Promoting genuine learning through virtual reality
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How Gamification can Improve Outcomes with Eric Gantwerker, Vice President, Medical Director at Level Ex, Inc. was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2019.
Saul Marquez:
Hey, everybody Saul Marquez here with the Outcomes Rocket. Are you going to HLTH? That’s HLTH. It’s the largest and most important conference for health innovation. HLTH pronounced health is one of a kind of ecosystem event for the health industry. And they’re on a mission to bring together 5,000 plus senior leaders to solve the most pressing problems facing healthcare today and actualize the most promising opportunities to improve health. They bring together senior leaders from across across payers, providers, employers, investors, fast growing startups, pharma, policymakers, and innovation centers to ask one question. How do we create the future of health? I’ll be there. And I hope to see you there, too. If you use outcomesrocketpodcast150 as the promo code that’s outcomesrocketpodcast150. You’ll get a hundred and fifty dollars off your ticket. Looking forward to seeing you there. Go to hlth.com to sign up. That’s hlth.com to sign up. Use that promo code outcomesrocketpodcast150. And I am excited to see you there. I’ll even have a booth recording some podcast live at the event. The MGM in Las Vegas. So, so excited to see you there. If you do sign up, don’t be afraid to say hi and we’re gonna learn a lot there. So go ahead and sign up hlth.com.
Saul Marquez:
Today I have the pleasure of having Dr. Eric Gantwerker. He is a pediatric ENT surgeon and Assistant Professor in Otolaryngology at Loyola University Medical Center, as well as the Vice President Medical Director of Level Ex. He holds a master’s of medical science and medical education degree with a focus on education technology from Harvard Medical School and a Master of Science in Physiology and Biophysics from Georgetown University. He’s a previous Clinical Instructor at Harvard Medical School and Assistant Professor at U.T. Southwestern. As Medical Director of Level Ex, he provides clinical oversight for all its video games, developed for physicians, and worked closely with partners from medical societies and industry to develop innovative programs using the company’s mobile AR and VR experiences. Academic interests include implementation of education technologies, motivational theory, and cognitive psychology of learning. He speaks nationally and internationally about education, technology, teaching MedEd in the 21st century and putting cognitive theory into practice for medical education. We’re going to dive into his thoughts on education, new technologies and ENT surgery in this podcast. So looking forward to having him here. Eric, welcome.
Eric Gantwerker:
Thank you so much. I appreciate having me on.
Saul Marquez:
It’s a pleasure, Eric. And as a fellow Chicagoans, it’s always great to have you on the podcast. Tell me, what is it that got you into healthcare to begin with?
Eric Gantwerker:
So originally I actually was wanting to be a food scientist. My brother was a physician and he sort of went straight through from college to medical school. And I sort of wanted to take the different path. So I sort of wanted to put science and chemical engineering, which is what my uncle did. He worked for Quaker Oats at the time, also ended up working for Pepsi, doing research and development. And I thought that was pretty cool. So I started down that road and then I started to got an opportunity to become an emergency medical technician. So training down at Universal only where I was from undergrad, I said, “hey, why not? Let’s let’s try this.” So I tried it a joint. I became an ENT and worked on the ambulances, worked at the ballgame, started working in the emergency room at the trauma center there. And I was like, “hey, you know, this was actually really fun. This is interesting.” Maybe I should just try to go into medicine and go to medical school. So that’s when I sort of applied. The rest is history.
Saul Marquez:
Wow, that’s awesome. So you sort of dabbled in food sciences and then got a bug. You just have to do it.
Eric Gantwerker:
I was actually a medic firefighter for a short period of time before I went to med school.
Saul Marquez:
Wow. Very cool. Very cool. And, hey, you know, a good way to put your foot in the water before kind of going all the way in.
Eric Gantwerker:
Absolutely. It was very fun.
Saul Marquez:
So you still held on to this very unique approach, right? I mean, the work that you’ve done and in education, psychology, now you’re working with VR and AR platforms. I mean, you still maintain this uniqueness about the way you’re approaching medicine.
Eric Gantwerker:
Yeah, absolutely.
Saul Marquez:
So with the work that you do with Level X as well as in your practice, what would you say is something that needs to be front and center in health leaders minds today?
