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Episode #128: Andrew Ibrahim
171 Plays7 years ago
Andrew M. Ibrahim MD, MSc is a House Staff Surgeon at the University of Michigan and Chief Medical Officer at HOK Architects. He completed his undergraduate and medical degrees education both with Honors at Case Western Reserve University with a year...
The post Episode #128: Andrew Ibrahim appeared first on PolicyViz.
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Transcript
Introduction to Andrew Ibrahim
00:00:11
Speaker
Welcome back to the Policy Viz Podcast. I'm your host, John Schwabisch. On this week's episode, we are going to talk about how to create visual imagery, visual artifacts, data visualizations to highlight key findings in research journal articles. And one of the leaders in this field, in this area of creating more visual abstracts,
00:00:34
Speaker
is Andrew Ibrahim, who currently has numerous roles, I think would be fair to say. He is a resident surgeon at the University of Michigan. He's also the chief medical officer at HOK, which is a design and architecture firm, which is headquartered in San Francisco. Andrew, welcome to the show.
00:00:52
Speaker
Great. Well, thanks, Jonathan. Thanks for having me. It's really exciting to get a chance to talk about how we better disseminate our research work and make it more accessible, especially to people who are making decisions about health care.
What are Visual Abstracts?
00:01:05
Speaker
So you sort of pioneered this idea of a visual abstract of taking what is a long journal article, summarizing it and whatever it is, 100, 250 words, but also creating something that's a visual tool.
00:01:21
Speaker
And I want to give you a chance to talk about that, and I have a bunch of follow-up questions. But before we dive into all of that, maybe you can give us a little bit about your background.
Ibrahim's Unique Career Path
00:01:31
Speaker
I think most people who listen to the show regularly, I think you're probably the first surgeon to come on to the show. So I think people will probably be interested in your background and how you got interested in this idea of communicating data and analysis more effectively.
00:01:47
Speaker
Yeah, brilliant. Yeah, I'm happy to. So, you know, for as long as I can remember as a kid, I've been obsessed with systems level thinking and how to do regional planning. And as I got older, I got exposed to healthcare quite a bit, ended up becoming a doctor. In medical school, I said, you know, who's the person that helps you plan and make decisions for a whole population?
Challenges in Research Dissemination
00:02:11
Speaker
not just for a single patient or maybe just a hospital. And at that time, I'd actually just finished a year of architecture in London prior to medical school. So I was really trying to merge these ideas of regional planning and population health with
00:02:27
Speaker
medicine, fell in love with surgery clinically. And as I was finishing medical school, I had a really formative experience. There was rumblings of universal health care and what would later become the Affordable Care Act. So I took actually a year leave for medical school, moved to the DC area and got involved in policy work because I felt that that was the way to improve health care delivery on scale.
00:02:54
Speaker
And one of the gaps that I saw readily at that time was we have a lot of great research that's done by some of the most brilliant people in the world. And a lot of those key findings are buried in journal articles that either people don't read or even people who are looking for those things have trouble finding them.
00:03:14
Speaker
So fast forward a few years later, I joined the editorial board at the Annals of Surgery, which in the surgical world is our top tier journal in the world, gets cited the most often and we often get some of the best research papers in the world sent to
Innovations in Visual Abstracts
00:03:30
Speaker
us.
00:03:30
Speaker
And one of the things that I was asked is they said, you know, we have a lot of great research articles here, but we're worried that some people who would be interested in that work don't get a chance to read them or aren't aware of them. You know, what could we do to help disseminate our work? That really resonated with me because I saw those same gaps when I spent time thinking about the Affordable Care Act and the work that informed that.
00:03:56
Speaker
So I became their creative director and I started to pilot other different visual formats that would summarize these research articles that wouldn't be a substitute for the article, wouldn't take place of it, but would give a preview of the article so that somebody could look at four or five different visual summaries of five different articles and then say, oh, you know, that's the article I've been looking for. That's what I want to go read. So while I was developing that, piloted a bunch of different formats.
00:04:26
Speaker
and found that there are three or four kind of formats that seem to resonate the most with people. And there became the visual abstract, the visual summary of a research article. So we started that in July of 2016 at the Annals of Surgery. And the first article we did it for was an article about trauma in London.
00:04:49
Speaker
And we noticed very quickly that the article on social media was shared eight times more often when it had a visual abstract and that the article actually on the publisher's website was downloaded three times more often.
