Development of Podcasts in a Hospital Setting: A User-Centered Approach

Abstract

Patient information plays a pivotal role in preparing individuals for hospital visits and empowering them to actively participate in decision-making processes regarding their healthcare. However, many patients face challenges related to reading comprehension. In response, podcasts have become a popular, user-friendly medium for sharing essential and easily understandable information in an engaging format.

The aim of the present project was to use a user-centered approach to develop podcasts providing patient information prior to hospital visits. We aimed to describe the steps of the development in detail with the purpose of inspiring podcast development in the future.

In Phase 1 we conducted interviews with patients and focus groups with clinicians based on the “empathy map” method, with the purpose of exploring patients’ needs on which to subsequently build the podcasts’ content and format. In Phase 2 we produced and refined the podcasts on the basis of feedback from clinician- and patients representatives.

Our results indicated the importance of clear and concise language, personalization of communication, and content alignment with patients’ needs. Our project resulted in a description of each step of the development that can be used as inspiration for others who wish to take a user-centered approach to podcast development.

Patient-provider communication is an important element in all phases of patients’ healthcare trajectories impacting satisfaction, adherence, and treatment efficacy (Ammentorp, Sabroe, Kofoed, & Mainz, 2007). However, many patients experience anxiety and uncertainty before hospital visits, hindering their ability to engage and retain important information (Nguyen et al., 2019). Informed patients are more likely to actively participate in healthcare decision making and self-management (Elwyn, 2004; Gaston & Mitchell, 2005; Husson, Mols, & van de Poll-Franse, 2011), and this highlights the need for improved communication and information dissemination (Nguyen et al., 2019). In the digital age, diverse healthcare information formats, including podcasts, are crucial for equal access (King, 2022; Lee & Ortiz, 2021). However, to our knowledge, podcasts lack empirical studies on their development and evaluation for patient information dissemination (Cho, Cosimini, & Espinoza, 2017; Fine, Peyser, Abittan, Mullin, & Goldman, 2023; Gill, Kitney, Kozan, & Lewis, 2010). This study bridges the gap by exploring a user-centered approach (Borge et al., 2022; Domecq et al., 2014; Ferreira, Silva, Oliveira, & Conte, 2015) in podcast development, prioritizing and addressing the unique needs of patients to enhance patient-provider communication.

Diversity of healthcare communication

While the traditional written format remains prevalent in leaflets, apps, and online resources, it is crucial to acknowledge that not everyone can easily access or comprehend written information. Factors such as low literacy levels, language barriers and cognitive difficulties present significant challenges. The World Health Organization (WHO) emphasizes this challenge under the label “health literacy,” defined as an individual’s ability to “gain access to, understand and use information in ways which promote and maintain good health” (Nutbeam, 1998).

Recognizing the need for diverse healthcare information formats beyond traditional written materials, there has been a growing emphasis on accessibility. The inclusion of alternative formats, such as podcasts, alongside text-based content, enhances information accessibility, catering to the diverse needs of patients (Harter, 2019). This commitment aligns with the European Union’s focus on web accessibility, demonstrated through the implementation of regulations. Such diversity ensures equal access to healthcare information, regardless of individuals’ literacy or language skills (Chen et al., 2018; King, 2022; Lee & Ortiz, 2021).

Podcasts in healthcare communication

The shift from traditional to digital formats is emphasized, with podcasts emerging as a crucial factor in making information more accessible. An exploration of audio recordings as a powerful medium emphasizes the importance of podcasts in storytelling within acoustic spaces (Harter, 2019). The study argues for audio formats based on their capacity to engage academics in multi-sensorial inquiry and connect them with broader publics. The creation of podcasts is presented not only as a scholarly endeavor but also as a means of establishing connections with diverse audiences, including health communication scholars, healthcare providers, patients, and the broader public interested in well-being and healthcare (Harter, 2019).

