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

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.

To tweet or not to tweet, that is the question: A randomized trial of Twitter effects in medical education

Introduction

Many medical education journals use Twitter to garner attention for their articles. The purpose of this study was to test the effects of tweeting on article page views and downloads.

Methods

The authors conducted a randomized trial using Academic Medicine articles published in 2015. Beginning in February through May 2018, one article per day was randomly assigned to a Twitter (case) or control group. Daily, an individual tweet was generated for each article in the Twitter group that included the title, #MedEd, and a link to the article. The link delivered users to the article’s landing page, which included immediate access to the HTML full text and a PDF link. The authors extracted HTML page views and PDF downloads from the publisher. To assess differences in page views and downloads between cases and controls, a time-centered approach was used, with outcomes measured at 1, 7, and 30 days.

Results

In total, 189 articles (94 cases, 95 controls) were analyzed. After days 1 and 7, there were no statistically significant differences between cases and controls on any metric. On day 30, HTML page views exhibited a 63% increase for cases (M = 14.72, SD = 63.68) when compared to controls (M = 9.01, SD = 14.34; incident rate ratio = 1.63, p = 0.01). There were no differences between cases and controls for PDF downloads on day 30.

Discussion

Contrary to the authors’ hypothesis, only one statistically significant difference in page views between the Twitter and control groups was found. These findings provide preliminary evidence that after 30 days a tweet can have a small positive effect on article page views.

Immunology and social networks: an approach towards impact assessment

Scientific journals have changed the mechanisms they use for distribution and dissemination of information. Different approaches towards determining impact have emerged and among these, metrics derived from activity on social media are an emerging trend. This article aims to assess whether a correlation exists between the traditional impact factor and activity on social media. We assessed journals categorized within the area of "immunology" on the SCImago Journal and Country Rank website. Variables reflecting traditional and alternative measures of impact were collected. Differences between journals with and without social networks were assessed using non-parametric Mann-Whitney U tests. Correlation was assessed through Spearman tests. 156 journals were analyzed, 17% had at least one social network. 48.2% of journals with social networks were classified within SJR's quartile 1. An almost perfect correlation was found between the SJR and the number of followers on Twitter, this correlation remained statistically significant after adjusting for time since creation of the account [Spearman's correlation (r_s) = 0.83]. We propose the use of Twitter as a mechanism for dissemination of information by immunology journals, as well as other social networks for their potential to increase their audience, as well as the dissemination and impact of their publications.

Public's Attitudes Toward Health Information on Twitter: A Cross-sectional Survey Based on the Saudi Population

Health information dissemination through social media networks has transformed the process of communication between health practitioners, patients, and the public. Twitter is one of the most commonly used social media networks in Saudi Arabia for sharing health information. However, the reliability of health information on Twitter has been questioned by some skeptics, thereby placing the public at a significant health risk. This study was conducted to assess the attitudes of the general population of Saudi Arabia towards health information sought from Twitter. Of the 384 total respondents, 199 (51.8%) considered using Twitter as a source of health information as a positive experience due to its ease of use and the accessibility of information (131, 66.0%). The study found that respondents have great concern about nutrition/weight loss (229, 59.6%), healthy lifestyle (225, 58.6%), and getting a better understanding of health care misconceptions (168, 43%). Most of the respondents (167, 43.5%) were satisfied using Twitter as a source of health information. However, a few respondents experienced harm to their health as a result of false medical advice (2, 0.5%) and false health information (2, 0.5%) they found on Twitter. This study concludes that Twitter is mainly useful in obtaining health knowledge for maintaining good health, preventing illness, and curing illnesses or diseases. However, the public must take extra caution when obtaining health information from Twitter. It is essential for Twitter users seeking medical information to also seek professional medical advice or consultation, as necessary, to prevent a significant health risk.

Ontology-Based Healthcare Named Entity Recognition from Twitter Messages Using a Recurrent Neural Network Approach

Named Entity Recognition (NER) in the healthcare domain involves identifying and categorizing disease, drugs, and symptoms for biosurveillance, extracting their related properties and activities, and identifying adverse drug events appearing in texts. These tasks are important challenges in healthcare. Analyzing user messages in social media networks such as Twitter can provide opportunities to detect and manage public health events. Twitter provides a broad range of short messages that contain interesting information for information extraction. In this paper, we present a Health-Related Named Entity Recognition (HNER) task using healthcare-domain ontology that can recognize health-related entities from large numbers of user messages from Twitter. For this task, we employ a deep learning architecture which is based on a recurrent neural network (RNN) with little feature engineering. To achieve our goal, we collected a large number of Twitter messages containing health-related information, and detected biomedical entities from the Unified Medical Language System (UMLS). A bidirectional long short-term memory (BiLSTM) model learned rich context information, and a convolutional neural network (CNN) was used to produce character-level features. The conditional random field (CRF) model predicted a sequence of labels that corresponded to a sequence of inputs, and the Viterbi algorithm was used to detect health-related entities from Twitter messages. We provide comprehensive results giving valuable insights for identifying medical entities in Twitter for various applications. The BiLSTM-CRF model achieved a precision of 93.99%, recall of 73.31%, and F1-score of 81.77% for disease or syndrome HNER; a precision of 90.83%, recall of 81.98%, and F1-score of 87.52% for sign or symptom HNER; and a precision of 94.85%, recall of 73.47%, and F1-score of 84.51% for pharmacologic substance named entities. The ontology-based manual annotation results show that it is possible to perform high-quality annotation despite the complexity of medical terminology and the lack of context in tweets.