Eric Gantwerker:
That’s a great question. I mean, I just like sort of my path towards non-traditional life. I challenge people to be nontraditional. I challenge people to try to think outside the box. Think of different solutions to the problems that they have. And trying to be… I hate the term innovative, but try to be more innovative just because it’s a little bit overused word, but really for me there’s a learning is really at the core of what I do. Learning and teaching. And I think there’s a lot of old school traditional ways of teaching and learning that people are still ascribing to. And I think that there’s different ways to do that in different ways to think about it. And I think from a healthcare training standpoint, we need to think outside the box because of all the pressures that are happening. Healthcare, like the decreased amount of time, will decrease the amount of funding we need to make it much more efficient with our time. And that means looking at innovative approaches for teaching and learning as opposed to the old school didactic sage on a stage kinda routine.
Saul Marquez:
Yes, that’s a great point. And so you happen to be involved in several ways to facilitate to help people with their learning. Give us an example of one of those ways, whether it be your work at Level Ex or some of the other work you do through speaking internationally and nationally on how you’ve created results by doing things differently or you’ve seen results be created through different approaches and learning.
Eric Gantwerker:
Yeah. So I think that probably the number one way as it is twenty nineteen is using technology for education. I think the old traditionalists that are in medicine and health care think that technology is putting your slide deck into a PowerPoint and using the same slides. And really that’s not what technology is for. Technology has these immense abilities and Moore’s Law dictates that the power of computers doubles every 18 months and then medical content is doubling every 74 days. So if you think about the amount of learning that has to happen and the amount of computing power that you have, we need to use technology different. And so in simple ways, in my own education, my own teaching, I use things like audience response systems that have opened many questions. I use sort of some games to help with learning techniques to try and learn very complex things that they can’t go. Right… so I sort of feel like if it’s something you can Google and get an answer in five seconds, that’s not really something you should be teaching because the student can just Google it. They need more application of knowledge. And so using the technology to help apply knowledge and test knowledge I think is the better way. At Level Ex the way that we can do that is we create a game environment. So we actually do constant assessment and constant performance of people using their own medical knowledge and actually learned through experiential learning, which is a much more effective model of learning than just sitting and passively listening to some kind of lecture.
Saul Marquez:
Yeah, I think those are some great examples Eric, and I had the opportunity as about a year ago, I went to a conference that DocSF conferences it’s orthopedic conference. Yeah, they had a big focus on technologies and I was at one of the booths there was the JNJ booth and they had a VR set and they walked me through doing a total knee replacement in the VR set and that’s pretty cool. And they’re telling me how they’re doing a lot of training now through that.
Eric Gantwerker:
Absolutely. And there’s a bunch of different companies out there using virtual reality and augmented reality. And I think the idea is to contextualize the learning in the actual area that you would be doing it and being in an O.R. is very expensive.
Saul Marquez:
It is.
Eric Gantwerker:
We’re trying to recreate that experience within a virtual reality setting is much better. And now that we have controllers that interact and you can actually have inputs and to be are instead of passively watching it, it makes it a lot more genuine learning because you’re actually doing the physical movements that you wouldn’t realize. Some of the issues I see in VR though, is as some people are not using it correctly, they’re just putting their slide that’s in a PowerPoint. Essentially what we are where they’re uploading animations that aren’t even in 3D. There’s a lot of poor uses of virtual reality and some clutches see a lot of other people using it for a value add for the education as opposed to just sort of using it as a media tool.
Saul Marquez:
Yeah, that’s a great point, right? I mean, and now we had a chance to connect before our interview today and you said, “hey, you know, VR might be in a hype cycle” and you know that media use of it is one thing, but the actual appropriate use where it delivers value that leads to better outcomes. That’s where the action’s at. Tell me about the ENT space and maybe the use of these technologies since this is your physician focus area.
