Exploring Research with Drs. Matthew Wright and Ryan White

In this episode, host Cody Sasek connects with Dr. Ryan White (Rutgers School of Health Professions Associate Dean of Clinical Affairs) and Dr. Matthew Wright (Rutgers PA program faculty). White describes a nearly 20-year PA career, a PhD in health systems and policy, and research in healthcare workforce, health policy, and patient-provider communication via patient portals with health equity concerns. Wright, a PA and registered dietitian, outlines clinical practice experience and a PhD in health and human performance focused on PA student wellbeing and educational innovation. They discuss motivations, financial and institutional support and mandates for doctoral training, rank and promotion in academia, and that impactful scholarship can be done without a PhD. They advise learners to ask questions, seek mentors and teams, join committees, peer review, and pursue feasible projects. They also highlight research opportunities in AI (ambient scribes), wearables-driven data overload, and technology’s medical-legal and equity implications.

Transcript

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0:00

Hello, welcome to Building Bridges, a podcast from the Butler University Doctor of Medical Science Bridge Program. I'm Cody Sasek, and I'm so glad you're here. This podcast is all about connection, bringing together voices from across healthcare, education, leadership, and beyond. Whether you're a practicing PA, a student, an educator, or someone passionate about where healthcare is headed, this space is for you. Today, we're joined by Dr. Ryan White and Dr. Matt Wright from the Rutgers University PA program.

DMSBridgeInfo 0:28

All right, well, welcome to the podcast. Glad to have you both joining us, here on building Bridges. as we discussed in the intro, we're really interested in people's journey and how do they end up, where they end up and what are the steps and things that they encounter along the way. And so, we're glad to have both of you here today to talk about kind of your journey, maybe specifically in scholarship. but I imagine we'll cover all kinds of topics in our time together. So thanks for joining us.

Ryan White 0:55

Happy to be here. Thanks for having us.

Matt W 0:57

Thanks for having us.

DMSBridgeInfo 0:58

well, so we, we, generally introduced you a little bit, but maybe, if each, each of you wants to say a little bit about kind of your, your story, your, your history, what's led you, what's led you here? maybe, Dr. Whiteman start with you.

Ryan White 1:12

I am the Associate Dean of Clinical Affairs at the Rutgers School of Health Professions. I've been a PA for. Almost 20 years now. I began my career in primary care, spent some time in neurology, and for the past 14 years I've been, on the faculty at the Rutgers PA program. pretty soon after joining the faculty started my PhD journey. That took, quite some time, and, really caught the research bug. got into some health policy research, finished a PhD in health systems and policy, and since that time have been spending as much time as I can thinking about. Writing about and publishing in health services research specifically around the healthcare workforce. and more recently have begun to pivot a bit into patient provider communication, looking at some interesting emerging research in, the use of patient portals, to facilitate patient provider communication and some of the health equity concerns around that topic.

DMSBridgeInfo 2:13

I'm really interested to, hear more about the latter part of your introduction there. you know, on the patient side of things, my interactions in the, healthcare space are very transactional. You know, like, here's your annual physical and away I go. But having some. Family health things and seeing how some providers are really utilizing the, portal side of things to communicate in written form I think is really interesting. So,

Ryan White 2:34

it's so interesting that you say that Cody, and I'll just note that what the research is coalescing around is that providers tend to see the patient portal as a means to. communicate information and patients tend to see the patient portal as a means to, request consultation and engage more in, a discussion around, their health concerns. so sort of a one-sided, push of information from the provider side, but more interest in engaging in deeper conversations from the patient side.

DMSBridgeInfo 3:05

Yeah.

Ryan White 3:06

Yeah.

DMSBridgeInfo 3:06

Dr. Wright, tell us about yourself.

Matt W 3:07

I have been a PA now for 13 years and I've been a registered dietician for 20 years. I started at the Rutgers PA program in 2016, so I've been in education now for 10. I came by way of my dietician career, first college health. and then renal nutrition, which was a totally different experience and that really gave me the inspiration to want to know more about medicine. And that's what led me to PA school in general. from there I worked in family medicine. I worked in urgent care. I did some internal medicine, primarily all outpatient based. A little bit of fast track emergency medicine. So I got a nice scope of pre-hospital work for the most part. my research interests primarily lie in two buckets. my doctoral work was in student wellbeing primarily. my PhD that I got while working as faculty, is in health and human performance, and I looked at. Exercise as a potential mediating factor for anxiety and depression among PA students. but I also really enjoy doing education, innovation research. and that's what I've been doing a little bit more. Lately though, we do have an ongoing project at our school levels, surveying student, wellness and things like that. So my interests kind of lie in those two areas and they all kind of align back to my nutrition training. And that's kind of where my interest in research sparked. I was doing some clinical research at the time and I really enjoyed it and I knew that at some point I would come back to it and I got the opportunity at Rutgers.

DMSBridgeInfo 4:47

So let me ask you this question, which I think I might know the answer to,

Matt W 4:50

Sure.

