Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Shaping the Future of Surgery: Dr. Eric Gantwerker on Tech, Education, and AI in Pediatrics

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Shaping the Future of Surgery: Dr. Eric Gantwerker on Tech, Education, and AI in Pediatrics · Becker’s Healthcare -- Pediatric Leadership Podcast

• 0:00
  Welcome to the Becker's Healthcare podcast. I'm Chris
• 0:02
  Sosa, the copy chief here at Becker's, and
• 0:04
  I'm thrilled to be joined by doctor Eric
• 0:05
  Gantwerker, a pediatric otolaryngologist
• 0:08
  in Northwell Health and associate professor at the
• 0:10
  Zucker School of Medicine. Eric, thank you for
• 0:12
  joining us today. Thanks so much for having
• 0:14
  me.
• 0:15
  Eric, you have your your hands in so
• 0:17
  many different buckets. You do so much in
• 0:19
  the health care space.
• 0:21
  But for those, in our audience who are
• 0:22
  maybe not familiar with you and your work,
• 0:24
  could you please introduce yourself and tell us
• 0:26
  a little bit more about your background?
• 0:28
  Absolutely. Thank you, Chris. So I'm Eric Gammwicker.
• 0:31
  I'm a practicing pediatric otolaryngologist in New York
• 0:33
  at at Northwell Health, and obviously teach at
• 0:36
  the medical school. And sort of my
• 0:38
  presence and my identity is sort of focused
• 0:40
  on really three different areas, and that's obviously
• 0:43
  being a a good clinician surgeon
• 0:45
  and taking care of kids especially with airway
• 0:47
  problems, tracheostomy,
• 0:48
  complex air digestive, and, complex sleep. And then
• 0:51
  I sort of live in the education world.
• 0:53
  You know, I have a master's in medical
• 0:55
  education, and my real focus is on professional
• 0:58
  development and creating the next generation of surgeon
• 1:00
  educators. And then I live in this technology
• 1:03
  world, especially with extended reality,
• 1:05
  like virtual reality, augmented reality, and also doing
• 1:09
  a lot of work in the artificial intelligence
• 1:10
  space as it intersects both clinical practice as
• 1:13
  well as education.
• 1:15
  Yeah. That's all very fascinating,
• 1:17
  Eric. I'm not sure we can cover all
• 1:19
  of it today, but I do wanna cover
• 1:20
  as much as possible. So let's just start
• 1:22
  with this. So what are your top priorities
• 1:23
  today in terms of pediatrics?
• 1:26
  Yeah. So, you know, I think there's a
• 1:28
  lot of stuff on the clinical side as
• 1:29
  well as the technology and education side. On
• 1:31
  the clinical side, obviously, you know, we're trying
• 1:34
  to just advance and practice in an era
• 1:36
  of technology. Right? And so I'm trying to
• 1:38
  teach the next generation how to leverage technology
• 1:41
  and then telling faculty how to teach the
• 1:43
  next generation
• 1:44
  with technology to try and integrate it into
• 1:46
  clinical practice. So that includes ambient listening and
• 1:49
  AI. That includes all the LLM and clinical
• 1:51
  decision making support that's gonna come with the
• 1:53
  integration of AI into health care. And I've
• 1:56
  started to dab a little bit into sort
• 1:57
  of the informatics world, and starting to do
• 1:59
  some some work there, especially as it integrates
• 2:02
  with technology and and AI.
• 2:04
  I think from an educational standpoint, I think
• 2:06
  just creating the next generation of educators,
• 2:09
  and even today's educators to understand that there's
• 2:12
  going to be a future of health care
• 2:13
  that's gonna be supported by technology.
• 2:16
  And
• 2:16
  trying to
• 2:18
  teach faculty to not focus on content, more
• 2:21
  on concept, and then how
• 2:23
  students can leverage technology in real time to
• 2:26
  access some of that more declarative knowledge, the
• 2:28
  stuff that the facts that people don't really
• 2:30
  need to know on a day to day
• 2:31
  basis, and focus more on that conceptual foundational
• 2:34
  model and practicing
• 2:36
  applying
• 2:37
  to novel problem solving. And then from a
• 2:40
  technology standpoint, obviously, trying to teach faculty how
• 2:43
  to use these new tools. And
• 2:45
  next generation of educators and surgeons and
• 2:48
  students already know and already using these technologies,
• 2:51
  so they have to teach up a little
• 2:52
  bit.
• 2:53
  Eric, where do you find the most resistance
• 2:55
  in terms of
• 2:57
  helping surgeons and and other physicians adapt to
• 3:00
  all this technology? And what is your best
• 3:03
  what's your best advice for helping to overcome
• 3:05
  that?
