool more performed better on summative exams (r = 0.35, p < 0.001). Qualitative analysis revealed that trainees were motivated to learn for improved clinical knowledge and to be a good physician, not only passing exams. Benefits of the tool included the relationship to clinical practice and thorough explanation of answers, while disadvantages included topics unrelated to India. CONCLUSION: The integration of a FA tool has provided positive outcomes for trainees in EM education programs in India. Lessons learned may apply globally to other contexts and programs.

Violence in the emergency department: a quantitative survey study of healthcare providers in India.

BACKGROUND: Workplace violence (WPV) in Emergency Departments (EDs) is an increasingly recognized challenge healthcare providers face in low-resource settings. While studies have highlighted the increased prevalence of WPV in healthcare, most of the existing research has been conducted in developed countries with established laws and repercussions for violence against healthcare providers. More data on WPV against ED providers practicing in low-resource settings is necessary to understand these providers' unique challenges. OBJECTIVE: This study aims to gain insight into the incidence and characteristics of WPV among ED healthcare providers in India. METHODS: This study was conducted at two EDs in geographically distinct regions of India. A survey was designed to assess violence in EDs among healthcare providers. Surveys were distributed to ED workplace providers, completed by hand, and returned anonymously. Data was entered and stored in the RedCAP database to facilitate analysis. RESULTS: Two hundred surveys were completed by physicians, nurses, and paramedics in Indian EDs. Most reported events involved verbal abuse (68%), followed by physical abuse (26%), outside confrontation (17%), and stalking (5%). By far, the most common perpetrators of violence against healthcare workers were bystanders including patient family members or other accompanying individuals. Notably, reporting was limited, with most cases conveyed to ED or hospital administration. CONCLUSION: These results underscore the prevalence of WPV among Indian ED healthcare providers. High rates of verbal abuse followed by physical abuse are of concern. Most perpetrators of WPV against healthcare providers in this study were patient family members or bystanders rather than the patients themselves. It is imperative to prioritize implementing prevention strategies to create safer work environments for healthcare workers.

Shifts in Students' Attitudes Towards Pain Patients, Pain, and Opioid Management Following a Dedicated Medical School Pain Curriculum.

Objective: To examine the immediate effects of a comprehensive pain course on medical students' pre-existing perceptions and attitudes toward pain patients and opioid management. Methods: First-year medical students at a major academic medical center enrolled in a required pre-clerkship pain course in June 2020 and completed pre- and post-course online surveys with Likert-scale questions about their attitudes toward pain management and opioid-related issues. Additionally, the surveys included a free-text question where the students listed the first five words that came to mind when hearing the word "opioids". These words were categorized as "professional" or "lay" words and further as having "positive", "negative", or "neutral" connotations. Data analyses included descriptive statistics, as well as non-parametric and parametric tests. Results: Fifty-four of the 119 students responded to pretest and posttest surveys and were included in paired analyses. There was a significant difference between the number of professional words used before (M=1.21, SD=0.97) and after the course (M=2.40 SD=1.33); t(52)=-6.39, P<0.001. Students also used more lay-positive words after the course (M=0.81, SD=0.63) than they used pre-course (M=0.23, SD=0.43); t(51)=-5.98, P<0.001. Students' post-course responses to several key Likert-scale questions showed significant shifts toward more positive attitudes about caring for patients with pain. For example, students acknowledged greater comfort in providing opioids for chronic pain (P<0.001) where appropriate, and enhanced interest in handling complex pain cases (P<0.001). Conclusion: Results showed that a comprehensive, multi-disciplinary pain course could greatly enhance first-year medical students' attitudes toward pain management, chronic pain patients, and the complex issues surrounding opioids.

Does Extended Reality Simulation Improve Surgical/Procedural Learning and Patient Outcomes When Compared With Standard Training Methods?: A Systematic Review.

