Effective use of Twitter and Facebook in pathology practice

Smartphone assisted telepathology: A review

OBJECTIVES

Many practicing pathologists of the current generation have used smartphone-assisted telepathology at some point in time or the other. The use case may vary-second opinions, social media posts, teaching, and so on. This has largely been made possible by the recent improvements in smartphone cameras, better smartphone microscope adaptors, and faster internet. This review aims to provide insights into the different techniques, practical applications, limitations, and prospects of smartphone-assisted telepathology.

METHODS

We provide a ready reference for all practicing pathologists who want to use smartphone-assisted telepathology more effectively. The review is based on literature available on MEDLINE and personal observations and experiences.

RESULTS

Smartphone-assisted telepathology despite its limitations is here to stay. With the introduction of 5G internet, internet speeds are bound to improve. However, the extent of this improvement would ultimately decide how far the smartphone can disrupt the world of telepathology.

CONCLUSION

Learning to use the smartphone effectively for telepathology is important for all pathologists. It is a silent revolution that is slowly but surely changing the way pathologists interact with each other professionally.

Exploring the Impact and Prospects of Social Media in Advancing Pediatric Pathology

Social media has been recently highlighted as a unique and modern virtual force that allows for worldwide connection, collaboration, communication, and engagement between pathologists, trainees, and medical students. Much literature has been focused on the role of social media in recruitment and medical education practices of different pathology subspecialties, such as dermatopathology and hematopathology. However, current literature on pathology social media's status and potential future roles in promoting pediatric pathology is sparse. Herein, this review intends to narrow this knowledge gap by reviewing how social media has been utilized in different pediatric subspecialties, the current use of social media in pathology, and how the future of pediatric pathology social media use may look moving forward regarding education, research, and recruitment. Specific tips and related online resources are provided.

Ten Years of Pathology on Twitter (X): Landscape and Evolution of Pathology on Twitter From 2012 to 2023

CONTEXT.—

Social media is a powerful tool in pathology education and professional networking that connects pathologists and pathology trainees from around the world. Twitter (X) appears to be the most popular social media platform pathologists use to share pathology-related content and connect with other pathologists. Although there has been some published research on pathology-related activity on Twitter during short time frames, to date there has not been published research examining pathology-related Twitter activity in totality from its earliest days of activity to recently.

OBJECTIVE.—

To comprehensively evaluate the use of pathology on Twitter (X) during the last 10 years.

DESIGN.—

Pathology-related tweets were systematically scraped from Twitter from January 2012 to January 2023 using pathology hashtags as a surrogate measure for all pathology content on Twitter. COVID-related tweets were approximated by tweets containing the term "COVID."

RESULTS.—

There were 591 812 unique pathology-related tweets identified during the time period, with #pathology being the most common hashtag used and #PathTwitter becoming more popular since 2020. There has been positive annual growth of pathology Twitter, with peaks in use during major pathology conferences. During the initial phases of the COVID-19 pandemic, a sustained increase in pathology tweets was observed.

CONCLUSIONS.—

Pathology Twitter has grown during the last 10 years and has become increasingly popular for pathology education and networking. With the changing landscape of social media platforms, this study provides an understanding of how pathology medical education and professional networking uses of social media happen and evolve over time.

#PathArt: from glass slide to canvas; with a mission of enlightening the burdens of life

Pathology requires visual aptitude, pattern, and color recognition as a medical specialty. This can account for the growing PathArt (or #PathArt via social media, or SoMe) movement. For the purpose of this review, the authors define PathArt as any form of art inspired by pathology topics, such as microscopic images (i.e. surgical histology, cytology, hematology, immunohistochemistry), gross pathology, and clinical pathology (including molecular/genetics). Pathologists are well-versed in the use of hashtags and commonly utilize them to tag relevant medical topics to share with colleagues through online platforms, such as Twitter (renamed X in 2023). As the professional laboratory network has expanded virtually, artists within the community have emerged and shared numerous pathology artworks. However, displaying pathology as "beautiful" art pieces gives rise to concerns over portraying cancer light-heartedly given the humanity of disease. For this review, we discuss the history of art and medicine, pathology as a visual and creative specialty, explore the conceptual framework of the hashtag #PathArt is associated with sharing pathology-related art on SoMe, and address the psychological and medico-legal implications that surround PathArt. This article is intended to provide a guide to fostering PathArt and #PathArt in an ethical and positive manner. References were obtained via qualitative review of non-peer-reviewed and peer-reviewed literature pertinent to this topic.

