Volume 199 - Issue 9
Social media and medical education: making an animated video for YouTube
Authors: Joseph E Ibrahim and Prateek Bandopadhayay
Med J Aust 2013; 199 (9): 627-628. || doi: 10.5694/mja13.10490
Published online: 4 November 2013
Published online: 4 November 2013
A physician partners with a filmmaker to create an educational video for clinicians, and reflects on the possibilities and pitfalls of using social media for medical education.
What does it take to use social media for medical education?
The sound of laughter echoed through the room. Was my idea so ridiculous? No. They were laughing because it was I who was presenting it.
I played back the past 5 minutes in my mind. I had walked to a meeting with our research assistant. Greeted colleagues I had known for the better part of 5 years. Sat down, put my grey Nokia 3330 mobile phone on top of my 80-page red moleskin paper notebook on the conference table and launched into my exciting news.
The animated video about driving and dementia I had been working on was finished and ready to be posted on YouTube. My journey to the dark side of technology was almost complete. But will anyone be listening on the other side?
The initial idea arose 2 years earlier, when a young medical registrar arrived in Australia from England to commence basic physician training. The registrar completed a clinical audit that examined whether our patients’ fitness to drive had been assessed before their discharge from the Geriatric Evaluation and Management Ward. The results were presented at our weekly medical staff education meeting. Surprisingly, more patients were still driving than we expected. Not so surprisingly, we identified a gap in our approach to this issue.
Once raised, the issue kept recurring in much the same way that we keep stubbing a broken big toe on the furniture. Our medical staff on the wards got better, for a time, at raising the issue of “fitness to drive” with the patients and their family, advising them that an assessment would be required in the community by their general practitioner. As a consequence, unhappy patients confronted our staff who were providing continuing care in our community-based programs (Transition Care and Rehabilitation in the Home). The unhappy patients included those who had been told not to drive but still wanted to, as well as those who had not been told to stop but who the program staff thought should have stopped. Everyone had an opinion but no one had a definitive set of criteria that would effectively balance the competing interests and provide a clear solution.
We wondered if discourse would provide that answer — if we got our staff together and discussed our concerns and ideas, maybe we could resolve the problem. And so the idea grew — from in-service education between medical and allied health staff, to a grand round, then to a half-day organisation-wide training session, and finally, a one-day statewide seminar held in March 2012 in Ballarat.
A pre-existing collaboration with the Victoria and Tasmania Dementia Training Study Centre made the seminar possible. It was a success. We had a range of speakers including clinicians, patients (now known as consumers) and technical experts in their fields. VicRoads released the new “Fitness to Drive” guidelines.
We made an audiovisual recording of the seminar that our staff could use as an education resource in the future. More than 60 delegates attended; some even travelled from Melbourne to Ballarat. (Surely this shows how worthy the event was!)
The message that came out of the seminar was that clinicians need to take a balanced approach when considering a patient’s fitness to drive: we need to weigh the rights of the individual with risk of harm to the community. But how could we take the message further with limited resources?
Around this time, I had caught up with Prateek, a past medical student I had taught briefly more than 10 years ago. He had re-established contact by inviting me to Facebook when it was first taking off — and so I signed up to get his message but my account has remained inactive ever since (apologies to anyone waiting for my confirmation to be a friend).
We then met face-to-face and talked, just like people did when I was an undergraduate. It was a noisy, hip place in the Melbourne CBD. I wanted his opinion about how to better engage younger health professionals in education, and whether using social media was worth the effort. I did not have the patience or desire to learn new formats or to engage in cyber socialising each day. I knew what YouTube was only because it allowed me to locate obscure music videos from the 70s and 80s. I understood that apps could make life easier but resisted downloading any because I felt they take the joy out of exploring the web and making serendipitous discoveries. Besides, my phone was a “talk and text”, not a smartphone.
Prateek explained his view on the role of social media. He had taken a courageous and adventurous path in life, taking time out of medicine to work in Sydney as a feature film screenwriter for producer/director George Miller.
Prateek had a novel idea about getting the message out to clinicians, using minimal resources: an animated video for YouTube. This would reach a broad audience.
The key would be to engage the audience through classical dramatic technique rather than the standard medical education approach. Prateek waffled on for some time about the art of filmmaking, narrative structure and the science of storytelling. He explained the need to have an engaging character with an Aristotelian dilemma to keep the audience thinking.
