Transcript: Learning Via App

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Interview with SiNae Pitts, CEO, Amphetamobile

For podcast release Monday, March 3, 2014

KENNEALLY: We are in Philadelphia, joined again by someone who’s become something of a regular on Beyond the Book, SiNae Pitts, who is CEO and founder of Amphetamobile. SiNae, welcome back to Beyond the Book.

PITTS: It’s my pleasure, Chris. Thank you.

KENNEALLY: It’s a delight to talk to you again, because over the years, we’ve been learning from you about the way that scientific, technical, and medical publishers are adopting and adapting to the mobile world and to app technology.

Coming up, you’ll be speaking to the National Association for Medical Direction of Respiratory Care on a topic that sounds very specialized – mobile learning for mobile and busy pulmonologists. I suppose they must be all busy, but what you have to say to that particular group is of interest because it’s really about what makes for a good learning app. Yet I want to remind the audience how it is you came to be so specialized – you and Amphetamobile came to be so specialized in this particular world of medical instruction for the practicing physicians.

PITTS: Thank you, Chris. Actually, scholarly publications in education has always been a focus of Amphetamobile. In fact, even before I had started the company in the fall of 2008, my very first app that I consulted on was an education app for vocabulary learning. Our first app in the STM world was for the American College of Chest Physicians to create a mobile application from a very popular print series they had produced for board review for chest-related doctors – critical care, pulmonary medicine, and sleep medicine.

KENNEALLY: But that has brought you into contact with a whole world that sort of ranges through all the various body parts. You were telling me briefly at the beginning about that. So you are now working with what kind of publishers and what kind of publications?

PITTS: Sure. We’re working with Elsevier medical textbooks. We’re also working with the otolaryngology society, with the gastroenterology society, an anesthesia research society, as well as a dermatology group.

KENNEALLY: Well, indeed, so that really does give everybody a sense of almost latent hypochondria, because we’re thinking about all the different areas of your body that can go wrong. But what you have been doing is helping medical professionals keep up with their profession to be sure that they remain certified, to stay up with all the advances. Of course, they are now doing that learning, as you say in the title, in the midst of their busy lives. So they’re carrying around tablets and other kinds of devices and using an opportunity at lunch or somewhere where they have a moment to do some studying to get that practicing in. Is that how it works?

PITTS: Yes. The health care profession, especially physicians, it’s a lifelong learning commitment. For their board certifications and for their licensure, they’re required to get continuing medical education to pass board exams periodically. Keeping up with the latest in medical research and evidence-based medicine means that they need to find time to review case studies and board review materials. Some doctors tell us on a plane ride or even down an elevator, they’ll be answering a few questions and answers. That’s why mobile is so practical and handy for this format.

KENNEALLY: Right, because they always have the tablet with them. If they forgot their textbook back at the house or back in the hotel room, they wouldn’t be able to do that. That must be a real relief for them to have that immediate access.

PITTS: Absolutely. The typical case study book is really dense, heavy, because it’s glossy images, and it’s definitely a weight burden.

KENNEALLY: Right. OK, well no longer they have that. As I always tell people, if you want to understand the way the profession is changing, they’re supposed to be redesigning the lab coat to have a pocket for the iPad. I’m sure that you’ve seen that progress. When you began your work, the iPad wasn’t even around.

PITTS: That’s true. Our first question-and-answer apps were for the iPhone and the iPod Touch, and then we expanded the format to include the iPad as well. We’re finding that doctors typically own both devices, both smartphones and tablets, and they use it for their medical profession increasingly and for education.

KENNEALLY: Right. What the iPad does, though, is it kind of gives you a canvas on which to work that really, I’m sure, helps you be as creative as you want to be.

PITTS: Yeah. All of our board review apps have a figure viewer, where the inline images can be made full-screen, where the physician can really zoom in into X-rays and to high-resolution images and graphs, so they can really see the case study-related images.

KENNEALLY: You’ve done some thinking about what makes for a good learning app, and I suppose the place to start is with the quality of the content, really, right? Because all the bells and whistles aren’t going to mean a lot to a chest physician who has to know what to do if someone shows up in the OR with a very serious condition.

PITTS: That’s absolutely true. Medical apps is one of the fastest growing category in the app store, particularly in Google Play, since they’re catching up a little bit later. It’s easy for anyone to put some content and put together an app. However, for doctors, they don’t want to waste their time on content from unknown sources. So we work with established society publishers who are considered the authorities in their field, and physicians know that they can count on the material that they’re consuming.