Is Social Media Here to Stay?: Survey Results Indicate Increasing Pathologist Interest and Engagement Over Time

CONTEXT.—

Social media has become widely adopted by pathologists and other physicians for professional purposes. While engagement has likely increased over time, there remain few concrete data regarding attitudes toward its use.

OBJECTIVE.—

To assess pathologists' use of and attitudes toward social media over time.

DESIGN.—

We created a survey regarding personal and professional use of social media and circulated it via multiple channels in December 2017 and again in February 2022. Results of the 2 surveys were compared for statistically significant differences.

RESULTS.—

The 2017 survey was completed by 97 participants, and the 2022 survey by 305 participants. Respondents were predominantly female and academics, included pathologists in all age categories and all time-in-practice length. In both surveys, Twitter (now X) was the most popular platform for professional use and Facebook was the most popular for personal use. Professional barriers to social media use remained consistent between the 2 surveys, including the amount of time required. Education was seen as the main benefit of social media use in both surveys, while other benefits such as networking and increasing professional visibility were endorsed significantly less often in the second survey. While the second survey received more than 3 times as many responses as the first, several aspects of social media use (mainly demographics) remained similar during the timeframe, while other aspects (such as usage and perceived values) decreased.

CONCLUSIONS.—

Pathologists continue to find social media valuable. Barriers remain, though overall pathologists of all ages and practice settings appear receptive to using social media to further educational and other opportunities.

Assessment of Pathology Domain-Specific Knowledge of ChatGPT and Comparison to Human Performance

CONTEXT.—

Artificial intelligence algorithms hold the potential to fundamentally change many aspects of society. Application of these tools, including the publicly available ChatGPT, has demonstrated impressive domain-specific knowledge in many areas, including medicine.

OBJECTIVES.—

To understand the level of pathology domain-specific knowledge for ChatGPT using different underlying large language models, GPT-3.5 and the updated GPT-4.

DESIGN.—

An international group of pathologists (n = 15) was recruited to generate pathology-specific questions at a similar level to those that could be seen on licensing (board) examinations. The questions (n = 15) were answered by GPT-3.5, GPT-4, and a staff pathologist who recently passed their Canadian pathology licensing exams. Participants were instructed to score answers on a 5-point scale and to predict which answer was written by ChatGPT.

RESULTS.—

GPT-3.5 performed at a similar level to the staff pathologist, while GPT-4 outperformed both. The overall score for both GPT-3.5 and GPT-4 was within the range of meeting expectations for a trainee writing licensing examinations. In all but one question, the reviewers were able to correctly identify the answers generated by GPT-3.5.

CONCLUSIONS.—

By demonstrating the ability of ChatGPT to answer pathology-specific questions at a level similar to (GPT-3.5) or exceeding (GPT-4) a trained pathologist, this study highlights the potential of large language models to be transformative in this space. In the future, more advanced iterations of these algorithms with increased domain-specific knowledge may have the potential to assist pathologists and enhance pathology resident training.

Learning at a distance: results of an international survey on the adoption of virtual conferences and whole slide imaging by pathologists

AIMS

This study presents the findings of a global survey of pathologists' views of online conferences and digital pathology.

METHODS

An online anonymous survey consisting of 11 questions focusing on pathologists' perceptions of virtual conferences and digital slides was distributed to practising pathologists and trainees across the globe using the authors' social media accounts and professional society connections. Participants were asked to rank their preference for various aspects of pathology meetings on a 5-point Likert scale.

