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The COVID-19 pandemic has brought virtual web-based learning to the forefront of medical education as training programs adapt to physical distancing challenges while maintaining the rigorous standards of medical training. Social media has unique and partially untapped potential to supplement formal medical education.
The aim of this review is to provide a summary of the incentives, applications, challenges, and pitfalls of social media–based medical education for both trainees and educators.
We performed a literature review via PubMed of medical research involving social media platforms, including Facebook, Twitter, Instagram, YouTube, WhatsApp, and podcasts. Papers were reviewed for inclusion based on the integrity and power of the study.
The unique characteristics of social media platforms such as Facebook, Twitter, Instagram, YouTube, WhatsApp, and podcasts endow them with unique communication capabilities that serve different educational purposes in both formal and informal education settings. However, contemporary medical education curricula lack widespread guidance on meaningful use, application, and deployment of social media in medical education.
Clinicians and institutions must evolve to embrace the use of social media platforms for medical education. Health care professionals can approach social media engagement in the same ethical manner that they would with patients in person; however, health care institutions ultimately must enable their health care professionals to achieve this by enacting realistic social media policies. Institutions should appoint clinicians with strong social media experience to leadership roles to spearhead these generational and cultural changes. Further studies are needed to better understand how health care professionals can most effectively use social media platforms as educational tools. Ultimately, social media is here to stay, influencing lay public knowledge and trainee knowledge. Clinicians and institutions must embrace this complementary modality of trainee education and champion social media as a novel distribution platform that can also help propagate truth in a time of misinformation, such as the COVID-19 pandemic.
Social media has become an integral vehicle for the delivery and dissemination of health care education. Although social media use has become ubiquitous among patients, health care practitioners have shown variable enthusiasm with regard to adoption and engagement within the social media realm. The COVID-19 pandemic has brought virtual web-based learning to the forefront of medical education as training programs adapt to physical distancing challenges while maintaining the rigorous standards of medical training. Social media offers unique and partially untapped potential to supplement formal medical education. Indeed, social media has also provided clinicians who must practice social distancing for public safety with an opportunity and virtual space for educational discourse, community, camaraderie, and support. Notably, contemporary curricula on the application, deployment, and professional etiquette of social media are lacking. In this review, we provide a summary of the incentives and applications of social media–based medical education for both trainees and educators. Likewise, we highlight the challenges and pitfalls of social media–based medical education.
We performed a literature review by searching PubMed for medical research studies involving social media platforms, including Facebook, Twitter, Instagram, WhatsApp, and podcasts. Papers were reviewed for inclusion based on the integrity and power of the study.
A social media platform is characterized as a web-based application that facilitates interactive creation and sharing of information and ideas through virtual communities. Facebook, Twitter, Instagram, YouTube, WhatsApp, and various podcast-hosting applications are among the most popular and established electronic communication tools and social media platforms. Each platform has its own individual smartphone mobile app with unique user interfaces. These individual platforms have variable degrees of flexibility and limitation on how content is posted. Twitter permits a total of 280 characters in a single tweet, whereas other platforms may be far more generous; for example, Facebook permits up to 63,206 characters in a single post. Images and videos are permitted on all platforms; however, the number of images and the permitted video length may differ between these platforms. Instagram is intentionally built to share images and short videos. YouTube is strictly built for videos and does not restrict video length. WhatsApp provides secure, encrypted messaging and sharing of audiovisual material capabilities within closed groups; however, it is restricted to mobile devices and does not have a traditional desktop, web-based user interface. These platform-specific parameters enable each social media platform to be used uniquely for different types of educational learning.
