The ID Digital Institute: Building a digital education toolset and community

Organic digital education (ODE) includes online medical education content that can take various forms, such as blogs, social media, videos, podcasts, or infographics. Multimedia ODE platforms have unique benefits and have quickly become an essential part of medical education. Modern medical educators with competency in digital teaching modalities can leverage these for teaching as well as career development and dissemination of scientific research. The ID Digital Institute is a digital education program with a curriculum designed to equip infectious diseases (ID) professionals with the skills to appraise, create, curate, and integrate ODE into their teaching and career. We share the structure, content, and lessons learned from the ID Digital Institute program. We also illustrate how digital education skills can present unique opportunities to align with current and future transplant and immunocompromised host infectious diseases education efforts.

The Future of Social Media, Anesthesiology, and the Perioperative Physician

Social media has rapidly developed in the past decade to become a powerful and influential force for patients, physicians, health systems, and the academic community. While the use of social media in health care has produced many positive changes, such as rapid dissemination of information, crowd-sourced sharing of knowledge, learning, and social interaction, social media in health care has also negative effects. Recent examples of negative impacts of social media include rapid and unchecked information dissemination leading to patient misinformation and inadvertent reputational harm for health care professionals due to engaging in controversial topics on public platforms. Members of the anesthesiology community, like other medical specialties, have rapidly adopted social media at many different levels. However, most anesthesiologists, health systems, and academic communities have little education, preparation, and guidelines on optimizing the use of social media technology while minimizing the risks of social media. Anesthesiology has been and will continue to be impacted by the forces of technology and the cultural influences of social media for the foreseeable future. The purpose of this article was to examine the recent history of social media adoption in anesthesiology and perioperative medicine, understand the current impact of social media across our specialty, and consider how the future development of technology and evolving social and cultural dynamic influences of social media will have on anesthesiology over the next quarter century.

Emerging technologies adoption in healthcare: A SOHI model

The internet and emerging technologies have increased the utilisation of digital platforms. This study aims to draw on performance expectancy, social influence, and satisfaction to investigate a proposed model which is geared toward social media healthcare information (SOHI) adoption. The proposed model uses a structured online questionnaire, and 300 responses were evaluated using partial least squares and structural equation modelling [PLS-SEM]. From the findings, performance expectancy of social media (PESM) and satisfaction with social media (SATSM) were revealed to be significant predictors of behavioural intention towards social media (BISM). Satisfaction with social media (SATSM) had the greatest impact on BISM, accounting for 63.8 per cent of the variance in users' intentions to utilise SOHI. Similarly, PESM and social influence on social media (SISM) had the most predictive influence on SATSM, accounting for 50.5 per cent of the variance in users' social media satisfaction, which led to SOHI adoption. Unlike others, the social influence on social media (SISM) did not have a significant effect on BISM. BISM and satisfaction with social media (SATSM) were significant predictors of SOHI adoption, accounting for 54.5 per cent of the variance in SOHI adoption. The recommendations in this study would help healthcare professionals change their approach to digital healthcare engagement.

Multifaceted intervention including Facebook-groups to improve guideline-adherence in ICU: A quasi-experimental interrupted time series study

BACKGROUND

The impact of social media, with its speed, reach and accessibility, in interventions aimed to improve adherence to guidelines such as assessment of Pain, Agitation/Sedation and Delirium (PAD) in intensive care is not described. Therefore, the primary objective of this quality improvement study was to evaluate the impact of a multifaceted intervention including audit and feedback of quality indicators (QI) via Facebook-groups, educational events and engagement of opinion leaders on adherence to PAD-guidelines in four ICUs.

METHODS

A quasi-experimental interrupted time series study with eight monthly data points in the two phases Before and Intervention was designed. Proportion of nursing shifts with documented PAD-assessment (PAD-QIs) were retrieved from the electronical medical chart from included adult ICU patient-stays in four participating ICUs. Difference between the two time periods was assessed using generalised mixed model for repeated measures with unstructured covariance matrix, and presented as Beta (B) with 95% confidence interval (CI).

RESULTS

Finally, 1049 ICU patient-stays were analysed; 534 in Before and 515 in Intervention. All three PAD-QIs significantly increased in Intervention by 31% (B = 30.7, 95%CI [25.7 to 35.8]), 26% (B = 25.8, 95%CI [19.4 to 32.2]) and 34% (B = 33.9, 95%CI [28.4 to 39.4]) in pain, agitation/sedation and delirium, respectively.

CONCLUSION

A multifaceted intervention including use of Facebook-groups was associated with improved guideline-adherence in four ICUs, as measured with process PAD-QIs of PAD assessment. Further research on use of social media to improve guideline adherence is warranted, particularly as social distancing impacts clinical education and training and new approaches are needed.

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.