00:05:05
Speaker
And that was a single article and I thought, oh my goodness, this is actually working. But more than just aesthetics and like, this looks good and it felt good that people are reading the work. I really want to know as a scientist, as a researcher,
00:05:20
Speaker
Can we reproduce this? Does it actually hold up weight for more articles? So we designed a prospective trial where we took 44 research articles at Annals. Half of them were shared in text-only format, and half of them were shared with a visual abstract.
00:05:38
Speaker
We waited about a four-week washout period and then shared the same articles but in the opposite format. So for each of the 44 articles, we could see its dissemination both in text alone format and in visual abstract format. And in short, we found that what we saw in that first article, we could actually reproduce and that across the board, articles were read nearly three times as often and were being shared on social media eight times as often.
00:06:06
Speaker
So one of the interesting findings or really baseline of that experiment is the idea of sharing these more technical academic journal articles. Do you think that the sharing is helping getting those articles and the findings in front of people who may not have
00:06:27
Speaker
you know, read a journal article to begin with, or do you think they're just finding more researchers, getting the articles in front of more researchers, but still within that sort of universe of people?
Case Study: Opioids and Media Impact
00:06:38
Speaker
Yeah, one of the things that's really been exciting is, you know, one of the concerns I've always had and that many authors have had is that, you know, are you simplifying my work too much? Are you dumbing it down and sort of cheapening the quality of the research?
00:06:54
Speaker
And one of the things that's been interesting is after a visual abstract is shared, is to watch the way that it gets reshared and rediscussed. And it actually becomes like a much deeper and richer conversation.
00:07:07
Speaker
about the article. But one example that alludes to what you just mentioned, Dr. Atul Gawande in Boston had written a paper for annals of surgery about the opioid crisis. And he said, you know, I think there are five strategies we should implement to reduce excess opioid use related to surgical procedures.
00:07:29
Speaker
So he wrote us a really nice thousand word essay and we turned that into a visual abstract and it was just incredible to see on social media after we shared it as a visual abstract not too long after he shared it in his network.
00:07:44
Speaker
And within a week, it was in five or six of the major news outlets, including Forbes and CNN. So it was clear that part of communicating his work, he's obviously a great writer, but also being in that visual format helped communicate it to an audience that was far broader than researchers or people in healthcare.
00:08:06
Speaker
The Atul Gawande book, Being Mortal, I think is one that a lot of people should read. And I think that part of it is about the style of his writing and the arguments that he makes. I would guess that making the argument to him that a visual abstract would be useful is probably pretty easy. But how do you make the argument to researchers who, like you said,
00:08:26
Speaker
You know, maybe more hesitant because they think it's going to dumb things down or it's going to get rid of some of the subtlety and nuance. So how do you make the case to researchers that a visual abstract of this sort will be useful to them? I think one of the most important things we did
00:08:45
Speaker
to this work was to rigorously evaluate it with research empirically. And what I usually say when I talk to researchers about a visual abstract, I say, you know, you've been working for years, sometimes decades on this work. It's really important to you.
00:09:01
Speaker
Wouldn't it be great if three times as many people read your work than would otherwise? And almost universally everyone says, yeah, of course that would be great. And I say, look, part of it may mean that your message needs to be communicated.
00:09:16
Speaker
in a clear way that doesn't have as much of the nuance that you understand it, but would reach a broader audience.
Open Sourcing Visual Abstracts
00:09:25
Speaker
And most people get a little uncomfortable to say, is the image just being shared more? But when they see that their article gets downloaded and read more, then they get really excited. And then they get excited that their work is being shared to audiences they want to know. So we hit an interesting point about six months into this.
00:09:45
Speaker
Annals of Surgery for the first few months was the only journal doing it. And we were consistently hitting 30, 40,000 impressions on Twitter from a visual abstract. And so other journals started to reach out to us and say, you know, we'd like to reproduce that at our journal. Could you tell us how you did it? And it was really interesting crossroads because
00:10:09
Speaker
On one side, you might say, this is a proprietary thing. If people want a visual abstract, then you submit their work to the Annals of Surgery, and it would be a great competitive advantage for our journal. And the other side is, actually, there's far more research that is important to the public good and to policy that is not published in Annals of Surgery that we think people need to know about.