DMSBridgeInfo 4:51

for either of you, did you think as a applicant, as a, maybe an undergrad or a PA student, or early in your career, did you think you'd end up here doing what you're doing now and kind of thinking about what you might do in the future? Did this, this all play out as you kind of had, had thought or scripted in in your mind?

Ryan White 5:11

So, I'm, I'm one of the. perhaps, part of the dying breed of PAs who as an undergrad had never heard of the PA profession. And so I certainly as an undergrad did not see myself ending up where I am now. Although, I, I, I have always, I, I think I've had a lifelong interest in, in scholarship and in research. so it's perhaps not surprising. Thought I'd be a neuroscientist. That was kind of the path. and, and, and, and pivoted, shortly after undergrad. but when I began my career as a pa, I, you know, I very much had an interest in, in scholarship, in evidence, in formed practice, and in research. And I had done some, public health training. so, my, my, you know, in my first role out of PA school, I was always looking for ways to kind of join together or align my clinical practice with some of those, you know, some, some of the emerging research interests that I had at that point. And, looked for various ways to do that in, in primary care, and was able to fulfill some of that interest along the way, even prior to joining the faculty at Rutgers.

Matt W 6:17

Yeah. And I thought I was gonna be a nutrition professor. So you, to answer your question briefly, yes. I thought I'd end up back in academia at some point. my experiences in, in Philadelphia, so I was working in inner city Philadelphia at a dialysis clinic, and those were really transformational for me. prior to that, I had been doing some clinical, research in a master's that I have in, in, Nutritional science essentially. and I really loved doing clinical research at the time, but then I went out to clinical practice as a dietician and realized like all, all my patients were ending up on dialysis because they had poor access to primary care. And I saw the PA route as a really good means, but really more like excellent means to fill that gap that a lot of people were, were falling into. So I went to PA school and while I was there I said, oh, okay, this is what I wanna be a professor in.

Ryan White 7:13

Yeah, it's funny how that happens. I had mentioned public health training. I did a dual degree. program, and. When I was in PA school in New Jersey, then the then governor of New Jersey passed the first of its kind law in the country that mandated, that certain providers screen new mothers for postpartum depression. it was a large initiative of the first Lady of New Jersey at that time. And, I had just begun my clinical rotations. It was something that was being actively discussed on my OB GYN rotation. And here I am, this, you know, public health PA student studying some health policy. And I thought I'd look into it. And I ended up pursuing that as part of my public health capstone project. I looked at claims data, looked at postpartum depression diagnoses in New Jersey six months prior to that law taking effect, and six months after, and found that there was no increase, meaning at that point that there hadn't been sufficient education, there hadn't been sufficient de-stigmatization. and other, sort of efforts that need to take place around passing a new law like that, that would've led to it being more effective, at least in the early stages. and from there, I just really, that's probably the point in time where I, where I caught the bug and sort of shifted my, my approach to my career.

DMSBridgeInfo 8:30

You know, in working with students doing research, how the ability to access data, In my experience, probably the number one barrier oftentimes, well, there's time and money. Those are always, always barriers, of course.

Ryan White 8:43

Absolutely.

DMSBridgeInfo 8:44

the training that led both of you or the, the path that, you know, you, you know, you all have, you both have kind of, educational backgrounds in addition to your PA training. At what point was it for both of you thinking about additional training as with a PhD to get to, to deepen that research background? Was there something, was there, was there something that led you to think that that was the next great move for you? Or was it, tell, us about the, like, what that, that experience was like for you.

Matt W 9:16

Good. Ryan, have two interesting I think answers that we could give here.

Ryan White 9:21

I, mentioned that the public health training, so I already had a master's in public health, and so for me it was, a logical extension to continue with that work toward a PhD. but that wasn't the only reason I chose to do that. at the time, I was able to get some, support, for pursuing a PhD, without which I'm not sure I would've been able to finance, that path because it was a seven year process. You know, as many of us in this career experience, it's also something we're doing on top of our full-time job. So, it was a natural extension for me to continue down that path, but. You know, I also at that point was very set on pursuing research. I wanted to be a researcher. I wanted to be a qualitative researcher. I, really dove into the world of, political science and economics, and I knew that that's what I wanted to do with my life. and so, it was the right path for me. I also recognize it is absolutely not the right path for many folks, and it's also not required in any way, shape or form to be a scholar, to be a researcher, to be a PA educator, to be a practicing pa. and there are many examples of folks who've, had very successful, long and fruitful careers as scholars, who didn't pursue the PhD path. but for me it was just the path that made the most sense and was most aligned with my interests.

DMSBridgeInfo 10:43

Yeah, I love when the interest aligns with some financial support because you're right. it is certainly time and resource intensive. and when I say resources, I mean. All of them. Right?

Ryan White 10:54

That's right.

DMSBridgeInfo 10:55

and so that was, I, I still remember there's always that question of do I, do I jump in the deep end? and when is the right time? And it turns out there's likely no right time.

Ryan White 11:07

That's right.

