Listen Up: A Systematic Review of the Utilization and Efficacy of Podcasts for Medical Education

doi:10.21203/rs.3.rs-4977226/v1

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Research Article

Listen Up: A Systematic Review of the Utilization and Efficacy of Podcasts for Medical Education

https://doi.org/10.21203/rs.3.rs-4977226/v1

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Background

Podcasts are increasingly utilized in medical education due to ease of use and ability for remote and asynchronous learning. Despite their uptake and learner satisfaction, literature regarding their efficacy is limited, and no prior systematic review has evaluated educational outcomes or the methodological quality of published literature. We conducted a systematic review to evaluate the use of podcasts by physicians and physician trainees to evaluate (1) trends in audio podcast utilization and research over time, (2) podcast uptake within differing medical specialties, (3) the methodological quality of published research, and (4) the evidence supporting podcasts as an efficacious learning modality.

Methods

A systematic PRISMA search was conducted by a medical librarian for studies regarding podcasting and medical education. Studies without full text English language availability were excluded. Review papers, opinion pieces, manuscripts focused on patients or non-physician healthcare professionals, as well as those which described an educational method which included non-audio interventions were excluded. COVIDENCE software was used for manuscript evaluation and data extraction. Abstract and text screening was performed by three authors with consensus required for inclusion. The Medical Education Research Study Quality Instrument (MERSQI) was used for quality and bias assessment.

Results

Following de-duplification, 1,140 studies underwent screening, and after abstract and full text screening, 149 were ultimately included, of which 66% were published between 2020-2023. We noted three themes in the literature: (1) description of podcast utilization and uptake, (2) podcast topics or availability, and (3) evaluation of podcasts as an educational modality. The number of publications and citations steadily increased over the study period with rapid acceleration noted after 2020. In aggregate, 66% of trainees were utilizing podcasts, with increasing percentages seen in the post-2020 literature (75%). Evaluation of the number of podcast episodes available in each medical specialty demonstrated between 63 and 4,406 episodes. The largest number of manuscripts concerned podcasts focused on emergency medicine trainees or medical students.

Assessment of included studies by Kirkpatrick level highlighted that, of studies including an educational intervention, few studies investigated higher-order educational outcomes with the majority (45 [75%]) evaluating only listener satisfaction. The average MERSQI score was 7.2, consistent with low educational quality. Of nine studies which compared podcasts to traditional educational modalities, four (44.4%) found them to be “as efficacious”, while five (55.5%) found them to be “superior”.

Conclusions

Podcasts are increasingly utilized in medical education, and the rate of publication has escalated in the post-COVID pandemic period. However, the efficacy of podcasts is unclear based on current literature with the majority of studies reporting only Kirkpatrick 1 outcomes. Additional rigorous research is required to evaluate podcasts as an educational modality for medical trainees, especially in surgical disciplines that are underrepresented in the published literature.

New media formats such as podcasts have rapidly taken off, becoming popular methods for dissemination of knowledge due to their low-cost method of production by educators and ease of use by learners. As early as 2005, medical schools were making recordings of their lectures available online, and by 2009, many medical journals had a regular podcast (1,2). Currently, medical podcasts are available in a variety of specialties covering a diverse range of topics, designed for a broad range of medical education uses from review of medical school subjects to providing continuing medical education (CME) to attending physicians (3). When podcasts are included in curricula for medical students, the vast majority elect to use them as a study tool and those who do may have higher test scores (4). Recent studies show that between 60 and 90% of residents are utilizing podcasts to learn core content or keep up with the scientific literature (5,6). Many learners prefer new media methods such as podcasts and other online resources to traditional methods of instruction such as lectures and textbooks as they offer the ability to multitask, increased entertainment value compared to traditional learning methods, and more up-to-date information (7). With their rapid uptake and high learner satisfaction, knowledge of the efficacy and use of podcasts is essential for medical educators.

Despite their popularity, podcasts have rarely been evaluated as a method of effective knowledge delivery for medical learners. Learners have even noted that their ability to retain information from podcasts is limited, and they are likely to become distracted while listening (8). Objective data regarding the efficacy of listening as a learning modality is mixed with some studies showing increased mind-wandering, decreased knowledge uptake, and lower recall when podcasts are compared to traditional learning modalities such as textbooks or lectures (9–11). For non-physician medical learners, podcasts have been shown to be inferior to live classroom teaching and to visual text instruction (12,13). However, conflicting studies have demonstrated the benefit and efficacy of podcasts as a method for learning, including the ability to learn without explicit effort, and superior knowledge gain among podcast users when compared to textbook users or students who listened to traditional lectures (14–16). These mixed results limit the ability for educators and learners to draw conclusions about the efficacy of podcasts.

The COVID19 pandemic caused a rapid increase in the need for asynchronous and virtual learning methods (17). With this need, an increase was seen in the number of available virtual education methodologies, including podcasts (18). While prior work has evaluated the use of podcasts in the medical education literature, no work has evaluated medical education podcasts since the rapid increase in publications seen in the post-2020 period (19,20). Additionally, no work has evaluated the methodological quality of studies on medical podcasts, limiting the ability of researchers to utilize the data from these studies or understand the potential bias within the literature.

We conducted a systematic review to evaluate the use of podcasts for physicians and physician trainees in the medical education literature. This review evaluates (1) the trend of audio podcast utilization and research on podcasting over time, (2) podcast uptake within differing medical specialties, (3) the methodological quality of published research in this area, and (4) the evidence supporting podcasts as an efficacious learning modality for physicians and physician trainees.

Literature Search Strategy

A medical librarian (LHY) searched the literature for records including the concepts of education, teaching, podcasts, medical students, residents, and fellows. The librarian created search strategies using a combination of keywords and controlled vocabulary in Ovid Medline 1946-, Embase 1947-, Scopus 1823-, Cochrane Databases of Systematic reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature Plus (CINAHL Plus) 1937-, and Academic Search Complete 1887-. All search strategies were initially completed July 16, 2019, and a total of 1,049 results were found and exported to Endnote, after which 517 duplicate records were deleted after using described de-duplification processes (21). All searches were then updated on September 12, 2023, limiting results to 2019–2023 to identify additional results. No filters were used during the search. Fully reproducible search strategies for each database can be found in Appendix 1.

Abstract/Full-Text Screen and Article Selection

A total of 1,140 studies were screened. Three investigators (KC, JZ, CF) independently screened all abstracts for inclusion. A consensus of at least two of three investigators was required for inclusion. Inclusion criteria included English-language articles regarding the use of podcasts for medical education with a target population of physicians or physician trainees (including residents, fellows, and medical students). Articles published after 2004 were included as this is generally recognized to be the introduction of podcasts in the educational literature, and prior reviews have not demonstrated any relevant literature prior to this date (19,20). Exclusion criteria included non-English language articles, articles without full text available, review papers, opinion pieces regarding podcasts, and manuscripts focused on patients or non-physician healthcare professionals including nurses, therapists, and others. Articles describing an educational method that included video or other non-audio interventions were also excluded. After abstract review, 899 articles were excluded. Following full-text screening, an additional 92 manuscripts were excluded.

Data Extraction

The data extraction form was piloted using 5 studies. Subsequently, two reviewers evaluated the extraction form for information that was not captured, or questions that resulted in different answers, between the two reviewers. The data extraction form was modified, and the final form was used to extract data from all 149 included studies.

