Welcome to the latest episode of Stay Current and Pediatric Surgery, a multimedia production designed to spread the latest knowledge freely. This chapter is created and edited by Todd Ponsky, Alex Cassar, Alex Gibbons, and myself, Ray Hickey, in partnership with the Behind the Knife podcast crew. If you haven't heard, there were a few things a little different about ABSA's 50th anniversary meeting. Our colleagues Wu and Megna from Behind the knife met with Dr. Herschel himself to discuss it. As we changed things up, it really was around, uh, how we might alter the typical meeting, at least in pediatric surgery. We have a history of having 45 minute to an hour long named lectures, and, and we've broken it up, so it's. Yeah, basically there's just about no lecture that's longer than about 20 or 25 minutes. We introduce what we call TED talks, pediatric surgery, education, and and disruption. It's a lot like TED. Ted like talks and tried to make those out of the domain of pediatric surgery and in many instances out of the domain of medicine. So on robotics or artificial intelligence. We also came from behind the podium. We put on what's known as a stage thrust and gave everyone headset mics, so it was kind of fun because first introduction of the meeting which I gave, I started out behind the podium and then stepped out and went to the front, and it was something that really we had never done before and all of a sudden the speakers were out in the crowd, you know, there's something free about that. And and then I think the other thing is that that the emphasis was Uh, for instance, on the tech talks, I think you mentioned the top educational conference talks, we have a wonderful process in pediatric surgery, really unique, where, where what's known as the Professional Development Committee or what we call the PDC synthesizes all the information from the literature, from our committees, you know, from our meetings and and all the sources, and then synthesizes what the practice gaps are in pediatric surgery, the things that pediatric surgeons need to know. And then the tech talks were a summary of the practice gaps from last year in one talk and then 4 new talks, 10 or 15 minutes on a practice gap, and they were almost like a visual abstract. That is, it wasn't the fundamental this study and it had this many patients and it was randomized and these were the control group and that instead it was we had these studies and this is what they found and this is what you should be doing and it was very concise, something that really allows the attendees to come away with something they can remember to change their practice and And well thought out, well delivered, interesting, concise, and effective. So I think that all together really energized the meeting in many ways, you know, I think we'll, at least for ABSA, will set the path for what we'll do in the future. So APSA is changing the way our national meetings are run, including talks beyond the medical field and engaging us with TED style speakers. But the proposed changes in academic surgery don't stop there. There were talks about shifting the entire training program for general surgery, potentially moving our research from during our clinical years to after or combine it with our fellowship training. Here are Doctor Alan Goldstein's thoughts. Discussions I've heard is consideration of those who truly do want to start their own lab that it may be more beneficial to take that time off at the end of residency, complete your clinical training, and then do your two years so that way you can, you're closer by the time you become an attending to starting your own lab and you've you've developed that those skills, your grants and things may even still be active. However, then the consideration. How do you review those people for fellowship applications? So what are your thoughts on that? That's also a terrific question. The American Board of Surgery, I think, is trying to tackle this. The concept of taking 2 years off for research and then completing 2 to 3 years of residency followed by 2 years of fellowship, and you get back into the lab 5 years later when the field has completely changed and likely the techniques you learned are obsolete creates a problem for that. Aspiring surgeon scientist, I don't have an answer for it. I think that in some medical, uh, fellowships, the research time is embedded with the fellowship time, so maybe a year of clinical fellowship and a year or two years of research. Changing the paradigm is challenging. Moving the years of research would require a lot of juggling by a lot of surgical programs, so how you do it, I don't know. I do think that some change is needed so that the surgeon scientists can remain competitive and get started on a trajectory, you know, that really can aim for success. A debate that continues to evolve is the role of social media and academic medicine. Meganna and Wu capture the differing opinions of doctors Alan Goldstein and our very own Todd Potsky. The ultimate goal of research is to improve patient care and patient outcomes, and now we're in a generation of social media and a lot of online resources and dissemination. And with the goal of research to improve patient outcomes, we do want to disseminate these things to the masses, even surgeons in rural communities or who may not have access to some of these journals that are institutionally subscribed to, uh, we want them to get this information, and that's what I feel is the utility of social media. However, there was There's been a conversation at this meeting and in general about