Twitter as a tool for communication and knowledge exchange in academic medicine: A guide for skeptics and novices

Comparing the Digital Footprint of Pulmonary and Critical Care Conferences on Twitter

Background: Pulmonary and critical care societies, including the American Thoracic Society, the American College of Chest Physicians, and the Society of Critical Care Medicine have large memberships that gather at academic conference events, attracting thousands of attendees. Objective: With the growth of social media use among pulmonary and critical care clinicians, our goal was to examine the Twitter presence and digital footprint of these three major medical society conferences. Methods: We used Symplur Signals (Symplur, LLC) to track the tweets and most active participants of the 2017-2019 annual conferences of American Thoracic Society, American College of Chest Physicians, and the Society of Critical Care Medicine. Attendance records of participants were obtained from each society. Results: During the study period, there was growth in the number of tweets, participants, and impressions for all three society conferences. Across all conferences, the amount of original content generated was less than the retweets, which comprised 50-72% of all tweets. Individuals physically attending each conference were more likely to post original content than those not in attendance (53-68% vs. 32-47%). For each society and at each meeting, clinicians made up the largest group of participants (44-60%), and most (59-82%) were physicians. A small cohort of participants was responsible for a large share of the tweets, with more than half of the participants at each conference for each society tweeting only once and only between 5-8% of participants tweeting more than 10 times. Seventy-eight individuals tweeted more than 100 times at one or more of the conferences. There was significant overlap in this group, with 32 of these individual participants tweeting more than 100 times at two or more of these conferences. Conclusion: Growth in conference digital footprints is largely due to increased activity by a small group of prolific participants that attend conferences by multiple academic societies. Original content makes up the smallest proportion of posts, suggesting that amplification of content is more prevalent than posting of original content. In a postpandemic environment, engagement of users producing original content may be even more important for medical societies.

Reach and Power of Physician-Initiated Tweets in a Twitter Inflammatory Bowel Disease Community

Background

Inflammatory bowel disease (IBD) specialist Twitter engagement and thematic content was assessed.

Methods

The nature of interaction between IBD specialists and users who responded to them was analyzed based on (1) content analysis of stakeholders who responded to them; (2) nature of interaction through a manual thematic content analysis of IBD specialist tweets and responses; (3) prominence of interaction by employing descriptive analysis and statistical inferences relative to the number of replies, likes, and retweets. Analyzed samples included of tweets (n = 320) compiled from 16 IBD specialists, and associated replies (n = 299), retweets (n = 869), and likes (n = 4068).

Results

Healthcare professionals (HCPs) more often engaged with peer-HCPs, compared to other stakeholders. When it comes to the nature of exchanges, of original tweets, the most common content was for knowledge sharing (58%) and endorsement (28%). In the knowledge sharing category, research accounted for more than half of those tweets (53%). Of replies, knowledge sharing occurred most frequently with a subtheme of IBD management (62%).

Conclusions

HCP-HCP Twitter engagement was more frequent than HCP-other Twitter stakeholder interaction. The primary purpose for this engagement was found to obtain real-time information, professionally network, and disseminate research.

Will Podcasting and Social Media Replace Journals and Traditional Science Communication? No, but

The digital world in which we live is changing rapidly. The evolving media environment is having a direct impact on traditional forms of communication and knowledge translation in public health and epidemiology. Openly accessible digital media can be used to reach a broader and more diverse audience of trainees, scientists, and the lay public than can traditional forms of scientific communication. The new digital landscape for delivering content is vast, and new platforms are continuously being added. In this article, we focus on several, including Twitter and podcasting, and discuss their relevance to epidemiology and science communication. We highlight 3 key reasons why we think epidemiologists should be engaging with these mediums: 1) science communication, 2) career advancement, and 3) development of a community and public service. Other positive and negative consequences of engaging in these forms of new media are also discussed. The authors of this commentary are all engaged in social media and podcasting for scientific communication, and we reflect on our experiences with these mediums as tools to advance the field of epidemiology.

Dissemination of Anesthesia Information During the Coronavirus Disease 2019 Pandemic Through Twitter: An Infodemiology Study

BACKGROUND

Twitter is a web-based social media platform that allows instantaneous sharing of user-generated messages (tweets). We performed an infodemiology study of the coronavirus disease 2019 (COVID-19) Twitter conversation related to anesthesiology to describe how Twitter has been used during the pandemic and ways to optimize Twitter use by anesthesiologists.

METHODS

This was a cross-sectional study of tweets related to the specialty of anesthesiology and COVID-19 tweeted between January 21 and October 13, 2020. A publicly available COVID-19 Twitter dataset was filtered for tweets meeting inclusion criteria (tweets including anesthesiology keywords). Using descriptive statistics, tweets were reviewed for tweet and account characteristics. Tweets were filtered for specific topics of interest likely to be impactful or informative to anesthesiologists of COVID-19 practice (airway management, personal protective equipment, ventilators, COVID testing, and pain management). Tweet activity was also summarized descriptively to show temporal profiles over the pandemic.

RESULTS

Between January 21 and October 13, 2020, 23,270 of 241,732,881 tweets (0.01%) met inclusion criteria and were generated by 15,770 accounts. The majority (51.9%) of accounts were from the United States. Seven hundred forty-nine (4.8%) of all users self-reported as anesthesiologists. 33.8% of all tweets included at least one word or phrase preceded by the # symbol (hashtag), which functions as a label to search for all tweets including a specific hashtag, with the most frequently used being #anesthesia. About half (52.2%) of all tweets included at least one hyperlink, most frequently linked to other social media, news organizations, medical organizations, or scientific publications. The majority of tweets (67%) were not retweeted. COVID-19 anesthesia tweet activity started before the pandemic was declared. The trend of daily tweet activity was similar to, and preceded, the US daily death count by about 2 weeks.