Two reviewers independently extracted data into Covidence Systematic Review software (Veritas Health Innovation, Melbourn, Australia, 2023) with extraction criteria that was decided a priori. Final extraction included: year of publication, country in which the study was conducted, the category of podcast evaluation (uptake, topics/availability, evaluation as learning modality), specific mention within the manuscript or figures of COVID-19, characteristics of the podcast evaluated, subspecialty topic, type of medical learners included, total number of participants reported, reported podcast statistics (episodes created, average episode length, number of downloads per episode, countries listened, number of podcasts and episodes available on a topic), and Kirkpatrick level.

Conflicts

were resolved through discussion to reach consensus.

Kirkpatrick level

Table 1

Kirkpatrick Model based on Streith (2021) and Anand (2023) as described by Kirkpatrick (2006)
Level	Classification	Description
1	Reaction	Measure learner’s views of the experience and satisfaction with the use of a podcast
2	Learning	Measure learner’s change in attitude or perception following the use of a podcast. Measure learner’s acquisition of knowledge, concepts, or skills after the use of a podcast
3	Behavior	Measure learner’s behavioral change in a workplace due to knowledge or skills gained through use of a podcast
4	Result	Measure an improvement in and impact on an organizational-level targeted outcome as the result of the use of a podcast

Kirkpatrick levels were defined by in accordance with other recently published educational research scoping reviews (22,23) based on original definition by Kirkpatrick (24). (Table 1). For our review, outcomes in which learners reported belief of behavioral change or improved knowledge without objective assessment of these were coded as level 1 outcomes due to lack of demonstrated evidence to confirm higher level outcomes.

Quality and Bias Assessment

To evaluate the quality of the educational research methodology that was used, the Medical Education Research Study Quality Instrument (MERSQI) score was used. The MERSQI score is a well-described tool for the evaluation of educational research studies and assesses research in six domains: study design, sampling, type of data, validity of the evaluation instruments, data analysis, and outcome (25). A minimum score of 5 and maximum score of 18 can be obtained, with low scores representing poor methodological quality and thus high risk of bias.

Data Analysis

Descriptive statistics were utilized to characterize the use of podcasts for medical education including the year of publication, type of subjects included, podcast topic, subspecialty, Kirkpatrick level, and MERSQI score. Missing data was excluded from the analysis due to inability to extrapolate data from provided information within studies and inability to impute data based on heterogeneity of study design. A pooled analysis was performed to evaluate the trends present within the literature over time. A combination of ANOVA and Kruskal-Wallis testing were utilized to compare changes in podcast listeners, countries, and available podcasts in groups depending upon the normalcy of data distribution. Interrater agreement was evaluated using Cohen’s kappa score.

PRISMA Checklist and Data Reporting

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist (26) was used to ensure comprehensive reporting. This review was not registered as it does not qualify for registration with PROSPERO or Cochrane review registries. The completed checklist can be found in Appendix 2. Template data collection forms are available upon request. No analytic code was used in the generation of this review.

Outcome of Search

After de-duplification, a total of 1140 studies were considered for inclusion with 241 undergoing full-text review for eligibility. Ultimately 149 studies underwent data extraction. The study selection process, including the reasons for full-text exclusion are included in the PRISMA diagram (Fig. 1). Inter-rater agreement was measured using Cohen’s kappa; with a value of 0.86 for title and abstract review and 0.79 for full-text review.