Podcasts, particularly in medical educational programs, have seen significant expansion, acknowledged for their ease of production, cost-effectiveness, and effectiveness in imparting information (Alam et al., 2016; Bensalem-Owen, Chau, Sardam, & Fahy, 2011; Cho, Cosimini, & Espinoza, 2017; Evans, 2011; Gill, Kitney, Kozan, & Lewis, 2010; Lichtenheld, Nomura, Chapin, Burgess, & Kornegay, 2015; Münch-Harrach, Kothe, & Hampe, 2013). Patient associations have also embraced podcasts, with feedback highlighting their positive impact in fostering a sense of connection and reassurance among patients (Fine, Peyser, Abittan, Mullin, & Goldman, 2023; Lung Cancer Foundation of America, 2023; Power, 2018; Upstage Lung Cancer, 2023). The podcasts initiated by these associations provide an intimate platform for individuals to share their challenges and experiences, creating a supportive environment that enhances overall well-being and understanding. However, to our knowledge, studies on how to develop and evaluate podcasts to be used in patient information dissemination are lacking (Cho, Cosimini, & Espinoza, 2017; Fine, Peyser, Abittan, Mullin, & Goldman, 2023).

User-centered approaches to podcast development

User-centered approaches to podcast development revolutionize the creation of patient information materials, challenging the traditional clinician-driven model. While conventional methods rely on established practices, research findings, and readability principles (Sekhar, Unnikrishnan, Vyas, & Rodrigues, 2017; Vinay, Shastry, Kodangala, Mateti, & Bhat, 2021), their effectiveness may falter in addressing the diverse and real-world needs of patients (Elwyn, 2004; Gaston & Mitchell, 2005; Husson, Mols, & van de Poll-Franse, 2011). To address these challenges and bridge the gap between standardized content and patient-specific needs, a user-centered approach is paramount. A user-centered approach in healthcare communication signifies a shift toward prioritizing the needs and experiences of end-users, primarily patients. It involves a thorough understanding of the diverse needs of patients, and ensures that the development of information materials is similar to what patients require (Borge et al., 2022; Domecq et al., 2014; Ferreira, Silva, Oliveira, & Conte, 2015).

While there is anecdotal and practical experience within clinical settings suggesting the feasibility of using podcasts to provide information to patients before hospital visits, it is essential to note that, to our knowledge, there has not been empirical examination of the development of podcasts in this context.

Objectives

The aim of the present project was to use a user-centered approach to develop podcasts providing patient information prior to hospital visits. We aimed to describe the steps of the development in detail with the purpose of inspiring podcast development in the future.

Method

This project was based on a user-center approach and was conducted at the Department of Medicine at Vejle Hospital, Denmark from 2019 to 2022. We aimed to develop three distinct podcasts, one for each of the following groups of respiratory patients: suspected lung cancer, chronic obstructive pulmonary disease (COPD), and sleep apnea. These diseases vary significantly in terms of diagnosis, treatment, prognosis, and the emotional impact they have on patients. All three groups - COPD, lung cancer, and sleep apnea patients - face the common challenge of low health literacy (Ellender et al., 2022; Etindele Sosso & Matos, 2021; Haas et al., 2018). Recognizing this shared barrier, podcasts emerge as a valuable medium to bridge the gap by delivering information in an accessible and easily understandable spoken format.

The Regional Ethics Committee was informed, but determined that the study did not require formal ethical approval (ID-no. 20202000–222). The study was registered with the Regional Danish Data Protection Agency (ID-no.: 20/55212).

The project was divided into two phases, as presented in Figure 1. Phase 1 consisted of the design of the podcasts’ content and format, which included an in-depth exploration of patients’ specific information-related needs. To explore these needs, individual interviews were conducted based on the empathy map method. In Phase 2, podcasts were produced, and adjustments were made based on input gathered during a workshop that included feedback from patients, clinicians, researchers, and communication specialists.

Figure 1. Process of development of podcasts.

The figure shows a detailed flow diagram of the process development of the three different podcasts for patients with suspected lung cancer, COPD and sleep apnea. The process is divided into two phases. Phase 1 consists of the design phase, including patients’ need for information, and phase 2 the development of podcast production and adjustment.

Phase 1: Design

Interviews, Focus Groups and Empathy Maps

In the design phase, we used the “empathy map” method, to understand patients as the target audience for our podcasts and to anticipate their potential information needs prior to hospital visits (Ferreira, Silva, Oliveira, & Conte, 2015; Gibbons, 2018; Pigneur & Clark, 2010). While this method is commonly used in marketing, it has also found application in the design of patient information leaflets (Khodambashi et al., 2017) and can be integrated into a user-centered approach.

The primary objective of empathy mapping is to construct a theoretical presentation of a typical patient, allowing insights into patients’ thoughts, emotions, needs and behaviors (Ferreira, Silva, Oliveira, & Conte, 2015). Unlike the traditional presentation, we actively involved both patients and clinicians as part of our user-centered approach. Patients provide valuable insights into their personal experiences, emotions, and needs, while clinicians contribute their expertise and understanding of the medical aspects and treatment processes.

