Dr. Eric Gantwerker is the Vice President, Medical Director at Level Ex, creator of industry-leading medical video games for physicians. Their games help practicing physicians hone their skills and allow them to experience rare and challenging patient cases. Level Ex also enables physicians to learn about new medical devices, techniques, and medications. Dr. Gantwerker leads the company’s medical strategy, directs CME development, conducts efficacy studies, and manages the company’s 150+ physician advisory council and relationships with institutions.
Q: Tell us about the journey that led you to become the Vice President, Medical Director at Level Ex.
Eric Gantwerker: I’m a pediatric ear, nose and throat surgeon focusing on airway surgery and sleep surgery. My interest has always been in education, and I ended up getting my master’s from Harvard Medical School in medical education after completing my fellowship at Boston Children’s Hospital. My specific focus is on medical education technology and how to bring medical education into the 21st century. I have also done a lot of “theory to practice” workshops with physicians. Initially, Level Ex asked me to serve as an advisor when the company first started. That relationship then blossomed into a more formal opportunity to work with Level Ex as their Medical Director.
Q: How has Level Ex been clinically validated?
EG: Our medical team works directly with physicians who have either submitted a case to Level Ex or reviewed a case that was shared with Level Ex. Physicians are included throughout our development process. We usually have a lead physician who works with us on a weekly basis to review all the content that’s going to be live in the app. We also have a larger physician group that reviews all of the content. These physicians are what we call “agnostic” to Level Ex; they’ve never seen or heard of our games prior to the review. They provide feedback on not only the look and feel of the game but also on the medical validity of the content.
What’s the alternative to Level Ex? How do physicians encounter these rare scenarios in training, without Level Ex?
EG: Experiential learning such as apprenticeships and direct patient care have been the main methods of training for decades, giving physicians hands-on experience but oftentimes limited access to rare and challenging cases. Experiential learning is predicated on a patient presenting with a certain disease state, so if no patient with that certain disease ever comes in, the training physician never gets exposed to it. Recently, a fair amount of mannequin-based simulation has been implemented, but this type of training also has access limitations including cost, being available only at certain facilities during certain times and working alongside a proctor. Once the physician leaves that facility, he or she no longer has access to that mannequin or simulation. Medical journals and conferences are also sources of CME, but those learning methods are passive and contingent upon access.
Q: Why is the inclusion of the physician voice in the development of digital health solutions so important?
EG: Design thinking and user-centered design have been extremely important in the development of many new products for healthcare in the 21st century, and medical video games are no exception. With physicians as the end-users, it is vital to include them in the entire process from ideation to implementation to ensure the solutions meet their unmet needs.
Q: How does Level Ex improve health outcomes?
EG: We give doctors the opportunity to see unique patient cases, and practice these cases over and over again. Level Ex enables the physician to test different strategies and create a procedural plan around what they would do in a certain scenario. For example, in one of our Pulm Ex games, we have a bronchus with an embedded nail in it and the physician has to learn the exact right angle to remove the nail. It’s incredibly difficult – once you do take the nail out, there’s bleeding that must be managed and the physician has to decide when and how to take the nail out, how to manage the blood loss, and weigh the urgency of both. They make interesting decisions and immediately see the consequences of those decisions through our games. Then in real life, when they encounter similar scenarios, they already have a plan and can just focus on enacting the plan. That mental exercise of determining the best course of action is invaluable in improving health outcomes.
Q: How can healthcare professionals play Level Ex’s games? How can physicians get involved in Level Ex?
EG: Currently, we have four mobile games available to download for free from the App Store and Google Play. These include Cardio Ex, Pulm Ex, Gastro Ex, and Airway Ex. Additionally, we are always looking for physicians to work with us to review new game levels, submit rare cases they’ve encountered and generally advise in specific specialties. If a physician is interested in working with us, they can reach out at firstname.lastname@example.org.
The Physician Innovation Network thanks Dr. Gantwerker and Level Ex for their innovative work that prepares physicians for rare and complicated medical scenarios. We're proud to support Level Ex in their work!