I continued to listen because his mentor, Miller, had directed Mad Max. “Just get the audience to care, then pose a strong question and they won’t be able to look away from our little video”, he proclaimed as he finished sipping his cafe latte.
Needless to say, it seemed ridiculous — but I was attracted to the idea because it would help shatter everybody’s perception of me as a neo-Luddite.
We wrote a script. Or rather, I wrote what I thought was a short piece suitable for publication in a journal and Prateek rewrote, edited and finessed this to generate a story with the aim of engaging online viewers and getting them emotionally invested. The illustrator was a good friend and colleague of Prateek’s and extraordinarily generous in completing the work for next to nothing.
All I had to do was narrate the story. With script in hand, we sat down late one evening in a research centre room to do the audio recording. Sound and other technical checks completed, I began reading the script for the 7-minute video aloud. Three hours later, the security guard arrived to lock up the room. Relieved and exhausted I went home.
However, a month or so later, I got a call from Prateek. There had been a technical glitch with the audio and we would have to redo the whole exercise. That “technical glitch” was not in the recording: it was in the “talent”.
A lot of what I had narrated was stilted and boring to listen to. Consequently, the next time we sat down for another 3 hours, I was coached, cajoled and annoyed into delivering something useable, even if the sound engineer had to reconstruct each sentence one word at a time.
The crew completed the editing, animation and sound mix in their “downtime” and, by January 2013, we had a video to show. Now, audience testing was required.
With some trepidation I started to show it to family, friends and colleagues. My ego was fragile. I was opening myself to criticism as an academic, clinician, teacher and actor! I was bound to fail in some aspect. Initial feedback was as expected: my mum wanted to know why my caricature was not more handsome, my wife said I sounded grumpy, and my administrative officer thought I was angry. Having survived those comments it was time to test it on the intended audience, medical practitioners.
The video was presented at our Tuesday lunchtime meeting, with all our junior medical staff in attendance. I wondered whether the animation would undermine my credibility as the director of the service. Feedback was universally positive about the animation, the story and the importance of the clinical issue. However, no one suggested that I was good enough to pursue an alternative career as a professional voice-over actor.
We needed to get the video out, entice people to watch it and perhaps participate in the online discussion forum we planned to establish. Or at the very least encourage people to view the detailed presentations from our seminar that were posted on the health service website. By the time we created the YouTube video, these had been online for 12 months, but had only had 19 hits.
Generational difference became evident in my conversations about the risks, value and format of releasing this material. There is little guidance about the medical, legal and educational merits of publicly available discussion forums for health professionals. An old-fashioned blog seemed the best option to engage viewers in a more in-depth discussion, and allowed ongoing threads of conversation. Twitter would offer instant feedback and short, sharp commentary, but was unlikely to create the thought-provoking debate we felt the topic warranted.
Who would facilitate and how would we monitor what was said? Someone mentioned defending against trolls. I wondered if they were sane. Why did I need a defence against mythical creatures out of J R R Tolkien’s books?
Am I allowed to post on YouTube, blog or twitter, sorry, I mean tweet? Does this create an issue for me professionally? What does the Australian Health Practitioner Regulation Agency say about medical practitioners using social or emerging media? Will the CEO and hospital board allow it? What of the university? Who do I represent? When am I me? When am I an employee? How do I make it clear I am not giving medical advice? Would a disclaimer be sufficient? Are there legal consequences if anyone acted on comments?
Over 2 years we explored the issue of how to engage our audience and communicate the message in different forms. A one-on-one discussion during a ward round, a presentation of an audit to our medical staff group, a 1-day educational seminar, web-based education presentations from the seminar and a YouTube video.
Same issue, different formats. How do we engage? Is the message or the modality more important these days?
How do we comment on areas of clinical complexity and risk, such as assessing fitness to drive, in a professional and public forum? These areas are always contentious, if they were not, we would not need to discuss them.
Has all the work been worth it? It is too early to tell. Watch the video (Driving with dementia, http://www. youtube.com/watch?v=4F9z8mPhcTw&feature=youtu.be) and, hopefully, you will laugh with me this time, and maybe even contribute to the discussion on whether people with dementia are fit to drive.
Competing interests
No relevant disclosures.
Provenance: Not commissioned; not externally peer reviewed.