Since its launch in 2010, the image-sharing service Instagram has become one of the most popular social networks, with over 1 billion monthly active users [1]. Communication on Instagram relies on short videos, which are suitable for the current fast-paced lifestyle. Social media (SM) platforms have evolved into essential tools for the delivery of both formal and informal educational content [2]. A recent study revealed that health science students spend over 3 hours daily on SM, with 37% of this time dedicated to Instagram [3]. Additionally, a recent survey found that up to 90% of medical and health science students use SM for educational purposes [4].

The use of videos in medical education dates back to the 1960s [5]. Videos are an effective way of communicating knowledge, particularly in medical education [5,6]. Previous studies have demonstrated the effectiveness of videos as educational tools [7,8]. A systematic review found that adding video materials to existing higher education teaching methods significantly improved learning outcomes [9]. For example, compared to standard textbooks, watching a short instructional video before splinting led to faster learning and more successful procedural skills [10]. Video-based education has been shown to enhance knowledge acquisition in surgical training compared to traditional teaching methods [11].

Multimedia learning uses text, narration, pictures, or videos, engaging all senses and minimizing any extra words or pictures, and is suitable even for complex topics [12]. Microlearning involves acquiring knowledge or skills in smaller units [13]. Keeping with the multimedia learning principles and microlearning, 2 comparable eLearning programs on type 2 diabetes treatment were converted into media clips that were 30 to 180 seconds and distributed via SM [14]. The transition from eLearning programs to short SM clips increased participation in the programs by up to 100-fold compared to traditional eLearning programs [14]. An online application was created for emergency medicine guidelines covering 7 topics, for example, chest pain and headache, and was used during shifts by medical students [15]. With the application, they significantly enhanced the frequency and quality of emergency medicine education for undergraduate students in the emergency department [15]. From another standpoint, a family medicine program produced SM videos on evidence-based medicine topics to teach family medicine residents, resulting in significantly improved learner engagement and knowledge acquisition [16]. Although the principle of the cognitive theory of multimedia learning was established already in 2001 [17], it remains applicable to the current medical student Generation Z, as they favor visual and technology-enhanced learning methods [18].

As SM, and especially Instagram, is a widely used tool to share visual material, its educational potential has been recognized [4,19,20]. The use of SM in medical education [21] is a unique combination of open educational resources (OER); social networking; and with regard to videos, multimedia learning. Medical education on SM may use OER and enable just-in-time (JIT) learning to provide resources as needs arise rather than as prescheduled lessons [22]. Aligning with JIT’s on-demand accessibility, SM is well suited for educational purposes via smart devices, either to learn new materials or to revisit what has been learned before. Although OER in medical education is recommended, there are still several obstacles to its widespread use. Such barriers include copyright issues and, especially in clinical contexts, concerns over the use of patient data, photographs, and videos.

Instagram has been instrumental in surgical education, facilitating the sharing of procedural videos and resources to a broad audience while fostering collaboration among students and professionals [23]. Pathologists, in particular, have been active in using Instagram and static images. In previous studies, Instagram accounts developed for histology education demonstrated high usability (98% of respondents), increased learner confidence (95%), and were associated with improved final examination performance [20,24]. Furthermore, an Instagram-based dermatopathology course outperformed a more traditional Canvas platform–based course among a group of 40 dermatology residents [19]. These examples underscore Instagram’s potential to complement traditional learning methods.

SM has been described as promoting social isolation [25,26]. However, SM may also create a sense of communal belonging [27,28]. Interacting with other account followers and content creators by liking, asking, and answering questions in the comment section or through direct messaging is nowadays a new way of expressing sociability. Connectivism, a learning theory, explains learning and teaching in networks using modern technology [29]. It provides insights into using new technology to deliver knowledge, such as diversity, autonomy, openness, and connectivity [30], all of which seem to be fulfilled when using SM in medical education.