Patients eligible for “empathy map” interview had to meet the following criteria:

• Patients with suspected lung cancer, COPD or sleep apnea

• Patients aged 18 and above

• Patients capable of understanding and speaking Danish.

Patients with severe mental illness, memory impairments or terminal physical illness were excluded. Eligible patients were identified by an outpatient nurse and provided with oral and written information about the project before agreeing to participate. Written consent was obtained before conducting individual telephone interviews with patients. Clinicians from each of the included clinics (lung cancer, COPD, sleep apnea) took part in separate “empathy map” focus group interviews. These clinicians were selected from the clinic to provide a diverse range of perspectives, including both young and experienced nurses and physicians, as well as a psychologist.

The interviews and focus groups followed an interview guide (see supplementary material) that was based on previous work on user-centered approaches (Borge et al., 2022; Domecq et al., 2014) and empathy mapping (Ferreira, Silva, Oliveira, & Conte, 2015).

Development of Podcast Manuscripts

After conducting individual patient interviews and clinicians’ focus group interviews a collaborative and consensus-building process took place. This collaboration involved a patient representative who was a communication specialist with insights into the patients’ perspective through the empathy map interview and a team of clinicians, including three physicians, a nurse, and a psychologist, all with research experience. During this process, the team identified common patterns and recurring themes across the interviews, allowing for a comprehensive understanding of the collected data. Subsequently, a consensus empathy map was meticulously constructed, representing the collective experiences, emotions, and needs of the three different patient groups. Podcast manuscripts were developed on the basis of the consensus empathy maps.

Phase 2: Development

Podcast Production

For each of the three podcasts, we used the same patient because of his sonorous voice and one physician. Listeners learning from podcasts has been linked to their perceived connection to the podcast hosts. And the voice of the host has been shown to have an important influence on the listeners´ attraction, influence, and retention to the podcast (Shamburg, O’Neill, Jimenez, Rodriguez, & Harb, 2023). We engaged three different physicians, each contributing their unique medical expertise and experiences. Before recording the podcasts, we guided the patient and clinicians who participated as speakers in the podcasts on recording techniques, tested the audio, and performed a first reading of the manuscript so that the speakers were familiar with the podcast production, as well as the patients’ perspectives and needs obtained from the empathy maps. The format of the podcasts was dialogue-based featuring conversations between patients and clinicians, as this has previously been shown to improve listening experiences (Cho, Cosimini, & Espinoza, 2017; Wilson, Petticrew, & Booth, 2009). The dialogue-based format emphasizes the importance of avoiding a scripted tone, highlighting the significance of a natural and spontaneous exchange for optimal engagement (Wilson, Petticrew, & Booth, 2009). An expert podcast agency handled the recording and editing.

Workshop

A two-day workshop was organized with the purpose of discussing the contents and format of the podcasts and making relevant adjustments. Workshop participants consisted of the patient representative, one communication professional and a diverse group of clinicians working with patients having suspected lung cancer, COPD or sleep apnea. Because of the vulnerability often experienced by some of these patient groups, characterized by uncertainty and anxiety, their participation in the workshop was not feasible. The patient representative conveyed the patients’ perspectives throughout the workshop, compensating for the patients´ inability to participate in the workshop.

The first author, with a background in teaching and clinical practice, facilitated the workshop, leveraging her experience in conducting similar sessions. All the data from the workshop were summarized to finalize the podcasts. Results from the workshop contributed to the conceptual development of the final podcasts.

Results

We developed three podcasts aimed at preparing patients with suspected lung cancer (Frølund, Farver-Vestergaard, & Søby, 2021), COPD (Frølund, Farver-Vestergaard, & Løkke, 2021) and sleep apnea (Frølund, Farver-Vestergaard, & Gantzhorn, 2021) for their hospital visits.

Empathy Map and Podcast Manuscript

The project involved six patients, with an additional four declined to participate due to feeling unwell or lacking the energy. Patients’ ages ranged from 52 to 72, with a gender distribution of four females and two males. Marital status varied, with two patients being married and four single. Employment statuses included one full-time worker, one part-time employee, one with a flexible work arrangement, two on disability pension, and one receiving full pension.

For each podcast, two patients took part in empathy map interviews. Furthermore, 12 clinicians, four for each podcast, voluntarily took part in empathy map focus groups. The interviews and focus groups informed the development of an empathy map for each of the three podcasts. For the sake of simplicity, we only present the results for the empathy map and podcast manuscript for suspected lung cancer.

