How can Twitter support your studies?
Is there a # for that?
Social media has become an established presence in our lives, with countless platforms available such as Twitter, Facebook, Instagram, Pinterest, and Tumblr. It is this era’s game changer, with its ability to detect trends, spark conversations, connect individuals, and circulate information on a grand scale. With electronic modules, well stocked intranets, and online forums, medical students now have more learning resources at their disposal than ever before. But what role can Twitter, one of social media’s most popular platforms, play in supporting your learning and education?
What is Twitter used for?
Twitter is a social networking tool with an active membership of over 200 million. It is a microblogging site where users are able to post unlimited numbers of “tweets” about anything they want to as long as these are within a 140 character limit. Tweets can comprise text, links, photos, or videos, but their main function is to communicate an update about your own status or something that you would like to share. Tweets are open access, which means they can be viewed, searched, archived, or shared with anyone.
Keeping up to date
Medical professionals use Twitter in a variety of ways to keep up to date (fig 1 1 ). Tweets that are about a particular topic are usually given a dedicated hashtag (#)—for example, #meded to archive all tweets relating to medical education. Many other hashtags have been created, including #medfinalsrev (revision tweets for medical finals), #RespEd (respiratory education), and #tipsfornewdocs (invaluable practical advice from senior clinicians to graduating medical students). Hashtags enable users to search for information relating to a topic and check what has been added recently. There are over 55 well known health related Twitter hashtags on the web, covering a wide range of topics.
Using Twitter in medicine
Probably the best known medical hashtag is Free Open Access Medical Education (#FOAMed), which is the brainchild of Mike Cadogan, a consultant emergency physician at Sir Charles Gairdner Hospital in Perth, Australia. Since its creation in 2012, it has amassed a loyal following of FOAM enthusiasts in its quest to “share education resources” and “ask questions pertinent to medical education, research, best practices and guidelines.” FOAM supporters often display the hashtag #FOAMed in their Twitter profiles, making them readily identifiable to interested medical professionals or students who wish to follow them. FOAM is not exclusive to Twitter, but it uses Twitter as a major channel to link users to resources across the web, including podcasts, lecture slides, case discussions, electrocardiographs, and webinars.
Hashtags that gain a lot of attention within a short space time can end up “trending.” Medical conferences are an excellent example of this. The BMJ Quality Forum (#Quality2014) in April 2014 trended frequently throughout its four days as one of the most popular hashtags in the UK. Delegates often tweet quotes from speakers or workshops at the conference and ascribe an official hashtag designated by the conference organisers. This allows those attending the conference to look at how other delegates are responding to events. These hashtags also serve to widen audience participation to beyond those able to attend the conference in person. This is particularly useful for students, who can search these hashtags and review tweets from delegates and in doing so follow these conferences without needing to spend the money or time to attend. You can also revisit the key points made at conferences through archived Storify versions, where delegates summarise the best bits of the event for those unable to attend.
There have also been innovative uses of hashtags to connect conferences that take place simultaneously but in different locations. For example, in October 2013, the Royal College of General Practitioners annual conference and the Society of Acute Medicine conference collaborated to hold a workshop exploring the potential of social media in bridging the gap between primary and secondary care. Delegates from each conference who attended the workshop were encouraged to tweet under the hashtag #RCGPSAM with salient points for discussion.
Twitter can also be used more interactively—for example, to discuss published research through Twitter journal clubs or in case discussions. Journal clubs usually have a regular set time when followers of a hashtag log on to Twitter and discuss the clinical implications of a new piece of research on their practice. Some background reading is often required to participate fully in the discussion, which is usually led by a facilitator. Two examples of these are the Twitter Journal Club (@twitjournalclub) and the International Urology Journal Club (@iurojc), which have more than 3400 and 1800 followers respectively.
The papers’ methods, results, and discussion sections are scrutinised, and participants are able to observe the discussion as it unfolds and interject with comments, thereby improving their analytical skills. Anyone who wants to can join in—medical students, trainees, consultants, or academics, breaking down medicine’s seemingly hierarchical structures. A good example of this is the Twitter Journal Club’s discussion of the 2009 New England Journal of Medicine article, “A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population.” Professor Atul Gawande, one of the authors of the article, joined the conversation on Twitter and elucidated the study’s strengths and weaknesses and also shared new research efforts around the topic (fig 2 2 ).
Case based discussions (CBDs) are also popular on Twitter as the rapid fire nature of Twitter lends itself particularly well to real time discussion. The functions of these discussions are to both impart new knowledge on a common case and to encourage lateral thinking. Currently, there are accounts holding regular discussions on anaesthesia (@gasclass), haematology (@teamhaem), and interpreting electrocardiograms (@ECGclass).