DMSBridgeInfo 11:08

remember sitting, shortly after starting my first full-time, PA education role and realizing that. I didn't know much about this education thing. I kind of knew my own experience, but there was, there was so much to know and so many questions to ask. And and I remember having a conversation with my supervisor at that time and, and some other mentors. And, the fact that there was university support for, for a PhD degree that was, that aligned with, with my interest was, made that a, an easier decision. So I think it was, I think it was probably six or eight months from the time that I. That I first started working in PA education, that I was already starting to take classes, and

Matt W 11:45

Hmm.

DMSBridgeInfo 11:46

And certainly you'll hear stories about what, the, the, experiences people have sometimes framed negatively with, with doctoral programs, specifically PhDs. But, I found it really interesting. I found, you know, it was a. A great way to learn. And, and if I could do that at, at a relatively low cost at a state school that was supporting it, while I was still paying back my student loans, and continued, I don't, I think I

Ryan White 12:09

Yeah.

DMSBridgeInfo 12:09

with my PhD and still had student loans.

Ryan White 12:11

Yeah,

DMSBridgeInfo 12:12

But,

Ryan White 12:12

I did.

DMSBridgeInfo 12:13

yeah, so it was, I don't know if the bigger celebration was finishing paying the student loans or finishing the degree, but both were, certainly celebrations. So yeah, that piece of it resonated.

Matt W 12:24

I,

Ryan White 12:24

I, I just, I'll just add, I, I, I probably, you know, hindsight is 2020, but if I had known when I was finishing up PA school, that. I would be where I am now, I probably would've gone back and started the PhD program sooner. Cody, you mentioned there's never, there's never a right time, there's never a good time. but it does take time. And so that's probably, if I had to change anything, that's probably one thing I would've changed is start that journey just a little bit earlier.

DMSBridgeInfo 12:49

Yeah.

Matt W 12:52

So, I picked PhD the program that I found, I mean, that's kind of the way I was leaning already when I was looking at programs. I first started at Rutgers. I took a year to research programs to really get to know PA education, learn what I enjoyed, learn what are the areas of my own background expertise that I would want to study moving forward? Also, like what does it mean to be a PA educator? What does it mean to be an advisor? What does it mean to mentor students through this stressful environment? So I took a a full year and got comfortable as an educator also just research programs. So the various types of doctorates one could get to find. the program that would be most aligned with my goals and, and my background and what most interests me. And interestingly, the first program I found, which was, an online PhD program at Concordia University Chicago. it was in health and human performance. That's the first program I found, and I really liked it. And it was a legitimate PhD. It was all the coursework. There was a comprehensive exam. there was all the dissertation phases and a defense. and I said, you know what? I'm gonna take a year that's there. I'm gonna ignore it for a while. I found myself circling back after I did all the research and saying, this is still the one that's most applicable. it was also. At the time, within the amount of tuition that the university would reimburse, so it would be covered, which was a very critical factor for me. I wasn't gonna go to a place that unfortunately, there were some really interesting, good programs out there that were beyond what the university would reimburse, and I, I just, I didn't have the financial means to do them either. So it kind of just all fell into place at, at, at this program. the one difference between Ryan's journey, or I suppose one of the bigger differences between Ryan's journey and mine is that I took the position with a doctoral degree mandate in place for new faculty coming in. we started it as lecturers when we were first hired. This was beginning, I believe, right around 2015. 2016.

Ryan White 15:06

Yeah. I think 2015.

Matt W 15:08

so you get hired, you're mandated to do a doctoral degree of whatever you choose. and you must finish within something like nine years. So you're working against the clock a bit. So I had some additional extrinsic motivation, not just like my family going, Hey, you got, when are you going to get done with all this extra work that's taking you away from us? it was such a nice fit. and I found that I really, one of my goals was I really wanted to learn the skills to be someone who I didn't wanna work independently, but could function independently as a researcher, did have a more thorough knowledge of statistical methodology and, and, and, study design as well, and I found that this was, was really a, a helpful, applicable path. So that's what ultimately made me choose it. And then I found that my interest also aligned in the program and I could continue to look at things that, that motivated me while I was in the classes I was studying and applying things that interest me in the projects within the class. So it all kind of aligned to, to also help me complete, say the dissertation phase where a lot of students I know fall out because they don't have the course deadlines in place anymore.

DMSBridgeInfo 16:20

I remember the timing of things. I had, finished coursework and comprehensive exams and was looking towards the dissertation and had a plan put together. My advisor and I and committee were all on the same page. Big chunk of it in-person data collection. And then of course 2020 happens and COVID happens, and then you have to figure out how do you pivot really, you know, hopefully really quickly. So that was the, that was a core, I would say, COVID experience. I was staying at home. And so, you know, might as well do a little, do a little, research and a little, a little work. Matt, for the, for the folks who, who li who are listening, who might not, who might not kind of fully appreciate the academic rank and, and kind of what that means. Could you talk just a little bit about like your experience with, know, kind of what that is typically and how your, your doctoral training kind of in either directly or indirectly kind of played a role in that?