CONCLUSIONS

The toll of the pandemic has been reflected in the anesthesiology conversation on Twitter, representing 0.01% of all COVID-19 tweets. Daily tweet activity showed how the Twitter community used the platform to learn about important topics impacting anesthesiology practice during a global pandemic. Twitter is a relevant platform through which to communicate about anesthesiology topics, but further research is required to delineate its effectiveness, benefits, and limitations for anesthesiology discussions.

Implications of Twitter in Health-Related Research: A Landscape Analysis of the Scientific Literature

Background: Twitter, representing a big social media network, is broadly used for the communication of health-related information. In this work, we aimed to identify and analyze the scientific literature on Twitter use in context of health by utilizing a bibliometric approach, in order to obtain quantitative information on dominant research topics, trending themes, key publications, scientific institutions, and prolific researchers who contributed to this scientific area. Methods: Web of Science electronic database was searched to identify relevant papers on Twitter and health. Basic bibliographic data was obtained utilizing the "Analyze" function of the database. Full records and cited references were exported to VOSviewer, a dedicated bibliometric software, for further analysis. A term map and a keyword map were synthesized to visualize recurring words within titles, abstracts and keywords. Results: The analysis was based on the data from 2,582 papers. The first papers were published in 2009, and the publication count increased rapidly since 2015. Original articles and reviews were published in a ratio of 10.6:1. The Journal of Medical Internet Research was the top journal, and the United States had contributions to over half (52%) of these publications, being the home-country of eight of the top ten most productive institutions. Keyword analysis identified six topically defined clusters, with professional education in healthcare being the top theme cluster (consisting of 66 keywords). The identified papers often investigated Twitter together with other social media, such as YouTube and Facebook. Conclusions: A great diversity of themes was found in the identified papers, including: professional education in healthcare, big data and sentiment analysis, social marketing and substance use, physical and emotional well-being of young adults, and public health and health communication. Our quantitative analysis outlines Twitter as both, an increasingly popular data source, and a highly versatile tool for health-related research.

Understanding the "Social" in "Social Media". An Analysis of Twitter Engagement of Pulmonary and Critical Care Fellowship Programs

Background: Social media is ubiquitous as a tool for collaboration, networking, and dissemination. However, little is known about use of social media platforms by pulmonary and critical care medicine fellowship programs.

Objective: We identify and characterize pulmonary and critical care fellowship programs using Twitter and Instagram, as well as the posting behaviors of their social media accounts.

Methods: We identified all adult and pediatric pulmonary, critical care medicine (CCM), and combined pulmonary and critical care medicine (PCCM) programs in the United States using the Electronic Residency Application Service. We searched for Twitter profiles for each program between January 1, 2018, and September 30, 2018. Tweets and Twitter interactions were classified into the following three types: social, clinical, or medical education (MedEd) related. We collected data about content enhancements of tweets, including the use of pictures, graphics interchange format or videos, hashtags, links, and tagging other accounts. The types of tweets, content enhancement characteristics, and measures of engagement were analyzed for association with number of followers.

Results: We assessed 341 programs, including 163 PCCM, 36 adult CCM, 20 adult pulmonary, 67 pediatric CCM, and 55 pediatric pulmonary programs. Thirty-three (10%) programs had Twitter accounts. Of 1,903 tweets by 33 of the 341 programs with Twitter accounts, 476 (25%) were MedEd related, 733 (39%) were clinical, and 694 (36%) were social. The median rate of tweets per month was 1.65 (interquartile range [IQR], 0.4-6.65), with 55% programs tweeting more than monthly. Accounts tweeting more often had significantly more followers than those tweeting less frequently (median, 240 followers; 25-75% IQR, 164-388 vs. median, 107 followers; 25-75% IQR, 13-188; P = 0.006). Higher engagement with clinical and social Twitter interactions (tweets, retweets, likes, and comments) was associated with more followers but not for the MedEd-related Twitter interactions. All types of content enhancements (pictures, graphics interchange format/videos, links, and tagging) were associated with a higher number of followers, except for hashtags.

Conclusion: Despite the steadily increasing use of social media in medicine, only 10% of the pulmonary and critical care fellowship programs in the United States have Twitter accounts. Social and clinical content appears to gain traction online; however, additional evaluation is needed on how to effectively engage audiences with MedEd content.

Examining Serendipitous Encounters and Self-Determination in Twitter-Enabled Innovation

Serendipity refers to unexpected encounters with ideas or insights and their intentional application to achieve favorable outcomes. Despite extensive prior studies, the concept lacks theoretical logic and empirical validation regarding the role of an intentional act in the relationship between serendipitous encounters and their favorable outcomes. Drawing from self-determination theory, we develop a model that highlights the role of needs satisfaction in explaining this relationship. Positioning the empirical context to fortunate discoveries of information and social connections in professional use of Twitter, we validate the model by a cross-sectional survey study of 473 users. The model builds on the observation that individuals’ serendipitous encounters are associated with Twitter-enabled innovation, that is, a contextualized form of task innovation. The study findings support the research model revealing that serendipitous encounters are positively associated with needs satisfaction and that needs satisfaction is positively associated with Twitter-enabled innovation. In other words, fortunate discoveries of new information and contacts increase Twitter users’ intent to utilize the platform in new ways to accomplish work when the three key psychological needs of autonomy, competence, and relatedness are satisfied.

From Tweetstorm to Tweetorials: Threaded Tweets as a Tool for Medical Education and Knowledge Dissemination

Tweetorials are a form of threaded tweets that have emerged as a tool for medical education and knowledge dissemination. Making use of features not available in traditional formats, tweetorials offer novel opportunities for educators of all levels to engage with a potential audience of millions. Despite their increased use, questions remain about how best to create, post, and track the impact of individual tweetorials. In addition, uncertainties about how tweetorials fit into the portfolio of medical educators remain unanswered. This review discusses the emergence of tweetorials, their benefits and drawbacks, recommendations for their creation, and outlines unanswered questions.