00:10:31
Speaker
So I give a lot of credit to two of the editorial board members at Annals of Surgery, one being Dr. Keith Lilamo, who's the chair at MGH, and one being Dr. Justin Dimick, who's a surgeon at Michigan. And they actually encouraged to open source the visual abstract.
00:10:48
Speaker
They said, it's a good idea and it's good for science and it's good for research. So we wrote a visual abstract primer back in 2016. That was just an eight page guide on how to create a visual abstract. We kind of openly shared some of the things we tried that didn't work, a lot of the concerns that we got from authors. And it was fascinating because journals started to adopt the visual abstract.
00:11:14
Speaker
and would start sharing their experience too and say, you know, when we implemented it, these were the hurdles we hit. And so iteratively, I said, you know, would you mind if I added that into the visual abstract primer? Fast forward two years later, the visual abstract primer is now 57 pages. It has 11 authors, all of whom are people who have run with the visual abstract, tried to push its application,
00:11:41
Speaker
into different areas for the good of disseminating research. And my favorite part about it is it's stayed in open source idea. And the visual abstract is free to download at surgeryredesign.com. And I still get emails almost every week of people who come up with another way to innovate it, another way to make it better. And I just add it to the primer and it comes out kind of in the next edition.
00:12:09
Speaker
That's a really cool story of how take an idea and to circulate it and to have people build it. It's sort of this great example of the open source framework that we have. Can you talk a little bit about how a researcher who
00:12:25
Speaker
maybe not familiar with how to create good visuals, good data visualizations, illustrations. How do they start thinking about creating an abstract where they might say, well, I don't have Adobe Illustrator. I don't have design chops. How do you lower the bar? What are the stuff that a researcher needs to take to create an effective visual abstract? Great question. So I think there's two fundamental components to an effective visual abstract.
00:12:53
Speaker
And I'll discuss them separately. The first is, what is your message? Do you have a clear sense about exactly what you're trying to communicate? And then the second is, do you have the visuals that support that message to get those in line? My experience has been with researchers almost universally. All of them think their message is super clear the way they wrote it. And they said, yeah, I already have the message down. Let's just move on to the visuals.
00:13:19
Speaker
And they think the visuals are going to be the hard part. But truthfully, the real challenging part for most researchers is actually clarifying their narrative. It's like, look, you wrote 3,000 words of great science. But what is your one or two sentence message? What is the thing? No one's going to memorize 3,000 words after reading your article. What's the one or two things you want people to take away after they read your work?
00:13:46
Speaker
And actually people after they master that part, the visual stuff comes much easier. So I remember doing so I got asked to do a bunch of workshops on visual abstracts. And I did one at the CDC a few months ago. And I asked
00:14:01
Speaker
each of these CDC researchers I said you know find the article that you've read in the last six months or that you've written that you were just passionate about you wish everybody a new understood had an awareness about that you want to share and see read more broadly so they did and I said you know take some time
00:14:22
Speaker
start by summarizing it into a paragraph." And they did. I said, you know, break it down to just three bullet points. That was definitely harder, but they were able to do it. I said, take your three bullet points and get them down to three short phrases of what you think the core of that message is. And I said, share those three phrases with your neighbor
00:14:43
Speaker
and see if they are excited or if they understand what you're talking about. If not, revise it. And so they'd go back and forth and they'd ultimately curate their research down to three short phrases. And then when they put that into a visual abstract template, adding the visuals were easy. But one of the exciting moments that kind of happened there is one of the researchers called me over and he said,
00:15:09
Speaker
You know, Andrew, now that I've put the core of my research work into these three phrases, I almost wish I wrote the paper differently. I almost wish I'd actually set up some of the full writing differently because I really now understand what
00:15:25
Speaker
my work is about and what I want to communicate. So I think truthfully the hardest part for researchers in this whole process that's underestimated is clarifying your message about your work and I think the design side comes easier to people than they think. Certainly your website and your resources are an awesome website and resource for people to start getting more comfortable with different visual elements but I'd say it's important not to overlook
00:15:55
Speaker
how valuable it is to spend time clarifying the message.
00:15:58
Speaker
Yeah, I think that's really important. And it's funny that you got that response of the writing would have changed had the person thought about boiling things down to the sort of core messages. You've mentioned a few examples of sort of success stories. Do you have any other examples of visual abstracts that have helped move research in front of new eyeballs or that have helped make maybe even researchers more aware of how to better communicate their own work?