Social media health interventions to improve diabetes mellitus patient outcome: a systematic review

OBJECTIVES

The use of modern technology and social media has revolutionized the way health information is distributed to diabetes mellitus patients. Social media can be used as a medium of providing health interventions to improve patient health outcomes. Social media is able to provide a more intensive communication facility between healthcare professionals and patients. We aim to systematically review and describe the effect of social media interventions on health outcomes of patients with diabetes mellitus.

METHODS

A systematic review was carried out from three electronic databases (Pubmed, Scopus, and Medline). Eligible publications are studies that describe the application of social media interventions on the health outcomes of patients with diabetes mellitus.

RESULTS

Fourteen studies were selected for this systematic review, 10 studies with a randomized controlled trial design, and 4 studies with a nonrandomized controlled trial design. Six studies only used interventions using social media, A blend of face-to-face social media intervention was used in 6 studies, 2 studies used a combination of telephone and social media intervention. One study had treatment behavior outcomes with improvement in treatment behavior, 6 studies had clinical outcomes (an improvement in HbA1c values in the four studies), 6 studies had treatment behavior outcomes and clinical outcomes (1 study had improved treatment behavior and clinical outcomes, 3 studies had improved treatment behavior outcome only), and 1 study had medication adherence outcome (no improvement in medication adherence).

CONCLUSIONS

These findings indicate that the intervention using social media can improve the health outcomes of diabetes mellitus patients.

Social Media Adoption by Health Professionals: A TAM-Based Study

This research identifies the underlying drivers impacting on healthcare professionals’ social media usage behaviours using the technology acceptance model (TAM) as the theoretical lens. A self-administered survey questionnaire was developed and administered to 219 healthcare professionals. Data are analysed applying the structural equation modelling (SEM) technique. The SEM model demonstrated an acceptable model fit (χ2 = 534.241; df, 239, χ2/df = 2.235, RMSEA = 0.06, IFI = 0.92, TLI = 0.93, and CFI = 0.92) and indicates content quality, perceived risk, perceived credibility, peer influence, confirmation of expectations, supporting conditions, and perceived cost significantly influence the notion of perceived social media usefulness. Furthermore, perceived social media usefulness positively affects social media usage behaviour of healthcare professionals. This research generates important insights into what drives the adoption of social media by healthcare professionals. These insights could help develop social media guidelines and strategies to improve the state of professional interactions between health professionals and their clients.

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.

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.

Impact of social media interventions and tools among informal caregivers of critically ill patients after patient admission to the intensive care unit: A scoping review

Background

The use of social media in healthcare continues to evolve. The purpose of this scoping review was to summarize existing research on the impact of social media interventions and tools among informal caregivers of critically ill patients after patient admission to the intensive care unit (ICU).

Methods

This review followed established scoping review methods, including an extensive a priori-defined search strategy implemented in the MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane CENTRAL Register of Controlled Trials databases to July 10, 2020. Primary research studies reporting on the use of social media by informal caregivers for critically ill patients were included.

Results

We identified 400 unique citations and thirty-one studies met the inclusion criteria. Nine were interventional trials–four randomized controlled trials (RCTs)–and a majority (n = 14) were conducted (i.e., data collected) between 2013 to 2015. Communication platforms (e.g., Text Messaging, Web Camera) were the most commonly used social media tool (n = 17), followed by social networking sites (e.g., Facebook, Instagram) (n = 6), and content communities (e.g., YouTube, SlideShare) (n = 5). Nine studies’ primary objective was caregiver satisfaction, followed by self-care (n = 6), and health literacy (n = 5). Nearly every study reported an outcome on usage feasibility (e.g., user attitudes, preferences, demographics) (n = 30), and twenty-three studies reported an outcome related to patient and caregiver satisfaction. Among the studies that assessed statistical significance (n = 18), 12 reported statistically significant positive effects of social media use. Overall, 16 of the 31 studies reported positive conclusions (e.g., increased knowledge, satisfaction, involvement) regarding the use of social media among informal caregivers for critically ill patients.

Conclusions

Social media has potential benefits for caregivers of the critically ill. More robust and clinically relevant studies are required to identify effective social media strategies used among caregivers for the critically ill.

Using Social Media for Rapid Information Dissemination in a Pandemic: #PedsICU and Coronavirus Disease 2019

OBJECTIVE

To describe the impact of a strategy for international collaboration and rapid information dissemination on Twitter among the pediatric critical care community during a global pandemic.

DESIGN

Analysis of #PedsICU and coronavirus disease 2019 Twitter data in the Symplur Signals Database between February 1, 2020, and May 1, 2020.

SETTING

Social media platform Twitter.

PATIENTS

None.