There are also Twitter communities specifically for medical students, such as the Twitter finals revision group (@twitfrg), founded in 2012 by Sophie Bishton, then a medical student at the University of East Anglia. @twitfrg holds regular, hour long, case based discussions in which students are encouraged to think like junior doctors. The approach is similar to that of problem based learning—students are given a brief introduction to the scenario and then have to coax out further details to determine plans for investigation and management. Bishton says that @twitfg offers students “a range of cases that cover all manner of presentations and topics, and also present challenges such as multitasking, triage, and prioritising jobs. We also have Q&A sessions, provide evidence bases (by linking to papers and resources), provide a support network and advice about becoming a junior doctor, and openly talk about the difficulties we face.” An example of a particularly good @twitfrg CBD was “Major Trauma: ETA 5 minutes,” which also had input from Helgi Johannsson (@traumagasdoc), a London based anaesthetist with a special interest in trauma. Students were invited to contribute and join the discussion in real time (fig 3 3 ). They were challenged to consider the practicalities of managing a trauma patient–for example, being aware of possible sources of haemorrhage in the patient–and also to explore the rationale guiding volume replacement in trauma in the ever popular crystalloids, colloids, or blood debate (fig 4 4 ).
Although Twitter cannot convey huge amounts of clinical information, it does provide digestible nuggets of medical knowledge and thought processes to students through effective discussion and information sharing. Additionally, because of Twitter’s potential to flatten hierarchy and break down communication barriers, expert input from ever busy consultants and clinicians is no more than a tweet away. Professor Simon Carley (@EMManchester), emergency medicine consultant at the Manchester Royal Infirmary and cofounder of @stemlyns, a prominent FOAMed resource for emergency medicine, says that, “The greatest advantange to me [of learning on Twitter] and I think to others is to highlight areas of unconscious incompetence. It tells me about stuff I don’t know I don’t know. It allows me to share what I have learnt and to keep an online memory of my learning.”
Twitter and the curriculum
Twitter functions best as an adjunct to existing medical education approaches and is not meant as a replacement for a structured curriculum. The advantage of Twitter lies in encouraging individuals to develop their own brand of inquisitive learning. The crux of learning through Twitter is similar to that of problem based learning and rests not in plainly searching for the right answers, but instead, in learning how to ask the right questions. For example, to improve a patient’s clinical condition in a case based scenario users must learn to prioritise and ask the most important questions pertinent to the case. Twitter can also provide a welcome change from lecture based courses, which might teach components such as physiology, pathology and pharmacology separately, and challenge students to reconcile this knowledge and cohesively apply it to hypothetical cases in discussions on Twitter.
The medical school at Dundee University has been one of the forerunners in embracing social media by incorporating it into the curriculum. Both students and educators have been behind Twitter accounts spanning general medical education (@DUmeded), anaesthesia (@dundeegas), public health (@DundeePublicH), and medical ethics (@Dundee_Ethics). During the first year respiratory block students take part in a series of scenarios describing the development of a major flu pandemic. Students were asked how they would react to unfolding information relating to the pandemic under the hashtag #fluscenario, and members of the public were encouraged to join in and add to the scenario. Ellie Hothersall, consultant and undergraduate teaching lead for public health, says, “Using an online, interactive scenario gives students insight into pandemic influenza and emergency planning, areas that historically don’t get much coverage within the curriculum, although every doctor needs to understand them.”
Learning through Twitter challenges you to take what you have learnt in the classroom and apply it within a different environment, often together with medical students from around the world. The question now seems to be whether more medical schools will encourage a more formal link with this informal style of learning that develops students into self directed learners.
- Twitter for healthcare professionals: an introductory guide. Learn how to tweet and why you should consider doing so. www.dur.ac.uk/resources/public.health/leadingtransformation/event2/Twitter-For-HealthCare-Professionals.pdf.
1University of Manchester, Manchester, UK
Correspondence to: firstname.lastname@example.org
I thank Simon Carley, Richard Lee, Anne-Marie Cunningham, Ellie Hothersall, Helgi Johannsson, Sophie Bishton, and Fi Douglas for their insights.
Competing interests: I have read and understood BMJ policy on declaration of interests and declare that I am founder of @medfinalsrev, a Twitter based resource to help medical students revise for their final exams.
See also commentary by Rhys Davies doi:10.1136/sbmj.g4147
Provenance and peer review: Not commissioned; not externally peer reviewed.
- Holt R. Twitter in numbers. Telegraph 2013 Mar 21. www.telegraph.co.uk/technology/twitter/9945505/Twitter-in-numbers.html>.
- Healthcare Tweet Chats. Symplur: www.symplur.com/healthcare-hashtags/tweet-chats/.
- Grundlingh J, Harris T, Carley S. FOAM: the internet, social media and medical education. Emerg Med J 2013;(suppl):2-4.
- Cunningham AM. 10 reasons to have a social media presence. J R Coll Physicians Edinburgh 2013;43:318-22.
- Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AHS, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009;360:491-9.
- Gawande A. VA surgery study in 74 hsptls scaled checklist thru training. Electronic data & good ctrls. JAMA: Deaths cut 11%+. No Hawthorne. #twitjc. 3 Jul 2011. https://twitter.com/Atul_Gawande/status/87604887420026880.
- Twitter Finals Revision Group. Major trauma: ETA 5 Minutes (with Tweets), 2 June 2014. https://storify.com/twitfrg/major-trauma-eta-5-minutes.
- Lex J. International EM education efforts and e-learning. Free emergency medicine talks. http://freeemergencytalks.net/2012/08/joe-lex-international-em-education-efforts-e-learning/.
Cite this as: Student BMJ 2014;22:g4129