00:16:29
Speaker
Yeah, I've had so much fun. Every now and again, most of my day job is busy being in an operating room. But it's fun sort of on an off day or when there's some downtime to go search the visual abstract hashtag on Twitter and just see how different people are using it. And a couple examples that I've just enjoyed watching
00:16:49
Speaker
One has been the New England Journal of Medicine. They've decided every week to create a visual abstract for their feature article.
Adoption by NEJM and Nonprofits
00:16:58
Speaker
And it's been actually a great way. A lot of those articles are papers I typically maybe wouldn't read on immunology or randomized trial of a
00:17:06
Speaker
new oncology medication that I can sort of quickly stay up to date. And a journal like the New England Journal of Medicine making that part of their regular dissemination strategy has certainly elevated the bar for the quality of the work, but has also gotten more people excited about doing it. There's been a phenomenon recently run by Dr. Chelsea Harris, who's a surgery resident from Maryland,
00:17:34
Speaker
And what she started to do is she would go to these big academic conferences and she'd realize there were so many great talks there that often had three or four key messages or key points. And so she on the spot while listening to the talk would create what she calls a live visual abstract. That would essentially be the visual summary of the talk that was given at a large meeting
00:17:59
Speaker
And she did it a couple of times and I asked her, you know, aren't the people upset that you're sharing their work? She said, well, it's a public meeting. It's like an open audience. It's free to share. But interestingly, she found that afterwards,
00:18:15
Speaker
multiple people at the rest of the meeting said, Dr. Harris, I'm giving a talk tomorrow. Could I share with you my slides ahead of time? And would you mind making a live visual abstract so that people could know about my work who couldn't attend the meeting? And so we now have five or six big academic meetings
00:18:36
Speaker
who are actually pre-planning live visual abstracts during the meeting so that the message of the talks that happen at that meeting go far beyond the people who are able to attend. So to be sort of democratizing
00:18:52
Speaker
access to information. And also for a lot of us who are super busy, can't go to every meeting you want to go to, can't listen to every talk you want to go to. It's great to see these summaries and if it's something of interest, then I'll go back and try to find the talk or read the paper. But it very quickly allows me to find the work that's most relevant to what I'm trying to learn.
00:19:15
Speaker
Yeah, that's really interesting. Although I'm sitting here thinking, is it cheating? It's like behind the scenes, you know, sort of like they're planning to have a live visual abstract. So is it is it cheating? But it's funny, Dr. Harris actually still enjoys the time crunch of doing it on the fly. Yeah, without getting the slides beforehand. I think in my
00:19:38
Speaker
My proclivity, I think maybe because I trained in surgery, I'm a planner and I love having the odds in my favor all the time. So I love trying to get information ahead of time but she's been doing both. Interestingly, another follow-up email I got from a nonprofit agency who came across the visual abstract through the CDC
00:20:02
Speaker
They said, you know, we don't do research articles and that's not really kind of the core of our work, but we deal with a lot of partners and collaborators who don't really understand what we do.
00:20:15
Speaker
And we've started to create a visual abstract of what are the three key things that we do at our nonprofit organization. And we share that on our social media. And it's helped us engage new partners and new people we collaborate with, just as a way to clarify our message and clarify our goals about
00:20:33
Speaker
what our organization's about and how to communicate that outwardly. So it's just been fun. I get such a joy watching people adapt it and make it useful for their organizations and for their work and to make it more accessible.
00:20:48
Speaker
Yeah, it's terrific. I'm gonna put all the links to the visual abstract site and to some of the empirical papers you mentioned up on the show notes page so people can check them out and I hope they will. I think it goes a long way in helping get research out there and make it more visual and make it more accessible to people. So Andrew, thanks so much for coming on the show. I assume you have to go back to the operating room now. I'll go back to coding something in Stata or something like that. That sounds good.
00:21:16
Speaker
Thanks so much. Thanks a lot for coming on the show. I appreciate it. Thanks Jonathan. I really appreciate it.
Conclusion and Future of Visual Abstracts
00:21:21
Speaker
Thanks to everyone for tuning into this week's episode. I hope you enjoyed it. I hope you will check out some of the information about the visual abstract and maybe weigh in with your own visual abstract. Obviously, we've talked a lot about the medical field, but this idea can clearly be used in any field of research.
00:21:37
Speaker
If you do have comments or questions, please do let me know on the show notes on the website or on Twitter. So until next time, this has been the policy of this podcast. Thanks so much for listening.