Tuesday, May 1, 2012

The Advancing Role of Technology in Emergency Medicine Education and Training: Interview with Amal Mattu, MD FAAEM

Originally Published: Common Sense, May/June 2012
Original Author:
Ali Farzad, MD
AAEM/RSA Publications Committee Chair
Linda J. Kesselring, MS ELS, Copyeditor

Amal Mattu, MD FAAEM
 In this issue, we stick with the theme stated in my previous articles and continue to explore the evolving role of technology in emergency medicine (EM) education and training. This time, I have the pleasure of interviewing one of the greatest educators of our time, Dr. Amal Mattu, Vice-Chair of the University of Maryland Department of Emergency Medicine. Dr. Mattu is a seasoned clinician with a true passion for EM and is known internationally as one of the premier speakers in our field. He is a well-respected expert in emergency cardiology and electrocardiography and a dedicated teacher who strives to make a difference by delivering quality education about high-risk topics.

Throughout the years, he has developed quite a loyal following because of the entertaining way he is able to present important clinical topics. He is the host of EMCast, a 90-minute monthly podcast in which he discusses recent literature, interesting cases, and current “hot” topics. He has kindly let me ask him a few questions about how technology has affected his teaching and delivery of educational materials, and even provides AAEM/RSA members with access to his new “EKG of the Week” video podcast. Dr. Mattu has created an incredible collection of must-watch videos that teach important EKG interpretation skills and present must know information that will help you save lives!

AF: So, Dr. Mattu, please tell us a little bit about yourself and your educational background.
Dr. Mattu: I went to Johns Hopkins for college, and during that time I was interested in medicine. I grew up in Maryland. Most of my life was spent in Maryland, my family was in Maryland, so I went to medical school at the University of Maryland. I had become interested in emergency medicine relatively early in my career; in fact, I wanted to be “Hawkeye” Pierce from M*A*S*H. That was one of the reasons I went into medicine in the first place.

As I went about choosing what type of residency to go into, I really debated a lot between going into trauma surgery and emergency medicine. I decided that emergency medicine gave more variety to what I wanted to do, so I pursued EM. I decided to leave the Maryland area and went up to Philadelphia for residency and trained at Thomas Jefferson University Hospital. That is where I met my wife, who is a practicing primary care physician now. Her family is also all in Maryland, so coming back to Maryland was naturally an easy decision for us.

I joined the faculty back here at Maryland and completed a teaching fellowship my first year out. My original interest was in geriatric EM, and when I came back to Maryland to join the faculty, I planned
to create a curriculum in geriatric EM. Then, one opportunity led to another in emergency cardiology and suddenly I found myself developing an academic niche in electrocardiography. I still really like emergency geriatrics, but I would say that it is my second area of interest now; my primary interest is in emergency cardiology and EKGs.

AF: What do you think about the role of technology in EM education and training? What are the areas of study that can be supported with technology, in your opinion?
Dr. Mattu: I am not a “techie” whatsoever. I know how to do a few basic things, and I try not to overdo it when it comes to technology. I think there are a lot of technological things that people do that probably detract from the message. For example, people overuse PowerPoint for sure. They have all kinds of fancy slides with things spinning in, zipping in and flying in from different angles. They include videos and all kinds of things, which in some cases can add to the presentation, but in many cases take away from the learning and take-home points. It can be interesting to watch, but people end up being distracted from the message. So I think a lot of technology in education can be overused and unnecessary. In many cases, simple techniques are more effective. However, I think that technology can also be very beneficial in some circumstances, especially with training for topics that require visual stimuli like electrocardiography, radiology, or even dermatology. I think of technology as a double-edged sword, in that it can add to the effectiveness of certain types of teaching, but it has to be used wisely, as it can also cause distraction and take away from the message when overused.

I have found podcasting to be a useful way of incorporating technology to help with learning. Like many people, I spend a lot of time in my car and have a long commute to work. I fell in love with the concept of audio learning several years ago, and I do a lot of my continuing medical education (CME) through audio podcasts in my car. I think I learn well that way, and I think a lot of other people find it to be a time-efficient way of learning. Using video makes it a little more limited, as you typically have to sit and watch, while audio provides a bit more flexibility; but the use of technology must be tailored to the topic that is being taught.