RESULTS

There were 562 respondents from 79 countries. Several advantages of virtual meetings were recognised, including that they are less expensive to attend than in-person meetings (mean 4.4), more convenient to attend remotely (mean 4.3) and more efficient due to no loss of time for travel (mean 4.3). The lack of networking was reported as the main disadvantage of virtual conferences (mean 4.0). Most respondents (n=450, 80.1%) preferred hybrid or virtual meetings. About two-thirds (n=356, 63.3%) had no concern regarding the use of virtual slides for educational purposes and viewed them as an acceptable substitute for glass slides.

CONCLUSIONS

Online meetings and whole slide imaging are viewed as valuable tools in pathology education. Virtual conferences allow affordable registration fees and flexibility for participants. However, networking opportunities are limited, meaning in-person meetings cannot be entirely replaced by virtual conferences. Hybrid meetings may be a solution to maximise the benefits of both virtual and in-person meetings.

Cytopathology in the era of social media

In today's medical landscape, social media (SoMe) platforms have expanded their reach beyond mere communication and entertainment, making a significant impact in the pathology field, including cytopathology. In recent years, SoMe platforms have become increasingly adopted by cytopathologists, facilitating continued education, professional networking, enhancing patient engagement, and entertainment. This adoption has influenced the professional growth of cytopathologists, and at its best, has led to the establishment of a robust professional online presence and ultimately contributed to leadership positions, fellowship opportunities, and academic promotions. Moreover, the integration of SoMe into the academic field has shown a profound impact on the visibility of academic journals and has provided a platform for lower-impact factor journals to expand their reach, ultimately increasing article citation rates and positively contributing to journal impact factor growth. SoMe platforms created a modern avenue for conference networking that has revolutionized knowledge dissemination and enhanced real-time engagement. The advantages of SoMe have extended to a global scale, positively enhancing professional expertise sharing, facilitating effective communication and teleconsultation worldwide, and reaching developing countries. Drawing insights from the recent medical literature and the practical insight from the experts' personal experience, this article provides a comprehensive review of how SoMe and cytopathology intersect to create new opportunities, facilitating informed discussions, global collaboration, and advancements in the field of cytopathology. This article also delves into the challenges surrounding SoMe platform navigation and addresses ethical and regulatory concerns, providing guidelines on what to post and what not to post on SoMe platforms.

#PathX: #PathTwitter's Transformation and a Discussion on Different Social Media Platforms Used by Pathologists in 2024

#PathTwitter is a well-known virtual community that has historically been positive for pathologists, trainees, and medical students worldwide to communicate, collaborate, and connect for free. However, in 2023, the popular social media platform Twitter (parent company: X Corp.) transitioned to "X" and, with this, #PathTwitter evolved into #PathX. Although the overall user experience of X and Twitter has not changed significantly, this transition brought much anecdotal hesitancy from the online virtual pathology community early on. Thus, the purpose of this review is to discuss the background of Twitter's importance in pathology, the implications of this transition to the online pathology community, current views from this community regarding Twitter versus X, and to provide an overview of pertinent changes in the platform, as well as of different popular social media platforms that may be used by pathologists in 2024.

A Reassessment of the Impact and Significance of Social Media to Pathology

CONTEXT

Social media (SM) use in pathology and medicine today is widespread, receives active advocacy, and is said to bring a host of benefits. In latter days, the harmful effects of SM have received attention, but they have yet been followed by greater encouragement of professionalized SM usage. SM use in medicine has seen adoption in parallel to its general ascendancy, even though the platforms are products with purposes misaligned with the practice of medicine.

OBJECTIVE

To (1) characterize premises and forces that propel professional SM platform adoption and use, and (2) examine wide-ranging literature, both medical and nonmedical, that substantiates the premises and to find counteracting perspectives and evidence.