Critical to the global adoption of social media platforms is the parallel and complementary development of high-speed internet and smart devices, which laid the groundwork for their creation and global adoption. The ability to capture and share high-quality audiovisual media evolved from basic email and text messaging to dissemination of such media via social networks, with social network access transitioning from a computer interface to a smartphone interface. The prevalence of smartphone technology is undoubtedly widespread in the United States, with the estimated number of Americans who owned a smartphone rising from 56% in 2013 to 77% in 2017 [
Prior generations of physicians were apprehensive about engaging on social media out of concern about patient privacy, liability, lack of time, compensation, and familiarity with the technology; however, times are changing [
The advent of COVID-19 further catalyzed the adoption of social media platforms such as Twitter to more rapidly disseminate and spread information about an unknown and contagious disease directly to frontline reporters as new information unfolded. This was critical in many instances, such as providing guidance on helping health care workers to maintain safety during aerosolizing procedures like endotracheal intubation [
The COVID-19 pandemic also disrupted medical education. It forced medical schools and residency and fellowship training programs to adapt to how they educate their trainees. Aided by virtual platforms such as Zoom and Microsoft Teams, formal educational lectures, noon conferences, grand rounds, and even medical conferences have migrated onto the web to adapt to the “new normal” [
The use of Facebook by patients to access and share medical information for chronic disease management has been well studied, and these studies may provide insight into how closed Facebook groups can be harnessed for medical education [
The historically robust engagement of physicians with Twitter has led to several educational opportunities for medical trainees and attending physicians alike. Opportunities such as virtual case conferences, Twitter-based journal clubs, and “tweetorials” provide physicians with the ability to communicate with and learn from experts in their field whom they otherwise would not be able to access. For example, #MondayNightIBD is a weekly social media version of a multidisciplinary case conference. The weekly hashtag is used to identify discussion threads about the treatment or management of inflammatory bowel disease (IBD). It brings together clinicians from around the world to share their knowledge and research as it relates to a complex or controversial topic or situation [
Twitter-based journal clubs are similar to contemporary journal clubs. They exist across various medical specialties, including but not limited to internal medicine, radiology, nephrology, urology, and echocardiography [
A tweetorial is a collection of threaded tweets with the goal of educating those who read them [
As the field of medicine grows, new ways also grow for health care professionals and those in training to digest educational material. In formal medical education classrooms, didactic lectures still predominate. Residency and fellowship training programs as well as continuing education for attending physicians are often at least partly driven by case-based learning through direct patient care. These important teaching points that physicians experience daily are often difficult to translate into formal lectures; however, widely available smartphones and software applications such as WhatsApp are disrupting and enhancing modern medical education.
WhatsApp is a secure, encrypted messaging software app that is restricted to mobile devices [
Coleman and O’Connor’s scoping review [
The intuitive and interactive design and widespread use of Instagram create multiple teaching avenues for physician educators and learning opportunities for medical trainees. Sharing images to educate other health care professionals is not a new concept; however, the means and ease of doing so have changed. In 1992, the
Instagram is an ideal medium to share visually appealing teaching points, and it has been described in several specialties, including dermatology, plastic surgery, radiology, infectious disease, and cardiology [
For prospective medical students, Instagram Stories may show them a glimpse into the medical field to supplement formal shadowing opportunities. For medical students and resident physicians, Instagram can similarly supplement formal rotations to gain insight into various fields or niche specialties that they would otherwise not be exposed to in their current rotations. Moreover, learners can transcend geography, time zones, and schedules to engage and learn from educators whom they otherwise may not have had the opportunity to interact with. Importantly, this informal setting may also allow trainees to voice questions they may not otherwise feel comfortable asking. For educators, the Instagram platform can be used in parallel to complement formal didactic lectures, share unique and interesting cases, and continue to provide teaching points even after the formal lecture is complete.