INTERVENTIONS

Promotion of the joint usage of #PedsICU and #COVID19 throughout the international pediatric critical care community in tweets relevant to the coronavirus disease 2019 pandemic and pediatric critical care.

MEASUREMENTS AND MAIN RESULTS

We collected data on all tweets containing the hashtag #PedsICU in addition to those containing both #PedsICU and coronavirus disease 2019 hashtags. Tweets including #PedsICU were shared 49,865 times on six continents between February 1, 2020, and May 1, 2020; between February 1 and March 13, only 8% of #PedsICU tweets included a coronavirus disease 2019 hashtag. After a sharp rise during the week of March 14, 2020, coronavirus disease 2019 content has dominated the #PedsICU conversation on Twitter, comprising 69% of both #PedsICU tweets and impressions (p < 0.001). The most commonly used coronavirus disease 2019 hashtag over the study period was #COVID19 (69%). Proportionately, a greater percentage of #PedsICU tweets including the coronavirus disease 2019 hashtag (vs not) had images or videos (45% vs 41%; p < 0.001). In addition, non-physician healthcare providers were the largest group of users (46%) of the combination of #PedsICU and coronavirus disease 2019 hashtags. The most popular tweets shared on Twitter were open-access resources, including links for updated literature, narrative reviews, and educational videos relevant to coronavirus disease 2019 clinical care. Concurrent hashtags and words in tweets containing #PedsICU and coronavirus disease 2019 hashtags spanned several different disciplines and topics in pediatric critical care.

CONCLUSION

Twitter has been used widely for real-time information sharing and collaboration among the international pediatric critical care community during the coronavirus disease 2019 pandemic. Targeted use of #PedsICU and #COVID19 for engagement on Twitter is a conduit to combat misinformation and optimize reach to pediatric critical care stakeholders across the globe when rapid dissemination is needed.

Paediatric Free Open Access Meducation (FOAM): behaviours, trends and implications

INTRODUCTION

Free Open Access Meducation (FOAM) describes online resources assisting learning in medicine. Little is known about users or their behaviours.

METHODS

Using Google Analytics for a popular FOAM site (www.paedatricfoam.com), we explored user demographics and patterns of behaviour. We analysed these further with descriptive and statistical tests using SPSS (version 26). Data are presented as mean (SD).

RESULTS

There were 181.44 (75.16) mean daily users accessing the site throughout a 4-month period during 2018/2019. 68.9% of users were female; 44% were 25-34 years; 57.3% used a mobile device. The mean session duration was 73.55 (9.41) seconds, with more time spent per session and a greater number of pages per session observed in users accessing the site from a desktop or tablet as opposed to a mobile phone. 84.3% of mobile users left the site after viewing a single page. Referral source was also associated with device used (p<0.001). Age was not related to user behaviours (p>0.05).

DISCUSSION

FOAM is a rapidly developing form of medical education, with large user numbers seen for a site just 2 years old. The site is being used by many beyond its intended readership. Rather than accessing multiple pages from a desktop, users have varied online behaviours, with the majority viewing a single page on a mobile phone, referred by social media or Google.

CONCLUSIONS

Google Analytics can powerfully display usage of medical websites but has important limitations if statistical exploration is required. FOAM users are a heterogenous group, and thus content should be designed with this in mind. Further research must be prioritised focussing on the scope, curriculum coverage, accuracy of information and the effectiveness of FOAM as an educational resource.

Use of social media for communicating about critical care topics: A Norwegian cross-sectional survey

BACKGROUND

Social media (SoMe) might be an alternative platform for communicating critical care topics to implement evidence-based practice in the intensive care unit (ICU). This survey aims to describe ICU nurses' and physicians' use of SoMe in general, and their perception of using closed Facebook-groups for receiving content on critical care topics.

METHODS

A cross-sectional, web-based, anonymous survey was distributed to ICU physicians and nurses in four ICUs in autumn 2017 via an email-campaign. Descriptive statistics with rates, percentages and median numeric rating scale (NRS) scores, interquartile ranges are presented.

RESULTS

The response-rate was 64% (253/ 394) including 210 nurses and 43 physicians. Overall, 93% had a SoMe-profile, and 77% had a profile on more than one network site. Facebook was the most used social network site, with 87% having a profile. Totally, 68% were daily users, but more nurses used Facebook daily vs physicians (81% vs 60%, respectively, P = 0.006). Nurses were also more positive toward being members of closed Facebook-groups aimed to exchange content on critical care topics (median NRS 9 (6-10) vs 6 (3-9), respectively, P = 0.014).

CONCLUSION

The majority of ICU nurses and physicians were active SoMe users, mainly for personal purposes, and Facebook was the most popular SoMe. Nurses used Facebook daily more frequent and were more positive toward content on critical care topics on Facebook than physicians. These findings might be relevant to customize future communication about critical care topics via SoMe.