• 3:06
  Yeah. I mean, there's a lot of barriers.
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  Obviously, you know, in medicine, we're very traditionalistic.
• 3:10
  And so there's a lot of people who
• 3:12
  say, well, you know, the next generation of
• 3:13
  educators
• 3:15
  or the next generation of surgeons rather,
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  are they just
• 3:18
  they need to learn the way that we
• 3:20
  learned. Right? So they need to learn all
• 3:21
  the different details and minutia and stuff, and
• 3:24
  they hearken back to times when everything was
• 3:26
  in a text book and not available to
• 3:28
  them in real time. And so I think
• 3:29
  there's a huge barrier to understand
• 3:32
  that the way that they teach is predicated
• 3:34
  on a on a antiquated
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  model of how education was
• 3:38
  done before technology was enabled. If you think
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  today's
• 3:42
  students,
• 3:43
  as as far as somebody who's starting medical
• 3:44
  school today, they've never known a world without
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  technology. We're getting to the point where they've
• 3:48
  never known a world without tel cell phones.
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  So, you know, just think about that generation
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  and saying, oh, well, you need to read
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  a book. Well, books are out of date
• 3:55
  by the time they're published.
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  And so we have to think more,
• 3:59
  more creatively about how to
• 4:01
  get these, faculty to teach in a different
• 4:03
  way, and to understand that the next generation
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  also
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  of students are using multimedia, they're using technology,
• 4:10
  and they just don't learn the way that
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  that other students learn. So I think there's
• 4:15
  just a cultural barrier, I think. And again,
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  trying to get them to understand that students
• 4:21
  don't learn the way that they learn. They
• 4:22
  have different tools. They're gonna have practice medicine
• 4:24
  in different way.
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  You obviously have a lot of the Luddites,
• 4:27
  the people who are just anti technology, and
• 4:29
  think that, you know, AI is gonna come
• 4:31
  take their jobs.
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  Those are hard people to overcome, because they're
• 4:35
  sort of set in their ways. But again,
• 4:37
  just showing them the tools that educators can
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  have. You know, I do a lot of
• 4:42
  AI faculty development to understand how LLMs
• 4:45
  and some of the different softwares can help
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  them educate,
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  creating case based learning questions,
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  doing,
• 4:53
  you know, more simulation based stuff using technology.
• 4:56
  And I think once they sort of see
• 4:57
  the tools and they get their hands dirty
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  with the tools, it can overcome some of
• 5:01
  those barriers for people who are typically late
• 5:04
  adopters.
• 5:06
  So, Eric, if you can paint a picture
• 5:07
  for our audience a little bit here. So
• 5:10
  when a student walks into your classroom
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  at the medical school,
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  what should they expect?
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  Yeah. So number one, they should expect not
• 5:18
  to be talked at, but talked with.
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  So again, I still ground everything in theory
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  and bringing theory to practice, and everything we
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  know about education and the cognitive science of
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  learning is you need to be active in
• 5:29
  your learning. You can't be passive. And so
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  I will never give a lecture. I don't
• 5:33
  even call it a lecture. All of my
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  didactics are discussions,
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  and I very much believe in the Socratic
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  method, which again was not asking inane questions.
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  It's trying to challenge people's knowledge, and trying
• 5:45
  to have them access that prior knowledge and
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  apply it to novel context and integrating new
• 5:50
  knowledge. So one of the things you'll always
• 5:52
  expect with me is I will find out
• 5:54
  what you know. I will identify misconceptions, and
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  I will target that lesson specifically
• 6:00
  to where you are and where you need
• 6:01
  to go, as opposed to just delivering
• 6:04
  a lecture or pontificating based on where I
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  think you should be. Because, again, we need
• 6:08
  to take people to the next step, and
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  if you are way below people's knowledge level
• 6:12
  and skill level, you're gonna lose them. And
• 6:14
  if you're way above, you're gonna lose them.
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  So you need to have some kind of
• 6:17
  ability to access where they're at in their
• 6:19
  knowledge base and where they need to go.
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  So my sessions are never the same. I
• 6:23
  never give the same discussion twice, because it's
• 6:26
  always student led. It's always having you critical
• 6:29
  think,
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  and,
• 6:31
  I think trying to apply that knowledge immediately.
• 6:34
  So instead of just delivering knowledge without having
• 6:36
  you apply it, I have you immediately apply
• 6:38
  that knowledge into some kind of problem solving
• 6:40
  context so that you can integrate into your
• 6:42
  knowledge base.
• 6:44
  Eric, you mentioned that you've
• 6:47
  had plenty of experience in the VR and
• 6:49
  gaming space. I mean, what led you to
• 6:51
  that in particular?