KENNEALLY: And because the source of the material is, if you will, at the very highest level, it’s also about much more than just text. It also includes a variety of other media.

PITTS: Yes. We include full multimedia. So that might be images, PET scans, X-rays. We even have some sound files and some videos, so you can see, say, an image of a lung sliding curtain for pulmonologists, who would be familiar with that.

KENNEALLY: I have to ask you a question, then. For these particular types of physicians, do you see a trend so that text is giving way to more of these other non-text type media?

PITTS: Absolutely. There are certain fields where there’s very few visuals, and it’s all sounds. For other fields, they’re using a lot of video-based equipment to look at – to monitor organs and things like that. We’re increasingly going from not just converting traditional print materials into mobile, but going to mobile-first content that is multimedia-rich.

KENNEALLY: And really taking advantage of what the mobile technology, what the apps, and what the devices make possible, so that’s really important. Going beneath the surface, then – something that I, as someone who is not at all a trained physician could see and appreciate – all the attractive media you’re speaking about. Below that, though, is a whole layer that you would understand better than I do. It includes hyperlinks and references that get them around the particular app. Is that correct?

PITTS: Yeah. A lot of the principles of what makes a good learning app is applicable across many fields. One is having additional references, material or key words, where a physician could look up and do further study on a topic. So we include primary literature links in each of our questions and answers as source material.

The other kinds of things is we think about, well, what kinds of general study tools would be helpful to a physician learning this material? One is simply having very good indexes, so they can find just the topics of interest, having full-text search and having an easy-to-use user interface. Another is being able to highlight and to take notes – not just text notes, but also voice annotations. Because as you may know, doctors love to save time with voice annotations, and they can associate that on a question-by-question basis.

KENNEALLY: I would imagine that, as the developer working with the publisher, you can see what’s working, what’s not working, what’s particularly popular. I would imagine, too, that there’s a lot of feedback here. So over time, you’ve been learning about what it is that really is received well by the end user.

PITTS: Absolutely. Not only do we supply the user interface platform, but we also provide technical support to our society publishers, since we know the app best, and we pay close attention to what our users say they like or would like to see in the app. For example, from that, we started to put a place in the app where they wanted to see all of their notes in one place, or all their favorite questions in one place. For other apps, where content was organized in a variety of different chapters, they wanted the ability to shuffle questions from across chapters.

KENNEALLY: We’re talking with SiNae Pitts, who is CEO and founder of Amphetamobile in Philadelphia, at the very busy Bellevue Hotel. What we’re learning from you about is something that has been tested by the marketplace. As you mentioned, SiNae, ACCP brought you all in back in 2008-2009 to develop the very first of these types of products. That particular product for chest has been one of the most popular in the iTunes store, you’ve told me.

PITTS: That’s true. In the early days, we’ve seen that year on year, the sales for the app has increased. In the last year and a half, it’s regularly been in the top five grossing iPad medical apps. Considering it’s a narrow subspecialty, I think that’s quite impressive, and ACCP should be very proud of those sales.

KENNEALLY: Indeed. I think it really is a testimony to the very rapid adoption in the medical field particularly, right? The doctors have understood this is something that beyond the time-saving that you were talking about before, is really, I think, probably improving the quality of their education and improving the quality of their service to their patients.

PITTS: Absolutely. You’re right. Medical doctors are one of the fastest populations to adapt the mobile devices for their professions, and there’s a wide variety of apps for them. A top concern is the electronic medical health records. But even before those became widespread, there were reference apps, publications apps. And I think in particular, professional education is a use case that very much suits mobile, because it’s something that is easily consumed in bite-sized chunks, and it’s something they have to keep up with throughout their lives, year after year.

KENNEALLY: Right. One of the things that you can do with the apps, and you could have done in the print version of these kinds of test preparation, is to look up whether you got the answer right. But here you get that kind of feedback instantly, and that’s important, I think, to the app.

PITTS: Yes, absolutely. In fact, that is a comment that quite a few of our doctors have given back to us for products where it exists in print and mobile simultaneously. They’ve told us, you know, the problem with the print book is that you have to flip back to the back of the book to see the answer, and you have to try to avoid seeing the answer to the next question. Whereas in the app, we give them feedback right away, and we also keep track for them. So we show their progress of how many answers they got right, wrong, and are un-attempted.