The empathy map results, and the subsequent podcast manuscript considerations, will be presented in the following. An overview of the empathy map related to suspected lung cancer can be found in Figure 2 and the podcast manuscript is shown in Table 1. Empathy maps and podcast manuscripts for COPD and sleep apnea can be found in the supplementary material.

Figure 2. Empathy map: suspected lung cancer.

Statements from patients are marked with (P) and statements from clinicians are marked with (C).

Table 1. Podcast manuscript for suspected lung cancer

General Considerations

The target audience of the podcast The podcast is tailored for patients referred to the Diagnostic workup of lung cancer with suspected lung cancer. Patient characteristics The patients commonly experience nervousness, fear, anxiety, frustrations, physical limitations, and a sense of loss of control due to their health condition Review the empathy map as it can assist podcast speakers in gaining insight into patient emotions and needs, thereby enhancing their ability to communicate effectively and provide valuable content. Podcast development This podcast is a dialogue between a patient and a clinician, and our primary goal is to foster trust by acknowledging and addressing their emotions, as highlighted in the empathy map. Throughout this podcast, we will emphasize our commitment to providing support every step of the way and being readily available to address any questions or concerns they may have. Look through the podcast manuscript and make keywords for yourself.

Podcast contents

Intro Overall - Briefly introduce yourself and what the podcast is about. Welcome to the Medical Department’s patient podcast about what it means to be referred to the Diagnostic workup for lung cancer due to suspected lung cancer. My name is [Your Name], and I am a senior physician here at the department. Addressing Patient’s Feelings See patient characteristics. Podcast contents In this podcast, we will talk about: Why have you been referred to the Diagnostic workup for lung cancer? What should happen on your first visit? How is the examination progress for suspected lung cancer? What could you do while you wait for an answer? Summary

Why have I been referred to the Diagnostic workup for lung cancer?

Suspected lung cancer. It is important to emphasize that just because you have been referred to the Diagnostic workup for lung cancer, it does not necessarily mean you have cancer. We will delve into the reasons behind this referral to help you better understand your situation.

What will happen during my first visit?

During your first visit, you will have the opportunity to speak with a junior doctor or a nurse who will outline the plan ahead. It is crucial for us to get to know you better, which includes inquiring about your medical history, current medications, and any past treatments. Ensure that your scans have been reviewed by a specialist doctor who has developed a comprehensive care plan tailored to your needs

How is the examination progress for suspected lung cancer?

The journey through the Diagnostic workup for lung cancer typically involves four key steps: Step One: You will receive a referral to the Diagnostic workup for lung cancer. We meticulously review this referral to plan the next steps in your care. Step Two: Our dedicated secretary will reach out to you, informing you about your appointment and whether preliminary scans are necessary. Step Three: You will visit either our X-ray department or the Nuclear Medicine Department for the required scans. Step Four: Following the scans, you will receive answers as part of the Diagnostic workup for lung cancer. It is essential to understand that, in most cases, a definitive diagnosis of lung cancer cannot be made solely based on scans. Additional investigations are often needed to provide a complete and accurate assessment of your condition. We will guide you through this process every step of the way.

What can I do while I wait for an answer?

While waiting for your diagnosis, here is some valuable advice to help you navigate this challenging period:

Question Notes: Write down any questions or concerns you have. We are here to provide answers and clarity. Open Conversations: Talk openly with loved ones; their support can bring comfort and strength. Maintain Normalcy: Try to continue your daily routines; it can ease anxiety during the wait. Prioritize your overall well-being.

Summary

Briefly summarize the information from the podcast.

Gain and Needs

For patients, the primary need was to find out whether or not they had cancer. They emphasized the importance of clear, transparent communication from clinicians, including information about the likelihood of cancer, required diagnostic tests, and the steps involved in confirming or ruling out the disease. Clinicians, on the other hand, usually avoided using the term “cancer” and instead opted for “disease,” to prevent immediate distress in patients. They believed that delaying the disclosure allowed them to shield patients from fear and undue panic. Clinicians often sought additional diagnostic information and consultations with specialists before delivering potentially life-changing news. We prioritized the patients’ needs in the podcast, using the word “cancer,” but acknowledged the clinician´ perspective, highlighting that a referral to the diagnostic workup for lung cancer do not inherently signify a cancer diagnosis.