Videos are an excellent medium to illustrate highly complex medical concepts. Signaling this potential, in 2006,
YouTube is the single largest video-sharing platform on the internet and is the leading free web-based source of videos used by students and health care workers worldwide [
Numerous medical YouTube channels already exist. Some individual physicians use their channels to teach the general public about various health issues, such as Dr Danielle Jones, an obstetrician/gynecologist who produces content on her channel at
Podcasts are ideal media for the delivery of medical education due to their relatively low cost, ease of access, and rapidity of distribution. Podcasts offer medical trainees the ability to learn at their own pace and can reinforce contemporary in-person lectures and can even foster more meaningful and engaging lectures. Podcasts are increasingly popular among medical trainees, with an increasingly more favorable perception over traditional books and journals [
Podcasts can have varying structure and focus. One popular podcast,
It remains difficult to objectively assess the clinical utility of podcasts in medical education [
First, we must acknowledge the prevalence and spread of misinformation on social media. This issue was present prior to the COVID-19 pandemic and is being exacerbated by it. Translating one’s credibility in the medical community is often difficult to replicate on social media. Similarly, accounts with large followings may not have verifiable credentials to provide medical education. For instance, an analysis of dermatological hashtag use on Instagram showed that only 5% of the top dermatology-related posts were created by board-certified dermatologists [
There are several limitations in our review. Formal medical education programs adapted enthusiastically to physical distancing requirements during the ongoing pandemic; however, the effectiveness of these virtual learning modalities has not been extensively studied. It remains unclear if social media or virtual learning modalities are applicable as a true substitute when in-person learning is limited. Similarly, it remains difficult to study the effectiveness of individual components of social media in medical education due to the multifactorial nature of medical education and the individual user variation of social media. However, the utility of various aspects of social media, including Instagram Stories, tweetorials, YouTube videos, and podcasts, is evident. Future studies should focus on guiding clinical educators on how to best use these platforms effectively and appropriately for their respective specialty. Even prior to the COVID-19 pandemic, an increasing number of health care professionals began engaging across social media platforms to provide informal medical education. However, the degree to which these web-based social media platforms will continue to be wielded for meaningful medical education following the eventual recovery from the pandemic is yet to be seen. Additionally, the trend toward the permeation of medical education across social media is apparent on platforms such as Reddit, TikTok, and Clubhouse; however, due to the limited availability of studies assessing educational content on these platforms, they were not included in our review.
For health care professionals, uniform training in proper use of social media is often insufficient. Many medical and educational institutions forbid active social media engagement by their trainees or provide vague guidelines on its use. As a result, unprofessional or perceived unprofessional behavior by health care professionals remains an ongoing issue. Organizations such as the Association for Healthcare Social Media and social media campaigns such as #VerifyHealthcare are concrete steps by health care organizations and individual professionals to combat this chronic issue [
Although these challenges are not new, they do complicate the already difficult task of using social media as an educational tool. As previously detailed, WhatsApp has been successfully integrated into formal medical school classes and informal cardiovascular disease fellow training [
Studies should isolate differences between educating health care professionals in various stages of training. We surmise that there will be specialty-specific variations with regard to ideal platforms as well.
Future social media studies should implement process-evaluation strategies to ascertain which specific aspects of social media have the greatest impact. A conceptual framework was developed to aid future researchers in establishing studies on social media. This framework, known as the Therapeutic Affordances of Social Media (TASoMe), is grounded by the biopsychosocial model, or the interconnection between biology, psychology, and socioenvironmental factors [
It also remains difficult to quantify the academic impact of physician engagement on social media. As health care professionals engage on social media, they will gradually redirect their time from other responsibilities. Unfortunately, contemporary criteria used by academic institutions to evaluate individuals for academic promotions and tenure may not fully encompass the impact of social media posts or publications [
Lastly, contemporary studies on Facebook in medical education focus on perceived digital professionalism and likely reflect generational attitudes toward social media [
Social media platforms may come and go, and their engagement patterns may fluctuate; however, their impact on modern society is incalculable. The seeds of social media were enriched by separate yet intertwined technological advances that served as the building blocks of a communication revolution and spawned these integrative and seemingly inescapable social media platforms. In a time period that requires novel communication and teaching methods, social media can put the “social” back into physical distancing and medical education. The characteristics of each social media platform endow them with unique communication capabilities that have never before been seen in telecommunication history. Their use as educational tools must be approached with accelerated caution and monitored as they are implemented. Further studies are needed to better understand how health care professionals can most effectively use social media platforms as educational tools. Health care professionals can approach social media engagement in the same ethical manner that they would with patients in real life; however, health care institutions ultimately must enable their health care professionals to do this by enacting realistic social media policies. Institutions should appoint clinicians with strong social media experience to leadership roles to spearhead these generational and cultural changes. Ultimately, social media is expected to play a permanent role in influencing lay public and trainee knowledge. Clinicians and institutions must evolve to embrace and champion these platforms to preserve educational integrity and public trust.
US Centers for Disease Control and Prevention
inflammatory bowel disease
New England Journal of Medicine
Therapeutic Affordances of Social Media
None declared.