Medical Education During the COVID-19 Pandemic

All aspects of medical education were affected by the COVID-19 pandemic. Several challenges were experienced by trainees and programs alike, including economic repercussions of the pandemic; social distancing affecting the delivery of medical education, testing, and interviewing; the surge of patients affecting redeployment of personnel and potential compromises in core training; and the overall impact on the wellness and mental health of trainees and educators. The ability of medical teams and researchers to peer review, conduct clinical research, and keep up with literature was similarly challenged by the rapid growth in peer-reviewed and preprint literature. This article reviews these challenges and shares strategies that institutions, educators, and learners adopted, adapted, and developed to provide quality education during these unprecedented times.

Comparison of Intercom and Megaphone Hashtags Using Four Years of Tweets From the Top 44 Schools of Nursing: Thematic Analysis

Background

When this study began in 2018, I sought to determine the extent to which the top 50 schools of nursing were using hashtags that could attract attention from journalists on Twitter. In December 2020, the timeframe was expanded to encompass 2 more years of data, and an analysis was conducted of the types of hashtags used.

Objective

The study attempted to answer the following question: to what extent are top-ranked schools of nursing using hashtags that could attract attention from journalists, policy makers, and the public on Twitter?

Methods

In February 2018, 47 of the top 50 schools of nursing had public Twitter accounts. The most recent 3200 tweets were extracted from each account and analyzed. There were 31,762 tweets in the time period covered (September 29, 2016, through February 22, 2018). After 13,429 retweets were excluded, 18,333 tweets remained. In December 2020, 44 of the original 47 schools of nursing still had public Twitter accounts under the same name used in the first phase of the study. Three accounts that were no longer active were removed from the 2016-2018 data set, resulting in 16,939 tweets from 44 schools of nursing. The Twitter data for the 44 schools of nursing were obtained for the time period covered in the second phase of the study (February 23, 2018, through December 13, 2020), and the most recent 3200 tweets were extracted from each of the accounts. On excluding retweets, there were 40,368 tweets in the 2018-2020 data set. The 2016-2018 data set containing 16,939 tweets was merged with the 2018-2020 data set containing 40,368 tweets, resulting in 57,307 tweets in the 2016-2020 data set.

Results

Each hashtag used 100 times or more in the 2016-2020 data set was categorized as one of the following seven types: nursing, school, conference or tweet chat, health, illness/disease/condition, population, and something else. These types were then broken down into the following two categories: intercom hashtags and megaphone hashtags. Approximately 83% of the time, schools of nursing used intercom hashtags (inward-facing hashtags focused on in-group discussion within and about the profession). Schools of nursing rarely used outward-facing megaphone hashtags. There was no discernible shift in the way that schools of nursing used hashtags after the publication of The Woodhull Study Revisited.

Conclusions

Top schools of nursing use hashtags more like intercoms to communicate with other nurses rather than megaphones to invite attention from journalists, policy makers, and the public. If schools of nursing want the media to showcase their faculty members as experts, they need to increase their use of megaphone hashtags to connect the work of their faculty with topics of interest to the public.

Social Media in Radiology: Overview and Usefulness of Online Professional #SoMe Profiles

Social media is a ubiquitous part of society and used by many healthcare professionals, including radiologists. This article prepared by the 2019-2020 Radiology Research Alliance Social Media Task Force presents different uses and benefits of an online professional social media profile. Physician and healthcare-specific issues along with popular platforms such as LinkedIn, Facebook, Twitter, Instagram, and YouTube are used to explore topics including education, branding, research, mentorship, promotion, and leadership.

Lessons in Public (Mis)communication about the Laboratory from the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic has put the clinical laboratory in the spotlight. The news media is regularly seeking out interviews with microbiologists, infectious disease specialists, and pathologists.

The coronavirus disease 2019 (COVID-19) pandemic has put the clinical laboratory in the spotlight. The news media is regularly seeking out interviews with microbiologists, infectious disease specialists, and pathologists. Increased public exposure offers opportunities to improve how laboratory professionals communicate our insights. We can emphasize what is new, unusual, or controversial about our knowledge; utilize social media effectively; and improve relationships with journalists by understanding their workflow and traditions. While public engagement has risks and must be considerate of institutional policies, it also validates our value to patients, policy makers, and employers.

Pediatric Program Directors Should Have an Active Presence on Twitter

For academic pediatricians, social media has become an important avenue for professional development through continuing education, professional networking, and academic collaboration. Pediatric residency program directors have recognized additional benefits of social media engagement via program promotion and resident recruitment. The novel coronavirus disease 2019 (COVID-19) pandemic and subsequent move to virtual interviews for the 2020-2021 residency interview season have created a new urgency for pediatric program directors to establish an active social media presence, primarily as a means to engage applicants and provide them with information in lieu of cancelled away rotations and in-person interviews. Twitter is a free microblogging and social networking platform that allows real-time engagement among academic pediatricians. Here, we make the case that all pediatric program directors should have an active presence on Twitter.

A Social Media Campaign (#datasaveslives) to Promote the Benefits of Using Health Data for Research Purposes: Mixed Methods Analysis

BACKGROUND

Social media provides the potential to engage a wide audience about scientific research, including the public. However, little empirical research exists to guide health scientists regarding what works and how to optimize impact. We examined the social media campaign #datasaveslives established in 2014 to highlight positive examples of the use and reuse of health data in research.

OBJECTIVE

This study aims to examine how the #datasaveslives hashtag was used on social media, how often, and by whom; thus, we aim to provide insights into the impact of a major social media campaign in the UK health informatics research community and further afield.