Table 2

Included Studies
Title	Author	Year	Outcome Summary	Characteristic	Kirkpatrick Level Evaluated
Podcasting for Exam Preparation: Tuning into Alternative Study Strategies for Residents(27)	Abdelhakim	2022	Evaluates the uptake of a podcast developed as a study tool for neurology residents with 90% of residents using the podcast and 82% reporting satisfaction.	Uptake	1
Facilitating #FOAMED: Indexing Internal Medicine Podcasts to Promote Integration into Medical Curricula(28)	Agrawal	2021	Describes the current number of episodes for the top 3 podcasts available in internal medicine	Topics	No intervention
Characteristics of Oncology Podcasts: Attitudes, Speakers, Conflicts(29)	Akman	2022	Describes the current number of podcasts available for oncologists and the types of speakers on these podcasts	Topics	No intervention
Podcasting in dermatology education(30)	Alikhan	2010	Describes the number of podcasts available for dermatologists	Topics	No intervention
PodMedPlus: An Online Podcast Resource for Doctors(31)	Alla	2014	Evaluates the effect of a podcast in increasing medical student knowledge showing increased knowledge after listening with knowledge gains of 6% and 23% on two quizzes and 78% of participants were satisfied	Learning	2
Development and Utilization of a Medical Student Surgery Podcast During COVID 19(32)	Anteby	2021	Description of the uptake and development of a podcast developed for Israeli medical students based on the ACS/ASE medical student core curriculum	Uptake	No intervention
Morning Report for All: The Use of Podcasts to Disseminate Clinical Reasoning Tools(33)	Augustin	2019	Description of the uptake of a single university produced case study podcast	Uptake	No intervention
The Use of Podcasts as a Tool to Improve Clinical Reasoning: A Pseudorandomized and Controlled Study(34)	Augustin	2021	Evaluates the effect of a podcast to improve clinical reasoning skills of medical students on an IM clerkship demonstrating no difference between students who listened to the podcast and those who did not	Learning	2
Superior Gain in Knowledge by Podcasts Versus Text-Based Learning in Teaching Orthopedics: A Randomized Controlled Trial(15)	Back	2017	RCT comparing textbook learning to podcasts in a group of medical students learning about orthopedic diseases showing higher post-education quiz scores in the group of students who listened to a podcast compared to those who read a textbook chapter	Learning	2
Engaging Pediatric Residents Through a Journal Club Podcast(35)	Banker	2020	Description of the uptake and development of a podcast for pediatric residents	Uptake	No intervention
How to Create a Subspecialty Podcast: Headmirror's ENT podcast Series(36)	Barnes	2020	Description of the uptake and development of a podcast for ENT surgeons	Uptake	No intervention
Creation of a New Educational Podcast: "Headmirror's ENT in A Nutshell"(37)	Barnes	2020	Description of the number of podcasts available for ENT surgeons	Topics	No intervention
Evaluating the Use of Podcasting for Residents During EEG Instruction(38)	Bensalem-Owen	2011	Comparison of a podcast v. conventional lecture for increasing EEG knowledge showing no difference in quiz scores between podcasting and traditional didactics.	Learning	2
Medical Education Podcasts: Where We Are and Questions Unanswered(39)	Berk	2020	Description of the listeners of a large medical education podcast for internal medicine	Topics	No intervention
Texting Brief Podcasts to Deliver Faculty Development to Community-Based Preceptors in Longitudinal Integrated Clerkships(40)	Bernstein	2018	Description of the uptake and satisfaction with a podcast for community-based preceptors	Uptake	1
A Nationwide Survey of Educational Resource Utilization and Perception Among Internal Medicine Residents(5)	Bernstein	2021	Evaluate the use of podcasts by internal medicine residents	Uptake	1
Neuropodcases: A Clinical Neuroscience Podcast - A remove Learning Resource(41)	Bharambe	2022	Describe the uptake of a podcast about neuroscience cases for medical students.	Uptake	No intervention
E-learning vs lecture: which is the best approach to surgical teaching?(42)	Bhatti	2011	RCT comparing podcast v. conventional lecture for third year medical students about hemorrhoidal disease showing increased knowledge gain with podcast v. lecture	Learning	2
Development of a medical education podcast in obstetrics and gynecology(16)	Black	2021	Description of the current number of podcasts available for OBGYNs	Topics	No intervention
Educational Preferences Among Residents in the ICU(43)	Block	2018	Evaluate the number of residents listening to critical care podcasts as a way to learn topics in critical care and their satisfaction with the medium.	Uptake	1
Medical Education Blog and Podcast Utilization During the COVID-19 Pandemic(44)	Boreskie	2022	Description of the change in podcast downloads in the pre- and post-COVID pandemic period.	Uptake	No intervention
Teaching Medical Documentation Skills - An Innovative Method to Improve Patient Care(45)	Bragg	2013	Evaluates a podcast as a method for teaching medical students best practices for documentation with increase in scores (17.9 v 23.9) when compared to students who did not get the intervention.	Learning	2
A Randomized-Controlled Trial Comparing Efficacy and User Satisfaction of Audio Podcasts Versus a Traditional Lecture on Multiple Sclerosis in Family Medicine Resident Education(46)	Brust	2015	Compared the results of a podcast v traditional lecture to improve family medicine resident knowledge of multiple sclerosis with greater post-learning test scores in the podcast group (49.8 v 41.7).	Learning	2
What Kind of Doctor Do You Want to Be? Geriatric Medicine Podcast as a Career Planning Resource(47)	Byszewski	2017	Evaluate the effect of a podcast about geriatric medicine to improve the understanding of medical students about a career in geriatrics and their satisfaction with the podcast	Learning	1
CREOGs Over Coffee: Feasibility of an Ob-Gyn Medical Education Podcast by Residents(48)	Cai	2020	Describes the uptake of a resident-led podcast for OBGYN residents	Uptake	No intervention
Podcast for residents on veteran-centered care(49)	Caputo	2022	Evaluates the uptake of a podcast about veteran care for residents rotating at a VA medical center	Uptake	1
A survey on the educational impact of a resident-produced emergency medicine education podcast(50)	Carroll	2012	Evaluates the impact of an EM podcast on residents with the usefulness of the podcast rated 8.6/10	Uptake	1
MSK Matters - A sport and exercise medicine podcast for Canadian medical learners(51)	Carson	2021	Describes the uptake of a podcast about sports medicine for family medicine residents and medical students	Uptake	No intervention
A Novel Curricular Design Exposing Clinical Medical Students to the Hidden Curriculum(52)	Chapa	2022	Evaluates the uptake of medical students with a podcast about the hidden curriculum	Uptake	1
Microbe Mail: A microbiology and infectious diseases podcast for clinicians and students(53)	Chibabhai	2023	Describes the uptake of a podcast about microbiology and infectious disease	Uptake	No intervention
Podcast Pearls in Residency Training(54)	Childers	2014	Evaluates the uptake of a single-institution podcast for internal medicine residents	Uptake	1
Podcast Use in Undergraduate Medical Education(55)	Chin	2017	Evaluates the current use of podcasts by medical students and their preferences around utilization as well as evaluate two podcasts as a method of learning	Uptake	2
Spot diagnosis: the anatomy of a dermatology podcast(56)	Chong	2022	Describes the uptake of a podcast for dermatologists	Uptake	No intervention
Resident physician impressions of menopause core content delivered by podcast(57)	Clark	2020	Evaluate the uptake of and satisfaction with a podcast about menopause for OBGYN, family med, and IM residents.	Uptake	1
Giving Radiologists a Voice: A review of podcasts in radiology(58)	Clarke	2020	Describes of the current number of podcasts available for radiologists	Topics	No intervention
Podcasting in Medical Education: How Long Should an Educational Podcast be?(59)	Cosimini	2017	Describes the preferred podcast length for medical education	Uptake	No intervention
Telephone management training by podcast-length and content considerations(60)	Cosimini	2017	Evaluates the satisfaction of pediatric residents with a podcast to train them about telephone management of cough.	Uptake	1
Integrating Podcasts into Pediatric Critical Care Education: Reach of "PICU Doc on Call" Podcast(61)	Damania	2022	Describes the uptake of a podcast about pediatric critical care	Uptake	No intervention
Future of Pediatric Critical Care Remote Learning: Role and Reach of a Podcast Series(62)	Damania	2022	Describes the uptake of two non-clinical pediatric critical care podcast episodes	Uptake	No intervention
(Pod)Casting A Large Net in Addiction Medical Education(63)	Daneshvar	2023	Describes the uptake of a podcast about addiction medicine	Uptake	No intervention
Current Status of Podcasts in Orthopaedic Surgery Practice and Education(64)	Danford	2022	Describes of the current number of podcasts available for Orthopedic Surgery	Topics	No intervention
Education on the Go: Studying the Use of Podcasts in Resident Education(65)	De Los Reyes	2017	Describes the efficacy of podcasts to teach residents information from the ACOG practice bulletins showing no difference in average quiz scores between podcast and traditional groups (70% and 80%)	Learning	2
Learning on the Go: Assessing Knowledge Gained from Medical Podcast Created for Vulvovaginal Disease Education(66)	Dmytryshyn	2022	Evaluates a podcast for medical students and residents about vulvovaginal disease demonstrating increased test scores from pre- to post- intervention (20% and 23%).	Learning	2
MacEmerg Podcast: A Novel Initiative to Connect a Distributed Community of Practice(67)	Dong	2020	Describes the uptake of a podcast on emergency medicine topics	Uptake	No intervention
Impact of the Febrile Podcast and Learning Resource as an Infectious Diseases Education Platform(68)	Dong	2022	Evaluates the uptake of and satisfaction with a podcast on infectious disease	Uptake	1
Effectiveness of a Podcast for Education among obstetrics and gynecology clerkship students(69)	Drummond	2021	Evaluates the efficacy of a podcast about OBGYN for medical students in improving clerkship quiz scores (91% v 80%) with 77% of students satisfied	Learning	2
An electronic survey of preferred podcast format and content requirements among trainee emergency medicine specialists in four Southern African universities(70)	Ekambaram	2021	Describes the current use of podcasts by emergency medicine trainees in South African Universities	Uptake	No intervention