Systematic reviews have highlighted the benefits of integrating SM into medical education [31-33]. Despite the increase in research on SM as an educational resource, evidence remains limited regarding the types of content that maximize engagement on platforms like Instagram [34]. Previously, in studies on engagement, accounts have been created solely for study purposes [16,19,20,24]. There is a paucity of research on the engagement of educational SM posts in real-life medical education accounts.

Therefore, we analyzed engagement metrics for medical education posts from a real-world educational SM account using a cross-sectional design. We also aimed to identify the most engaging types of videos by analyzing several features, thereby providing real-life recommendations for effective medical education content on SM.

In this study, we analyzed the content of a real-life SM account focused on medical education to determine which types of content were most well received by followers. To the best of our knowledge, no previous studies have performed a longitudinal real-life content analysis of a similar Instagram account [23,31-33]. By focusing exclusively on videos, this study provides new insights into their educational value. We specifically studied videos shared on Instagram, which is an applicable platform for short instructional educational videos applying the principles of multimedia learning and microlearning [4,17,36].

Health promotion and awareness posts were particularly successful in reaching audiences, as they reached most accounts (health promotion and awareness vs clinical skills, P=.003; health promotion and awareness vs theory, P=.006; health promotion and awareness vs entertainment, P=.04). As the World Health Organization (WHO) recognizes, SM platforms provide unique opportunities for promoting health awareness and prevention [37]. Video-based educational interventions have previously been used to promote health awareness and prevention by professionals, researchers, and a variety of organizations [38,39]. For example, video interventions resulted in more targeted short-term health behaviors such as sunscreen adherence and breast self-examination, although the data are not uniform [39]. Our data support previous findings, as health promotional videos reached the widest audience. These videos could be integrated into broader organizational educational campaigns. Plasticsteacher’s health promotion and awareness videos were usually inspired by and produced to match SM trends, which could at least partially explain their popularity. There might be an opportunity to both educate students and spread medical knowledge by combining medical education with SM trends [21,29].

The median length of Plasticsteacher videos was 72 seconds, which is longer than the previously found average length of 33 seconds for medical posts on SM [40]. Health promotion and awareness videos, as well as entertainment videos, were significantly shorter than theory and clinical skills videos (health promotion and awareness vs theory, P=.006; health promotion and awareness vs clinical skills, P=.002; entertainment vs theory, P=.003; entertainment vs clinical skills, P=.002). We aimed to seek the optimal length for educational videos by assessing views, reaches, and relative watch time. Both the videos that were 60 seconds or less or more than 120 seconds were evenly reached and viewed, yet still statistically significantly better than videos that were 61 to 120 seconds (≤60 seconds vs 61-120 seconds, P=.02; >120 seconds vs 61-120 seconds, P=.02). However, the shorter videos (≤60 seconds) were watched significantly further when comparing the relative watch time (≤60 seconds vs 61-120 seconds, P=.003; ≤60 seconds vs >120 seconds, P=.002). Hence, the shortest videos (≤60 seconds) were most effective to deliver information, but longer videos (>120 seconds) were equally popular. Although previous qualitative and experimental studies have demonstrated that shorter videos were more engaging and university students were more inclined to rewatch videos [41], our study indicates that a variety of video lengths may be suitable for medical education on SM. The shortest video length in our study was 9 seconds, and the longest was 6 minutes and 16 seconds. Microlearning, which involves acquiring information in small units, serves as an emerging educational technique in medical education [36,42]. Depending on the literature, a microlearning lesson can be up to 5 minutes long or even up to 15 minutes in length, although students’ focus tends to decrease after 9 minutes [36]. On the basis of our findings, short videos, adhering to the principles of microlearning, could be used to help students prepare for exams, such as reviewing the key steps of surgical procedures.