How much do preclinical medical students utilize the internet to study physiology?

Medical students increasingly utilize social media platforms to supplement their preclinical learning; however, the prevalence of social media use for physiology learning in medical education remains unclear. The aim of the present study was to determine how first-year medical students from both direct entry medicine and graduate entry medicine interacted with social media as a learning tool by assessing its prevalence, perceived benefits, favored platforms, and reason(s) for its use. Seventy-one percent of surveyed students (out of 139 participants) stated that they interacted with social media in general more than 12 times per week. However, 98% had previously used internet platforms to source physiology information, with 89.2% doing so at least once per week during term. YouTube was the primary source of learning for 76% of students. Significantly, 94% of students indicated that they would first search for answers online if they did not understand something in physiology rather than contacting their instructor in person or by e-mail. However, only 31% of students "fact-checked" physiology information obtained from online sources, by using textbooks, papers, and/or instructors. Our study has revealed that most preclinical medical students utilize social media extensively to study physiology. However, the absence of academic and ethical oversight, paired with students' lack of critical appraisal of possibly inaccurate information, does raise concerns about the overall utility of social media as part of physiology education.

Study Comparing Traditional Versus Alternative Metrics to Measure the Impact of the Critical Care Medicine Literature

Supplemental Digital Content is available in the text.

Our objective was to evaluate the association between traditional metrics such as Impact Factor and Eigenfactor with respect to alternative metrics. The Altmetric Attention Score for the top nine pulmonary and critical care journals was compared with Impact Factor, Eigenfactor, and citations over two time periods (2007–2011 and 2012–2016). There was a significant increase in the Altmetric Attention Score (52 from 2007 to 2011 vs 1,061 from 2012 to 2016; p < 0.001) but no significant differences in Total Citations, Impact Factor, or Eigenfactor. There was a strong positive correlation between citations and Altmetric Attention Score, negative correlations between Eigenfactor and Altmetric Attention Score for most journals, and no clear association between Impact Factor and Altmetric Attention Score. Over time, the digital reach of traditional publications has increased significantly, while no significant increase was noted for the traditional metrics. These findings likely reflect discussions of articles online that are not captured by traditional metrics and hence their impact on the community at large.

Supporting the development of a professional identity: General principles

While teaching medical professionalism has been an important aspect of medical education over the past two decades, the recent emergence of professional identity formation as an important concept has led to a reexamination of how best to ensure that medical graduates come to "think, act, and feel like a physician." If the recommendation that professional identity formation as an educational objective becomes a reality, curricular change to support this objective is required and the principles that guided programs designed to teach professionalism must be reexamined. It is proposed that the social learning theory communities of practice serve as the theoretical basis of the curricular revision as the theory is strongly linked to identity formation. Curricular changes that support professional identity formation include: the necessity to establish identity formation as an educational objective, include a cognitive base on the subject in the formal curriculum, to engage students in the development of their own identities, provide a welcoming community that facilitates their entry, and offer faculty development to ensure that all understand the educational objective and the means chosen to achieve it. Finally, there is a need to assist students as they chart progress towards becoming a professional.

How scientists and physicians use Twitter during a medical congress

OBJECTIVES

During medical congresses Twitter allows discussions to disseminate beyond the congress hall and reach a wider audience. Insights into the dynamics of social media interactions during congresses, dissemination of scientific information and the determinants of a successful tweet may allow us to better understand social media's role in science communication.

METHODS

We retrospectively extracted social media data during the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) 2017 and 2018 using NodeXL. We compared social media activity during these two congresses. Subsequently, we conducted in-depth analyses to identify the components of a successful tweet and multivariable analysis to assess independent factors associated with retweet activity.

RESULTS

In 2018, approximately 13 000 delegates attended ECCMID, but only 591 Twitter accounts actively tweeted about the congress. Although fewer tweets were posted in 2018 compared with 2017 (4213 versus 4657, respectively), ECCMID 2018 generated a 63% increase in the total number of retweets (p < 0.001). According to multivariable logistic regression analysis, using multimedia, URL or hashtags and mentioning other Twitter account(s) were independently associated with retweet success. Mentioning of other users and use of multimedia were the only consistent predictors of retweets irrespective of the number of followers.

CONCLUSIONS

A substantial increase in retweet activity and a modest increase in the number of influential Twitter accounts were observed between two successive congresses. Dissemination of scientific messages is more successful when connected accounts are actively involved in social media activity, and social media posts constitute the right combination of components.