INTRODUCTION: The use of extended reality (XR) technologies, including virtual, augmented, and mixed reality, has increased within surgical and procedural training programs. Few studies have assessed experiential learning- and patient-based outcomes using XR compared with standard training methods. METHODS: As a working group for the Society for Simulation in Healthcare, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and a PICO strategy to perform a systematic review of 4238 articles to assess the effectiveness of XR technologies compared with standard training methods. Outcomes were grouped into knowledge, time-to-completion, technical proficiency, reactions, and patient outcomes. Because of study heterogeneity, a meta-analysis was not feasible. RESULTS: Thirty-two studies met eligibility criteria: 18 randomized controlled trials, 7 comparative studies, and 7 systematic reviews. Outcomes of most studies included Kirkpatrick levels of evidence I-III (reactions, knowledge, and behavior), while few reported level IV outcomes (patient). The overall risk of bias was low. With few exceptions, included studies showed XR technology to be more effective than standard training methods in improving objective skills and performance, shortening procedure time, and receiving more positive learner ratings. However, XR use did not show significant differences in gained knowledge. CONCLUSIONS: Surgical or procedural XR training may improve technical skill development among trainees and is generally favored over standard training methods. However, there should be an additional focus on how skill development translates to clinically relevant outcomes. We recommend longitudinal studies to examine retention and transfer of training to clinical settings, methods to improve timely, adaptive feedback for deliberate practice, and cost analyses.

Pediatric Code Cart Challenge for Emergency Medicine Trainees in Emergency Departments in India.

BACKGROUND: Code carts provide accessible emergency medication, supplies, and equipment to resuscitate a child. Unfortunately, there are limited studies on pediatric code cart use in resource-limited settings, including in India. METHODS: This was a Pediatric Code Cart Challenge for emergency medicine (EM) trainees in India. After receiving education on pediatric code carts, participants created their code carts and submitted a video showcasing their project. Reviewers evaluated each team's code cart using a rubric. A six-month follow-up survey assessed participants' use of code carts and their perception and satisfaction. RESULTS: Forty-nine participants across six sites completed the survey. The median number of pediatric code cart uses in the past six months was two. Materials frequently used from the code cart included medications (76%), followed by airway equipment (59%), and intravenous (IV) equipment (57%). Only 4% of respondents used an intraosseous (IO) catheter. Two of six sites reported modifying their code cart within the past six months by rearranging and/or adding equipment and medications. Local protocols, pediatric advanced life support guidelines, and references from other hospitals led to changes. Most respondents rated the pediatric code cart useful and appreciated its accessibility, ease of use, organization, and equipment. Respondents said they would add more pediatric equipment, including IO supplies, to improve their code cart. CONCLUSION: Participating sites now have pediatric medications and equipment accessible and organized in their code carts. Additionally, EM trainees learned what is needed and how to improve their current pediatric code carts. Future steps include expanding this pilot project to additional sites in low- and middle-income countries.

Developing cognitive workload and performance evaluation models using functional brain network analysis.

Cognition, defined as the ability to learn, remember, sustain attention, make decisions, and solve problems, is essential in daily activities and in learning new skills. The purpose of this study was to develop cognitive workload and performance evaluation models using features that were extracted from Electroencephalogram (EEG) data through functional brain network and spectral analyses. The EEG data were recorded from 124 brain areas of 26 healthy participants conducting two cognitive tasks on a robot simulator. The functional brain network and Power Spectral Density features were extracted from EEG data using coherence and spectral analyses, respectively. Participants reported their perceived cognitive workload using the SURG-TLX questionnaire after each exercise, and the simulator generated actual performance scores. The extracted features, actual performance scores, and subjectively assessed cognitive workload values were used to develop linear models for evaluating performance and cognitive workload. Furthermore, the Pearson correlation was used to find the correlation between participants' age, performance, and cognitive workload. The findings demonstrated that combined EEG features retrieved from spectral analysis and functional brain networks can be used to evaluate cognitive workload and performance. The cognitive workload in conducting only Matchboard level 3, which is more challenging than Matchboard level 2, was correlated with age (0.54, p-value = 0.01). This finding may suggest playing more challenging computer games are more helpful in identifying changes in cognitive workload caused by aging. The findings could open the door for a new era of objective evaluation and monitoring of cognitive workload and performance.

Neurocognitive Correlates of Clinical Decision Making: A Pilot Study Using Electroencephalography.

The development of sound clinical reasoning, while essential for optimal patient care, can be quite an elusive process. Researchers typically rely on a self-report or observational measures to study decision making, but clinicians' reasoning processes may not be apparent to themselves or outside observers. This study explored electroencephalography (EEG) to examine neurocognitive correlates of clinical decision making during a simulated American Board of Anesthesiology-style standardized oral exam. Eight novice anesthesiology residents and eight fellows who had recently passed their board exams were included in the study. Measures included EEG recordings from each participant, demographic information, self-reported cognitive load, and observed performance. To examine neurocognitive correlates of clinical decision making, power spectral density (PSD) and functional connectivity between pairs of EEG channels were analyzed. Although both groups reported similar cognitive load (p = 0.840), fellows outperformed novices based on performance scores (p < 0.001). PSD showed no significant differences between the groups. Several coherence features showed significant differences between fellows and residents, mostly related to the channels within the frontal, between the frontal and parietal, and between the frontal and temporal areas. The functional connectivity patterns found in this study could provide some clues for future hypothesis-driven studies in examining the underlying cognitive processes that lead to better clinical reasoning.