KENNEALLY: Interesting. For this particular group of physicians, the very busy pulmonologists, there’s a community there. Obviously they get together at various conferences, and there are departments within major hospitals that focus on all of this. How do you get a feedback loop established from them? And what kinds of things have you learned sort of outside the app itself by speaking to the community?

PITTS: Sure. I think social sharing is very important, and there are some fields where knowing what your peers are doing is very important. I think part of that is a lot of times, doctors who are, say, going for their board exams or licensure – they’re only getting evaluated once a year, and it’s very important. It’s hard for a busy doctor or busy resident to know, how am I doing compared to my peers? Do I know enough material?

Increasingly we’re finding groups that are saying, we want to share the peer statistics, so that after you answer the question, you can see what have your peers answered as well, to see the standing. That’s what we’re finding is that people care not just about their performance, but how their performance measures against their peers.

KENNEALLY: That’s fascinating. Again, because they can get that right away, they can really respond to it. If they only found that out once a year, they’re not able to adjust and to do the kinds of things that are going to make them a better physician.

PITTS: Absolutely. Getting assessment and feedback and finding good sources of new material to learn and study up on is really key.

KENNEALLY: I can imagine, too, that the learning that you are doing at Amphetamobile on all of this is going to trickle down to learning apps that probably will wind up in use in high schools as well as in colleges. Are you seeing, just in your own work, adoption into the general population of these kinds of things?

PITTS: Oh, absolutely. I think learning, especially things for flashcards and vocabulary – those are very popular categories. All the standardized tests are well-supported with different apps. Some things that we’re learning from other apps that we may bring into our professional education apps is the idea of quiz modes, the idea of creating – kind of gamifying, to have scoreboards and leaderboards, and also allowing the user to give their confidence as to whether a question is easy or hard, or a word or term is easy or hard, and then have that word presented to them another time. One of my colleagues in the field, who started Brainscape – his learning platform is based on what they call confidence-based repetition.

KENNEALLY: What is that? What is confidence-based repetition?

PITTS: It’s based on a learning theory that in order to take new knowledge from short-term memory into long-term memory, you need to be exposed to it more than one time. In fact, the advertising industry knows that well. Confidence-based repetition is – it gives the end user the control to say, how often should I see this again, based on how confident I am about my knowledge?

Say I’m learning foreign words. If I say, oh, this word is easy, I don’t need to see it again for a few days. But this new word, it’s hard. I’m going to need to see it again more frequently. There are apps that can help you create your own decks of easy words and hard words that will be presented to you in a regular fashion.

KENNEALLY: I’m just thinking that that really makes it kind of a personalized experience, and so therefore so much more valuable, because the textbook that’s printed in a million copies is one size fits all. But for the apps, each person’s app on their own individual tablet is going to be specialized to them, personalized to them.

PITTS: Absolutely. In fact, that very first app that I consulted on, that vocabulary app, we had the concept of the user could create two different stacks of flash cards, and they could name them – one maybe easy and another one review later – and then even a group that’s excluded. So instead of seeing the same default list of vocabulary words that everyone was seeing, they were creating and customizing their own list.

KENNEALLY: What I like about that again is it puts the power into the place of the person who actually has to do the learning. I think if I feel like I’m in charge of it, I’ll just be more enthusiastic somehow.

PITTS: Yes. I think personalizing learning, instead of catering to the lowest common denominator or creating too-difficult material, is what’s going to be key across the board in learning all different kinds of content.

KENNEALLY: Well, when there’s some new developments in the app world, we’ll turn back to SiNae Pitts, who is CEO of Amphetamobile, and founder of the company as well, based in Philadelphia. SiNae, it’s been great to talk to you.

PITTS: Thank you very much, Chris. It’s been my pleasure.

KENNEALLY: Beyond the Book is produced by Copyright Clearance Center, a global rights broker for the world’s most sought-after materials, including millions of books and e-books, journals, newspapers, magazines, and blogs, as well as images, movies and television shows. You can follow us on Twitter, find Beyond the Book on Facebook, and subscribe to the free podcast series on iTunes or at the Copyright Clearance Center website, copyright.com. Just click on Beyond the Book. Our engineer is Jeremy Brieske of Burst Marketing. My name is Christopher Kenneally. For all of us at Copyright Clearance Center, thanks for listening to Beyond the Book.