Twitter Hashtags for Anesthesiologists: Building Global Communities

Twitter is a social media platform that has been encouraged for use among anesthesiologists as a way to stimulate conversation, distribute research, enhance conference experiences, and expand journal club sessions. We aimed to establish the typical baseline use of hashtags that are not related to events such as conferences. Systematic searches were performed on Twitter, as well as through hashtag-tracking services, to identify actively used anesthesia-related hashtags. The most frequently used general anesthesia hashtags were #anesthesia and #anaesthesia. The most popular and relevant hashtags within anesthesia subspecialties or interest groups include #pedsanes, #anesJC, #OBanes, #intubation, #regionalanesthesia, #neuroanesthesia, and #cardiacanesthesia. We have identified the most popular anesthesia-related hashtags on Twitter to help anesthesiologists increase the reach and degree of discussions in anesthesia-related social media or twitter verse.

Use of a Coordinated Social Media Strategy to Improve Dissemination of Research and Collect Solutions Related to Workforce Gender Equity

Background: To increase awareness, search for solutions, and drive change, disparity-related research needs to be strategically disseminated. This study aimed to quantify whether a social media strategy could: (1) amplify dissemination of gender equity-related articles and (2) collect proposed solutions to gender equity issues. Methods: In April 2018, eight published journal articles covering separate gender equity issues were presented in a 1-hour Twitter chat hosted by Physician's Weekly. Metrics data were collected before, during, and after the chat. During the chat, one question related to each article was tweeted at a time. Qualitative data were extracted from responses and evaluated for thematic content. Results: In the 16-hour period during and following the chat, we tallied 1500 tweets from 294 participants and 8.6 million impressions (potential views). The Altmetric Attention Score of each article increased (average, 126.5 points; range, 91-208 points). Within the respective journal, the Altmetric Rank of seven articles improved (range, 3 to ≥19), while the eighth maintained its #1 rank. The one article for which share and download data were available experienced a 729% increase in shares following prechat posts and another 113% bump after the chat, a 1667% increase overall (n = 45-795). Similarly, downloads, and presumably reads, increased 712% following prechat posts and another 47% bump after the chat, a 1093% increase overall (n = 394-4700). We tallied 181 potential solutions to the eight gender equity-related questions. Conclusion: Our results demonstrate that social media can be used strategically to increase the dissemination of research articles and collect solution-focused feedback.

Digital Presence of a Research Center as a Research Dissemination Platform: Reach and Resources

BACKGROUND

Web-based platforms can be powerful tools for research dissemination. By leveraging the advantages of mass media and interpersonal channels of communication, Web-based dissemination platforms may improve awareness about, and subsequent adoption of, evidence-based practices (EBPs). Digital dissemination strategies can augment traditional dissemination models, improving stakeholder access to digestible and actionable information and promoting translation of EBPs.

OBJECTIVE

This study aimed to describe the reach and content of the Web presence of a National Institute on Drug Abuse Center of Excellence and how it is used to disseminate research related to digital behavioral health approaches.

METHODS

The Center for Technology and Behavioral Health (CTBH) has a website and regularly updated Facebook and Twitter accounts. The website features include summaries of digital behavioral health approaches and related empirical literature, a blog feed focused on the state of the science and technology concerning digital health care approaches, and a newsletter about Center activities. We extracted website usage metrics from Google Analytics and follower counts from social media accounts for the period from March 1, 2013, to July 17, 2018.

RESULTS

Since the implementation of analytic tracking, 70,331 users have initiated 96,995 sessions on the CTBH website. The website includes summaries of 86 digital therapeutic programs, encompassing 447 empirical articles. There are 1160 posts in the CTBH blog feed, including 180 summaries of scholarly articles. The Twitter and Facebook accounts have 577 and 1500 followers, respectively. The newsletter has reached a growing subscriber network and has a high open rate relative to industry standards.

CONCLUSIONS

The CTBH Web presence serves as a model for how to leverage accessible and easily updatable digital platforms as research dissemination channels. Digital dissemination tools can augment traditional dissemination strategies to promote awareness about evidence-based digital therapeutic approaches for behavioral health and health care more broadly.

Social Media and Health Policy

The current era is characterized by the vibrant and rapidly evolving communication technologies. Communication in any form has evolved and now includes media such as Facebook, Twitter, and Instagram to report a few. Communicating and consuming information has shifted from the more traditional ways to new ones as part of this communication evolution. Cancer is an area of healthcare where such social media have been championed either to promote public awareness and drive campaigns or influence political decision-making. Although health-care lags behind many other industries in adopting social media as a part of a business or policy strategy, the increasing engagement of patients, the public, and the policymakers in social media raised the need for integrating these tools as a part of an overall program to support the strategic imperatives of the health care. As these and other new ways to communicate are introduced to the world and injected into our cultural and political systems, the question that raises here is: “How successful are social media in influencing health policy?”

Analyzing Twitter as a Platform for Alzheimer-Related Dementia Awareness: Thematic Analyses of Tweets

Background

Dementia is a prevalent disorder among adults and often subjects an individual and his or her family. Social media websites may serve as a platform to raise awareness for dementia and allow researchers to explore health-related data.