• 6:53
  Yeah. I think my entry point really was
• 6:55
  through education. I was always very passionate about
• 6:57
  education, and my my father was a grade
• 6:59
  school teacher in in the sit, down in
• 7:02
  in Chicago,
• 7:04
  and a public school teacher rather. And so
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  I always loved education, but my dad wouldn't
• 7:08
  let me go into education, so instead I
• 7:09
  went to medicine.
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  I followed my my brother's footsteps, and so
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  I think when I got into the education
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  space, and I started doing especially my masters,
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  technology was really taking off, and XR was
• 7:21
  making a revival.
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  And really, the technology was advancing, and I
• 7:25
  was able to sort of fine tune my
• 7:27
  educational masters
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  focused on product development educational technology.
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  And,
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  these technologies were hitting at the same time.
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  And so that sort of sparked that curiosity.
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  And, you know, I got an opportunity to
• 7:39
  be a medical director for a video game
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  startup that was using these to create experiential
• 7:43
  learning, and so I got a lot of
• 7:45
  product development start up entrepreneurial type spirit with
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  that, and through that, I learned a lot
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  more about how product design, technology,
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  and all those different applications
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  can be applied to medical education, surgical education.
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  I think that's really what sort of sparked
• 7:59
  it. And then I sort of continued on
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  with that passion and trying to integrate into
• 8:03
  everything I do.
• 8:05
  Switching gears here a little bit, Eric. So,
• 8:07
  certainly, as you mentioned,
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  the example I love that you said, you
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  know, when
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  a textbook comes out, it's
• 8:14
  obsolete. The knowledge, you know, just doesn't last,
• 8:16
  you know, for very long because everything's changing.
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  In terms of change, how do you anticipate
• 8:21
  your role is gonna change, and how is
• 8:22
  the role of your team gonna change over
• 8:24
  the next eighteen months or so?
• 8:26
  Yeah. I mean, everything is going so fast.
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  You know, you it's impossible to keep up
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  with everything that's going on. And I think
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  as far as my role is concerned, you
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  know, I'm continuing to try to figure out
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  how I can integrate
• 8:39
  education technology into my everyday practice besides being
• 8:41
  a full time clinician.
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  And so my role is ever evolving. Like
• 8:45
  I said, I'm getting involved a little bit
• 8:47
  into informatics and trying to integrate that into
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  my experience. I'm doing a lot of research
• 8:51
  in extended reality. I'm doing a lot of
• 8:54
  faculty development around surgical education.
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  And I think continuing my role on that
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  at our institution as well as on a
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  national international level is really what I'm hoping
• 9:02
  to achieve over the next eighteen months. And
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  I think the other fact is is we
• 9:07
  have to understand that AI is not gonna
• 9:09
  be a fad. AI is real. It's gonna
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  change the way that we practice medicine, and
• 9:13
  the tools that are getting created,
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  you can sit by and say, oh, I'm
• 9:17
  not gonna use AI, and the tools are
• 9:19
  gonna be created without you. And so I
• 9:21
  think you need to be as a frontline
• 9:23
  clinician understand how these tools are being integrated,
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  what's good and what's bad. Because again, people
• 9:27
  are very overwhelmed when they get introduced to
• 9:29
  these technologies, not totally understanding how they're being
• 9:31
  integrated,
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  and the fact that clinicians aren't always at
• 9:34
  the frontline of integration.
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  So as clinicians, we need to be at
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  that front line. We need to be at
• 9:39
  the table, and we need to help guide
• 9:40
  and say, this is actually gonna be useful
• 9:42
  for us. And get away from that fear
• 9:44
  that your jobs are gonna be taken as
• 9:46
  opposed to understanding what the dyad of a
• 9:48
  clinician and technology are going to be over
• 9:50
  the next eighteen months.
• 9:52
  Eric, you mentioned that your projects have an
• 9:55
  international reach.
• 9:57
  How far are we talking about? Like, what
• 9:59
  what other countries and systems are are you
• 10:01
  connecting with to to work on creating the
• 10:03
  next generation of,
• 10:05
  surgeon educators?
• 10:06
  That's a great question. I've I've been very
• 10:08
  fortunate to be involved in several organizations at
• 10:10
  the international level and having lots of friends.
• 10:13
  I have a lot of friends who I
• 10:14
  went through as far as my master's program
• 10:16
  in Thailand, Australia,
• 10:19
  The UK, and I've been in all those
• 10:21
  places trying to do education, and trying to
• 10:23
  understand the local context, which is obviously very
• 10:26
  different from The United States. And in many
• 10:28
  ways, a lot of these other countries are
• 10:29
  much more advanced in their integration of technology
• 10:32
  for a variety of different reasons.