METHODS

We analyzed all publicly available posts (tweets) that included the hashtag #datasaveslives (N=13,895) on the microblogging platform Twitter between September 1, 2016, and August 31, 2017. Using a combination of qualitative and quantitative analyses, we determined the frequency and purpose of tweets. Social network analysis was used to analyze and visualize tweet sharing (retweet) networks among hashtag users.

RESULTS

Overall, we found 4175 original posts and 9720 retweets featuring #datasaveslives by 3649 unique Twitter users. In total, 66.01% (2756/4175) of the original posts were retweeted at least once. Higher frequencies of tweets were observed during the weeks of prominent policy publications, popular conferences, and public engagement events. Cluster analysis based on retweet relationships revealed an interconnected series of groups of #datasaveslives users in academia, health services and policy, and charities and patient networks. Thematic analysis of tweets showed that #datasaveslives was used for a broader range of purposes than indexing information, including event reporting, encouraging participation and action, and showing personal support for data sharing.

CONCLUSIONS

This study shows that a hashtag-based social media campaign was effective in encouraging a wide audience of stakeholders to disseminate positive examples of health research. Furthermore, the findings suggest that the campaign supported community building and bridging practices within and between the interdisciplinary sectors related to the field of health data science and encouraged individuals to demonstrate personal support for sharing health data.

Emergency Physicians and Personal Narratives Improve the Perceived Effectiveness of COVID-19 Public Health Recommendations on Social Media: A Randomized Experiment

Background

Containment of the coronavirus disease 2019 (COVID‐19) pandemic requires the public to change behavior under social distancing mandates. Social media are important information dissemination platforms that can augment traditional channels communicating public health recommendations. The objective of the study was to assess the effectiveness of COVID‐19 public health messaging on Twitter when delivered by emergency physicians and containing personal narratives.

Methods

On April 30, 2020, we randomly assigned 2,007 U.S. adults to an online survey using a 2 × 2 factorial design. Participants rated one of four simulated Twitter posts varied by messenger type (emergency physician vs. federal official) and content (personal narrative vs. impersonal guidance). The main outcomes were perceived message effectiveness (35‐point scale), perceived attitude effectiveness (PAE; 15‐point scale), likelihood of sharing Tweets (7‐point scale), and writing a letter to their governor to continue COVID‐19 restrictions (write letter or none).

Results

The physician/personal (PP) message had the strongest effect and significantly improved all main messaging outcomes except for letter writing. Unadjusted mean differences between PP and federal/impersonal (FI) were as follows: perceived messaging effectiveness (3.2 [95% CI = 2.4 to 4.0]), PAE (1.3 [95% CI = 0.8 to 1.7]), and likelihood of sharing (0.4 [95% CI = 0.15 to 0.7]). For letter writing, PP made no significant impact compared to FI (odds ratio = 1.14 [95% CI = 0.89 to 1.46]).

Conclusions

Emergency physicians sharing personal narratives on Twitter are perceived to be more effective at communicating COVID‐19 health recommendations compared to federal officials sharing impersonal guidance.

Translating COVID-19 knowledge to practice: Enhancing emergency medicine using the "wisdom of crowds"

In the spring of 2020, emergency physicians found themselves in new, uncharted territory as there were few data available for understanding coronavirus disease 2019 (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. In response, knowledge was being crowd sourced and shared across online platforms. The "wisdom of crowds" is an important vehicle for sharing information and expertise. In this article, we explore concepts related to the social psychology of group decisionmaking and knowledge translation. We then analyze a scenario in which the American College of Emergency Physicians (ACEP), a professional medical society, used the wisdom of crowds (via the EngagED platform) to disseminate clinically relevant information and create a useful resource called the "ACEP COVID-19 Field Guide." We also evaluate the crowd-sourced approach, content, and attributes of EngagED compared to other social media platforms. We conclude that professional organizations can play a more prominent role using the wisdom of crowds for augmenting pandemic response efforts.

Digital and Social Media in Anatomy Education

The use of images in various forms (drawing, photography, digital applications) has always been intrinsically associated with anatomy; however, the way in which anatomy educators and students create, access, view and interact with images has changed dramatically over the last 20 years. The method that anatomy educators use to engage with students and the wider public and how students engage with each other and faculty has also changed since the turn of the century, largely due to the emergence of social media. These two facets, the move towards digital images and the use of social media, are now intricately interlinked because social media enable anatomy educators to share digital learning resources easily and instantly to a global audience. This new trend of using social media to share digital images has created some ethical dilemmas that anatomy educators are researching and seeking guidance on to ensure that they are representing the potential conflicting needs and/or requirements of different stakeholders, including donors, donor families, students, the public, regulators and anatomy educators themselves. Meeting the various needs of stakeholders is complex; however, this chapter suggests an ethical approach for how digital images and social media can continue to be part of anatomy education.

#Covid-19: An exploratory investigation of hashtag usage on Twitter

BACKGROUND

The literature highlights Twitter as a vital instrument tool for health policy-makers for health communication and promotion. Furthermore, Twitter is a tool allowing us to understand the focus of people regarding a topic of interest.

OBJECTIVE

To provide health policy-makers with insights concerning key topics of interest in the Twitter community regarding Covid-19, and to support information search and health communication.

METHOD

A total of 28.5M tweets have been retrieved, of which 6.9M tweets included hashtags. The data was analyzed using data science and natural language processing libraries. Qualitative analysis was performed using thematic analysis.

RESULTS

907k different hashtags were used. Of these, only 1192 hashtags were used more than 1000 times. The qualitative analysis resulted in 13 themes. The top three themes regarding the number of hashtags used were related to Covid-19, identifying information, interventions, and geographical tagging. We explored the relationship between themes and showed how health practitioners can understand the communication in relation to specific topics expressed as hashtags (e.g., #stayhome).

CONCLUSIONS

The results provide first insights for policy-makers and health practitioners to identify relevant tweets and to choose appropriate hashtags for health communication. The results also show that only with a limited number of Tweets (10 per day) health organizations could have been among the top users.