ClerkCast: a novel online free open access emergency medicine curriculum for medical students(71)	Forestell	2020	Describes the uptake of a podcast for students on their emergency medicine rotation	Uptake	No intervention
How to Create and Evaluate a Resident-Led Audio Program: Six Clinical Podcasts for Medicine House Staff(72)	Ghiathi	2020	Describes the preferences and uptake of podcasts by internal medicine residents	Uptake	No intervention
Primary Care Anywhere: A Resident Led Podcast(73)	Gibson	2022	Describes the uptake of a podcast for IM residents about primary care topics	Uptake	No intervention
Maximizing the Morning Commute: A Randomized Trial Assessing the Effect of Driving on Podcast Knowledge Acquisition and Retention(74)	Gottlieb	2021	RCT comparing knowledge retention when listening to a podcast while driving v. while undistracted showing no difference between cohorts	Learning	2
Feel the Burn, While You Learn: The Impact of Exercise on Podcast Knowledge Acquisition and Retention(75)	Gottlieb	2023	Evaluates the effect of exercise on podcast knowledge retention among residents demonstrating no difference between exercise and undistracted cohorts on initial recall (74.4% and 76.3%) or delayed recall (52.3% v 52.5%)	Learning	2
The current landscape of dermatology podcasts: A descriptive analysis(76)	Guo	2020	Describes of the current number of podcasts available for dermatologist	Topics	No intervention
Podcasting in Clinical Allergy and Immunology: Our Experience and a Review of the Current Landscape(77)	Gupta	2023	Describes of the current number of podcasts available for allergy and immunology physicians the development of an allergy/immunology podcast	Topics	No intervention
Cardionerds: Pumping up Medical Education in the Podcast Era(78)	Hamo	2021	Describes the uptake of a cardiology focused podcast	Uptake	No intervention
Dermatology podcasting: An Untapped Resource for Continuing Education(79)	Henley	2013	Describes of the current number of podcasts available for dermatologist	Topics	No intervention
Pediatric Emergency Medicine Podcasts: Current Status(80)	Hernandez	2022	Describes of the current number of podcasts available for pediatric emergency medicine	Topics	No intervention
A survey study on student preferences regarding pathology teaching in Germany: a call for curricular modernization(81)	Herrmann	2015	Evaluates the preferences of medical students regarding the inclusion of podcasts into medical school curriculum with 75% supporting incorporation	Uptake	1
Medical Podcasting in Iran: Pilot, Implementation, and Attitude Evaluation(82)	Heydarpour	2013	Evaluates the satisfaction of medical students with a podcast about pharmacology	Uptake	1
Dragon bytes paediatric podcast: Developing a trainee-oriented podcast(83)	Javaid	2023	Describes the uptake of a podcast for pediatric residents	Uptake	No intervention
Good Morning, Orthopods: The Growth and Future Implications of Podcasts in Orthopaedic Surgery(84)	Jella	2021	Describes of the current number of podcasts available for orthopedic surgery	Topics	No intervention
Audible Bleeding, the Vascular Surgery Podcast: Affecting the Practice of Vascular Surgery(85)	Johnson	2020	Evaluates the uptake of a podcast about vascular surgery and the reported effect on listeners	Uptake	1
Continuing Education Evaluations of an Internal Medicine and a Pediatric Podcast.(19)	Kelly	2023	Describes the number of listeners who are using podcasting for CME	Uptake	No intervention
The Surgical Oncology Files: A Podcast-based Educational Module(86)	Krasnick	2020	Describes the uptake of a podcast about surgical oncology	Uptake	No intervention
What Is The Internal Medicine Resident's Perspective On Using Podcasts To Enhance Critical Care Medical Education(87)	Kuhlmann	2013	Evaluates the uptake of podcasts by residents for critical care education	Uptake	1
Learner-generated podcasts: “The Intern at Work” series(88)	Lai	2019	Describes the uptake of a podcast for internal medicine residents	Uptake	No intervention
Medical Podcasting and Circulation on the Run Why, How, and What Now(89)	Lam	2017	Describes the creation and uptake of a podcast for the journal circulation	Uptake	No intervention
Development and Implementation of an Emergency Medicine Podcast for Medical Students: EMIGcast(90)	Lichtenheld	2015	Describes the uptake of an EM focused podcast for medical students	Uptake	No intervention
A Randomized Comparative Trial of the Knowledge Retention and Usage Conditions in Undergraduate Medical Students Using Podcasts and Blog Posts(4)	Lien	2018	RCT comparing knowledge acquisition between students listening to a podcast v. reading a blog showing no significant difference in knowledge gain (22 v. 29%).	Learning	2
Podcasting in Medicine: The Current Content by Emergency Medicine Subspecialty(91)	Little	2020	Describes the number of podcasts in multiple different specialties demonstrating emergency medicine has the most episodes available and the longest episodes.	Topics	No intervention
Podcasting in Medicine: A Review of the Current Content by Specialty(3)	Little	2020	Describes the current number of podcasts available for emergency medicine	Topics	No intervention
Talking About Racism: Learning and Disrupting the Silence Through a Pediatric Resident-Produced Podcast.(92)	Lowery	2023	Describes the uptake of a podcast about racism for pediatric residents	Uptake	No intervention
Creation of a military, residency-driven gynecological surgery and obstetrics education podcast during the COVID-19 pandemic(93)	Mackinnon	2022	Describes the uptake of a podcast for OBGYN residents	Uptake	No intervention
Understanding the Use and Perceived Impact of a Medical Podcast: Qualitative Study(7)	Malecki	2019	Evaluates the reasons for podcast use among internal medicine physicians	Uptake	1
Podcast-Based Learning in Otolaryngology: Availability, Breadth, and Comparison with Other Specialties(94)	Malka	2021	Describes the current number of podcasts available for ENT physicians	Topics	No intervention
A survey of the current utilization of asynchronous education among emergency medicine residents in the United States(95)	Mallin	2014	Evaluates the current utilization of podcasts by emergency medicine residents	Uptake	1
Distribution of core content coverage among three popular emergency medicine podcasts: A 10-year analysis(96)	Mannix	2022	Describes topics covered by emergency medicine podcasts over the last 10 years	Topics	No intervention
Gender Distribution of Emergency Medicine Podcast Speakers(97)	Mannix	2022	Describes the number of female speakers in emergency medicine podcasts	Topics	No intervention
Self-Directed Learning with Digital Education Resources Among Internal Medicine Residents: A Multi-Institutional Study(98)	Manolas	2023	Evaluates the use of digital resources (including podcasts) by internal medicine residents.	Uptake	1
eLearning among Canadian anesthesia residents: a survey of podcast use and content needs.(99)	Matava	2013	Describes the utilization of podcasts by Canadian anesthesia residents.	Uptake	No intervention
A Proposed Educational Podcast for Gastroenterology Trainees - Hot Air or Potential Hit(100)	Materacki	2021	Evaluates the frequency of podcast use by gastroenterology fellows	Uptake	1
Serving up Peds Soup: Podcast-based paediatric resident education(101)	McCarthy	2020	Evaluates the uptake of and satisfaction with a podcast for pediatric residents	Uptake	1
Educational Podcast Impact on Student Study Habits and Exam Performance(102)	McCarthy	2023	Evaluates the uptake of and satisfaction with a podcast for medical students during the pediatric clerkship	Uptake	1
Educating medical residents through podcasts developed by PharmD students(103)	Miesner	2017	Evaluates the efficacy of a podcast for IM residents to increase knowledge of pharmacology with 40% improvement in quiz scores.	Learning	1
Leveraging Podcasts to Introduce Medical Students to the Broader Community of Health Care Professionals(104)	Miller	2021	Evaluates the uptake of a podcast about interprofessional education	Uptake	1
Creation of a Student-Run Medical Education Podcast: Tutorial(105)	Milligan	2021	Describes the uptake of a medical education podcast for medical students	Uptake	No intervention
The clinical problem solvers: An internal medicine podcast dedicated to teaching approaches to common medical problems(106)	Minter	2019	Describes the uptake of a podcast about common internal medicine topics	Uptake	No intervention
Utility of a Novel Trainee-Level Hematology/Oncology Podcast in Graduate Medical Education(107)	Mistry	2023	Evaluates the uptake of and satisfaction with a podcast for residents/fellows about hematology oncology.	Uptake	1
Podcasts in urology: A growing tendency?(108)	MorenoFontela	2021	Describes the number of podcasts available about urology topics	Topics	No intervention
The Neurology® Podcast: 2007–2012(109)	Moriarity	2012	Describes the uptake of a podcast about neurology	Uptake	No intervention
Audio podcasts in practical courses in biochemistry cost-efficient e-learning in a well-proven format from radio broadcasting(110)	Munch-Harrach	2013	Evaluates the uptake of and satisfaction with a podcast for medical students about biochemistry	Uptake	1
Podcasts for the Delivery of Medical Education and Remote Learning(111)	Newman	2021	Evaluate the uptake of and satisfaction with a podcast about HIV	Uptake	1
Use of podcast technology to facilitate education, communication and dissemination in palliative care: the development of the AmiPal podcast(112)	Nwosu	2017	Evaluates the uptake of and satisfaction with a podcast about palliative care topics	Uptake	1
Effectiveness of podcasts as an adjunct learning strategy in teaching clinical microbiology among medical students(113)	O'Neill	2010	Evaluates a podcast as a method to teach microbiology to medical students with an increase in post-implementation scores 4.9 to 6)	Learning	2
Morning report for all: a qualitative study of disseminating case conferences via podcasting(114)	Ow	2021	Evaluates the listening habits of users of a podcast for emergency medicine	Uptake	1
Podcast possibilities: Asynchronous mentoring for learners with disabilities(115)	Panzer	2020	Describes the uptake of a podcast for residents about persons with disabilities	Uptake	No intervention
Diversifying educational resources during the COVID-19 pandemic: delivering educational dermatology podcasts and webinars for healthcare professionals(116)	Paolino	2021	Describes the uptake of a podcast for dermatologists	Uptake	No intervention