• 10:34
  And so I've been very fortunate to talk
• 10:36
  to the Association for Surgeons and Training in
• 10:38
  The UK. I gave a talk at the
• 10:39
  Future of Surgery Conference on surgical education technology
• 10:43
  and gaming. That was a huge opportunity. I
• 10:45
  went to Australia and talked at Monash University,
• 10:47
  where one of my very, very good friends
• 10:48
  is Emeritus,
• 10:49
  and got opportunity to do some of that
• 10:51
  stuff. And a lot of my friends through
• 10:53
  the Harvard Macy Institute, who, again, are all
• 10:56
  over the world,
• 10:57
  have been very fortunate to engage with me
• 10:59
  in those in those discussions.
• 11:01
  And I just, I'm very passionate about education,
• 11:04
  as you can see in the application of
• 11:05
  technology, and finding like minded people across the
• 11:08
  world has been revival
• 11:10
  been
• 11:11
  identifying people across the world that share my
• 11:14
  passion has fostered and empowered me to continue
• 11:17
  on. And I'm also part of the,
• 11:21
  I'm also part of the International Association
• 11:24
  for Health Professions Education, formerly known as the
• 11:27
  Association for Medical Education Europe, and have been
• 11:30
  leading their surgery interest group special interest group.
• 11:32
  And so, again, trying to understand the context
• 11:34
  of surgery, what's new, and what's,
• 11:37
  amazing across surgical education
• 11:39
  across the world, not just in The US.
• 11:43
  Eric, all of that is very exciting. I
• 11:45
  can't believe you're you're
• 11:47
  working on so many things at one time.
• 11:48
  I don't know how you have the bandwidth,
• 11:49
  but certainly, it's a great thing that you
• 11:51
  do.
• 11:53
  Piggybacking off of that, this will be my
• 11:55
  last, may major question for you to do
• 11:57
  partner. So what else are you excited about
• 11:59
  right now, and what's making you a little
• 12:00
  bit nervous about pediatrics?
• 12:03
  Yeah. So, I mean, obviously, I'm excited about
• 12:06
  technology and where we're gonna go.
• 12:08
  What makes me nervous is several things. So
• 12:11
  I think
• 12:13
  the lack of regulation
• 12:14
  and understanding of the impact that artificial intelligence
• 12:18
  is gonna have on clinical practice
• 12:20
  makes me very nervous because we're already behind
• 12:22
  the eight ball. These technologies are advancing so
• 12:25
  fast,
• 12:26
  and these bodies, especially in healthcare, just aren't
• 12:28
  equipped to be able to to anticipate.
• 12:31
  They're much more reactive, and so you're way
• 12:34
  behind the eight ball. I gave a talk
• 12:35
  at a conference a few years back, a
• 12:37
  couple years back actually,
• 12:39
  and the room was full of editors in
• 12:41
  chiefs. And I asked as part of that
• 12:43
  talk, raise your hand if you have a
• 12:45
  plan to how to how to handle
• 12:47
  AI in scholarly work, or at least have
• 12:50
  a idea of what that you're talking about
• 12:52
  it. And zero people raised their hands.
• 12:55
  And at that moment, I turned to them,
• 12:57
  and I said, you better think about it
• 12:59
  now because this is yesterday. You you need
• 13:01
  to solve those problems now. And still, a
• 13:03
  lot of institute a lot of institutions and
• 13:06
  journals are still trying to figure out what
• 13:08
  their policy on AI is. How are they
• 13:09
  gonna prevent plagiarism?
• 13:11
  How are we gonna do narrative assessments and
• 13:13
  know that students haven't used AI? And obviously,
• 13:15
  we have AI detection software, but we have
• 13:17
  AI evasion software. And so it's a AR
• 13:19
  arms race that we may not be participating
• 13:22
  in. And so I think there's a lot
• 13:24
  of ethical, legal, and regulatory things that we
• 13:27
  should all be mindful of over the next
• 13:30
  several months, over the next several years rather.
• 13:32
  And we really need to get on the
• 13:34
  ball to try and figure out how we're
• 13:36
  going to guide
• 13:38
  ethical
• 13:40
  use of these tools.
• 13:43
  Eric, thank you for being so generous with
• 13:44
  all your time and your insights today. Absolutely
• 13:46
  cannot wait to share them with our audience.
• 13:49
  We appreciate you coming out with us, and
• 13:50
  we can look forward to connecting with you
• 13:52
  again soon, I hope. Awesome. Thanks so much,
• 13:54
  Chris. Thanks for having me.