Eric Gantwerker:
Yeah. So, you know, my job as a clinician, I’ve looked at a lot of server technologies that we’re using, ENT education alone. There’s a lot of 3D printing has come pretty heavily into ENT. You know, the original stimulator, which was a tumble going from a cadaver is more or less the original stimulator. And so there’s some groups down in Pittsburgh that are 3D printing temporal bones that can actually do them based on natural C.T. scans. And so the students and the physicians can actually practice on the actual bone that they’re going to be drilling in surgery. I have a friend that’s in New York that’s using VR for surgical planning. So he’s a skull based surgeon and he essentially puts on the VR goggles and actually practiced surgery and shows that actually show the patients. This is where your tumor is this or what it looks like in three dimensions. And you can actually plan your surgery and figure out, “Okay, this is work anatomy. Looks like this is where I need to report from this angle instead of this angle.” You can only see that. Really like a three dimensional rendering in virtual reality. And there’s haptic devices now that you can actually get some force feedback from that, especially for your surgery. There’s doing some stuff with VR through Ohio State, was doing some training with that. So I think there’s a lot of really cool stuff that’s coming that people don’t necessarily know about, but I think it’s gonna become more and more commonplace as the price point comes down on VR on your headsets and becomes much more consumer.
Saul Marquez:
Yeah, that’s a great point, Eric. And you know, I love the idea that you mentioned about time in the O.R. You know, it’s it’s very expensive. Traveling to an educational seminar and staying at a hotel that’s expensive. Right. So it’s getting rid of these operational expenses that I think offers a very attractive value proposition for this technology.
Eric Gantwerker:
Oh, absolutely. And if you look at it, even as a company from Level Ex, our stand, you know, the things that we really believe in this is that it should be mobile, it should be accessible. It should be in your pocket at all times as long as you have in your pocket something like ten thousand times faster than the computer that put the Apollo 11 into…
Saul Marquez:
Isn’t it nuts?
Eric Gantwerker:
That’s crazy.
Saul Marquez:
That’s crazy.
Eric Gantwerker:
Computer. You have computer in your pocket. So why not use it? So I think that’s really what Level Ex does is because the old school, when we come from a games industry, you look at the console games that Reznick arcades you had to go play with. That whole dynamic changed when we got consoles in the X-Box and that in your homes all of a sudden you can go to your home. Well, now you can play games on your phone and your phones with you at all times.
Saul Marquez:
Yeah.
Eric Gantwerker:
So I think that there is a huge cost to going to physical physical simulators, going to physical facilities to learn. And especially when you’re talking about learning in the operating room, you know, that is if you’re not there for that experience, it’s gone. You haven’t captured that experience. You can’t learn from that experience if you weren’t there. So why not recreate that experience in the virtual environment we can actually practice it and be able to make mistakes like you wouldn’t realize. And that’s sort of the fun and interesting part of games. That’s an interesting part of the art. And yet the platform that we’re using is to recreate those in a very lifelike and a very enjoyable, engaging experience.
Saul Marquez:
Now, this is so, so good, Eric. And one of the things folks listening to this question is what can you do today to experience the technology, to think about how you could transform some of the educational models and business operational models that you have today? Go get a pair of these VR sets. I mean, the best way you could do it is, is to get in it. Would you agree?
Eric Gantwerker:
Yeah, absolutely. I think I think. Dive in. I mean, I think there’s a lot of stuff out there on what sort of is available. And there’s new use cases that are coming out every single day for some of these technologies. But I think the best way to find out about them is just to talk to people, just listen, listen to podcasts, watch things, watch people, display them. And really, I don’t want people to be critical. I do think that there’s a huge, huge hype that is going around these technologies. But thinking about genuine ways that this can actually create a value add to the experience, I think patient education is another huge area that we really haven’t tapped into. I think physician education, I think putting this in the medical schools integrated into the curriculum, I think there’s huge use cases. But we have to remember, like, what does VR add to the experience? You know, your physical place in space, creating a virtual patient that you can walk around and move around these genuine interactions. Unique, interesting experience. These are the things that are the value add. So actually things with a critical eye. But just talk to people and listen to things and just ask for help.
Saul Marquez:
Some great feedback on how we could get deeper. So Dr. Gantwerker has a lot of experience in the psychology of learning and really understanding deeper size as you all think about leading your organizations, this might be something to think about. So did you have some sort of setback or anything that you wanted to share with us that helped you become who you are today and just kind of the learnings that you’ve made today that could help the leaders listening?