Objective

The objective of this study was to utilize Twitter, a social media website, to examine the content and location of tweets containing the keyword “dementia” to better understand the reasons why individuals discuss dementia. We adopted an approach that analyzed user location, user category, and tweet content subcategories to classify large publicly available datasets.

Methods

A total of 398 tweets were collected using the Twitter search application programming interface with the keyword “dementia,” circulated between January and February 2018. Twitter users were categorized into 4 categories: general public, health care field, advocacy organization, and public broadcasting. Tweets posted by “general public” users were further subcategorized into 5 categories: mental health advocate, affected persons, stigmatization, marketing, and other. Placement into the categories was done through thematic analysis.

Results

A total of 398 tweets were written by 359 different screen names from 28 different countries. The largest number of Twitter users were from the United States and the United Kingdom. Within the United States, the largest number of users were from California and Texas. The majority (281/398, 70.6%) of Twitter users were categorized into the “general public” category. Content analysis of tweets from the “general public” category revealed stigmatization (113/281, 40.2%) and mental health advocacy (102/281, 36.3%) as the most common themes. Among tweets from California and Texas, California had more stigmatization tweets, while Texas had more mental health advocacy tweets.

Conclusions

Themes from the content of tweets highlight the mixture of the political climate and the supportive network present on Twitter. The ability to use Twitter to combat stigma and raise awareness of mental health indicates the benefits that can potentially be facilitated via the platform, but negative stigmatizing tweets may interfere with the effectiveness of this social support.

Scientists on Twitter: Preaching to the choir or singing from the rooftops?

There have been strong calls for scientists to share their discoveries with society. Some scientists have heeded these calls through social media platforms such as Twitter. Here, we ask whether Twitter allows scientists to promote their findings primarily to other scientists (“inreach”), or whether it can help them reach broader, non-scientific audiences (“outreach”). We analyzed the Twitter followers of more than 100 faculty members in ecology and evolutionary biology and found that their followers are, on average, predominantly (∼55%) other scientists. However, beyond a threshold of ∼1000 followers, the range of follower types became more diverse and included research and educational organizations, media, members of the public with no stated association with science, and a small number of decision-makers. This varied audience was, in turn, followed by more people, resulting in an exponential increase in the social media reach of tweeting academic scientists. Tweeting, therefore, has the potential to disseminate scientific information widely after initial efforts to gain followers. These results should encourage scientists to invest in building a social media presence for scientific outreach.

Predicting the success of Twitter in healthcare

Purpose

The purpose of this paper is to predict Twitter satisfaction by healthcare professionals through integrating constructs of Csikszentmihalyi’s flow theory, quality dimensions and usefulness.

Design/methodology/approach

Survey responses of 108 physicians from a variety of specialisations in the United Arab Emirates have been validated and analysed by means of partial least squares-based structural equation modelling method using smartPLS software.

Findings

Service quality has emerged as the most influential quality dimension that positively impact flow state and perceived usefulness of Twitter, while information quality, surprisingly, does not show any effect. The findings also indicate that flow state plays a significant role in shaping physicians’ satisfaction with Twitter. The study also enhances our understanding concerning the effects of perceived usefulness on flow state and satisfaction.

Research limitations/implications

Understanding factors that influence Twitter satisfaction can help healthcare managers construct appropriate intervention strategies for maximising professional benefits of social media and minimising user resistance. This is important because top managers usually ratify traditional practices that are only of limited effect. Also, the findings help vendors to accentuate user’s concerns in addition to system functionalities in social media applications.

Originality/value

The paper is an early attempt to propose a model for social media success in a professional context in general and healthcare in particular. It also one of first studies that examine social media satisfaction through integrating contemporary information system success and acceptance models with flow theory.

Editorial Processes in Free Open Access Medical Educational (FOAM) Resources

BACKGROUND

Much of the skepticism toward online educational resources (OERs) in emergency medicine (EM) stems from the low barrier to publishing and a perceived lack of editorial rigor. Learners and educators have demonstrated unreliable gestalt ratings of OERs, suggesting a lack of capacity to consistently appraise these resources. The development of tools to guide clinicians and learners in the selection and use of blogs and podcasts is a growing area of interest. Disclosure of editorial process was identified in previous studies as an important quality indicator for OERs. However, little is known about editorial process in online EM resources and whether it can be reliably integrated into a critical appraisal tool.

METHODS

Two reviewers assessed 100 top EM and critical care OERs for mention and description of editorial process and academic and nonacademic affiliations. Ninety-two sites were accessible for review. All sites were also contacted to attempt clarification of their editorial process. Inter-rater reliability for mention and description of editorial process was evaluated using Cohen's kappa, and the relationship between academic affiliation and disclosure of editorial process was assessed by odds ratio (OR).

RESULTS

Eleven sites mentioned an editorial process, and 10 of these sites included a description. Five of the seven sites that responded to contact also described an editorial process. Inter-rater agreement was excellent for mention (κ = 0.90) and description (κ = 1.00) of editorial process. Eighteen sites listed academic affiliations and 21 sites had nonacademic affiliations. A greater proportion of sites with academic affiliations disclosed their editorial process compared to sites without academic affiliations (OR = 5.3, 95% confidence interval [CI] = 1.3-21.0; difference in proportions of 0.40, 95% CI = 11.6-60.8).