Matt W 17:09

Sure. Ryan, did you start at lecture as well or did you come in as instructor or assistant?

Ryan White 17:16

Yeah, I came in as an instructor and then went to assistant and then associate. So, go ahead Matt. You, you can describe the full process.

Matt W 17:23

So essentially you're hired if, if you're coming in as a new PA educator, master's trained at Rutgers. with the changes that that occurred around 2015 that required that doctoral degree, they were hiring everybody at a lecturer level, which is a title that was often reserved for, non full-time faculty members and probably at other universities, maybe adjuncts and things like that. And as you progress in your programs, you can, demonstrate your effectiveness with things like teaching outcomes, research outcomes, and you'll slowly get promoted. The next rank would be something like an instructor or perhaps associate, assistant professor, excuse me. and then the next step would be associate and then tenured. Perhaps full, full professor, tenured, maybe, maybe not, but a full professor would be the next rank. and there's various years. between each rank that you must meet, there's maybe a reappointment at your rank that you need to accomplish before you can move up. So we all started per our contracts at AT lecturer. And then once you've achieved the doctoral degree, if you can also show that you've been effective, effective in your job, in the other responsibilities, you would then go up for promotion at the end of that program at the doctoral degree, and you can show like, I'm ready for assistant professor. And that process is arduous, as I'm sure you both are aware. you have to submit a promotion packet, you have to write a personal statement, you have to get letters of recommendation for each ranking. You go up and it gets more complicated each way. So, fortunately once the doctoral degree was done, I was ready. I had enough educational and experience. I was able to show that I was ready to be an assistant professor at that.

Ryan White 19:09

One is that as Matt mentioned, for folks who may not be aware, this structure and this process can look remarkably different from university to university institution, institution. At Rutgers, we happen to be, have multiple collective bargaining units. So we're in a union environment and the, the collectively bargained contract dictates all those criteria for rank promotion that Matt just articulated. and the second is that the tenure process looks very different across different institutions. And so, at Rutgers we are not eligible for tenure because we are not. Full-time researchers. the only opportunity for tenure at many R one institutions like Rutgers is you've gotta be a full-time researcher. You have to be, successful in acquiring lots of extramural funding, including large NIH and equivalent awards over time. So, I think, perhaps fortunately for those of us who are not on that path, extramural funding is not something that we necessarily have to worry about a whole lot.

DMSBridgeInfo 20:11

Yeah, and I think it's, I think

Ryan White 20:12

I.

DMSBridgeInfo 20:13

I think it's something like of PA faculty have ever had any sort of grant funding, and that's. And that most of that is probably the, the survey didn't ask specifically, but most of that is probably intramural grants

Ryan White 20:25

Yeah,

DMSBridgeInfo 20:26

know, a thousand dollars for

Matt W 20:28

Yeah,

DMSBridgeInfo 20:28

Not the sort of competitive, you know, you think about federal grants, that, that sort of a of a thing. So,

Ryan White 20:34

yeah,

Matt W 20:35

think about the structure,

DMSBridgeInfo 20:36

Uhhuh.

Matt W 20:37

the

Ryan White 20:37

I.

Matt W 20:38

structure of a PA educator position, and the demands, the high demands, heavy demands of a teaching workload, and it would be nearly impossible to maintain an RO one. That

DMSBridgeInfo 20:49

it would be a unique situation where someone might have the time and space to be able to do

Matt W 20:53

Mm-hmm.

DMSBridgeInfo 20:54

I mean, you know, the good thing is most pa educators are, doing what they love and

Matt W 20:58

Mm-hmm.

DMSBridgeInfo 20:58

students.

Ryan White 20:59

Yeah.

DMSBridgeInfo 21:00

hopefully works well for folks. And I don't know about the, the two of you, but I, I kind of found it in terms of promotion. Certainly the doctoral degree helped. and that's probably true whether I was, you know, at the, big academic medical center like the University of Nebraska or, you know, now at a a, a private college like our private university like Butler. it, it opened up many opportunities that I might not have otherwise had. just because, you know, whether it's this application or this criteria or whatever it might be, you're just kind of in a position to, to kind of, take advantage of some of those things. I think maybe in ways that might not have otherwise been.

Ryan White 21:35

I think Matt and I have both had that experience, and, and in, in different ways. You know, sometimes it's collaborators, looking for partners on a project and they, they, they happen to see your, your degree or your, your. Your focus or your concentration. but there's also, there's committees at Rutgers, that you're not eligible to sit on if you don't have a doctoral degree. Matt mentioned you're not eligible for promotion, do a certain rank if you don't have a doctoral degree. And there are many committees where you have to be at a certain rank to sit on the committee. so it's certainly, something that, that has opened doors for us along the way.