It is important to emphasize that just because you have received a referral to the diagnostic workup for lung cancer, it does not necessarily mean that you have cancer.

And, at the end of the podcast:

It’s scary to think that you have to go through some examinations … , and that you might have cancer. But again, keep in mind that not everyone has cancer.

Patients expressed a desire to be spoken to as human beings rather than just patients. To address this, a patient-clinician dialogue format was adopted in the podcast manuscript.

The patients asked for an overview of the hospital visit. This was similar to the request by the clinicians, who presumed that the patients’ wanted a specific guide to the different procedures, in order to increase their knowledge. Therefore, the podcast manuscript included a step-by-step introduction to the hospital visit and an overview of the procedures.

Environment

Patients expressed deep concerns regarding the potential impact of their illness on their family members, both emotionally and practically. They were particularly worried about the emotional distress, fear, and sadness that their relatives might experience upon learning about the diagnosis. Additionally, patients considered the practical aspects of their relatives’ lives, such as increased responsibilities, including caregiving, managing household tasks, and potential financial burdens.

In contrast, clinicians thought that patients saw relatives solely as a valuable resource and a source of support. They believed that patients were interested in understanding how to involve their relatives in the healthcare process.

To address these differing perspectives, the podcast manuscript aimed to provide comprehensive support and guidance to patients while acknowledging relatives as potential sources of support in navigating the illness’s challenges.

I think it’s a good idea to have someone with you who you care about, because… then you have someone with whom you feel comfortable and who hears things, perhaps, in a slightly different way than you do yourself.

And, later in the podcast:

If you think it can be difficult to put into words the thoughts and feelings you have, then you can listen to this podcast together with your family.

Patients and clinicians acknowledged patients´ influence from internet searches, television, and social media. Despite their potential value, our podcast content did not directly integrate or reference them. Our podcasts, curated and developed based on research, expert knowledge, and input from patients and clinicians, aimed to counter misinformation on social media. The goal was to provide accurate and reliable information directly to patients through podcast available on social media platforms.

Difficulties

Patients and clinicians both noted that patients often struggled to retain information provided during hospital visits. Patients also reported challenges in understanding physicians’ language, primarily due to the use of complex medical terminology and the fact that some clinicians were not proficient in Danish. To address these issues, the podcast manuscript included the following statement:

We recommend taking a relative with you … You are likely to be nervous and apprehensive … , and having someone else present to hear the information is important.

Patients also expressed fatigue and reduced energy levels. While clinicians believed that patients faced challenges with the unknown, this concern was not explicitly mentioned by patients. The podcast addressed this by reassuring patients:

You may do exactly what you normally do. There are no restrictions … You can carry on as normal.

Think and Feel

Patients reported that they experienced feelings of anxiety, fatigue, fear and hopelessness in relation to their suspected lung cancer prior to the first hospital visit, which aligned with clinicians’ observations. Interestingly, clinicians were unaware of the patients’ sense of loneliness, instead perceiving stress and anger in their emotional state. To address these complex emotions, the podcast sought to connect with patients’ experiences:

What is it that you fear? Are you afraid to get a diagnosis? Or, do the upcoming procedures cause anxiety? What concerns you?

This empathetic approach aimed to validate patients’ feelings and provide emotional support during the diagnostic workup for lung cancer.

Questions

A disparity emerged between the questions interviewed patients wanted to ask and what clinicians in focus groups perceived the patients’ concerns to be. Patients were primarily interested in knowing if they had cancer and getting information about their prognosis. Clinicians, however, aimed to prevent unnecessary worry and therefore sustained from addressing these existential questions. Instead, they believed patients were more focused on understanding the diagnostic procedures and the expected timeline for obtaining answers. In the podcast, we chose to address the questions about mortality:

Recognizing that you may not be approaching this situation as objectively as possible, it’s essential to understand that receiving a referral for the diagnostic workup for lung cancer does not equate to an imminent demise.

This approach was designed to offer patients reassurance and a sense of perspective, acknowledging and addressing their existential concerns about the uncertainty of their situation.

Workshop

The results from the workshop focus on the development of all three podcasts. Three points for adjustments were identified in the workshop discussions: the format, length, as well as the combined theme of language and information presented in the podcasts.