The Role of Medical Education Podcasts in Pediatrics(117)	Parga-Belinkie	2023	Describes the number of podcasts available for pediatricians	Topics	No intervention
Using Podcasts to deliver pediatric educational content: development of Pediacast CME(118)	Patrick	2019	Describes the uptake of a podcast with CME credit for pediatric practitioners	Uptake	No intervention
Podocytes to Podcasts: New Avenues for Virtual Nephrology Learning During COVID19(119)	Pettersson-Yeo	2022	Evaluate the uptake of a podcast about nephrology topics	Uptake	1
Eyes for Ears: Usage and Efficacy of a Podcast for Ophthalmic Education(120)	Pouw	2023	Evaluation of the uptake of a podcast for ophthalmologists	Uptake	1
Narrative Podcasts to Foster Empathy and Reduce Stigma Among Third-Year Medical Students(121)	Powers	2023	Evaluate the effect of a podcast for medical students on the psychiatry clerkship to increase empathy and reduce stigma	Uptake	1
Staying connected in a disconnected COVID world with urology podcasts. A review of the growing trend(122)	Ptasznik	2022	Describes the number of podcasts available for urologists	Topics	No intervention
The use of free online educational resources by Canadian emergency medicine residents and program directors(123)	Purdy	2015	Evaluate the use of online resources (including podcasts) by EM residents in Canada demonstrating 91% were using podcasts	Uptake	1
An Internal Medicine Residency Podcast: Impact of the Educational Experience and Care Practices of Medical Residents(124)	Qian	2021	Evaluated the satisfaction with a podcast for internal medicine residents at a single institution.	Learning	1
Innovations in on-demand audio education: Beyond Trending(125)	Ratliff	2020	Described the uptake of a podcast about neurology	Uptake	No intervention
Urinary Tract Infections: Pediatric Primary Care Curriculum Podcast(126)	ReidBurks	2016	Evaluates the satisfaction of residents with a podcast about UTIs	Uptake	1
A Survey of Emergency Medicine Residents' Use of Educational Podcasts(6)	Riddell	2017	Evaluates the perspectives of residents about the effective features of podcasts	Uptake	1
Independent and Interwoven: A Qualitative Exploration of Residents' Experiences With Educational Podcasts(8)	Riddell	2020	Evaluates the current use of podcasts by emergency medicine residents using qualitative interviews	Uptake	1
Residents Perceptions of Effective Features of Educational Podcasts(127)	Riddell	2020	Evaluates the perceptions of residents about the effective features of podcasts using qualitative interviewing	Uptake	1
An Evaluation of Emergency Medicine Core Content Covered by Podcasts(128)	Riddell	2023	Describes the current topics covered by emergency medicine podcasts	Topics	No intervention
Medical Podcasting in Low- and Middle-Income Countries: A Needs Assessment and Vision for the Future(129)	Rodman	2021	Describes the uptake of medical education podcasts in low- and middle-income countries demonstrating low uptake	Uptake	No intervention
What are the Real-World Podcast-Listening Habits of Medical Professionals?(130)	Roland	2021	Evaluates medical professionals podcast listening habits in regard speed of playback and reason for stopping	Uptake	1
Why Not a Podcast? Assessing Narrative Audio and Written Curricula in Obstetrical Neurology(131)	Roth	2020	RCT to evaluate a podcast about neurology as a method for educating residents with equal efficacy in learning when compared to reading written materials	Learning	2
This Surgical Life An Exploration of Surgical Department Podcasting(132)	Samuels	2020	Evaluates the uptake of a podcast about general surgery education.	Uptake	1
Web 2.0 technologies for undergraduate and postgraduate medical education: an online survey(133)	Sandars	2007	Evaluates the number of medical students, residents, and physicians listening to educational podcasts	Uptake	1
The iCritical care podcast: a novel medium for critical care communication and education(134)	Savel	2007	Describes the uptake of a podcast about critical care medicine	Uptake	No intervention
Development and evaluation of an educational podcast format for medical students and young professionals on prudent antibiotic use(135)	Schneider	2023	Describes the uptake of a podcast about antibiotic stewardship	Uptake	No intervention
Podcasts as a teaching tool in orthopedic surgery(136)	Schobel	2020	Evaluates the change in lecture participation after podcasting made available	Uptake	1
Orthopaedic Sports Medicine Podcasts Should Tailor Characteristics Such as Episode Length and Social Media Utilization for Best Audience Engagement(137)	Sedgewick	2022	Describes the number of orthopedic surgery podcasts	Topics	No intervention
The Oncology Journal Club Podcast – An innovative format delivering oncology education(138)	Segelov	2020	Describes the uptake of a podcast about new literature in oncology	Uptake	No intervention
Using Podcasts in Place of Clinic Talks for Graduate Medical Education at a Multi-Site Residency Program(139)	Shekarchi	2018	Evaluates the efficacy of a podcast for pediatric residents when compared to traditional lecture demonstrating improved quiz scores in the podcast group (40%) as compared to the traditional lecture group (25%)	Learning	2
Self-reported priorities and resources of academic emergency physicians for the maintenance of clinical competence: a pilot study(140)	Sherbino	2009	Evaluates the number of emergency medicine physicians who are using podcasts for knowledge acquisition	Uptake	1
Radiology podcasting as a model for asynchronous remote learning in the COVID-19 era(141)	Shiang	2021	Evaluates the uptake of and satisfaction with a podcast on radiology for residents	Uptake	1
Neurology podcast utilization during the COVID19 pandemic(142)	Siegler	2021	Describes the number of podcasts available for neurologists	Topics	No intervention
A Critical Analysis of Anesthesiology Podcasts: Identifying Determinants of Success(143)	Singh	2016	Describes the number of podcasts available in anesthesiology and identifies predictors of success.	Topics	No intervention
Anatomy podcasts for medical education(144)	Skadorwa	2022	Evaluates the uptake of a podcast for medical students on anatomy	Uptake	1
Doctority: Plastic Surgery-An Informative Podcast for Applicants to Learn about Plastic Surgery Training Programs(145)	Stoehr	2021	Evaluates the uptake of a podcast for medical students about plastic surgery training	Uptake	1
Attending Physician's Attitudes Toward Podcasting as a Source of Medical Education: An Exploratory Study(146)	Tarchichi	2020	Evaluates the uptake of a podcast for pediatrics and enjoyment of the podcast	Uptake	1
Continuing Medical Education in the Time of Social Distancing: The Case for Expanding Podcast Usage for Continuing Education(17)	Tarchichi	2021	Describes the popularity of 5 COVID-19 related podcasts	Uptake	No intervention
Podcasts in Plastic Surgery: Where Do We Currently Stand?(147)	Tesfaye	2022	Describes the current number of podcasts available in plastic surgery	Topics	No intervention
An international, interprofessional investigation of the self-reported podcast listening habits of emergency clinicians: A METRIQ Study(148)	Thoma	2020	Evaluates the reasons medical professionals listen to podcasts and the activities they perform while listening	Uptake	1
Listen Up! Expanding the Educational Podcast Network at the Great Ormond Street Hospital (GOSH) Learning Academy(149)	Thomas	2023	Describes the uptake of educational podcasts about pediatric topics	Uptake	No intervention
Free Open Access Medical Education resource knowledge and utilization amongst Emergency Medicine trainees: A survey in four countries(150)	Thurtle	2016	Evaluates the uptake of podcasts for emergency medicine trainees in a multi-national sample	Uptake	1
The Role of Educational Podcast Use Among Otolaryngology Residents(151)	Vanstrum	2022	Evaluates of the listening habits of ENT residents to podcasts	Uptake	1
Educational Impact of Podcasts in the Retina Community(152)	Venincasa	2020	Evaluates the uptake of podcasts for ophthalmologists	Uptake	1
Medical podcasts going viral(153)	Walkinshaw	2011	Describes the uptake of a podcast about surgery for medical students	Uptake	No intervention
Effect of Interpolated Questions on Podcast Knowledge Acquisition and Retention: A Double-Blind, Multicenter, Randomized Controlled Trial(154)	Weinstock	2020	RCT to evaluate the effect of interpolated questions on knowledge acquisition from a podcast showing that interpolated questions improve knowledge retention compared to podcasts without questions	Learning	2
Surgery 101: evaluating the use of podcasting in a general surgery clerkship.(155)	White	2011	Describes the uptake of a podcasts for students on the surgery clerkship.	Uptake	No intervention
After the gold rush? A systematic and critical review of general medical podcasts(2)	Wilson	2009	Describes the internal medicine journal podcasts available	Uptake	No intervention
FOAMed in IR: designing an original podcast for future interventional radiologists(156)	Winterholler	2019	Describes the uptake of a podcast for interventional radiologists	Uptake	No intervention
Creation and Evaluation of an Anesthesiology and Critical Care Podcast(157)	Wolpaw	2018	Evaluates the uptake of a podcasts for anesthesiology and critical care	Uptake	1
A Multimodal Evaluation of Podcast Learning, Retention, and Electroencephalographically Measured Attention in Medical Trainees(158)	Wolpaw	2022	Evaluates differences in attention as measured by EEG for learners on a treadmill listening to a podcast, v listeners seated v. textbook readers showing no difference of mean attention network activation but with increased knowledge gain from podcasts as compared to textbooks	Learning	2
Evaluating the reliability of gestalt quality ratings of medical education podcasts: A METRIQ study(159)	Woods	2020	Describes the quality of podcasts for emergency medicine residents	Topics	No intervention
Performance Analysis of a Radiation Oncology Educational Podcast(160)	Wu	2023	Describes the uptake of a podcast for radiation oncologists	Uptake	No intervention
Physician preferences for accredited online continuing medical education(161)	Young	2011	Evaluates the preferences of physicians for online CME showing preferences for podcasting	Uptake	1
Eyes for Ears-A Medical Education Podcast Feasibility Study(162)	Young	2021	Describes the uptake of a podcast about ophthalmology for medical students and residents	Uptake	No intervention
How podcasts teach: A comprehensive analysis of the didactic methods of the top hundred medical podcasts(163)	Zhang	2022	Describes the didactic styles of podcasts in multiple specialties	Topics	No intervention