DMSBridgeInfo 22:09

Yeah. great. So thinking about your journey, switching gears here a little bit to the perspective of someone who might be. Maybe they're a pre-PA student, maybe they're a new grad, maybe they're in PA school, thinking about what the future might hold for them. And they're hearing, hearing this conversation and the idea that you could ask important, valuable questions and then find the answers to those questions, That's what we're doing with research. we're hopefully answering important questions that Im improve either what we do or the, the state of things and, and, so thinking about those people, do you have any advice from your, from your journey about how to think about that? Or if someone's thinking like, Hmm, I'd like to, I'd like to do some research, but I have no idea where to start. That all sounds so intimidating. That must be, you know, unobtainable or not reachable. Any, any advice that either of you would have for, for, that student?

Ryan White 23:05

I think you mentioned some of it. Cody. So first and foremost, ask questions. be curious. Scholarship and research is the foundation of the practice of medicine, and regardless of whether you're, in an academic program as a faculty member, you've got a PhD or not. We are all asking questions every day. That's what we do. We ask questions of patients, we ask questions of colleagues, and those are the questions that lead to scholarship, that lead to research, that lead to the advancement of knowledge collectively. so Conti, it sounds like the most simple thing, but ask questions. One of the physicians in my, in my practice, was the physician for a local school district, and they had recently undergone a change in leadership within the school district, and they weren't happy with their return to school policies after infections and after illness. So they asked the physician to look at their policies and. He didn't wanna do it, so he gave it to me. So I spent my time when I wasn't seeing patients doing a deep dive into infectious disease policies, into, public reporting policies, which, which types of infections have to be reported to the state. I spent time looking at. incubation periods and all of these things, for very common infectious diseases that impact children, school aged children, and some not so common infectious diseases that impact school aged children. I learned a lot. I ended up revising or helping the school district revise their policies. I could have published on that. I didn't. At that time, it just wasn't on my radar. I could have, I should have, it would've been at minimum, a nice systematic review. and could have potentially been more than that. And so that's something that any EPA student, any EPA graduate, in this country would have the ability to do. You know, arose out of a curiosity of mine and just being in the right place at the right time. so that's one thing is ask those questions, show up and be present. I know that sounds, again, very elementary, but you've gotta be there in order to recognize opportunities. you've gotta be in the room. You've gotta say yes to things. That's how opportunities arise. And the third thing is find a teammate. Find multiple teammates. find those folks who are senior to you, who are more experienced than you, and parrot them, shadow them. watch them from afar. Ask how you can get involved. something as simple as proofreading a manuscript, assisting with a literature review. helping to, write a discussion section of a manuscript, helping to create a poster or an abstract that's gonna be submitted to a conference. Those things are very low hanging fruit. They're things again that anyone who's been through PA school can do. and it's a great place to get started, and then it's just sort of snowballs from there. you pick up little tips and tricks along the way, and before you know it, you're sort of teaching the, the new folks who come along.

DMSBridgeInfo 26:04

Yeah, it's interesting as you're describing that I was thinking about my own process and, I think I had this idea when I started, my PhD program that, I would go through it, I would learn all of these things. I would graduate and I would be. I would know all of the things. And it just turns out it's so easy to have imposter syndrome when you're, it's, there's just a lot to know. And, I think you're exactly right that mentorship is really important. And I think about my own, I mean, kind of somewhat recent. journey being, being blessed to, to work really closely with, with Brenda Quincy, who has a great background. And, the two of you probably have, have, have met

Ryan White 26:40

Yes.

DMSBridgeInfo 26:41

just hearing somebody who really knows what's go, what, what, what's, happening. Talk and learn and also to hear. Yeah, that's a good question. I don't, I don't, I don't know that those, like those sorts of reaffirming moments where, all right, I don't know everything, but I do know some things

Ryan White 26:55

Absolutely. And, and yes, shout out to Brenda. She's incredible. yeah, and, and, and just, you know, finding like real practical advice from folks who are willing to give it, you know, it's, it's funny, one of the things in, in, at least in, in my PhD program, you, you take these relatively. Statistical classes and methodology, but no one shows you how to, which buttons to press in your statistics pass package. So, so I'm, I'm sitting there and, you know, I could, I could, I could pass an exam, I could tell you the theory behind this methodology and I had to sit down, with, with a statistician and I had to say, can you open Staa for me?

Matt W 27:33

Yeah.

Ryan White 27:33

What, what do I press? What button do I press? You know, so it's, it's, it's just that, it's, it's this, you know, okay, you have all the, all the education, but you need that practical wisdom to take that next step.

DMSBridgeInfo 27:47

the longest semester maybe of my life was, I, I don't even recall what the course title was, but it was a, one of the more advanced quant, quantitative classes that I took. and the, professor taught it using r and I had, which, which familiar, uses some coding language. And so it's not just like, calculate an average, calculate a mean, it, it's, So I spent the whole semester just trying to figure out what the, what, what

Ryan White 28:10

Yeah,

DMSBridgeInfo 28:11

But I think you're exactly, exactly right and, I suspect there'll never be a point. Where, I don't appreciate the value that a, a, a statistician brings to, to the, to the efforts. And, I thought the other, the other point about, about, know, it, it's, it certainly can be an individual activity, but, I view it as a, a team sport. And I think that, that the diverse perspectives and being able to see things from different angles and, and good thoughts, I think, think there's, there's value in that. Matt, I don't know if you have any, any other thoughts?