Format

While the dialogue style had been preselected, workshop participants actively deliberated its merits and engaged in a thoughtful discussion regarding the format of the podcasts. This discussion encompassed options like monologue, dialogue, or interview style. Ultimately, a consensus emerged, with participants generally agreeing that the dialogue format, featuring conversations between a patient and a senior physician, significantly enhanced the overall listening experience. Importantly, participants had a substantial degree of involvement, including the ability to suggest and implement changes to the format.

The incorporation of this storytelling technique, which creates a narrative through dialogs, proved effective in captivating patients. Participants, including both the patient representative and the clinicians, found that this format was aligned with the need for information, and fostered empathy with the patients featured in the podcast. Moreover, the dialogue style imbued the podcasts with a sense of personality and conveyed the local context of real hospital visits, thus instilling trust and credibility in the information presented. Despite these discussions, no changes were made to the podcasts, as the consensus reached during the workshop was that the chosen dialogue format was optimal for preparing patients for hospital visits.

Duration

The duration of the three podcasts ranged from 10 to 17 minutes. Workshop participants had varying opinions regarding the length of the podcasts. The podcast related to suspected lung cancer lasted for about 10 minutes and the sleep apnea podcast had a duration of 12 minutes. Most participants found the duration acceptable, though some considered them a bit lengthy. However, participants were hesitant to remove any segments, as they recognized the importance of repeating critical information for clarity. In contrast, the podcast for patients with suspected COPD lasted 17 minutes, which was perceived as too long. It contained unnecessary repetitions, prompting the decision to streamline the content. The workshop participants reached a consensus that information should be presented only once, with crucial points summarized at the end. As a result, the duration of this particular podcast was reduced from 17 to 14 minutes.

The Language and Information Given

The language utilized in the podcasts embraced an informal, accessible style to enhance audience engagement and comprehension. However, workshop participants debated this, balancing authenticity and professionalism. Supporters of a more relaxed tone believed in fostering intimacy and trust, enhancing empathy. Conversely, clinicians, favoring a professional tone, emphasized precision and credibility, cautioning against misinterpretation or oversimplification of medical content. Adjustments were made to maintain a friendly tone, fostering patient engagement, while delivering precise and reliable medical information. Additionally, changes were made to emphasize that patients had choices in their treatment and decisions, underlining the importance of healthcare decision-making.

Workshop participants found the podcasts both informative and dual functional, serving as post-visit aids for information retention. However, in the case of patients with COPD, participants recognized the need for a more diverse set of podcasts, given the wide variation in illness stage and treatment at the time of the initial hospital visit, e.g., patients with suspected COPD and long-term COPD patients. To cater to these distinct patient groups, clinicians proposed a multifaceted approach. Therefore, in addition to the hospital preparation podcast, we developed several specialized podcasts, each dedicated to specific topics such as living with COPD, smoking cessation, oxygen treatment, anxiety management, and tailored physical activity guidelines for COPD patients. This approach allows individuals to select and listen to the podcast most relevant to their specific needs and circumstances.

Discussion

To the best of our knowledge, this is the first attempt to systematically perform and present procedures for a user-based approach to the development of podcasts in a hospital setting. The insights from the development process is presented in Table 2, and can be used as inspiration for those who wish to develop future podcasts in the hospital setting.

Table 2. Description of the steps for developing podcast for patient information

The user centered approach in making a podcast contains five steps:
Step 1: Define the purpose of the podcast	Clearly identify the goals and objectives of the podcast. Determine the specific patient information to convey and the issues to address.
Step 2: Understand your patient needs by using an empathy map in the design process	Understand your target audience by using an empathy map. Consider their demographics, medical conditions, concerns, needs, questions and preferences. Tailor your content to meet the unique needs of your patient group.
Step 3: Plan Engaging Content	Research and gather accurate, reliable, and up-to-date information related to the podcast’s topic. Consult reputable sources such as medical journals, trusted healthcare organizations, and experts. Organize your content in a logical and structured manner. Break it down into manageable episodes or segments to avoid overwhelming listeners. Duration between five to fifteen minutes. Incorporate storytelling techniques to create a narrative that captivates your audience.
Step 4: Use the empathy map in the podcast	Speak in a conversational manner and avoid complex medical jargon. Use simple and easily understandable everyday language to ensure the message resonates with patients of varying health literacy levels. Acknowledge and validate the emotions that patients may be experiencing. Address their fears, anxieties, and uncertainties to create a safe and supportive space.
Step 5: Ensure Quality Production	Invest in good-quality audio equipment to ensure clear and crisp sound. Minimize background noise or distractions that may hinder listener comprehension. Edit the podcast episodes carefully to remove any errors or awkward pauses.