Characteristics of Included Studies

The full list of included studies can be found in Table 2. The majority of included studies were from the United States (n = 102). The most common specialty evaluated was emergency medicine (n = 23) with internal medicine (n = 19), pediatrics (n = 13), and medical school topics (n = 11) being other highly-represented groups. The most evaluated individual group of learners were residents (n = 45), though the majority of studies evaluated more than one category of learner (n = 69). (Table 3)

Table 3

Characteristics of Included Studies
Study Characteristics	N (%)
Region of Publication United States of America Canada United Kingdom Europe Australia Africa Other	102 18 11 8 4 2 4
Specialty Emergency Medicine Internal Medicine Surgical Subspecialty (ENT, orthopedics, etc.) Internal Medicine Subspecialty (cardiology, GI, etc.) Pediatrics Medical school OBGYN Neurology General Surgery Critical Care Dermatology Anesthesia Radiology Other More than one specialty	23 19 17 16 13 11 7 7 6 6 5 4 3 5 7
Type of Learners Evaluated Residents Medical Students Fellows Attendings More than one	45 28 1 6 69
Focus of Study Podcast Uptake or Utilization Podcast Topics or Availability Podcast as Learning Modality	100 28 21

The number of publications increased with increasing year (Fig. 2a). The earliest published article included in our series was from 2007. The most notable increase in publication rate was seen in 2020 with persistently higher rates of publications in the post-2020 period. This inflection correlates with the COVID-19 pandemic and the need for a conversion to virtual learning. Of the 81 manuscripts with publication dates post-March of 2020, 37 (46%) specifically mentioned the COVID-19 pandemic as a factor in the decision to create a podcast or as a possible explanation for a podcast’s uptake. The number of citations of included studies also increased with increasing year, indicating an overall increase in the interest in the scientific evaluation of podcasting over time (Fig. 2b). A similar inflection point is noted following the COVID-19 pandemic.

Number of included manuscripts (n = 149) published each year

Number of total citations for the included manuscripts by year

Manuscript Topics

The most commonly evaluated topic among our evaluated manuscripts was the uptake or utilization of podcasts by medical learners (n = 100). In general, these manuscripts described the creation of a podcast and then evaluated how many learners used the podcast once it was available. The largest group of these podcasts described a podcast that was originally designed for learners at a single institution with narrow focus, such as a group of medical students in an anatomy class or a group of residents at a single institution.(2,17,27,32,33,35,36,40,41,44,48–54,56,57,60–63,67,68,71–73,78,81–83,85–90,90,92,93,101,102,104–107,109–112,115,116,118–121,125,126,132,134–136,138,141,144–146,149,150,153,155–157,160,162). A smaller number of manuscripts described surveys to evaluate the broader habits and preferences of medical learners regarding podcasts (5–8,19,43,55,59,70,95,98–100,114,123,127,129,130,133,140,148,151,152,161).

The second most represented group of manuscripts evaluated the number of podcasts available in a particular specialty or the topics of podcasts available (n = 28). In general, these manuscripts evaluated the number of podcasts that were available in a particular specialty and did not include any intervention (16,28,30,37,58,64,76,77,79,80,84,91,94,108,117,122,137,142,143,147). A smaller number of manuscripts in this category evaluated the types of material covered by podcasts within a particular specialty, the speakers within podcasts, or evaluated the quality of included educational information (3,29,39,96,97,128,159,163).

The smallest number of manuscripts directly evaluated the use of podcasts as a learning modality for medical learners (n = 21). Many manuscripts evaluated pre- and post-podcast quiz scores to evaluate the ability of podcasts to be a method of knowledge transfer (31,34,45,47,66,69,103,113,124). A smaller number of manuscripts compared podcasts to another educational modality, such as written materials or lectures, in a non-randomized fashion (38,65,139). Three manuscripts evaluated the effects of attention on podcast knowledge acquisition (74,75,158). A total of six studies were randomized controlled trials that evaluated podcasts as a teaching modality. These compared podcast and textbook learning (15), podcast and conventional lecture learning (42,46), podcasts and written materials (4,131), and the effect of interpolated questions on podcast knowledge acquisition (154).