Although health promotion and awareness videos were the most popular, clinical skills, theory, and entertainment videos performed equally well, with no significant differences in reach or views between these categories. Plasticsteacher is targeting medical students on surgical topics, with views having an IQR of 4708 to 8601, which may indicate that videos of all categories are seen as meaningful. Interestingly, the video implementation type—whether using human models, phantom models, or animations—did not significantly impact video popularity, suggesting that producing a variety of video types may be beneficial when planning educational content. Different visualization methods, such as animations for explaining surgical techniques or human models for realistic demonstrations, can complement each other and enrich the learning experience [17]. However, the data on whether video implementation influences popularity or educational outcomes remain limited in the current literature [31-33]. For reference, in SM marketing, pictures with human faces and filters received more reactions compared to pictures without human faces or those that were unfiltered [43].

Plasticsteacher publishes posts in Finnish, which we see as an explanation for 98% of followers being from Finland. Eighty-three percent of the followers were females, and the largest age group was 25 to 34 years, with 44% representation. The primary target population for Plasticsteacher is medical students, with a secondary focus on other health care professionals. A survey was conducted among 4th to 6th year Finnish medical students, with a median age of 25 years and an age range of 21-42 years [44]. Similar results have been surveyed in Austria, where the mean age of medical students was 24.7 years, with an age range of 21‐32 years [45]. Females have been over-represented in surveys of medical students, with 51% to 58% representation [44,45], but globally, as in Finland, professional care work is a female-dominated sector [46]. Based on the findings, we see that demographic data from Insights are in line with the followers Plasticsteacher is aiming to reach.

Videos on Instagram are easily accessible and provide a suitable platform for educational videos when needed [34]. The mobile app as a platform enables viewers to use videos for JIT learning to obtain information when needed [13]. It has been shown that a JIT learning–based mobile app enhanced the quality of medical education during on-call shifts in the emergency department [15]. Similarly, a short instructional video on splinting yielded better outcomes in terms of learning and skills [10]. Our analysis underlines the potential of Instagram videos as an educational tool, as 36% of views were replays, showing that, on average, more than half of the videos were watched again after the initial view.

Despite these strengths, this study has some limitations. The basis for parameter selection was that reached accounts and views could be seen as objective parameters for general popularity. Further, relative watch time may have indicated whether the video was considered beneficial by the viewer. The wide variability observed in reach, views, and watch times across categories may reflect the influence of Instagram’s algorithms, which can cause posts to go viral unpredictably [43]. As in most retrospective studies, the data were not comprehensive and caused limitations for result interpretations. The development of Instagram Insights analytics during the study period also meant that some metrics were not consistently available for older posts. For example, Insights provided total watch time and average watch time beginning September 27, 2022. Nevertheless, these limitations were systematic, considering all types of posts similarly and did not compromise the overall findings.

Additionally, follower metrics including followers’ age range, gender, and geographic data were visible for only the previous 90 days. A recent questionnaire study evaluated the engagement and impact of an educational veterinary Instagram account [47]. It demonstrated a high engagement rate and a positive impact on knowledge and practical skills among veterinary students [47]. Similar studies in the medical field would enable a more comprehensive analysis of followers, which was prevented by the Instagram Insight data limitation.

In conclusion, this study provides a unique analysis of video-based real-life educational content on Instagram. The study emphasizes the opportunity to produce high-quality medical content for the public without using actual patient data. The role of social media as a platform for medical education has been increasing [31-34], yet there remains a need to develop educational material that is evidence-based [2]. There is a clear gap in analytical research on this topic, in which this study stands out as a pioneering effort. Our findings highlight the effectiveness of short video length and health promotional content in engaging viewers, while also demonstrating the value of diverse video implementation types. We observed that demonstrative video content is well received by audiences. Health promotion content can serve as inspiration for medical professionals, and based on its founded effectiveness, it may be beneficial to incorporate such content into larger educational campaigns on SM. Short videos can be used in diverse ways on SM, such as summarizing key points on theoretical topics or reviewing key steps of procedures. Future studies should explore the impact of Instagram’s algorithms on variations in video popularity and further examine how different demographic groups engage with educational content. Such studies would support the development of a more targeted and effective approach to medical education content creation.