#Neurosurgery: A Temporal and Content Analysis of Academic Neurosurgery on Twitter

Neurosurgery Residency Programs on Twitter (X): Current Use and Future Potential

OBJECTIVE

Twitter (X) is increasingly utilized by medical residency programs to boost engagement and potentially enhance ranking. This study aims to evaluate the role of Twitter (X) in neurosurgery residency programs, assessing their online activity, followership, and content to identify current practices and potential improvements.

METHODS

We identified 97/123 neurosurgery residency programs in the United States with Twitter accounts. Active accounts, posting in 2022 and 2023, were matched with the American Association of Neurological Surgeons Neurosurgical Residency Training Program Directory. Tweets from January 2022 through June 2023 were categorized as original or retweets and further subcategorized based on content. Descriptive and correlation analyses were conducted.

RESULTS

Twitter (X) accounts were found for 78.8% of accredited neurosurgery programs (n = 97/123), with 68.3% active as of July 2023 (n = 84/123). All active accounts amassed 167,068 followers. Among 5612 tweets identified, 2764 were original content, and 2848 were retweets. Tweets primarily focused on resident or program information (64.3%), research publications (32.0%), and conference participation (9.4%). Only 12.3% (n = 341) of original tweets contained public medical information. A significant correlation (r = 0.493, P < 0.001) was observed between Twitter (X) following and program ranking.

CONCLUSIONS

The majority of US neurosurgery residency programs actively use Twitter (X), primarily to showcase academic achievements and aid in recruitment. The correlation between Twitter following and program ranking suggests that online engagement reflects program visibility and impact, underscoring the importance of social media in program outreach and strategic management for maximizing program benefits.

The COVID-19 Applicant: The Rise of Twitter Among Matched Neurosurgery Applicants

INTRODUCTION

Social media is becoming increasingly ubiquitous in the professional realm. The coronavirus disease 2019 (COVID-19) pandemic accelerated the shift towards utilizing social media to network and disseminate information, especially via Twitter. Neurosurgery programs have also leveraged Twitter to inform and attract applicants.

OBJECTIVE

The purpose of this study is to identify factors influencing the adoption of Twitter by matched neurosurgery applicants before and during the COVID-19 pandemic.

METHODS

A list of matched U.S. neurosurgery residents from just before the start of the pandemic (2019-2020) to after the peak of the pandemic (2021-2022), was collated. Twitter was searched to evaluate the presence of a professional account at the time of Electronic Residency Application Service (ERAS) submission. The following demographic variables were collected: gender, medical school, and matched residency institution.

RESULTS

Over four application cycles (2019-2022), 897 matched residents were evaluated in the study. Overall, 31.1% had a Twitter account during the time of their residency application. In particular, international medical school graduates were more likely to have a Twitter platform compared to U.S. applicants (50.0% vs. 29.7%; p=.001). The percentage of matched neurosurgery applicants with a Twitter profile significantly increased during the pandemic (21.0% vs. 41.1%; p<.001) with a two-fold increase from 20.0% to 39.7% (p<.001) in U.S. applicants.

CONCLUSION

Over the past four years, an increasing number of matched neurosurgery applicants have adopted a Twitter presence during application. Driven by the increasing use of social media and accelerated by the COVID-19 pandemic, Twitter has become an important tool leveraged by during the application process.

Variation in academic neurosurgery departments' #neurosurgery social media influence

Background

Social media use is increasingly common among academic neurosurgery departments, but its relationship with academic metrics remains underexamined.

Methods

We examine the relationship between American academic neurosurgery departments' number of followers on Twitter, Instagram, and Facebook and the following academic metrics: Doximity Residency rankings, US News & World Report rankings (USNWR) of their affiliated medical schools, and the amount of NIH funding of those schools.

Results

Few departments had disproportionate number of followers. A greater proportion of programs had Twitter accounts (88.9%) than had Instagram (72.2%) or Facebook (51.9%) accounts (p=0.0001). Programs identified as "Influencers" had more departmental NIH funding (p=0.044), more institutional NIH funding (p=0.035), better Doximity residency rankings (p=0.044), and better affiliated medical school rankings (p=0.002). Number of Twitter followers had the strongest correlation with academic metrics, yet only modest correlations were identified to departmental NIH funding (R=0.496, p=0.0001), institutional NIH funding (R=0.387, p=0.0072), Doximity residency rank (R=0.411, p=0.0020), and affiliated medical school ranking (R=0.545,p<0.0001). On multivariable regression, only being affiliated with a medical school in the top quartile on the USNWR rankings, rather than neurosurgery departmental metrics, predicted having more Twitter (OR=5.666, p=0.012) and Instagram (OR=8.33, p=0.009) followers.