Podcast Range and Cost

Of the 149 manuscripts studied, only 91 included some data regarding the specific podcast characteristics, with significant diversity among published works about the types of data that were included (Table 4). Of these manuscripts, 58 reported data about the number of episodes created, 45 reported the average podcast length, 55 reported the number of downloads, and 39 reported the number of countries where listeners were present. Of manuscripts that described the creation of a podcast, only ten reported the average hours to create an episode, five reported the average cost per episode, and eight reported the startup cost to create an episode. On average, the described podcasts included 40 episodes, were 34.1 minutes in length, and had over 3000 downloads, though with a wide range depending on the podcast’s uptake. Similar diversity was seen within the literature regarding the time to create an episode with an average of 4 hours but ranging between 2 and 15 hours. The startup cost was reported between $50 and $3150 with the average cost being $763. Due to the small numbers of manuscripts that reported the time and costs associated with generating podcasts, we could not analyze the effect of time on the cost associated with podcast creation.

Table 4

Podcast Characteristics and Cost
Study Characteristic	Mean (range, SD)
Number of Episodes Created	41.7 (2-845, 108.9)
Average Podcast Length	34.1 minutes (6 minutes-260 minutes, 37.8 minutes)
Number of Downloads	3232.1 (49-94579,12869.2)
Number of Countries Listened	65.11 (1-192, 51.7)
Average Hours to Create Episode	5.1 hours (2 hours-15 hours, 4.0 hours )
Average Cost	$163.7 ($9-$709, $305.2)
Start-up cost	$762.9 ($50-$3150, $995.0)

Evaluation of Podcast Users

The published studies also indicated a steady increase in the number and diversity of learners utilizing podcasts over time. Seventeen manuscripts evaluated the number of podcasts available in different specialties, demonstrating an increasing number over time. Prior to 2013, the average number of podcasts in any given specialty was 9.3, which increased steadily to 13.0 from 2013–2016, 30.5 in 2017–2020, and finally to 64.0 from 2022–2023 (p = 0.02) (Fig. 3a). The number of episodes produced by a podcast was described in 58 manuscripts and was also demonstrated to increase over the study period with significant increases noted when comparing the 2013–2016 time period to both the 2017–2020 (6.0 v 26.5, p < .01) and 2021–2023 (6.0 v 31.6, p < .01) time periods (Fig. 3b). Additionally, there was a trend toward an increasing number of countries where a podcast was listened to over time growing from an average of a single country in the studies that reported this data in the pre-2013 and 2013–2016 periods (n = 39) to 65.3 in 2017–2020 and 82.3 in 2021–2023. Significant differences were noted when comparing the 2021–2023 time period to both 2013–2016 (p = .02) and the pre-2013 period (p = .02) (Fig. 3c). Additional data demonstrated an increase in the share of learners using podcasts as a learning modality. When considering studies that evaluated medical learners (i.e., medical students, residents, and fellows), there was a significant increase in the proportion of learners who were using podcasts. From pre-2013, only 2.2% of learners reported using podcasts when surveyed, which grew to 46.7% in 2013–2016. When comparing 2017–2020 (70.6% v 2.2%, p = .03) and 2021–2023 (74.8% v 2.2%, p = 0.04) to pre-2013 rates, significant changes in the percentage of learners were seen (Fig. 3d).

Number of podcasts available

Number of episodes produced by each podcast

Number of countries listening

Percent of learners within a study who reported using podcasts

Podcasts as an Educational Modality

We evaluated the Kirkpatrick level outcomes reported by manuscripts which evaluated podcasts as a learning modality.(Table 5) Overall, 65 manuscripts reported the Kirkpatrick level outcomes associated with their podcasts. Of these, 45 reported only Kirkpatrick level 1 outcomes: 22 reported specific metrics to evaluate the associated learner satisfaction, and the remaining 23 reported high learner satisfaction but did not measure this objectively, did not report the number of learners who were satisfied, and/or did not report the total sample size evaluated. On pooled analysis across all studies, 63% of learners reported satisfaction with the associated podcast evaluated, though with a broad range from 46–100%.

Twenty manuscripts reported Kirkpatrick level 2 outcomes, largely measured by quiz scores. Of these, eight studies had no comparison group and/or only reported pre- or post-podcast quiz scores. The remaining 12 studies directly compared podcasts to another method of learning including lectures (n = 4), textbooks/written material (n = 5), or another type of podcast (n = 3). Of the nine studies that compared a podcast to a more traditional learning method (lecture or written material), the data demonstrated no firm consensus on the efficacy of podcasts with five (55.6%) studies demonstrating podcasts to be superior to traditional methods (15,16,46,69,158), and four studies (44.4%) showing no difference between podcasts and the comparator group (4,38,65,131). Additionally, all five studies demonstrating podcasts to be superior to other methodologies of learning showed only small to moderate improvements in quiz scores in the immediate post-test period and did not assess long-term retention.

Table 5

Educational Outcomes
Study Characteristic
Kirkpatrick Level n (%) 1 2	45 (75%) 20 (25%)
Sample Size n(range) Kirkpatrick 1 Kirkpatrick 2	324 (17-7239) 72.15 (10–138)
Kirkpatrick Level 1 Learner Satisfaction Measured Objectively Not fully reported Average satisfaction	22 (48.9%) 23 (51.1%) 63% (45.5–100%)
Kirkpatrick Level 2 Comparison Groups Podcast (other method or context) Textbook/Written Material Lecture No comparison group	3 (15%) 5 (25%) 4 (20%) 8 (40%)
Result (n = 9) Podcast equally as effective Podcast is more effective	4 (44.4%) 5 (55.6%)

Methodological Quality

Finally, we evaluated the methodological quality of the published studies to assess for the potential of bias. We utilized the MERSQI score to evaluate the included studies. Of the 149 studies included, only 87 described an intervention and could be evaluated by the MERSQI score. The other 62 studies reported observational data only (e.g. reported the number of podcasts available in each specialty) and could not be evaluated by the MERSQI score. The overall MERSQI scores of the reported literature were low with an average score of 7.2 (Fig. 4a). The majority of studies (n = 74, 85.1%) demonstrated scores ≤ 9, which is considered to be of low methodological quality. Many of these studies lacked comparator groups, had low response rates, and/or were single-institutional interventions, limiting their translatability and indicating a high likelihood of bias. Seven studies (8%) demonstrated average quality and only six studies (6.9%) were of high methodological quality. Manuscripts that evaluated the effects of podcasts as a learning modality demonstrated higher MERSQI scores (10) as compared to manuscripts evaluating podcast uptake (6.5) or the topics of podcasts (5) (p < .01) (Fig. 4b).

As podcasts represent a novel learning modality, we investigated the effect of time on the published methodological quality. The MERSQI scores were not shown to improve with increased time and number of publications (Fig. 4c) but were relatively stable over the evaluated period.