How Health Care Workers Wield Influence Through Twitter Hashtags: Retrospective Cross-sectional Study of the Gun Violence and COVID-19 Public Health Crises

BACKGROUND

Twitter has emerged as a novel way for physicians to share ideas and advocate for policy change. #ThisIsOurLane (firearm injury) and #GetUsPPE (COVID-19) are examples of nationwide health care-led Twitter campaigns that went viral. Health care-initiated Twitter hashtags regarding major public health topics have gained national attention, but their content has not been systematically examined.

OBJECTIVE

We hypothesized that Twitter discourse on two epidemics (firearm injury and COVID-19) would differ between tweets with health care-initiated hashtags (#ThisIsOurLane and #GetUsPPE) versus those with non-health care-initiated hashtags (#GunViolence and #COVID19).

METHODS

Using natural language processing, we compared content, affect, and authorship of a random 1% of tweets using #ThisIsOurLane (Nov 2018-Oct 2019) and #GetUsPPE (March-May 2020), compared to #GunViolence and #COVID19 tweets, respectively. We extracted the relative frequency of single words and phrases and created two sets of features: (1) an open-vocabulary feature set to create 50 data-driven-determined word clusters to evaluate the content of tweets; and (2) a closed-vocabulary feature for psycholinguistic categorization among case and comparator tweets. In accordance with conventional linguistic analysis, we used a P<.001, after adjusting for multiple comparisons using the Bonferroni correction, to identify potentially meaningful correlations between language features and outcomes.

RESULTS

In total, 67% (n=4828) of #ThisIsOurLane tweets and 36.6% (n=7907) of #GetUsPPE tweets were authored by health care professionals, compared to 16% (n=1152) of #GunViolence and 9.8% (n=2117) of #COVID19 tweets. Tweets using #ThisIsOurLane and #GetUsPPE were more likely to contain health care-specific language; more language denoting positive emotions, affiliation, and group identity; and more action-oriented content compared to tweets with #GunViolence or #COVID19, respectively.

CONCLUSIONS

Tweets with health care-led hashtags expressed more positivity and more action-oriented language than the comparison hashtags. As social media is increasingly used for news discourse, public education, and grassroots organizing, the public health community can take advantage of social media's broad reach to amplify truthful, actionable messages around public health issues.

Next-Generation Scholarship: Rebranding Hematopathology Using Twitter: The MD Anderson Experience

Hematopathologists are witnessing very exciting times, as a new era of unsurpassed technological advances is unfolding exponentially, enhancing our understanding of diseases at the genomic and molecular levels. In the evolving field of precision medicine, our contributions as hematopathologists to medical practice are of paramount importance. Social media platforms such as Twitter have helped facilitate and enrich our professional  interactions and collaborations with others in our field and in other medical disciplines leading to a more holistic approach to patient care. These platforms also have created a novel means for instantaneous dissemination of new findings and recent publications, and are proving to be increasingly useful tools that can be harnessed to expand our knowledge and amplify our presence in the medical community. In this Editorial, we share our experience as hematopathologists with Twitter, and how we leveraged this platform to boost scholarly activities within and beyond our subspecialty, and as a powerful medium for worldwide dissemination of educational material and to promote our remote teaching activities during the COVID-19 pandemic.

Twitter Use Among Departments of Surgery With General Surgery Residency Programs

OBJECTIVE

To examine patterns of Twitter use by surgery departments with residency programs and understand relevant motivations and concerns. The primary outcome was to quantify account prevalence and activity. The secondary outcomes were to identify reasons for use and perceived benefits and concerns.

DESIGN SETTING, AND PARTICIPANTS

A cross-sectional study was performed on Twitter accounts of departments of surgery with Accreditation Council of Graduate Medical Education accredited general surgery residencies. An anonymous survey was distributed to all programs with accounts. Data acquisition was completed in August 2019 and analysis was completed in February 2020.

RESULTS

Among the 319 departments of surgery, only 80 (25%) had department of surgery Twitter accounts. Mean account age was 3.5 years (range: 0-9.8), with the highest account creation in 2017 (n = 23, 29%). Median total tweets per account was 314 (range 3-21,893), and median number of followers was 454 (range 18-22,353). Having a Twitter account was associated with program type: 66/123 (54%) university-based, 1/9 (11%) military, 13/124 (11%) community/university-affiliated, and 0/63 (0%) community (p < 0.01). Survey response rate was 40% (n = 32). Only 59% had formal posting guidelines. Daily logins (78%) and daily tweeting (53%) were common. The most frequent perceived benefits were "highlighting new research and major events" (97%), "increasing visibility within the academic community" (91%), and "improving resident engagement" (75%). The most common concerns were "professionalism" (72%), "privacy" (63%), and "time commitment" (53%).

CONCLUSIONS

Though only a quarter of departments of general surgery had Twitter accounts, they were felt to be key for improving academic reach. Formal posting guidelines existed for 59% of survey respondents, although concerns about privacy and content were common. An underutilized tool for surgery departments to promote academic achievements, Twitter use represents a potential opportunity to engage the surgical community more broadly.

Journal of Pediatric Surgery: Effects of an automated social media strategy for knowledge dissemination

BACKGROUND/PURPOSE

With increasing publications, it's hard to keep up with surgical literature. Social media is a valuable educational resource with global reach. We sought to analyze the impact of an automated social media strategy for the Journal of Pediatric Surgery (JPS).

METHODS

Analytics for March-August 2019 were retrospectively reviewed for automated posts using a SocialPilot queue from the journal's RSS feed. Descriptive and inferential statistics were utilized to analyze performance, including journal article views.