Empathy Maps in a Patient-Centered Approach

Our podcast development followed a patient-centered approach, tailoring content to individual patient needs. This ensured addressing specific challenges with pertinent, accessible, and engaging information. To our knowledge, the development and effectiveness of podcasts in a similar context had not been previously investigated. While many studies examine patient information, such as leaflets, they often lack patient and clinician involvement in the development process (Nguyen et al., 2019; Sekhar, Unnikrishnan, Vyas, & Rodrigues, 2017; Vinay, Shastry, Kodangala, Mateti, & Bhat, 2021). This underscores the novelty of our project in exploring podcasts as a patient-centered information medium.

Empathy mapping revealed disparities between patient information needs and clinician perceptions, consistent with prior research (Farrell, 1991; Frølund & Bruun, 2018; Hallstrom & Elander, 2001). This insight led to the creation of patient-centered podcast manuscripts, addressing concerns, delivered pertinent information, and resonating with the intended audience.

Our approach aligns with patient-centered care principles, crucial for effective healthcare delivery (Gabutti, Mascia, & Cicchetti, 2017). A fundamental aspect of patient-centered care is providing clear, and accessible information, empowering informed health decisions. Podcasts, as a form of patient information, play an important role in this process (Elwyn, 2004; Gaston & Mitchell, 2005; Husson, Mols, & van de Poll-Franse, 2011). Research has demonstrated that involving end-users in the development process, translating their insights into product design, enhances engagement with the final product (Davis et al., 2018; Paracha, Hall, Clawson, Mitsche, & Jamil, 2019).

Podcast Duration, Format, Language and Information Given

Our podcast episodes were adjusted to a duration of nine to fourteen minutes, a range supported by research on medical education podcasts (Cho, Cosimini, & Espinoza, 2017; Matava, Rosen, Siu, & Bould, 2013). This aligns with the typical listener attention span of five to fifteen minutes, preventing fatigue and aiding effective information absorption (Matava, Rosen, Siu, & Bould, 2013). Balancing depth and conciseness is essential for engagement without overwhelming patients. Segmenting content into shorter, focused episodes, as adopted for the COPD podcast, allows systematic exploration, making it more manageable and adaptable to diverse audience needs. Each episode covered specific aspects, enabling patients to consume content in smaller, digestible doses over time.

To create informative and engaging patient podcasts, we prioritized establishing a deep connection between patients and physicians. Structuring podcasts as conversations, breaks down barriers, fostering a relatable atmosphere. Our objective was to empower patients to actively participate rather than passively receive information. This approach is supported by research on podcasts’ ability to build community and connection (Riddell, Robins, Sherbino, Brown, & Ilgen, 2021). We featured local physicians in our podcasts, aligning with previous medical education podcast studies (Cho, Cosimini, & Espinoza, 2017; Matava, Rosen, Siu, & Bould, 2013). The conversational style created an empathetic and relatable environment, fostering a sense of connection between patients and physicians.

Podcasts are valuable supplements to patient-provider interactions (Medina-Córdoba, Cadavid, Pérez-Acosta, & Amaya-Giraldo, 2021), but not substitutes for personalized medical advice. They complement physician communications by equipping patients with foundational knowledge, encouraging informed questions, and empowering active patient roles in decision-making (Elwyn, 2004; Gaston & Mitchell, 2005; Husson, Mols, & van de Poll-Franse, 2011).

The language employed in our podcasts aligns with patients’ needs. While this study represents, to the best of our knowledge, the first of its kind in developing podcasts for patient information, our approach is informed by established research on patient leaflets (Medina-Córdoba, Cadavid, Pérez-Acosta, & Amaya-Giraldo, 2021). Crafting patient information involves considering literacy levels, comprehension, readability, and layout. Clear and concise language helps patients grasp complex medical concepts, procedures, and treatment options (Medina-Córdoba, Cadavid, Pérez-Acosta, & Amaya-Giraldo, 2021; Nguyen et al., 2019; Sekhar, MK, Vyas, & Rodrigues, 2017; Vinay, Shastry, Kodangala, Mateti, & Bhat, 2021). Physicians are typically trained to communicate in a precise and formal manner, prioritizing clarity and accuracy (Deveugele, 2015). This aligns with the approach used in written materials like leaflets (Kenny, 1998). Podcasts offer an opportunity for a more informal and conversational language, allowing physicians to express their personality and potentially establish a genuine connection with patients (Harter, 2019). Balancing relatability and professionalism is key to ensure accurate healthcare information conveyance (Deveugele, 2015). Podcasts can be a compelling alternative or supplement to traditional written leaflets, offering a more engaging and accessible way to convey healthcare information.