CONCLUSIONS

Although transparency is lacking, editorial processes exist among OERs. Inter-rater reliability for disclosure of editorial process is excellent, supporting its use within critical appraisal tools.

What advice is given to newly qualified doctors on Twitter? An analysis of #TipsForNewDocs tweets

CONTEXT

Twitter is a social media platform on which users post very brief messages that can be rapidly communicated across wide geographical areas and audiences. Many doctors use Twitter for personal as well as professional communications and networking. The #TipsForNewDocs hashtag is used on Twitter to give advice to newly qualified doctors as they commence their careers. This study explores the nature and focus of such advice.

METHODS

An analysis of Twitter activity containing the #TipsForNewDocs hashtag was performed using Symplur health care analytics software. Tweets sent during a peak 48-hour period in 2016 (immediately preceding the first day of work for newly qualified UK doctors) were studied. The geographical locations and professional backgrounds of participants were categorised and the content of tweets was subjected to thematic analysis. During 1 and 2 August 2016, 661 unique #TipsForNewDocs tweets were posted. A total of 621 (94.0%) were posted by people in the UK; 522 (79.0%) were posted by doctors, and the remainder by allied health care professionals and patients.

RESULTS

The majority of included tweets focused on aspects of professional development, improving personal or professional knowledge, particularly tacit knowledge, and developing 'know-how'. These aspects of professional knowledge have previously been described as fundamental to professional education and training. However, a significant subset of tweets focused on accelerating socialisation into the profession, an essential step in joining a professional community. The tweets relating to socialisation were often humorous and colloquial in nature.

CONCLUSIONS

Despite their brief and often jocular nature, #TipsForNewDocs tweets provided meaningful advice for newcomers to the profession, often focusing on tacit learning and professional socialisation. Hashtag-driven enquiries can be a valuable and time-efficient way of accessing and sharing tacitly held knowledge. Social media content analysis can provide valuable insights into key educational issues.

The Massive Online Needs Assessment (MONA) to inform the development of an emergency haematology educational blog series

BACKGROUND

Online educational resources are criticized as being teacher-centred, failing to address learner's needs. Needs assessments are an important precursor to inform curriculum development, but these are often overlooked or skipped by developers of online educational resources due to cumbersome measurement tools. Novel methods are required to identify perceived and unperceived learning needs to allow targeted development of learner-centred curricula.

OBJECTIVES

To evaluate the feasibility of performing a novel technique dubbed the Massive Online Needs Assessment (MONA) for the purpose of emergency haematology online educational curricular planning, within an online learning community (affiliated with the Free Open Access Medical education movement).

METHODS

An online survey was launched on CanadiEM.org using an embedded Google Forms survey. Participants were recruited using the study website and a social media campaign (utilizing Twitter, Facebook, Blogs, and a poster) targeting a specific online community. Web analytics were used to monitor participation rates in addition to survey responses.

RESULTS

The survey was open from 20 September to 10 December 2016 and received 198 complete responses representing 6 medical specialties from 21 countries. Most survey respondents identified themselves as staff physicians (n = 109) and medical trainees (n = 75). We identified 17 high-priority perceived needs, 17 prompted needs, and 10 topics with unperceived needs through our MONA process.

CONCLUSIONS

A MONA is a feasible, novel method for collecting data on perceived, prompted, and unperceived learning needs to inform an online emergency haematology educational blog. This methodology could be useful to the developers of other online education resources.

Social Medicine: Twitter in Healthcare

Social media enables the public sharing of information. With the recent emphasis on transparency and the open sharing of information between doctors and patients, the intersection of social media and healthcare is of particular interest. Twitter is currently the most popular form of social media used for healthcare communication; here, we examine the use of Twitter in medicine and specifically explore in what capacity using Twitter to share information on treatments and research has the potential to improve care. The sharing of information on Twitter can create a communicative and collaborative atmosphere for patients, physicians, and researchers and even improve quality of care. However, risks involved with using Twitter for healthcare discourse include high rates of misinformation, difficulties in verifying the credibility of sources, overwhelmingly high volumes of information available on Twitter, concerns about professionalism, and the opportunity cost of using physician time. Ultimately, the use of Twitter in healthcare can allow patients, healthcare professionals, and researchers to be more informed, but specific guidelines for appropriate use are necessary.