Matt W 28:42

Yeah, I, I was just gonna say that it, it's much more rewarding to, to do, to, to do your research with a team. you get that diverse perspective. You have people with their, they, they bring their individual expertise. It moves the project forward just so much more smoothly when you have support. I'll reinforce what, what you both have said about finding a mentor, especially as a, as a, a new graduate or, and somebody. Beginning their research journey that, finding somebody who's like-minded, equally motivated, has similar interests. Ryan was two doors for me, or has been my entire tenure with the faculty. So there have been multiple times, even now, reviewing articles for, for JP or Japa. I'll come in, I'll go, Hey, listen, this is what they did, or this is what I want to do. a group of us just got a grant, to look at, simulation and its effectiveness in, student outcomes, grades essentially. And, I remember talking through the statistical methods with him and, and we could just probably stop work for an hour to just talk stats and approach and methods and just completely get lost in that conversation. And if you find a person like that, it makes. It, it lowers the barrier to do something that's scary so much to know that you have somebody who's interested in what you're doing to somebody who's been there and can help you. so it's, it's just critical. and the last thing is maybe join a committee. if you're working at a hospital, oftentimes they'll be committees that are working on QA QI type projects. in that you're learning how to collect, where to collect data, how to analyze the data. It may not be that you're running these complicated statistical models, you're not doing complicated, binary logistic regression, things like that. but you're looking at data, you're analyzing data, you're making data informed decisions, and you're getting your feet wet in that scientific process. So that can be quite too.

DMSBridgeInfo 30:39

Yeah.

Ryan White 30:39

I, I, you know, read the literature. it's remarkable. And, and by the way, here's another plug. become a peer reviewer too. because there's just no better way to immerse yourself in the world of scholarship and research and to see what others are doing and to generate ideas. It's just, it's a wonderful way to begin, you know, sort of a life and research or scholarship.

DMSBridgeInfo 31:05

Yeah, it, that is tremendous service. You're, you know, supporting profession and, know, I think every, every manuscript that I've ever reviewed. I learned something from, and

Matt W 31:14

Yep.

DMSBridgeInfo 31:15

like, oh, that's a really elegant way to describe what's going on here. Or, you know, this topic that I thought I knew a lot about, but actually there's evolving literature that I wasn't aware of. Like those sorts of things. And Mo and for most of it, I think the, you know, it kind of depends on the nature of where you're peer reviewing, but most of it is applying your clinical expertise.

Ryan White 31:34

Yeah.

DMSBridgeInfo 31:35

or jpa, it's reading that with a. somewhat critical eye, in helping people improve their, improve their work. I know on the author side of things, I always, there's always a little bit of a, of a, it's like, reviewing, course evaluations. There's always a little bit of sense making that needs to happen and

Ryan White 31:51

Yeah.

DMSBridgeInfo 31:51

before I come au inevitably come full circle and say. Okay. I didn't agree with every point that the peer reviewer pointed out, but in total, my work is now better as a result.

Ryan White 32:01

Okay.

DMSBridgeInfo 32:02

So,

Ryan White 32:02

Yeah. to this day, I think the most cited paper I've written, number one, I published before I had a doctorate degree. and number two, the statistics was long division. so it's very possible to be successful, without a doctorate and without complicated advanced statistical methodology.

Matt W 32:27

my two most cited papers were both pre-doctoral work, my first paper as a PA educator was a small change I made in one single lecture, I had a traditional lecture on one medicine topic, and the next year I did it as a flipped lecture. And then I looked at the difference between student. Performance on asthma exam, questions in the flip setting versus two years of traditional. And they performed significantly better in the flip setting. So that was one small change and became an at least locally impactful paper.

DMSBridgeInfo 33:04

Yeah, I mean those are the sorts of things where we think about like, you know, these groundbreaking trials or studies and you know, sometimes the most impactful, practical, You know, like, like we ask about any sort of, of clinical study, is it clinically relevant, is it patient oriented? And if it's those two things and it fills a knowledge gap, it doesn't have to be big to be important and be impactful and, and, and so that's, sometimes I think. you know, kind of circling back to, you know, the dissertation process, I kind of started with, with the idea that, you know, if it wasn't the biggest and best, research study ever done, then that was, that was, that didn't seem like the right thing to do. and then quickly got some great advice for mentors that, you know, of this is part of a learning process and there's no finish line on, you know, graduation day or you're hooded. And that's the end of it. I think that's really important.

Ryan White 33:55

Yeah, and look, there's, there's a, there's a, a base of knowledge out there, and everything we do contributes to it in some way or another. It's either, it's either adding to our understanding of what we already think we understand, or it's forcing. Sort of a different perspective on what we thought we understood. but everything has, I mean, we have, you know, one of, one of the really amazing things that, that we have, that the benefit of, of having access to, at our program is there's a, a free primary care clinic, that's operated out of our program that many of our faculty, are able to practice at, that our students rotate through. And, and that one of our colleagues, directs and, A couple of our colleagues saw, a hookworm I affection. And, not uncommon, you read about it in textbooks. Every PA student learns about it, but we don't see hookworm in New Jersey. And so they wrote it up as a case report and it got published. and, and it's, it's, it's that kind of thing. it wasn't a statistical paper, it was a case report. But it was me. It was a meaningful contribution to the literature and it just so happened to, you know, one, one of the, one of the interesting things about the way they wrote it up was it was a patient presenting to a free clinic so they don't have insurance and, you know, how to, how to manage a patient in that environment.