DATA SOURCES

Review of the literature using relevant keyword searches in PubMed, Google Scholar, Dimensions, and Web of Science for articles that study/describe professional SM use in pathology and medicine. Additionally, we examined business, technology, and social sciences literature and high-quality gray literature (newspapers, books, blogs) that addressed questions in relation to the topic of professional SM adoption.

CONCLUSIONS

We identified 6 major premises as motivators of professional SM use and highlight significant counteracting factors. We conclude that the harms of professionalized SM use have not been fully considered in the medical literature and that a change in direction and the creation of new communication platforms would be beneficial.

Proper Tweeting Etiquette Guidelines for Pathologists, Trainees, and Medical Students on #PathTwitter

The use of social media in pathology has broadly had a positive impact on pathology education and outreach with the frequent posting of high-quality educational material of potential value to trainees, practicing pathologists, and other clinical and laboratory specialists. These posts are also of potential utility and interest to members of the public, who are now more than ever able to gain a window into the field and the role of pathologists in their medical care. There can be a lighthearted aspect to teaching material with the use of food items/analogies, emojis, or other descriptors, which may cross over into the classroom. However, when pathology discussion is taken to a public forum, such as on Twitter (parent company: X Corp.), there is the potential for posted material to be misunderstood, such as when certain emojis or adjectives may be used to describe a human disease state or patient sample. The authors present examples of potential areas of caution, suggestions of how to create a positive impact, and brief guidelines for social media etiquette on #PathTwitter that may apply to other social media platforms widely used by pathologists (including, but not limited to, Facebook, Instagram, YouTube, and KiKo). While the points discussed here may be common knowledge and well-known to pathologists who use social media for virtual medical education, the concerns mentioned here (such as using language like "beautiful" to describe abnormal mitotic figures and cancer cells) still exist and, henceforth, bear reinforcing.

Evolving educational landscape in pathology: a comprehensive bibliometric and visual analysis including digital teaching and learning resources

AIMS

Pathology education is a core component of medical training, and its literature is critical for refining educational modalities. We performed a cross-sectional bibliometric analysis to explore publications on pathology education, focusing on new medical education technologies.

METHODS

The analysis identified 64 pathology journals and 53 keywords. Relevant articles were collected using a web application, PaperScraper, developed to accelerate literature search. Citation data were collected from multiple sources. Descriptive statistics, with time period analysis, were performed using Microsoft Excel and visualised with Flourish Studio. Two article groups were further investigated with a bibliometric software, VOSViewer, to establish co-authorship and keyword relationships.

RESULTS

8946 citations were retrieved from 905 selected articles. Most articles were published in the last decade (447, 49.4%). The top journals were Archives of Pathology & Laboratory Medicine (184), Human Pathology (122) and the American Journal of Clinical Pathology (117). The highest number of citations was found for Human Pathology (2120), followed by Archives of Pathology & Laboratory Medicine (2098) and American Journal of Clinical Pathology (1142). Authors with different backgrounds had the greatest number of articles and citations. 12 co-authorship, 3 keyword and 8 co-citation clusters were found for the social media/online resources group, 8 co-authorship, 4 keyword and 7 co-citation clusters for the digital pathology/virtual microscopy/mobile technologies group.

CONCLUSIONS

The analysis revealed a significant increase in publications over time. The emergence of digital teaching and learning resources played a major role in this growth. Overall, these findings underscore the transformative potential of technology in pathology education.

