Podcasts have become increasingly popular platforms for knowledge synthesis and translation. Trainees now report spending more time with podcasts than any other educational resource, including textbooks and journals. Though almost two thirds of residents report podcast listening changes their clinical practice, there is uncertainty over the quality and influence of podcasts. Given the broad use of podcasts among emergency medicine (EM) trainees, there is a need to better understand the processes by which they sort, interpret, and judge information as they learn. What is not known is how EM residents make credibility judgements about podcast content, how their judgements compare to the judgements of attending physicians, and how those credibility decisions relate to other learning modalities. The objective was to explore the processes by which podcasts are weighed, valued, and judged relative to one another, and relative to other learning modalities. We performed a multi-center qualitative thematic analysis based on a constructivist grounded theory approach by conducting 11 semi-structured interviews with resident and attending physicians from three North American teaching institutions from January 2020 to June 2020. Narrative transcripts were coded line-by-line using constant comparative analysis to organize transcripts into focused codes, key conceptual categories, and then major themes. Three authors met regularly during the analysis to develop the coding schema, resolve discrepancies, and discuss themes. We identified four broad themes related to credibility judgements and educational podcasts: trust in source, congruence of content, triangulation of references, and application context. Participants had a baseline level of trust in a podcast resource based on popularity, recommendations from colleagues, format, Web site, and speaker credentials. When listening to podcast content, participants’ levels of scrutiny varied based on the type of material (core content vs. cutting-edge) and level of agreement of the content with their existing knowledge. When considering incongruent or cutting-edge information, participants triangulated the podcast content with their experience, understanding of physiology, content of other podcasts and online resources, reading the primary literature, and conversations with attending physicians. When applying information gleaned from podcasts, participants yielded to local practice contexts and, for residents, their attendings' judgments. When listening to educational podcasts, resident and attending physicians made a series of complex credibility judgements that weighed trust in the source, congruence of the content, triangulation of references, and the context of application.
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