Ask an anatomist: Identifying global trends, topics and themes of academic anatomists using twitter

Social media (SoMe) is increasingly used in higher education (HE) to access knowledge and enable global communication. The SoMe platform Twitter^® is particularly beneficial in these contexts because it is readily accessible, easily searchable (via hashtags) and global. Given these advantages, the twitter platform @AskAnatomist was created to foster a global weekly tweet chat, where students and academics can ask and address anatomy-related questions. The aim of this study was to identify themes arising in the early stages of the @AskAnatomy Twitter community to gain insights into current needs/key areas for academic anatomists, students, and other followers. A qualitative analysis of tweets including the hashtag #AnatQ, (the associated @AskAnatomist hashtag), was undertaken to achieve this aim. Thematic analysis revealed three core themes arising in the formative stages of the @AskAnatomist Twitter site: (1) anatomical education modalities, (2) specific anatomy content, and (3) research motivations. These themes reveal controversies within the field of anatomical sciences, areas for potential education resource improvement and research, as well as the humor of anatomists. Though the original intent of the @AskAnatomist site was to engage the general public in anatomy content and knowledge, tweet analysis suggests that academic anatomists were the primary active "tweeters". Interestingly, this analysis reveals that the @AskAnatomist site progressed into a web-based community of practice (CoP), suggesting an additional benefit of SoMe communities in the field of anatomy. Anat Sci Educ 11: 270-281. © 2017 American Association of Anatomists.

Social Media Engagement and the Critical Care Medicine Community

Over the last decade, social media has transformed how we communicate in the medical community. Microblogging through platforms such as Twitter has made social media a vehicle for succinct, targeted, and innovative dissemination of content in critical care medicine. Common uses of social media in medicine include dissemination of information, knowledge acquisition, professional networking, and patient advocacy. Social media engagement at conferences represents all of these categories and is often the first time health-care providers are introduced to Twitter. Most of the major critical care medicine conferences, journals, and societies leverage social media for education, research, and advocacy, and social media users can tailor the inflow of content based on their own interests. From these interactions, networks and communities are built within critical care medicine and beyond, overcoming the barriers of physical proximity. In this review, we summarize the history and current status of health-care social media as it relates to critical care medicine and provide a primer for those new to health-care social media with a focus on Twitter, one of the most popular microblogging platforms.

Creation of a national emergency medicine enhanced competency directory for residency training

Canadian emergency medicine Royal College residency training allows for pursuing extra training in enhanced competency areas. A wealth of enhanced competency training opportunities exist nationally. However, the search for the right fit is a challenging one because there is no centralized resource that catalogues all of these opportunities. A working group of the Canadian Association of Emergency Physicians (CAEP) Resident Section was assembled in 2016 to create a freely accessible and comprehensive directory of Canadian enhanced competency areas. The working group used stakeholder surveys (of residents, recent graduates, and faculty members), social media engagement, and program website searches. Information was collated into the first edition of a national enhanced competency directory, which is available at no cost at http://caep.ca/sites/caep.ca/files/enhancedcompdoc.pdf. Limitations include the scope defined by the working group and survey responses. A biannual update is also incorporated into the CAEP Resident Section portfolio to ensure it remains up-to-date.

Social media and professional identity: Pitfalls and potential

INTRODUCTION

Social media developments have completely changed how information is accessed and communicated. While great potential exists with these platforms, recent reports of online unprofessional behavior by doctors has threatened the medical professional identity; a matter of critical importance for clinicians and medical educators. This paper outlines a role for social media in facilitating support for clinicians and medical teachers; it will raise awareness of pitfalls and explain ethical and legal guidelines.

METHODS

An analysis of inappropriate behaviors and conflicting attitudes regarding what is acceptable in online posts, including the inter-generational contrast in online presence and perceptions of where the boundaries lie.

RESULTS AND DISCUSSION

Guidance documents are analyzed and potentially confusing and conflicting statements are identified and clarified. The authors believe that clinicians and medical students must follow ethical imperatives in both personal and professional spheres.

CONCLUSIONS

It is essential that medical educational and professional bodies encourage clinicians to support one another and share information online while providing clear legal and ethical advice on maintaining standards and avoiding common pitfalls. Education on the responsible use of social media and associated risk awareness should be a priority for medical school curricula.

The Impact of Public Health Awareness Campaigns on the Awareness and Quality of Palliative Care

OBJECTIVE

The right to health includes a right of access to good quality palliative care, but inequalities persist. Raising awareness is a key plank of the public health approach to palliative care, but involves consideration of subjects most of us prefer not to address. This review addresses the question: "do public health awareness campaigns effectively improve the awareness and quality of palliative care"?

BACKGROUND

The evidence shows that public awareness campaigns can improve awareness of palliative care and probably improve quality of care, but there is a lack of evidence about the latter.

METHODS

Rapid review and synthesis.

RESULTS

A comprehensive public awareness campaign about palliative care (including advance care planning and end-of-life decision making) should be based on clear and shared terminology, use well piloted materials, and the full range of mass media to suit different ages, cultures, and religious/spiritual perspectives. Arts and humanities have a role to play in allowing individuals and communities to express experiences of illness, death, and grief and encourage conversation and thoughtful reflection. There is evidence about key factors for success: targeting, networking, and use of specific, measurable, achievable, realistic time-bound objectives; continuous evaluation; and complementarity to national and international policy.

DISCUSSION

Campaigns should be located within the framework of public health promotion and the synergy between short national mass media campaigns and longer term local community action initiatives carefully considered. National and local projects to raise awareness should identify and address any barriers at the level of individuals, communities, and systems of care, for example, literacy skills and unequal access to resources.