RESULTS

One hundred sixty-five posts amassed 512,316 impressions and 9,795 article views. Facebook had greater overall impact (p < 0.01). Twitter was stronger when adjusted by number of followers (p < 0.01). Engagements and article views had strong correlation between platforms (p < 0.01). Day of the week had limited impact. Photographs were the preferred content format (p < 0.05). Topic had the highest effect on performance (p < 0.05) - with colorectal, EA/TEF, and general pediatric surgery leading to higher reach and engagement. ECMO/CDH was the least popular. Comments and shares were negligible.

CONCLUSIONS

We reached 3,105 users, with 59 article views per post. Topic had the strongest effect on performance. For comparison, custom infographics reached 7,368 users and averaged 101 article views. Alternative knowledge dissemination strategies are likely needed to foster online discussion and build more robust forums for collaboration.

TYPE OF STUDY

Retrospective, Non-clinical Study.

LEVEL OF EVIDENCE

Level III.

Social Media in Surgery

Social media has become a permeating form of communication with billions of daily users. Twitter in particular has become a tool for the surgical community to engage with other providers, as well as patients, through active online discussions, sharing of research, and highlighting opportunities for community outreach. Twitter can help with personal branding, mentorship, and international collaboration on multiple types of academic endeavors. Likewise, institutional and residency programs can harness the power of social media to develop an online presence and aid in resident recruitment.

Interdisciplinary Collaboration Between Veterinary and Communication Students to Promote Communication Skills: A Qualitative Pilot Study

Interdisciplinary collaborations are increasingly gaining popularity, as are active in higher education and innovative learning strategies. However, relatively little research has been performed related to interdisciplinary learning methodologies in higher education. In the present work, a pilot activity between communication and veterinary students was performed, consisting in performance of mock interviews at a professional television studio. Besides some drawbacks such as low participation rates by veterinary students, the activity was associated with a number of benefits, including enhanced acquirement of communication skills, greater topic-related knowledge assimilation, and reinforced practical application of the theoretical concepts.

Quality of the discussion of asthma on twitter

INTRODUCTION

Patients obtain a large amount of medical information online. Much of this information may not be reliable or of high quality. We investigated what influences the discussion of asthma on Twitter by evaluating the most popular tweets and the quality of the links shared.

METHODS

We used Symplur Signals to extract data from Twitter examining characteristics of the top 100 most shared tweets and the 50 most shared links that included the hashtag #asthma. Information on each site was assessed using an Asthma Content score, and validated DISCERN scores and HONCode criteria.

RESULTS

The top 100 asthma-related tweets were shared 10,169 times and had 16,044 likes. Healthcare organizations posted 49 of the top 100 tweets, non-healthcare individuals posted 20, non-healthcare organizations posted 16 and clinicians posted 14. Of the top 100 tweets, 62 were educational, 11 research-related, 10 political and 15 promotional. The top 50 links were shared 6009 times (median number of shares 92 per link (range 60-710)). Links most commonly (42%) led to educational content while 24% of links led to research articles, 22% to promotional websites, and 12% to political websites. Educational links had higher Asthma Content scores than other links (p < 0.005). Overall, all three scores were low for all types of links. Only 34% of sites met HONCode criteria, and 14% were assessed as high quality by DISCERN score.

CONCLUSION

The top tweets using the hashtag #asthma were commonly educational. The majority of top links on Twitter scored poorly on asthma content, quality, and reliability.

Tweeting from the Bench: Twitter and the Physician-Scientist Benefits and Challenges

Purpose of Review

Social media platforms such as Twitter are increasingly utilized to interact, collaborate, and exchange information within the academic medicine community. However, as Twitter begins to become formally incorporated into professional meetings, educational activities, and even the consideration of academic promotion, it is critical to better understand both the benefits and challenges posed by this platform.

Recent Findings

Twitter use is rising amongst healthcare providers nationally and internationally, including in the field of hematology and oncology. Participation on Twitter at national conferences such as the annual meetings of American Society of Hematology (ASH) and American Society of Clinical Oncology (ASCO) has steadily increased over recent years. Tweeting can be used advantageously to cultivate opportunities for networking or collaboration, promote one’s research and increase access to other’s research, and provide efficient means of learning and educating. However, given the novelty of this platform and little formal training on its use, concerns regarding patient privacy, professionalism, and equity must be considered.

Summary

These new technologies present unique opportunities for career development, networking, research advancement, and efficient learning. From “tweet ups” to Twitter journal clubs, physician-scientists are quickly learning how to capitalize on the opportunities that this medium offers. Yet caution must be exercised to ensure that the information exchanged is valid and true, that professionalism is maintained, that patient privacy is protected, and that this platform does not reinforce preexisting structural inequalities.

Growth of the Digital Footprint of the Society of Critical Care Medicine Annual Congress: 2014-2020

Since 2014, the Society of Critical Care Medicine has encouraged "live-tweeting" through the use of specific hashtags at each annual Critical Care Congress. We describe how the digital footprint of the Society of Critical Care Medicine Congress on Twitter has evolved at a time when social media use at conferences is becoming increasingly popular.

DESIGN

We used Symplur Signals (Symplur LLC, Pasadena, CA) to track all tweets containing the Society of Critical Care Medicine Congress hashtag for each annual meeting between 2014 and 2020. We collected data on the number of tweets, tweet characteristics, and impressions (i.e., potential views) for each year and data on the characteristics of the top 100 most actively tweeting users of that Congress.

SETTING

Twitter.

SUBJECTS

Users tweeting with the Critical Care Congress hashtag.

INTERVENTIONS

Not applicable.

MEASUREMENTS AND MAIN RESULTS

The Critical Care Congress digital footprint grew substantially from 2014 to 2020. The 2014 Critical Care Congress included 1,629 tweets by 266 users, compared with 29,657 tweets by 3,551 participants in 2020; average hourly tweets increased from 9.7 to 177. The percentage of tweets with mentions of other users and tweets with visual media increased. Users attending the conference were significantly more likely to compose original tweets, whereas those tweeting from afar were more likely to retweet Critical Care Congress content. There was a yearly increase in content-specific hashtags used in conjunction with Critical Care Congress hashtags (n = 429 in 2014 to n = 22,272 in 2020), most commonly related to pediatrics (18% of all hashtags), mobility/rehab (9%), sepsis (7%) social media (6%), and ICU burnout (1%).