Our project corresponds with patient-driven participatory design studies, where evidence-based knowledge is harmonized with end-users’ perspectives, incorporating user narratives for active engagement (Davis et al., 2018; Paracha, Hall, Clawson, Mitsche, & Jamil, 2019). By embracing this methodology, we aimed to ensure that our podcast language resonated with patients while meeting high standards of healthcare communication and credibility.

Strengths and Limitations

A significant strength of the project is its early involvement of patients, alongside a diverse array of multidisciplinary clinicians. This inclusive approach is consistent with the participatory methodology, and leads to interventions that are better tailored to the target population, a benefit frequently observed in such approaches (Gabutti, Mascia, & Cicchetti, 2017).

However, several limitations warrant consideration. There is a potential selection bias, as participants were drawn from patients who agreed to participate in creating empathy maps. Four eligible patients who declined cited feeling too unwell to participate or lacking the energy. It is likely that individuals with more severe illnesses, experiencing more pronounced symptoms, may have had distinct experiences and information needs for their hospital visits. Given the inherent variability in patients’ informational needs preceding hospital visits, the importance of personalizing consultations to accommodate their unique requirements and preferences cannot be overstated.

Another limitation is the sole reliance on one patient representative for patient input during the workshop. This limited representation may have implications for the comprehensiveness and generalizability of the findings, as it might not fully capture the diversity of patient experiences and perspectives. This limitation was unavoidable given the delicate nature of the patient population. Our project made the most of the available opportunities, while prioritizing patient well-being. To secure a broader patient evaluation of the podcasts, we plan to interview multiple patients who have used the podcast.

Implications for Practice

Patient information disseminated in the form of podcasts is in keeping with a general societal trend (Fine, Peyser, Abittan, Mullin, & Goldman, 2023). As technology continues to advance and patient-centered care becomes increasingly important, the use of podcasts in hospital settings holds great potential as an alternative or supplement to written leaflets. However, there is currently no established evidence-based standard practice for the development of podcasts in the context of healthcare communication. In recognition of the potential of podcasts as a valuable tool for communication and patient engagement, we have meticulously outlined a description of each step of the development, which are conveniently listed in Table 2. This step-by step description are now readily available for practical use when developing new podcasts in healthcare. When distributing podcasts, it is crucial to employ various implementation strategies that are aligned with the specific characteristics of the organization in which they are designed, with the purpose of maximizing impact (Damschroder et al., 2009). This could include integrating content into diverse platforms such as patient portals and written materials, strategically utilizing QR codes, and fostering collaborations with healthcare professionals and advocacy groups. Employing a range of distribution approaches ensures broad accessibility and resonance with the diverse preferences of the target audience.

By embracing podcasts, hospitals can provide patients with an additional way to access the information they need, ultimately leading to improved health outcomes and more patient-centered care.

Conclusion

In conclusion, our study sheds light on the promising role of podcasts in enhancing communication and patient involvement in healthcare decision-making, particularly in the context of hospital visits. While we have made progress in understanding the impact of empathy maps on user-centered approaches and the development of podcasts, there are still vital components contributing to the effectiveness of podcasts that require further exploration.

As patients were engaged in the development process after the decision to use podcasts had been made, future research could investigate the relative effectiveness of podcasts compared to other formats, like videos and leaflets, based on patients’ preferences. Additionally, studies of overall patient satisfaction and the impact of podcasts could yield valuable insights into the effectiveness of this medium, and contribute to the ongoing optimization of healthcare information dissemination and communication practices.

Acknowledgments

The authors wish to thank the patients and health professionals who participated in the study. Special thanks to Eva Hoffmann, RN, and Jette Tækker, RN, from the Department of Medicine, Vejle Hospital for their assistance in patient recruitment and to Lorna Campbell, MA, for language revision. We also extend our appreciation to OPEN, Open Patient data Explorative Network at Odense University Hospital, Region of Southern Denmark, for their valuable support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10810730.2024.2321385

Additional information

Funding

This research was supported by the Development and Innovation Fund at Lillebaelt Hospital, Denmark and the Novo Nordic Foundation [Grant number: NNF21OC0068374].