Benefits and Threats to Using Social Media for Presenting and Implementing Evidence

As a potential high-yield tool for disseminating information that can reach many people, social media is transforming how clinicians, the public, and policy makers are educated and find new knowledge associated with research-related information. Social media is available to all who access the internet, reducing selected barriers to acquiring original source documents such as journal articles or books and potentially improving implementation-the process of formulating a conclusion and moving on that decision. The use of social media for evidence dissemination/implementation of research has both benefits and threats. It is the aim of this Viewpoint to provide a balanced view of each. J Orthop Sports Phys Ther 2018;48(1):3-7. doi:10.2519/jospt.2018.0601.

Gamified Twitter Microblogging to Support Resident Preparation for the American Board of Surgery In-Service Training Examination

OBJECTIVE

We sought to determine if a daily gamified microblogging project improves American Board of Surgery In-Service Training Examination (ABSITE) scores for participants.

DESIGN

In July 2016, we instituted a gamified microblogging project using Twitter as the platform and modified questions from one of several available question banks. A question of the day was posted at 7-o׳clock each morning, Monday through Friday. Respondents were awarded points for speed, accuracy, and contribution to discussion topics. The moderator challenged respondents by asking additional questions and prompted them to find evidence for their claims to fuel further discussion. Since 4 months into the microblogging program, a survey was administered to all residents. Responses were collected and analyzed. After 6 months of tweeting, residents took the ABSITE examination. We compared participating residents׳ ABSITE percentile rank to those of their nonparticipating peers. We also compared residents׳ percentile rank from 2016 to those in 2017 after their participation in the microblogging project.

SETTING

The University of Connecticut general surgery residency is an integrated program that is decentralized across 5 hospitals in the central Connecticut region, including Saint Francis Hospital and Medical Center, located in Hartford.

PARTICIPANTS

We advertised our account to the University of Connecticut general surgery residents. Out of 45 residents, 11 participated in Twitter microblogging (24.4%) and 17 responded to the questionnaire (37.8%).

RESULTS

In all, 100% of the residents who were participating in Twitter reported that daily microblogging prompted them to engage in academic reading. Twitter participants significantly increased their ABSITE percentile rank from 2016 to 2017 by an average of 13.7% (±14.1%) while nonparticipants on average decreased their ABSITE percentile rank by 10.0% (±16.6) (p = 0.003).

CONCLUSIONS

Microblogging via Twitter with gamification is a feasible strategy to facilitate improving performance on the ABSITE, especially in a geographically distributed residency.

The Utility of Social Media in Providing Information on Zika Virus

Introduction

In 2015, there was an outbreak of Zika virus in Brazil that spread throughout the Americas. The association of Zika virus with birth defects in infants born to infected pregnant women created concern for women of childbearing age. Social media is an important platform for health promotion, communication, and education on preventative methods during Zika virus outbreaks.

Methods

We evaluated the utility of social media on providing information regarding Zika virus. Facebook, Instagram, Twitter, and YouTube were utilized for our study. A search of the term “#Zikavirus” on Twitter and Instagram, and “Zika virus” on Facebook and YouTube was performed. The first 50 search results were analyzed from each source. Only English, Spanish, or Portuguese results were included. Results were categorized into three groups: “Useful”, “Not Useful”, or “Misleading”.

Results

Search was conducted on December 17th, 2016, with 185 results. Forty (21.6%) were from Facebook, 50 (27%) from Twitter, 48 (25.9%) from YouTube, and 47 (25.4%) from Instagram. A total of 104 (56.22%) results were "Useful", 67 (36.2%) "Not Useful", and 14 (7.5%) were "Misleading”. There were significantly more “Useful” results compared to “Not Useful” and “Misleading” results (Fisher’s exact: p < 0.0001).

Conclusion

Social media is a useful resource for providing relevant information on Zika virus. Young women can utilize social media for Zika virus information. The role of social media in public health should be further investigated and established. Patient education interventions should focus on social media impact on behavior modification and education of public to recognize useful information.

Beyond Citation Rates: A Real-Time Impact Analysis of Health Professions Education Research Using Altmetrics

PURPOSE

To complement traditional citation-based metrics, which take years to accrue and indicate only academic attention, academia has begun considering altmetrics or alternative metrics, which provide timely feedback on an article's impact by tracking its dissemination via nontraditional outlets, such as blogs and social media, across audiences. This article describes altmetrics and examines altmetrics attention, outlets used, and top article characteristics for health professions education (HPE) research.

METHOD

Using Altmetric Explorer, a tool to search altmetrics activity, the authors searched for HPE articles that had at least one altmetrics event (e.g., an article was tweeted or featured in a news story) between 2011 and 2015. Retrieved articles were analyzed using descriptive statistics. In addition, the 10 articles with the highest Altmetric Attention Scores were identified and their key characteristics extracted.