Eric Gantwerker:
Oh, absolutely. I think my path to medicine was non-traditional. My path to everything has been sort of more traditional. I’ve been very low that about to have. I think you grow a little bit when you know you don’t have everything set in place and you have to go through these trials and tribulations of life. And I think it made me who I am. And I’m extremely lucky in fortune for everything that has come my way. And I wouldn’t change anything. You know, one of the struggles I had was when I first started college, I was actually at the University of Wisconsin up in Madison. And, um, academically, I just didn’t do well right after high school. So I realized that a couple of things about myself. One, I needed to stay busy, which is why I have two part time jobs that take up two full time jobs. So I think, you know, that was a learning experience and was a setback. And, you know, I originally had to do a master’s program. So it was Beckworth work because I graduated college and I was working down in O’Bannon’s as a medic firefighter. And I wanted for med school. And my GPA wasn’t great because of what happened my freshman year.
Saul Marquez:
Yeah.
Eric Gantwerker:
So that was a tough thing. I tried the medical schools. And I didn’t get a very good response. So I started to apply to graduate schools and was fortunate enough to end up at Georgetown for a master’s program there just to sort of get my GPA up and get back and saddle up and get my mind straight. And that was a great experience. And I actually one of the hardest decisions I ever had to make was I actually ended up getting off a waitlist for med school while as I was accepted for grad school and I had to make this decision. I didn’t think the med school was a good fit for me and for my career aspirations. And so I actually did find it and ended up going to grad school instead, which was probably one of the hardest decisions of my life because of my school is so painful and it’s so expensive.
Saul Marquez:
Yeah. True.
Eric Gantwerker:
And so I think that sent me on a certain trajectory in my life. And every time I asked myself what is doing, what’s the hard way and are going to grow through the hard way. And if so, then take the hard route. And I think that was my decision was it would’ve been easy just to go to med school. No, I didn’t think it was a good fit. And I think going to grad school is a hard decision. And it was a hard road. But it made me a better person and put me on that today.
Saul Marquez:
Now it’s a great share and if you had to summarize sort of the the thing that that people should walk away with, what is it from that learning?
Eric Gantwerker:
From that learning? It’s leaving yourself. I think it is… you know, it’s a sort of cliche phrase, but really, there’s truth to it. It’s really. What do you think is right for you? Do you know yourself well enough to make that decision? And I’m sure there’s a lot of people that are listening that would have taken a different road and done things differently. But I thought for myself and my career aspirations that it wasn’t a good fit and make it a tough decision. Be true to yourself and really understand what it is that it’s going to be your future and try to take the steps necessary to get there. And my whole life has been about opportunity. I’ve been extremely fortunate. You know, my work with Level Ex. It was, I was just in the right place at the right time.
Saul Marquez:
Yeah.
Eric Gantwerker:
And I’ve been very, very lucky. But put yourself in that position of opportunity by doing the best thing for yourself. I think that was the lesson.
Saul Marquez:
Love that Eric and you know, the other thing that I took from your shares. Don’t be afraid to take a detour.
Eric Gantwerker:
Absolutely.
Saul Marquez:
You know, and detour is character farming. I mean, if you hadn’t taken that detour and gotten your masters at Georgetown, this whole learning thing and what you’ve done in this niche probably wouldn’t have happened.
Eric Gantwerker:
Absolutely. And it happened to me again when I finished my fellowship in Boston and I decided I’m going to delay getting a job for a year or work part time. I got my Masters, which was a two year master’s program at the Harvard Medical School in Medical Education. And I just decided I think this is the right time. I think it’s a good opportunity. I can live out the life that I want to leave. I’ve always loved education and this will give me the skill set to be able to move forward with my career. And that’s honestly what ends up resulting in my work with the blacks and everything else that I’m doing now. It was one of the best decisions I’ve ever make.
Saul Marquez:
That’s awesome, man. Don’t be afraid to take detours. Hey and since then, take the risk. It definitely will pay off. Appreciate you sharing that Dr. Gantwerker. And so what would you say one of your proudest leadership experiences has been to date?