how to utilize alt metrics, Twitter statistics and things like that in assessing someone in academia with regards to promotion or just With regards to evaluating their success as a surgeon scientist or an academic surgeon, what are your thoughts on that? That is a challenging question to answer, particularly given my lack of participation in the social media community. But I think it's hard to judge quality by popularity and the uh at the end of the day, we have to Um, ensure you're right that that the word gets out about the work, but that it gets out in a sort of accurate and representative fashion. Often you read an article in the paper that summarizes some study that came out in the New England Journal, The Lancet. And all my members of the family will start to talk about it. Did you hear about this? And then you go back and you read the paper and you find out that what they represented was just so inaccurate. I think we have to be very careful about trying to uh pare down a complicated multi-center study to just a few lines on a Twitter feed. So, I would suggest that, um, that we be cautious about that approach, cautious about using the number of tweets or how many um likes you have as an indicator of quality or success and maybe just focus on doing the best science we can and disseminating it at venues like national meetings, peer-reviewed journals. And in a way that that we ensure we control the rigor of the of the dissemination of that information. I think that's very sage advice as the younger generation attempts to push forward with social media to remember that quality above all, be cautious just because something's popular doesn't mean it is of high rigor and quality. Dr. Ponsky, you gave a presentation about the needs of integrating journal articles, artificial intelligence, and that kind of natural language processing, integrating that into some sort of format where we can digest all of the information. That comes at us in medicine and surgery. So can you talk about how that led you to the stay current app? Yeah, so the gist is that there's an explosion and exponential growth of medical content, of medical knowledge, and it's absolutely impossible to be up to date and know about everything that's going on. So we have to figure out how we're going to be curating knowledge, this ridiculous amount of information. So I would say 3 things that are going to impact. The curation are going to be artificial intelligence or machine learning, crowd sourcing and platforms so machine learning we're working on developing an AI algorithm that will use natural language processing that means that it goes through it reads it, it picks out words and understands what those words mean and can probably help identify the high quality journals. That's a technology that is already. Widely used and when you talk to editors what we're studying is if you look at people that actually review articles, that's essentially what they're doing they're looking for the keywords, the power of the study, the type of the study, blah blah blah. So NLP can do that. The second thing is crowdsourcing. We know that the crowd is very good at picking out good content. We don't use them enough. We use an editorial board of 15 people. Instead of using that to decide what we should know, let's let the crowd decide what we should know. And have articles voted on and usually you'll find that the crowd is pretty good about picking out the good content and it rises to the top. So machine learning or AI crowdsourcing and platforms, we have to get away from thinking that we're gonna spread knowledge around the world by using podiums and journal articles. We have to go digital. We have to figure out how to disseminate it free and easy and so we've built several different platforms, but the one we've created now is called. Stay Current, and it tries to do all the above, curate content to make content really rich, rich media, so engaging, fun, exciting, short bits of content, not long. That's my guess on where the future is going with academic medicine. What are your thoughts on modernizing surgery and moving into this realm of social media and the online presence? Yep, so there's no doubt that things are going digital and for content to get noticed. Uh, just existing inside a journal or one person presenting at a podium is not going to disseminate it. We have found that social media is very good at disseminating. So how do we use it? That's the problem. We get it, we get that social media is great at disseminating. How do we do it responsibly? And how does it translate into academia? Some of the points that were made is that you can use social media to disseminate your content. You will get more highly recognized. It doesn't necessarily mean that your alt metric score. Which is the score of how much you're on the Internet is gonna actually help you get promoted. That's the point. It will get your word out. It'll get your message out. People will see it, but it doesn't necessarily mean that that's gonna be, uh, something that's measured for your success. However, I think that's gonna change. In the spirit of crowdsourcing, we wanna hear from you. How do you think academic medicine is going to change? What role is social media going to play? And how can we harness the benefits of social media without losing the validity we attribute to journal publications and podium presentations? Join the discussion and let us know what you think. This is Ray Hankey from Cincinnati Children's Hospital. Remember, knowledge should be free.
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