A visual-language foundation model for pathology image analysis using medical Twitter

The lack of annotated publicly available medical images is a major barrier for computational research and education innovations. At the same time, many de-identified images and much knowledge are shared by clinicians on public forums such as medical Twitter. Here we harness these crowd platforms to curate OpenPath, a large dataset of 208,414 pathology images paired with natural language descriptions. We demonstrate the value of this resource by developing pathology language-image pretraining (PLIP), a multimodal artificial intelligence with both image and text understanding, which is trained on OpenPath. PLIP achieves state-of-the-art performances for classifying new pathology images across four external datasets: for zero-shot classification, PLIP achieves F1 scores of 0.565-0.832 compared to F1 scores of 0.030-0.481 for previous contrastive language-image pretrained model. Training a simple supervised classifier on top of PLIP embeddings also achieves 2.5% improvement in F1 scores compared to using other supervised model embeddings. Moreover, PLIP enables users to retrieve similar cases by either image or natural language search, greatly facilitating knowledge sharing. Our approach demonstrates that publicly shared medical information is a tremendous resource that can be harnessed to develop medical artificial intelligence for enhancing diagnosis, knowledge sharing and education.

Fellowship Board Pass Rates Rising: Analysis of Pathology Subspecialty Board Examination Performance

CONTEXT.—

The American Board of Pathology (ABPath) publishes annual performance data for the anatomic pathology (AP) and clinical pathology (CP) board examinations, as well as for ABPath subspecialty examinations. Overall board pass rates for all AP and CP board examinees have increased during the past decade; however, no study has analyzed the board pass rates for pathology subspecialty examinations, and whether these follow the same trend.

OBJECTIVE.—

To evaluate ABPath subspecialty examination pass rates to assess the trend in certification.

DESIGN.—

We analyzed the total number of first-time test takers and board pass rates for 11 pathology subspecialties recognized by the ABPath from 2007 to 2021, acquired from annual reports published by the ABPath. We compared the pass rates in 5-year intervals (2007-2011, 2012-2016, 2017-2021) for each individual specialty. We also analyzed the pass rate of CP subspecialties compared with AP subspecialties.

RESULTS.—

The overall mean pass rate for ABPath subspecialty examinations during the previous 15 years was 89% (range, 78.9%-100%), with the overall pass rate being significantly higher in 2017-2021 (P = .02). The contemporary overall rate of passing was significantly higher for AP subspecialty examinations (P < .001) and was higher, though not significantly, for CP subspecialties (P = .13). There were significant differences between first-time test takers' mean pass rate (92.1%), repeat test takers' mean pass rate (54.5%), and the overall rate (P < .001).

CONCLUSIONS.—

Contemporary pathology subspecialty board examination pass rates are significantly higher than historic rates, possibly reflecting continuously improving and readily available preparatory materials.

A Scoping Review of Physician Advocacy on Twitter

Twitter has been adopted by physicians across most medical specialties; it allows for the wide dissemination of information and calls to action, brings new stakeholders into collations, promotes academic engagement, and fosters collaboration between academia and private practice. In this review of the literature, we briefly outline the state of advocacy in health care and summarize current Twitter-based advocacy efforts in the major specialties of health care, identifying both successful strategies as well as gaps in Twitter advocacy research. Relevant articles were obtained via PubMed and Google Scholar searches using the phrases "Twitter advocacy healthcare," "[specialty name] Twitter" and "[specialty name] Twitter advocacy." Several overarching themes were found to be widely utilized in specialty-specific discussions of Twitter advocacy efforts: organizing under a specific hashtag, fostering dialogue between stakeholders, and tweeting using personalized, action-oriented language. Fields such as pediatrics, heme/onc, ENT, and ophthalmology have most thoroughly embraced the desire to learn how to most effectively advocate on Twitter. Other fields such as OBGYN, cardiology, and surgery have less academic focus on online advocacy. Outside of advocacy efforts, the research and academic benefits of Twitter are well described in nearly every specialty. In conclusion, while clinicians are encouraged to advocate online, only broad strategies for online engagement are currently offered. Additional research into the details of how to successfully create an online profile and Twitter presence is needed to ensure all physicians are able to maximize their advocacy efforts, with clarification of the goals and objectives of this engagement also required.