Eric Gantwerker:
You know, that’s a great question. I’ve been very fortunate to have several other leadership positions. One medical school I did a lot of volunteer work and I was able to co-lead a group of volunteers that put on a health fair at the United Center and the organization. Are you caring? Was sort of in its infancy, 2 or 3 years old. Greg grew up and we were able to expand that group. And it’s still going to today an offshoot of that. We started a tutoring program called Our Tutoring that I understand is still going today and more graduate focus for 2008, 10 years later. And that program still going. It’s changed its name, but that was something that I started during my Schweitzer fellowship. I was an Albert Schweitzer fellow that I got during medical school, which was a phenomenal experience during the community service program and certain program and doing some obesity, education, Chicago public school system. That was a phenomenal opportunity. And I’m proud of myself for completing that. I’m proud of myself, getting the opportunity. And, you know, the long lasting achievement that’s been with that. I’ve been fortunate enough when I was down in Texas at Children’s Health was when we helped expand their airway program, started really program the quality improvement program for children’s with tracheostomies. That’s sort of the other had I where is sort of the quality improvement patient safety aspect and dealing with some of these very complex children with tracheostomies. And that program is alive and running and profitable. So I just think I think my stars that I was putting in the right position at the right time.
Saul Marquez:
Well, I’m a firm believer in that. Luck is when preparation meets opportunity and definitely done a lot of work preparing. And you’ve taken advantage of that.
Eric Gantwerker:
Absolutely. I appreciate it.
Saul Marquez:
So, Eric, tell me about one of the most exciting things you’re working on today. What get you up early and well, what keeps you up late?
Eric Gantwerker:
So, you know, I have this deep seated belief and this deep drive to help improve the way the medical education is being delivered. I think that from education, I think when you talk about outcomes, outcomes start by education. I think the stuff that I did with children with tracheostomy, part of it was teaching everybody in your organization about how to take care of the charge of the truck and how to look at the patient holistically. So it involves this heavy amount of education to all those that were taking care of these kids about, hey, this isn’t just a child with a trait, this is somebody’s child. And they should be afforded the same opportunities that any child has for speech, language and communication. And so I really believe that in the greater sense that my professional development is what gets me out of bed is trying to teach the teacher, trying to use the kind of science of learning and all of the technologies that we have available to us to change the dynamic of how we teach and learn and trying to get away from didactic sessions. We know that didactic leads a 5% retention of information. If you use multimedia that upset to about 20%. But still, that’s not great. Experience for learning, we’re talking about 70 to 75% retention when you actually experience something which is sort of the course virtual education. But how do we use that cognitive science of learning to be able to make genuine experiences so that people can learn better, learn them more efficiently and retain that information, be able to apply that knowledge and novel concepts? And that’s really where it comes down to that. And that’s what drives me.
Saul Marquez:
Love it and yeah, I love your passion for it. The numbers don’t lie. Right.. I mean, experiential learning is key.
Eric Gantwerker:
Well, absolutely.
Saul Marquez:
Now, I appreciate you sharing that. And so here we are close to the end. Eric, we’ve got the Lightning Round, followed by a book that you recommend to the listeners. You ready for that?
Eric Gantwerker:
Yeah, I’m ready.
Saul Marquez:
All right. Here we go. What’s the best way to improve healthcare outcomes?
Eric Gantwerker:
I think it through education and aligning incentives. I think there are so many things in healthcare where incentives are now aligned. And that’s what I think leads to poor outcomes.
Saul Marquez:
It’s great call. What’s the biggest mistake or pitfall to avoid?
Eric Gantwerker:
Doing it the way that we’re always done it.
Saul Marquez:
What would you say is the best way to stay relevant as an organization despite constant change?
Eric Gantwerker:
Be brave, be bold and constantly look for what’s out there and don’t rest on your morals.
Saul Marquez:
What’s an area of focus that drives everything for you?
Eric Gantwerker:
Again, it’s education. It’s trying to improve the way we teach them more of that.
Saul Marquez:
And these next to our more personal for the listeners to get to know you. What is your number one health habit?
Eric Gantwerker:
My number one health habit is trying to eat breakfast. I’m trying to get better about it to better mental focus. And eating a good breakfast gets you ready for the day.
Saul Marquez:
Love it. And what is your number one success habit?
Eric Gantwerker:
It’s counterintuitive, but I always say yes. And I know I’ll get a lot of yells. But I absolutely think that I wouldn’t be given the opportunities that I’ve been given without saying yes, at least at the beginning.