CONCLUSIONS

There has been significant growth in live-tweeting at the Critical Care Congress, along with the increased use of content-specific hashtags and visual media. This digital footprint is largely driven by a proportion of highly engaged users. As medical conferences transition to completely or partially online platforms, understanding of the digital footprint is crucial for success.

Bringing Life to Death: The Need for Honest, Compassionate, and Effective End-of-Life Conversations

Conversations about death and dying are a crucial part of all medical care and are particularly relevant in the field of oncology. Patients express a desire to have discussions about goals of care, and many patients have thought about their end-of-life (EOL) wishes but have not had an opportunity to openly talk with care providers about this. Deficiencies in medical training, lack of confidence, limited time, and cultural barriers all contribute to the paucity of these important discussions. Although physicians are often expected to lead these conversations, nurses and nurse practitioners also play a vital role in the identification of opportunities to address EOL goals and should be a resource for the care team in facilitating EOL conversations at all points on the care continuum. Public engagement is paramount in normalizing conversations about death and dying, and the health care system needs to partner with public health agencies and private groups to open dialogues about EOL. Providers at all levels need improved education in having these difficult but essential conversations.

“People are reading your work,” scholarly identity and social networking sites

Purpose

Scholarly identity refers to endeavors by scholars to promote their reputation, work and networks using online platforms such as ResearchGate, Academia.edu and Twitter. This exploratory research investigates benefits and drawbacks of scholarly identity efforts and avenues for potential library support.

Design/methodology/approach

Data from 30 semi-structured phone interviews with faculty, doctoral students and academic librarians were qualitatively analyzed using the constant comparisons method (Charmaz, 2014) and Goffman’s (1959, 1967) theoretical concept of impression management.

Findings

Results reveal that use of online platforms enables academics to connect with others and disseminate their research. scholarly identity platforms have benefits, opportunities and offer possibilities for developing academic library support. They are also fraught with drawbacks/concerns, especially related to confusion, for-profit models and reputational risk.

Research limitations/implications

This exploratory study involves analysis of a small number of interviews (30) with self-selected social scientists from one discipline (communication) and librarians. It lacks gender, race/ethnicity and geographical diversity and focuses exclusively on individuals who use social networking sites for their scholarly identity practices.

Social implications

Results highlight benefits and risks of scholarly identity work and the potential for adopting practices that consider ethical dilemmas inherent in maintaining an online social media presence. They suggest continuing to develop library support that provides strategic guidance and information on legal responsibilities regarding copyright.

Originality/value

This research aims to understand the benefits and drawbacks of Scholarly Identity platforms and explore what support academic libraries might offer. It is among the first to investigate these topics comparing perspectives of faculty, doctoral students and librarians.

Global Impact of Social Media on Women in Surgery

The professional use of social media is increasingly prevalent today, particularly in medicine and surgery. Several recent movements have highlighted the strengths of this forum for networking and mentorship for females in surgery who otherwise may lack mentors locally. We sought to describe modern uses for and strengths of social media for women in surgery globally via a systematic review of the literature. Multiple efforts and avenues have promoted gender equality in surgery, while also uniting female surgeons in a collaborative virtual network of colleagues. In particular, movements on Twitter, such as #ILookLikeASurgeon and #NYerORCoverChallenge, as well as other collaborative virtual fora have brought visibility to female surgeons, while drawing the young population of students and trainees toward surgical careers. Social media provides a unique opportunity for female trainees and established surgeons alike to network and establish mentorship relationships, which may aid in fostering interest in surgery and closing the gender gap in our field.

A Short History of Free Open Access Medical Education. The Past, Present, and Future

Free Open Access Medical education (FOAM) has taken the emergency medicine and critical care worlds by storm in the past decade. This article represents one perspective on the stages of transition for FOAM from its humble beginnings as a grassroots movement to the more recent multiauthor blogs that are described in the peer-reviewed literature. In this article, the authors describe the following four distinct waves of people within the movement, with each wave creating a new stage in the evolution of the FOAM community: Creation by the Founders, Adoption by the Enthusiasts, Structure and Formalization by the Structuralists, and Engagement and Activity by the End Users. The authors contextualize some of the phenomena that have been observed within this field and highlight challenges for the field moving forward.

Social media and the modern scientist: a research primer for low- and middle-income countries

Social media has changed the way we communicate. Wherever you are in the world, various forms of social media are being used by individuals to share information and connect without borders. Due to its ubiquity, social media holds great promise in linking clinicians, scientists, investigators, and the public to change the way we conduct scientific discourse. In this paper, we present a step-by-step guide on optimizing your social media strategy with regards to: research/scholarly practice (discourse, collaboration, recruitment), knowledge translation, dissemination, and education. This guide also highlights key readings that provide guidance to those interested in incorporating social media into their scholarly practice.

Twelve tips for developing and implementing a medical education Twitter chat

Live discussions on the social media site Twitter or Twitter chats are gaining popularity as powerful tools for engaging a broad audience in an interactive discussion. Medical education, in particular, is experiencing an increase in the use of this modality to support informal learning, as a means to encourage collaboration and share best practices, and as a platform for large-scale mentorship. Despite this growth in popularity, there are limited data to guide medical educators on the fundamentals of organizing a Twitter chat. In this Twelve Tips article, we discuss strategies relevant to potential Twitter chat organizers. We have arranged the tips chronologically, beginning with a discussion of initial considerations when planning and formulating a chat topic and publicizing the chat to potentially interested people and groups, followed by practical considerations while hosting the chat, and finally strategies for evaluating and extending a Twitter chat's impact.