Needs-based novel digital curriculum for the neuromodulation training deficit: Pain Rounds.

This study reports the needs-based development, effectiveness and feasibility of a novel, comprehensive spinal cord stimulation (SCS) digital curriculum designed for pain medicine trainees. The curriculum aims to address the documented systematic variability in SCS education and empower physicians with SCS expertise, which has been linked to utilization patterns and patient outcomes. Following a needs assessment, the authors developed a three-part SCS e-learning video curriculum with baseline and postcourse knowledge tests. Best practices were used for educational video production and test-question development. The study period was from 1 February 2020 to 31 December 2020. A total of 202 US-based pain fellows across two cohorts (early-fellowship and late-fellowship) completed the baseline knowledge assessment, while 122, 96 and 88 participants completed all available post-tests for Part I (Fundamentals), Part II (Cadaver Lab) and Part III (Decision Making, The Literature and Critical Applications), respectively. Both cohorts significantly increased knowledge scores from baseline to immediate post-test in all curriculum parts (p<0.001). The early-fellowship cohort experienced a higher rate of knowledge gain for Parts I and II (p=0.045 and p=0.027, respectively). On average, participants viewed 6.4 out of 9.6 hours (67%) of video content. Self-reported prior SCS experience had low to moderate positive correlations with Part I and Part III pretest scores (r=0.25, p=0.006; r=0.37, p<0.001, respectively). Initial evidence suggests that Pain Rounds provides an innovative and effective solution to the SCS curriculum deficit. A future controlled study should examine this digital curriculum's long-term impact on SCS practice and treatment outcomes.

Anaphylaxis knowledge among paramedics: results of a national survey.

BACKGROUND: Very little is known about prehospital providers' knowledge regarding anaphylaxis care. OBJECTIVES: The purpose of this study was to evaluate how well nationally registered paramedics in the United States recognize classic and atypical presentations of anaphylaxis. We also assessed knowledge regarding treatment with epinephrine, including dosing, route of administration, and perceived contraindications to epinephrine use. METHODS: This was a blinded, cross-sectional online survey of a random sample of paramedics registered by the National Registry of Emergency Medical Technicians that was distributed via e-mail. The survey contained two main sections: demographic data/self-assessment of confidence with anaphylaxis care and a cognitive assessment. RESULTS: A total of 3,537 paramedics completed the survey, for a 36.6% response rate. Among the respondents, 98.9% correctly recognized a case of classic anaphylaxis, whereas only 2.9% correctly identified the atypical presentation. Regarding treatment, 46.2% identified epinephrine as the initial drug of choice; 38.9% chose the intramuscular (IM) route of administration, and 60.5% identified the deltoid as the preferred location (11.6% thigh). Of the respondents, 98.0% were confident they could recognize anaphylaxis; 97.1% were confident they could manage anaphylaxis; 39.5% carry epinephrine autoinjectors (EAIs) on response vehicles; 95.4% were confident they could use an EAI; and 36.2% stated that there were contraindications to epinephrine administration in anaphylactic shock. CONCLUSIONS: Whereas a large percentage of the paramedics recognized classic anaphylaxis, a very small percentage recognized atypical anaphylaxis. Less than half chose epinephrine as the initial drug of choice, and most respondents were unable to identify the correct route/location of administration. This survey identifies a number of areas for improved education.

Podcasting as a Learning Tool in Medical Education: Prior to and During the Pandemic Period

Podcasting as a Learning Tool in Medical Education: Before and During the Pandemic Period Podcasts have seen significant growth as a medium for medical education over the last 15 years. The COVID-19 pandemic altered the way in which medical education is delivered to learners, including medical students, resident physicians, fellows, and practicing clinicians in the form of continuing medical education. A literature search using Google Scholar, PubMed, and NCBI was conducted to analyze and discuss how podcasts are utilized in medical education-both before and during the pandemic-and how this form of asynchronous education may influence clinical decision-making and patient outcomes. Finally, this review discusses how learners' habits while using podcasts may affect the way in which the information is internalized and the future of using podcasts to supplement medical education.