AF: Speaking of podcasts, tell us a bit about EMCast. How did you decide to start your own podcast? What is the goal of the program?
Dr. Mattu: EMCast is an audio podcast that is housed on the EMedHome website. EMedHome is a great website started by Dr. Rick Nunez, an emergency physician trained at Los Angeles County- University of Southern California, who works in the Boston area now. It is really quite an impressive website, with lots of available CME delivered through streaming videos from national lectures, great case presentations, and lots of good written and visual pearls. Back in 2007, I was approached to put together a monthly podcast that would be a small part of EMedHome. It started up as a project to give our faculty an opportunity to do podcasts and to present information relevant to EM clinicians in a fun way. It’s a simple podcast that we do for 90 minutes a month on cutting edge emergency medicine education. What I do is invite experts to discuss different topics of interest, various best practices, and important review articles relevant to our practice. It is a nice way for people to listen and keep up with what is going on in the world of EM.

AF: What can current listeners and fans expect from the future of EMCast?
Dr. Mattu: What I hope to do is create more and more group case discussions. I started by doing one-on-one interviews with an expert on a specific topic, but with group case discussions we go over challenging cases and call on different colleagues to give their opinions on how to approach these tough cases. For example, we might go through a difficult sepsis case and ask our airway expert, Dr. Ken Butler, how he would deal with the airway, then turn it over to our critical care expert, Dr. Michael Winters, for his approach to management using evidence-based practices, and then call on Dr. Bryan Hayes, our clinical pharmacist, for specifics about some of the drug-related issues we need to consider for the case. Frankly, it’s just a lot more fun to get together with colleagues providing different perspectives to create a podcast that is ultimately more useful for listeners.

AF: As an educator, how do you incorporate technology to make education and training more effective and efficient for your students and residents?
Dr. Mattu: Most of what I do is pretty basic from a technology standpoint. A lot of my teaching is done through group discussion and lectures, which I try to make as interactive as possible. I use very simple PowerPoint slides merely as a supplement to deliver the message. I have also been learning to incorporate more technology from our colleagues like Dr. Mel Herbert and Dr. Rob Rogers, who are more tech savvy. One thing I have started to use is an iPad app called Air Sketch, which can be used as an alternative to a laser pointer to draw attention to specific parts of my PowerPoint slides. I can project my lecture slides and use my iPad to navigate through the slides and point things out or draw right on the slides in real time. It is pretty simple to use and has been pretty effective for my live lectures and my EKG video podcasts. I started recording these short EKG lessons on a weekly basis last fall. With the help of our IT department, we have been able to post these lessons on a website (http://www.ekg.umem.org) that gives users access to the videos and allows people to learn at their own pace. I try to focus on important cases where competency in EKG interpretation can make huge differences in the way patients are treated. I encourage residents and students to check out the videos and see if it is a useful way for them to learn.

AF: “Techie” or not, you have clearly incorporated technology successfully to supplement your teaching for many years. What advice do you have for new educators who would like start using technology to improve their teaching and practice?
Dr. Mattu: Well, the first bit of advice that I would have for young educators is to not go too crazy with trying to incorporate technology. I would focus on starting by learning some good, strong, basic teaching skills. Learn how to be effective at leading small-group discussions. Learn how to give good, interesting and interactive lectures that don’t rely solely on technology to deliver the lesson. Once you have those teaching skills as a foundation, then you can start sprinkling on some technology to help get the message across. In other words, let the technology be the icing on the cake but not the cake itself.

AF: Good point! Last question. What advice would you give to current residents and students who are looking to make their learning as effective and efficient as possible?
Dr. Mattu: I recommend that residents and students try to expose themselves to many different forms of CME as early as possible, in order to discover what works best for them. People learn in different ways: Some people do well with reading, some with audio, and others with videos. In order for you to find out what works best, you need good exposure to all the different teaching media available. Once you find out what works best, focus on that.

Remember that learning should also be as interactive as possible. Teaching is also a great way to solidify your knowledge, so I encourage residents to think about becoming teachers themselves.

Resident Editor’s Note: AAEM/RSA continues to support the education of our members. We are proud to offer you access to the “EKG of the Week” video blog, compliments of Dr. Mattu and the University of Maryland Department of Emergency Medicine. Log on to http://www.ekg.umem.org to watch these videos from any computer or mobile device.

Please send comments and suggestions for future articles about technology and emergency medicine to alifarzadmd@gmail.com.

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