Saul Marquez:
I love that. Yeah. Have you ever seen that Jim Carrey movie? Yes Man or…
Eric Gantwerker:
Oh, yes. Man. Yeah. I thought Liar, liar, liar.
Saul Marquez:
Yeah, he is too funny. Oh man I love it. Now some great, great habits there, Eric. And obviously, they’ve proven to work very well as you’ve had a fruitful career in improving outcomes and education. What book would you recommend to the listeners?
Eric Gantwerker:
So I think, one, the books that really change the way I think about things is James Paul Gee’s book, What Video Games Have to Teach Us About Learning and Literacy. The way… and it’s really interesting because, you know, it’s very specific for how games and learning sort of interact. But really, the way that he changed my thinking was this idea of domain specific expertise that, you know, you could be an expert in one saying and be a novice to the other. And sort of the way that we teach and learn really depends on what domain you’re in and trying to introduce people sort of methodically into those worlds, you know, teaching people the right terms to use in that world, in that domain that they may not be open to. And for me, that’s been resounding because I live in a world with I work with a bunch of technology, a bunch of technophiles, people who play games. And I don’t come from that worlds very deeply and learning from them and trying to understand these different ways of thinking. I think James Paul Gee really changed the way that I think about different domains of my life. And even in surgery, you know, when we talk about doing your surgery, it’s not the same skill set to do science surgery. So they’re totally different domains. And so if you just change the way that I think about it.
Saul Marquez:
And so as far as the domains go, what’s the takeaway?
Eric Gantwerker:
So really it’s really trying to think about that’s some skills crossed domains and some don’t. At any time, anybody’s due to a certain domain that you have to start back at the beginning and say, “Okay, here are the terms we use and this is how we speak about it. This is sort of introduce you in and sort of take you through that learning curve that happens in games.” And I’ve taken that and and applied it in my surgical education. When I’m teaching residents, I’m like, “hey, how many times have you done this procedure?” These are some of the same skills. These are some of the different skills and taking them through that learning curve and really trying to challenge them. There’s a cognitive theory about the zone of proximal development that was paralyzed by Vygotsky. And if you haven’t heard about zone of proximal development, I strongly, strongly recommend it. But essentially it’s the idea that if you challenge somebody just enough, just past their ability and they achieve that, then they’ll continue to go. So you try to challenge them. And if your challenge to them is below that challenge level will get bored and they’ll disengage and games have perfected this because they want you to play. And so they put your challenge just beyond your reach so that you’re able to do it and you’re able to move on and you continue to do that for your learners, they will maximize their growth and maximize their transition from novice to expert. It’s just a phenomenal theory that I try to live by.
Saul Marquez:
That’s pretty cool. And what’s it called? The zone of what?
Eric Gantwerker:
Zone of Proximal Development.
Saul Marquez:
Proximal Development, okay.
Eric Gantwerker:
Again, the guy’s name is Vygotsky.
Saul Marquez:
Wow. I have to look into that. The Zone of Proximal Development.
Eric Gantwerker:
Yeah.
Saul Marquez:
Wow okay. So thanks for expanding. That was very interesting.
Eric Gantwerker:
Yeah. Appreciate it.
Saul Marquez:
Yeah. And so. Wow. Some very cool stuff here with Dr. Gantwerker. This is the end. I wish I had more time. But the 30 minute timeframe seems to be what the listeners enjoy most so…
Eric Gantwerker:
It flies by. But I appreciate the time.
Saul Marquez:
Yeah. Yeah, it’s been fun. So leave us with the closing thought, Eric. What should the listeners be thinking about doing? And what’s the best place they could continue the conversation with you/
Eric Gantwerker:
So I would say love what you’re doing. Be passionate. Share that passion with others and really try to just challenge the status quo. I really don’t like the rest on my world. I don’t want an organization to rest on their laurels. They need to challenge what is accepted and try to innovate and move forward. And if anybody wants to get in touch with me, we’ll make my email available to you guys. You can reach out to us on our website. The Level Ex’ website is level-ex.com. And we have a contact us tab there. But I really look forward to hearing more from you guys and I appreciate you taking the time with me.
Saul Marquez:
Hey it’s been a pleasure Eric and definitely looking forward to staying in touch. Thanks for joining us.
Eric Gantwerker:
All right. Thanks so much.
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