Impact of COVID-19 Pandemic on Pathology Residents/Trainees in North America: A Survey-Based Study

Background The COVID-19 pandemic has had a significant impact on resident training and education in the field of Pathology. This study aims to identify the tangible effects and resultant changes in education for Pathology trainees that have resulted from the pandemic. Design An electronic survey regarding Pathology trainee perceptions and experiences in relation to COVID-19 was created via Google Forms. The questionnaire was distributed to the pathology trainees via Twitter and email. The survey was also shared with all Pathology residency program coordinators across the USA and Canada. Results One hundred forty-five trainees responded to the questionnaire. 37.6% reported a significant decrease in specimen volume, whereas 43.3% reported a slight decrease in specimen volume. 18.3% reported the cancellation of educational lectures before shifting to a virtual platform for didactic purposes. However, 74.6% reported shifting all educational activities to virtual platforms. 35% cited cancellations of grand rounds, whereas 18.2% reported cancellations of grand rounds led by guest speakers. 53.5% took COVID-19 tests, and 22.7% were quarantined. 100% reported a change in sign-out culture. Conclusions This pandemic has significantly impacted pathology training in various aspects, including training, education, and well-being. Residents harbored anxiety and stress regarding board exam delays or uncertainties, inadequate exam preparation time, family separation, and compromised safety. The exact quantification of educational loss varied from program to program. A significant decrease in specimen volume and detrimental changes in sign-out culture are indicators of compromised resident education due to the pandemic. This pandemic has extended the use of digital pathology and virtual platforms to a higher extent. Free virtual educational resources provided by various pathology organizations were critically important interventions during this pandemic, contributing to resident education. The pandemic has shown that developing a comprehensive infrastructure to overcome the loss of educational opportunities is of paramount importance to alleviate stress and anxiety among trainees.

Decline of case reports in pathology and their renewal in the digital age: an analysis of publication trends over four decades

AIMS

We investigated the trend in case reports (CRs) publication in a sample of pathology journals. Furthermore, we proposed an alternative publishing route through new digital communication platforms, represented by the 'social media case report'.

METHODS

28 pathology journals were selected from SCImago database and searched in PubMed to identify the number of published CRs. Four reference decades (1981-2020) were selected. The 5-year impact factor (IF) was retrieved from the Academic Accelerator database.

RESULTS

CRs increased during the first three decades (6752, 8698 and 11148, respectively; mean values: 355, 27.3%; 334, 26.4%; 398, 28.8%) as the number of CR-publishing journals (19, 26 and 28, respectively). In the last decade, CRs significantly decreased (9341; mean 334, 23.6%) without variation in the number of CR-publishing journals (28). Half of the journals reduced CRs (from -1.1% to -37.9%; mean decreasing percentage -14.7%), especially if active since the first decade (11/14, 79%); the other half increased CRs (from +0.5% to +34.2%; mean increasing percentage +11.8%), with 8/14 (57%) starting publishing in the first decade. The 5-year IF ranged from 0.504 to 5.722. Most of the journals with IF ≥2 (10/14, 71%) reduced the CRs number, while 71% of journals with IF <2 increased CRs publication (especially journals with IF <1, +15.1%).

CONCLUSIONS

CRs publication decreased during the last decade, especially for journals which are older or have higher IF. Social media CRs may represent a valid alternative and by using standardised templates to enter all relevant data may be organised in digital databases and/or transformed in traditional CRs.

How to begin using social media for transfusion medicine education

This article highlights fundamentals that are important for the transfusion medicine educator to understand about social media. Several examples of personal practical application are shared. Finally, the potential future state of social media will be discussed. In the spirit of a growth mindset, please suspend any previous judgements about social media and allow yourself to consider the possibility of using social media with your transfusion education.

Challenges and Opportunities in Using Twitter as a Pedagogical Tool in Pathology and Laboratory Medicine Education

OBJECTIVES

Even though the benefits of using Twitter for teaching and information exchange within the pathology community are primarily undisputed, a fair number of users refrain from sharing educational content on this social media platform. The survey aims to identify challenges in using Twitter as a pedagogical tool and discuss ways of converting those challenges into opportunities.