RESULTS

The authors analyzed 6,265 articles with at least one altmetrics event from 13 journals. Articles appeared in 14 altmetrics outlets. Mendeley (161,470 saves), Twitter (37,537 tweets), and Facebook (1,650 posts) were most popular. The number of HPE articles with altmetrics attention increased 145%, from 539 published in 2011 to 1,321 in 2015. In 2015, 50% or more of the articles in 5 journals received altmetrics attention. Themes for articles with the most altmetrics attention included social media or social networking; three such articles were written as tips or guides.

CONCLUSIONS

Increasing altmetrics attention signals interest in HPE research and the need for further investigation. Knowledge of popular and underused outlets may help investigators strategically share research for broader dissemination.

Four strategies to find, evaluate, and engage with online resources in emergency medicine

Despite the rapid expansion of online educational resources for emergency medicine, barriers remain to their effective use by emergency physicians and trainees. This article expands on previous descriptions of techniques to aggregate online educational resources, outlining four strategies to help learners navigate, evaluate, and contribute online. These strategies include 1) cultivating digital mentors, 2) browsing the most popular free open access medical education (FOAM) websites, 3) using critical appraisal tools developed for FOAM, and 4) contributing new online content.

The unbearable emptiness of tweeting-About journal articles

Enthusiasm for using Twitter as a source of data in the social sciences extends to measuring the impact of research with Twitter data being a key component in the new altmetrics approach. In this paper, we examine tweets containing links to research articles in the field of dentistry to assess the extent to which tweeting about scientific papers signifies engagement with, attention to, or consumption of scientific literature. The main goal is to better comprehend the role Twitter plays in scholarly communication and the potential value of tweet counts as traces of broader engagement with scientific literature. In particular, the pattern of tweeting to the top ten most tweeted scientific dental articles and of tweeting by accounts is examined. The ideal that tweeting about scholarly articles represents curating and informing about state-of-the-art appears not to be realized in practice. We see much presumably human tweeting almost entirely mechanical and devoid of original thought, no evidence of conversation, tweets generated by monomania, duplicate tweeting from many accounts under centralized professional management and tweets generated by bots. Some accounts exemplify the ideal, but they represent less than 10% of tweets. Therefore, any conclusions drawn from twitter data is swamped by the mechanical nature of the bulk of tweeting behavior. In light of these results, we discuss the compatibility of Twitter with the research enterprise as well as some of the financial incentives behind these patterns.

Twitter 101 and beyond: introduction to social media platforms available to practicing hematologist/oncologists

Social media utilizes specific media platforms to allow increased interactivity between participants. These platforms serve diverse groups and purposes including participation from patients, family caregivers, research scientists, physicians, and pharmaceutical companies. Utilization of these information outlets has increased with integration at conferences and between conferences with the use of hashtags and "chats". In the realm of the "e-Patient" it is key to not underestimate your audience. Highly technical information is just as useful as a basic post. With growing use, social media analytics help track the volume and impact of content. Additionally, platforms are leveraging each other for uses, including Twitter, blogs, web radio, and recorded video and images. We explore information on social media resources and applications from varying perspectives. While these platforms will evolve over time, or disappear with new platforms taking their place, it is apparent they are now a part of the everyday experience of oncology communication.

Multiple Wins: Embracing Technology to Increase Efficiency and Maximize Efforts

Clinician educators (CEs) are challenged to produce meaningful scholarship while balancing various clinical and administrative roles. The increasing availability of technology provides new opportunities for scholarly output and dissemination. This article proposes three strategies for utilizing technology to enhance scholarly output for the busy CE. The strategies are supported by real examples of these techniques, followed by a discussion of potential limitations and future directions.

The Use of Social Media in Graduate Medical Education: A Systematic Review

PURPOSE

Despite the growing presence of social media in graduate medical education (GME), few studies have attempted to characterize their effect on residents and their training. The authors conducted a systematic review of the peer-reviewed literature to understand the effect of social media on resident (1) education, (2) recruitment, and (3) professionalism.

METHOD

The authors identified English-language peer-reviewed articles published through November 2015 using Medline, Embase, Cochrane, PubMed, Scopus, and ERIC. They extracted and synthesized data from articles that met inclusion criteria. They assessed study quality for quantitative and qualitative studies through, respectively, the Medical Education Research Study Quality Instrument and the Consolidated Criteria for Reporting Qualitative Studies.

RESULTS

Twenty-nine studies met inclusion criteria. Thirteen (44.8%) pertained to residency education. Twitter, podcasts, and blogs were frequently used to engage learners and enhance education. YouTube and wikis were more commonly used to teach technical skills and promote self-efficacy. Six studies (20.7%) pertained to the recruitment process; these suggest that GME programs are transitioning information to social media to attract applicants. Ten studies (34.5%) pertained to resident professionalism. Most were exploratory, highlighting patient and resident privacy, particularly with respect to Facebook. Four of these studies surveyed residents about their social network behavior with respect to their patients, while the rest explored how program directors use it to monitor residents' unprofessional online behavior.

CONCLUSIONS

The effect of social media platforms on residency education, recruitment, and professionalism is mixed, and the quality of existing studies is modest at best.