Conclusion

American academic neurosurgery departments preferentially use Twitter over Instagram or Facebook. Their Twitter or Instagram presences are associated with better performance on traditional academic metrics. However, these associations are modest, suggesting that other factors contribute to a department's social media influence. A department's affiliated medical school may contribute to the department's social media brand.

Neurosurgery Applicant Perspective of Neurosurgery Residency Websites

OBJECTIVE

Applicants rely heavily on virtual information in the form of neurosurgery residency websites (NRWs) to better understand a program's culture, faculty, and opportunities. There is a paucity of information regarding the value of NRW on applicant decision making. The advent of the supplemental ERAS application and continuation of virtual interviews may increase the propensity of which applicants use NRW. The objective of our study was to distribute a survey to further understand applicants' perceptions and opinions of NRW, as well as provide future direction for NRW optimization.

METHODS

The current study is a single-institution, retrospective survey design. A survey was designed via Qualtrics software to evaluate applicant demographics, resident education, resident recruitment, and future directions. The survey includes the most frequently used variables on NRW. The survey was distributed to neurosurgery applicants who received an interview at the University of Alabama at Birmingham. Data were analyzed using Microsoft Excel.

RESULTS

Among the 293 applicants who received a link to the survey, 87/293 (29.7%) completed it. Respondents elected that useful website variables were "resident rotation schedules and hospital locations," "faculty listings and biographies," and "neurosurgery residency websites served as a first impression of a neurosurgery residency program." More than half of the respondents agreed that their rank list would not be the same without an NRW. The most strongly received statement for future directions was "Neurosurgery residency programs will benefit from renovating their residency website."

CONCLUSIONS

Our data suggest NRWs play a vital role in resident recruitment and decision making. Residency programs will benefit from this data and may use it to restructure their virtual recruitment tools and discover innovative virtual recruitment strategies. Our team elucidated the most important variables found on NRWs and proposed future directions for their improvement and the virtual application and recruitment process.

Social media growth of orthopaedic surgery residency programs in response to the COVID-19 pandemic

BACKGROUND

In the Spring of 2020, residency programs across the country experienced rapid and drastic changes to their application process as a result of the coronavirus disease 2019 (COVID-19) pandemic. In response, residency programs shifted to virtual events and began harnessing social media to communicate with applicants.

AIM

To analyze the changes in social media usage by orthopaedic surgery programs in response to the COVID-19 pandemic.

METHODS

Based on the 2019 residency and fellowship electronic database, accredited US orthopaedic surgery programs were reviewed for social media presence on Instagram and Twitter. Approximately 47000 tweets from 2011-2021 were extracted through the Twitter application programming interface. We extracted: Total number of followers, accounts following, tweets, likes, date of account creation, hashtags, and mentions. Natural language processing was utilized for tweet sentiment analysis and classified as positive, neutral, or negative. Instagram data was collected and deemed current as of August 11, 2021. The account foundation date analysis was based on the date recognized as the start of the COVID-19 outbreak in the United States, before or after March 1, 2020.

RESULTS

A total of 85 (42.3%) orthopaedic surgery residency program Twitter handles were identified. Thirty-five (41.2%) programs joined Twitter in the nine months after the 2020 covid outbreak. In 2020, there was a 126.6% increase in volume of tweets by orthopaedic surgery residency accounts as compared to 2019. The median number of followers was 474.5 (interquartile range 205.0-796.5). The account with the highest number of tweets was Hospital for Special Surgery (@HSpecialSurgery) with 13776 tweets followed by University of Virginia (@UVA_Ortho) with 5063 and Yale (@OrthoAtYale) with 899. Sentiment analysis before 2020 revealed 30.4% positive, 60.8% neutral, and 8.8% negative sentiments across tweets. Interestingly, the positive sentiment percentage increased in 2020 from 30.4% to 34.5%. Of the 201 ACGME-accredited orthopaedic residency programs on Fellowship and Residency Electronic Interactive Database, 115 (57.2%) participate on Instagram, with 101 (87.8%) identified as “resident”-managed vs 14 (12.2%) identified as “department”-managed. Over three quarters (77.4%) of Instagram accounts were created after March 1, 2020. The average number of followers per account was 1089.5 with an average of 58.9 total posts.

CONCLUSION

Our study demonstrates a substantial growth of Instagram and Twitter presence by orthopaedic surgery residency programs during the COVID-19 pandemic. These data suggest that orthopaedic residency programs have utilized social media as a new way to communicate with applicants and showcase their programs in light of the challenges presented by the pandemic.