DMSBridgeInfo 35:09

Yeah, and I think about, Matt, I think you had mentioned, quality improvement, which I think is a fantastic way for PAs, including early career PAs to engage in their. Departments that practice their health systems and really make quality, make, really make improvements that, that benefit patients. It's also a great way to find out where there are gaps and what do we need to know more about, either locally or, or more broad, more broadly. And so I think those sort of, I think Ryan, you mentioned sort of the idea of getting involved, getting, involved with committees. Those are great ways to, think start to be recognized as someone that people might tap. And then if, when there's a study, you can in, in some role, and then suddenly there's the next one. You're have an elevated position and next thing you know, you're asking, you know, and answering really big questions.

Matt W 35:56

Yeah.

Ryan White 35:57

And Yeah. Oh, go ahead Matt.

Matt W 35:59

No, I was gonna agree.

Ryan White 36:00

Yeah.

Matt W 36:01

a really good starting point. Even, you know, like later on if as you're making changes and you're, you're evaluating your teaching work, you may, you may have adjusted your curriculum in some way. Maybe it's bigger than just one, you know, lecture. you can still begin to think about how can I look at this scientifically outside of just say, student survey feedback data. That can become a paper and that's helpful for other people to read as well.

Ryan White 36:27

I also think, the knowledge and experience that, The career PAs have around emerging technologies, it's far superior to mine. And to other people in my position. And so thinking about the way in which AI is now going to permeate every element of our clinical practice, the use of ambient scribes is something that, has been a big part of the conversation in our practices recently. technologies that I think, students, new graduates early. Career PAs or early career PA educators are gonna be much more familiar with, much more comfortable talking about, and will generate, I think, more insightful questions, and, and can lead to some really interesting work. And so, you know, it's, it's not just about picking the easy or the low hanging fruit, it's also. You know, having that fresh perspective, and recognizing where, where one's strengths lie, and, and being able to ask those interesting questions in ways that sort of the more established folks maybe aren't thinking about, or they're too established, too entrenched to see things through a different lens. I think there's gonna be some really great work that comes out, in those areas. beyond, what's been done so far.

DMSBridgeInfo 37:34

If I can use that as an opportunity to circle back to the earlier in our conversation, what do you think a sort of scholarship research perspective or maybe just a general PA perspective, when you look at, what do you think from a technology perspective, it's gonna be most, most game changing for a, for a, a clinical pa? Is there any specific aspect of that that you see?

Ryan White 37:56

we talk about AI all the time, but obviously, that can mean a lot of things to, to a lot of people. so what do we mean when we say AI? I've kind of working in, in the ambient scribe, area, recently. that to me is a very interesting, area for investigation, through a number of different lenses. one of them is the extent to which it has an opportunity to potentially humanize our interactions with our patients again, and that that's been talked about a lot, but it may provide us with an opportunity to go from. Eye contact with the computer to eye contact with the patient again during an encounter. it may also hallucinate and create some real medical-legal challenges. if it says that we did things we didn't do, or if it doesn't say that we did things that we did do. I was just yesterday talking with a colleague about the extent to which, an ambient scribe can accurately manage a situation where you have an interpreter in the room. Or a family member, in the room or a surrogate historian. and so, you know, the, to me these are, and, and this isn't necessarily gonna be quantitative work. This is gonna be qualitative work. This is gonna be descriptions and case reports and, best practices and qa qi work. And I think, could be a, a, a good source of, of literature, moving forward.

Matt W 39:17

Yeah. I also think it's got a really powerful impact on things like image reading, diagnostic act accuracy in, in radio radiology, and perhaps more earlier identification of serious conditions. It's certainly interesting, the accuracy, you know, that, that, I don't know how far along, I'm not totally up on that literature, but I know there's some promising. Things there. and if, things like ambient scribes do become effective and, and people are rereading their notes for accuracy, that tremendous ability to just save time, make life a little bit better for our clinically working PAs who do those 12 hour shifts that turn into 15. 'cause they have many charts to finish,

DMSBridgeInfo 40:01

Mm-hmm.

Matt W 40:02

especially after they've already given their reports.

DMSBridgeInfo 40:05

Yeah, I think about that in my own emergency medicine practice where, that efficiency piece, you know, where can we leverage that appropriately? and then in clin clinical decision support.

Matt W 40:15

Yeah.