Number of studies demonstrating each MERSQI score

Average MERSQI score in each topic category

MERSQI scores by publication year

Medical education podcasts are increasingly utilized and evaluated in the literature. Our work demonstrates that the number of publications regarding medical education podcasts is rapidly increasing over the last two decades with a significant uptick in the post-COVID19 period. Many specialties have a variety of podcasts regarding specialty-specific topics, and medical schools have adopted podcasts into their curricula for teaching a wide range of subjects. Overall, emergency medicine demonstrates the highest number of podcasts and publications regarding podcasting in the literature. The overall methodological quality of all evaluated studies was low, on average, with few studies meeting the threshold for rigorous educational research. Further, the methodological rigor of the published studies has not increased over time, with a large number of publications still reporting small sample sizes and subjective outcomes, limiting the ability of researchers to determine the effectiveness of podcasts as a learning modality. While a growing body of literature describes the uptake and utilization of these podcasts, the vast majority of research reports only qualitative data without educational interventions. In our review of the published literature, only 43.6% of manuscripts reported quantitative data, and of these, most addressed only Kirkpatrick level 1 outcomes regarding learner satisfaction.

Podcasts are an attractive method for learning as they can be produced at low cost and can be used by learners asynchronously. In our review, learners who use podcasts are generally satisfied with them as a learning modality, and many prefer them to more traditional learning methods due to their ease of use and ability to provide rapid up-to-date information(126,131,155). However, podcast research currently suffers from the evaluation of heterogeneous populations, small sample sizes, variabilities in data reporting, and overall low methodological quality. Despite their uptake, current data cannot definitively support podcasts as an effective learning modality, and further randomized controlled trials are needed. Data in the non-medical literature is mixed with some studies demonstrating podcasts to be inferior for knowledge gain and retention compared to traditional learning methods, though with some studies do report equal or improved knowledge (12,13). Our review of the literature demonstrates a similar heterogeneity of results among medical learners with some manuscripts demonstrating podcasts to be equivalent, while others demonstrated small improvements in knowledge gains using podcasts as compared to lecture- or text-based learning interventions (4,15,16,38,46,65,69,131,158). The efficacy of podcasts as knowledge-transfer mechanisms needs to be further evaluated in the realm of medical education. Specific studies should be performed with medical trainees and students due to the high precision and volume of knowledge necessary for these learners.

Medical students and residents are increasingly opting for online and novel educational methods for learning (164–167). With the speed of information change, podcasts and other online resources may offer the benefit of more rapid production speed and the ability to be updated as compared to textbook-based resources (168). Additionally, online resources may increase the equitability of resource availability for low-income medical learners or medical learners in low-resourced areas (129,169). Digital resources for self-directed learning must be selected carefully and tailored to the individual learner and learning scenario (170). Further, digital affinity has been shown to increase the ability of an individual to obtain knowledge from an e-learning method (171). As medical learners becoming increasingly accustomed to online learning methods due to exposure in childhood and/or at the undergraduate level, additional increases in podcasting popularity and utilization should be expected. However, some new education techniques have been questioned as methods of learning, and the literature regarding the efficacy of novel online learning techniques is still in its infancy, largely limited by poorly controlled studies and small sample sizes (172). The ability of these methods to effectively increase knowledge or change practice has not yet been proven. As the speed with which these technologies are being developed and utilized increases, there is an urgent need for high quality medical education research to evaluate these modalities.

Our study had several limitations which impact the ability to fully address the use of podcasts in medical education. We evaluated only published articles, which inherently excludes the use of a large number of medical education podcasts that have not been formally evaluated in the literature. Additionally, we used only English-language manuscripts, which biases our sample toward podcasts produced in English-speaking countries and likely does not represent medical education podcasts produced in many parts of the world. As we considered the entire body of work regarding podcasts dating back to 2007, research on podcasts published over a decade ago likely is not representative of the sample of learners today who have increasing access to technological devices such as smartphones and greater digital fluency. Additionally, the COVID-19 pandemic increased the speed of transformation of medical education to asynchronous and remote learning options, and as such, literature which predated 2020 may not fully represent the reality of a post-COVID world where hybrid and remote options are frequently used. While we have separated out pre-2020 and post-2020 literature in many areas within this review, in areas with small sample sizes these data were analyzed together. Additionally, there is likely a publication bias toward studies which showed podcasts to be efficacious and popular. We identified no studies which demonstrated a superiority of traditional learning methods over podcasts, indicating a bias in this data and largely the studies indicated high uptake and learner satisfaction. We anticipate that podcasts which were not well received or were shown to be ineffective are not described within the literature based on the lack of studies demonstrating this finding.

There is no standardized reporting of data regarding podcasts in the literature, and the methods used within the included studies are heterogeneous. Further, the low average MERSQI score indicates a high potential for bias and error within the included data, which affect the results of this systematic review. Though in many instances we analyzed data together in order to perform our pooled analysis and obtain a general understanding of the opinions of learners and the quality of podcasts in the medical education space, the included studies did not use similar methods of evaluation, did not study the same scope of topics, and/or did not use the same population of learners, thereby limiting their comparability and generalizability. Many manuscripts were also missing pieces of information that were assessable in analysis, which further contributes to bias. As noted by the low MERSQI scores, many manuscripts failed to report essential pieces of data, due to this we were unable to perform any standardized statistical calculation for heterogeneity within the data typically applied within systematic reviews. Cochrane standards note importance in identification of clinical, methodological, and statistical heterogeneity. We did note many variances within the included studies. Clinical variability was noted within variable populations included, ranging from medical students to attending physicians. There was no standard method for reporting or assessing podcast efficacy or popularity with significant variance in these methods including assessing learner satisfaction, using post-podcast quiz scores, or evaluating podcast downloads limiting the ability to assess heterogeneity through standard methods such as forest plot, funnel plot, or I² assessment.

The popularity, low-cost, and easy access to podcasts have made them a popular learning modality with high satisfaction among users. Despite heterogeneous methods and results, many studies demonstrate benefits to learners. Medical education podcasts are capable of reaching a wide scope of learners from physicians in practice to medical students, and even interested members of the public. They may serve to increase public awareness, provide access to up-to-date medical knowledge for students and medical professionals with limited financial means, and allow for asynchronous and remote learning. However, their efficacy as learning tools is still not definitively proven, and additional rigorous studies are needed to evaluate their ability to convey knowledge to medical learners in formal curricular settings and with long-term retention. Further, we found that in nearly all cases, literature regarding podcasts did not discuss the funding sources of the generated podcasts, and listeners must use discretion when considering the value of information gained from podcasts, especially when funding is not disclosed. We have demonstrated that while podcasts exist in many specialties, they may be underrepresented in surgical disciplines, especially in general surgery topics. In all disciplines, medical podcasts are popular, and can be produced at a low cost, though time to produce episodes varies widely and may represent a significant time-commitment for busy medical educators. The low barrier to entry for podcast creation and access offers significant benefits but also considerable threats to the medium as a learning modality. The veracity of information provided on podcasts should be considered, and learners should be aware of the source of medical education podcasts, when considering their use. Podcasts demonstrate significant potential as an educational innovation that should be incorporated into medical education for learners at all levels, but additional work should evaluate the best-use case for this developing technology.

Funding

The authors report no relevant funding for this work. All authors report no COI.

Data Availability

The authors confirm that all data generated or analyzed during this study are included in the published article.

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You are reading this latest preprint version

Listen Up: A Systematic Review of the Utilization and Efficacy of Podcasts for Medical Education

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Version 1

Abstract

Figures

INTRODUCTION

METHODS

Literature Search Strategy

Data Extraction

Kirkpatrick level

Quality and Bias Assessment

Data Analysis

PRISMA Checklist and Data Reporting

Results

Outcome of Search

Characteristics of Included Studies

Manuscript Topics

Podcast Range and Cost

Evaluation of Podcast Users

Podcasts as an Educational Modality

Methodological Quality

DISCUSSION

Declarations

Funding

Data Availability

References

Supplementary Files

Status:

Version 1