Misinformation During the Coronavirus Disease 2019 Outbreak: How Knowledge Emerges From Noise

Although the amount of information generated during this most recent coronavirus disease 2019 pandemic is enormous, much is of uncertain trustworthiness. This review summaries the many potential sources of information that clinicians turn to during pandemic illness, the challenges associated with performing methodologically sound research in this setting and potential approaching to conducting well done research during a health crisis.

Twitter metrics complement traditional conference evaluations to evaluate knowledge translation at a National Emergency Medicine Conference

OBJECTIVES

Conferences are designed for knowledge translation, but traditional conference evaluations are inadequate. We lack studies that explore alternative metrics to traditional evaluation metrics. We sought to determine how traditional evaluation metrics and Twitter metrics performed using data from a conference of the Canadian Association of Emergency Physicians (CAEP).

METHODS

This study used a retrospective design to compare social media posts and tradition evaluations related to an annual specialty conference. A post ("tweet") on the social media platform Twitter was included if it associated with a session. We differentiated original and discussion tweets from retweets. We weighted the numbers of tweets and retweets to comprise a novel Twitter Discussion Index. We extracted the speaker score from the conference evaluation. We performed descriptive statistics and correlation analyses.

RESULTS

Of a total of 3,804 tweets, 2,218 (58.3%) were session-specific. Forty-eight percent (48%) of all sessions received tweets (mean = 11.7 tweets; 95% CI of 0 to 57.5; range, 0-401), with a median Twitter Discussion Index score of 8 (interquartile range, 0 to 27). In the 111 standard presentations, 85 had traditional evaluation metrics and 71 received tweets (p > 0.05), while 57 received both. Twenty (20 of 71; 28%) moderated posters and 44% (40 of 92) posters or oral abstracts received tweets without traditional evaluation metrics. We found no significant correlation between Twitter Discussion Index and traditional evaluation metrics (R = 0.087).

CONCLUSIONS

We found no correlation between traditional evaluation metrics and Twitter metrics. However, in many sessions with and without traditional evaluation metrics, audience created real-time tweets to disseminate knowledge. Future conference organizers could use Twitter metrics as a complement to traditional evaluation metrics to evaluate knowledge translation and dissemination.

Describing the Digital Footprints or "Sociomes" of Asthma for Stakeholder Groups on Twitter

Background: Although there is a great deal of conversation on social media, there may not be good communication. Objective: We sought to investigate communicaton activity online by examining digital footprints (or "sociomes") of asthma stakeholders on Twitter. Methods: Tweets containing the word "asthma" and the hashtag #asthma were collected using Symplur Signals. Characteristics of usage and tweets were analyzed and compared first between the word "asthma" and the hashtag #asthma, and then among four different stakeholder groups: clinicians, patients, healthcare organizations, and industry. Results: The #asthma sociome was significantly smaller than the "asthma" sociome, with fewer users and tweets per month. However, the #asthma sociome correlated better to asthma seasons and was less susceptible to vulgarity and viral memes. For the #asthma sociome, there were 695,980 tweets by 308,370 users between April 2015 and November 2018. Clinicians were responsible for 16% of tweets, patients 9%, healthcare organizations 22%, and industry 0.3%. There were significant differences in the tweet characteristics, with healthcare organizations more likely to tweet with links, clinicians more likely to mention other users, and industry more likely to use visuals. Each April-May, there were significant spikes in the frequency of tweets by patients, healthcare organizations, and industry, whereas the usage patterns of clinicians were more random. There were also differences in the top terms and hashtags tweeted with #asthma in the stakeholder groups. Conclusion: Asthma stakeholder groups tweet differently, at different times, and use different associated terms. Further exploration may help improve health care-related communication and help guide education of patients and clinicians.

Social media in knowledge translation and education for physicians and trainees: a scoping review

INTRODUCTION

The use of social media is rapidly changing how educational content is delivered and knowledge is translated for physicians and trainees. This scoping review aims to aggregate and report trends on how health professions educators harness the power of social media to engage physicians for the purposes of knowledge translation and education.

METHODS

A scoping review was conducted by searching four databases (PubMed, Scopus, Embase, and ERIC) for publications emerging between 1990 to March 2018. Articles about social media usage for teaching physicians or their trainees for the purposes of knowledge translation or education were included. Relevant themes and trends were extracted and mapped for visualization and reporting, primarily using the Cook, Bordage, and Schmidt framework for types of educational studies (Description, Justification, and Clarification).

RESULTS

There has been a steady increase in knowledge translation and education-related social media literature amongst physicians and their trainees since 1996. Prominent platforms include Twitter (n = 157), blogs (n = 104), Facebook (n = 103), and podcasts (n = 72). Dominant types of scholarship tended to be descriptive studies and innovation reports. Themes related to practice improvement, descriptions of the types of technology, and evidence-based practice were prominently featured.

CONCLUSIONS

Social media is ubiquitously used for knowledge translation and education targeting physicians and physician trainees. Some best practices have emerged despite the transient nature of various social media platforms. Researchers and educators may engage with physicians and their trainees using these platforms to increase uptake of new knowledge and affect change in the clinical environment.

Emergency Medicine Education Research Since the 2012 Consensus Conference: How Far Have We Come and What's Next?

In 2012, the Society for Academic Emergency Medicine convened a consensus conference on the state of medical education research with goals of defining and advancing a future research agenda. Since that time, emergency medicine (EM) education research has grown significantly. A task force of EM education experts was assembled and sought to understand the current state of EM education research and future directions. Among the advances are increases in medical education fellowships, advanced degree and certification programs, faculty development programs, publication venues, and funding. These findings are discussed in light of the prior objectives from the 2012 consensus conference, and recommendations for future directions are provided.