DMSBridgeInfo 40:15

What are the implications for education if now we're we're, we're, less of a, a generator and more of a consumer and have to make judgements about the quality of that information. Just like does that slowly progress over time where it fundamentally changes how we need to learn and how we need to teach. and, and then of course all of that, going back to the, you know, safety and the medical legal sort of challenges. I think about it a little bit like the, you know, when they first started, launching, driverless cars and, you know, there were a few accidents. Yeah, 'cause they happen. but the rates were still lower than humans driving cars. But because we were comfortable with that, so, you know, what's the threshold where we can, where we can feel comfortable that whether it's, you know, reading a plain film, there's some really interesting, interesting work, in, in pancreatic cancer where there may be some subtle changes on CT scans that we can, that are are visible and. And consistently and reproducibly caught with, with AI that the human eye just can't perceive. and so, those sorts of things I think create. Really interesting questions about how do we use, how do we effectively use them? from a research perspective, I think we have to be, little cautious. It seems like that I can't, I was brainstorming for something and I, I can't really even remember the context, but I asked, I don't know if it was Gemini or what have you, the, and, asked for five references on this topic and the, the citations that it listed, looked, the journals were exactly where I thought they'd come from. The titles made sense. Nowhere to be found completely hallucinated. I think it was four of the five or something like that. And so, you know, you've already seen, some, some, some bigger name journals have to, do some retractions and things about some people who were, you know, turning out 300 manuscripts in 30 days, or not making those numbers up, but you know, something where that, that's clearly, that's not, that's not

Ryan White 42:16

If,

DMSBridgeInfo 42:16

humanly possible.

Ryan White 42:17

if only then we could get promoted.

DMSBridgeInfo 42:20

There you go. Yeah. Fast track.

Ryan White 42:22

Yeah,

DMSBridgeInfo 42:22

thing

Ryan White 42:23

You know, another area, you were asking about technology too. and it's something that I've done a little bit of work in, but would love to look into more. And this could, I think, be a great area of investigation for an early career pa or a researcher. Is, the emergence of data overload, personal data overload in the clinical environment. and I'm sure we, we've all experienced this, but we have patients now who wear an Apple watch, an ora ring, a whoop, they've got a continuous glucose monitor and they present with reams of personal data. And I am not aware, of a, an evidence supported, feasible. Way to digest that information in a way that's clinically relevant and meaningful to the patient. And it might be because it's not clinically relevant or meaningful. but that's a challenge. and then, you know, working with patients who have that amount of data and are looking for answers, or looking for clues, who might be looking for something that's not there. and so, that is, you know, it's not AI per se, but it is, a consequence of the digital revolution and the fact that we are just constantly monitoring and tracking ourselves and acquiring so much data that we just don't know what to do with at this point.

DMSBridgeInfo 43:42

Yeah, we've come a long way since the Holter monitor was our,

Ryan White 43:45

Yes, yes,

DMSBridgeInfo 43:47

one way to monitor, you know, the cardiac cycle.

Matt W 43:50

I had an

Ryan White 43:51

yes.

Matt W 43:52

I had a patient, this was a while ago, who was having episodes of a erasing heartbeat, and every time he came into it was captured by his apple watch it, it didn't have a rhythm or it couldn't identify any irregular rhythm yet. It just knew that his heart rate was going up in random times, But he had these discreet times where he brought in that information. He was like, look what's happening. So did a, a couple, we did an a loop recorder, not implantable. He was just wear, I think we had him wear a Holter for a couple of days, and it, it was identifying atrial fibrillation. The, that time, that entire time.

DMSBridgeInfo 44:24

Yeah, I just very recently had a conversation with a friend whose, wife's first clue that they were going to be expecting was that her ring said, something's off, something's different. you should look into this. And sure enough, something was different.

Ryan White 44:38

Yep.

DMSBridgeInfo 44:38

so it's, it's,

Ryan White 44:39

Yep.

DMSBridgeInfo 44:40

it,

Ryan White 44:40

Yep.

DMSBridgeInfo 44:40

a tremendously exciting time to be doing what we're talking about. I mean, and that's both clinical practice and scholarship. and, but also, you know, it can sometimes feel overwhelming about how we make sense of all of this and how we move forward in a way which best takes care of patients. You know, really does actually focus on the quadruple aim and, you know, including the, including, the provider in that equation.

Ryan White 45:05

New technology. how do we continue to deploy these technologies in a way that, at least takes into consideration things like health equity, and discrimination. and we, we see it with, with the wearables and the digital technology. We see it with AI applications and, and we see it with patient portals and EMRs. and I think that'll be an important area for focus moving forward as well.

DMSBridgeInfo 45:26

Yeah, I agree. Well, that is, about our time. I appreciate, appreciate both of you, great conversation. And we, I think we've just embarked on a, a conversation here, which could, could go on

Matt W 45:39

Mm-hmm.

DMSBridgeInfo 45:39

and, but really appreciate your, your, both of you offer your perspectives and, for taking some time to join us and share a little bit about your, about your story. So thanks.

Matt W 45:47

Thanks,

Ryan White 45:48

was great. Thank you so much.

Matt W 45:49

Yeah.

DMSBridgeInfo 45:50

Yeah, you bet.