METHODS

We performed a cross-sectional survey-based study involving 174 participants from the pathology community on Twitter.

RESULTS

The results demonstrated that procurement of content was the major challenge faced by 36.2% of the participants, with most participants being concerned or very concerned regarding institutional policies and Health Insurance Portability and Accountability Act issues. Content procurement concerns were followed by social media inertia, stated by 23% of the participants as an obstacle to posting educational content on Twitter.

CONCLUSIONS

The report helps elicit some common obstacles faced by the pathology and laboratory medicine community and allows us to recommend solutions to overcome these obstacles.

The Influence of Social Media in Promoting Knowledge Acquisition and Pathology Excellence in Nigeria

The use of social media has evolved from platforms designed primarily for social connection and news sharing to include vibrant virtual academic environments. These platforms allow pathologists from across the globe to interact, exchange knowledge, and collaborate. Pathology in Nigeria, as in much of Africa, faces severe knowledge and practice gaps, with a lack of supporting modern laboratory infrastructure. Social media represents a potentially highly valuable avenue to help address some of these deficiencies. In this Perspective piece, we highlight our experience with the increasing role of social media in providing quality medical education in pathology globally, with an emphasis on how it bridges many of these gaps in Nigeria. Social media sites serve as sources of readily accessible, free, high-quality information to pathologists and trainees through academic discussions, quizzes, journal clubs, and informal consultations. They also provide opportunities for professional networking and research collaborations. Despite the availability and wide reach of these platforms, social media as a tool for advancement of knowledge in pathology is still undersubscribed in this part of the world. Improving awareness of and support for these tools will ideally help mitigate some of the challenges of practicing pathology in low and middle-income settings.

Research Techniques Made Simple: Scientific Communication using Twitter

The scientific process depends on social interactions: communication and dissemination of research findings, evaluation and discussion of scientific work, and collaboration with other scientists. Social media, and specifically, Twitter has accelerated the ability to accomplish these goals. We discuss the ways that Twitter is used by scientists and provide guidance on navigating the academic Twitter community.

The "Make Surgical Pathology Easy" project: learning Pathology through tailored digital infographics - the case for renovation of an old teaching method

The term ‘infographics’ is a blend of the two words “information” and “graphics”. Infographics can be described as ‘information visualizations’, conceived as visual translation of data including text, numbers, graphs, charts, drawings and so on. Visual representations are a fundamental part of scientific communication. They match the need to organize different pieces of information in a coherent and synthetic structure and constitute one of the most effective methods scientists rely on to divulge their findings. In particular, infographics provide an overview of key points regarding specific topics in a form that promotes quick learning and knowledge retention. They can be presented in printed or digital formats, being the latter particularly suitable for a global-scale diffusion via social media or websites.

In recent years, many pathologists have started developing digital infographics as a strategy for providing free educational contents on Facebook, Twitter or websites. In the present review, we focus on the value of digital infographics to summarize various aspects of Surgical and General Pathology. They shed light on diagnostic criteria, differentials and predictive/prognostic markers for many diseases, being a useful learning tool both for residents and practicing pathologists. In this paper, the model of infographics ideation, processing and sharing to an online audience is described and the impact of infographics on knowledge processes in Pathology is investigated.

Next-Generation Scholarship: Rebranding Hematopathology Using Twitter: The MD Anderson Experience

Hematopathologists are witnessing very exciting times, as a new era of unsurpassed technological advances is unfolding exponentially, enhancing our understanding of diseases at the genomic and molecular levels. In the evolving field of precision medicine, our contributions as hematopathologists to medical practice are of paramount importance. Social media platforms such as Twitter have helped facilitate and enrich our professional  interactions and collaborations with others in our field and in other medical disciplines leading to a more holistic approach to patient care. These platforms also have created a novel means for instantaneous dissemination of new findings and recent publications, and are proving to be increasingly useful tools that can be harnessed to expand our knowledge and amplify our presence in the medical community. In this Editorial, we share our experience as hematopathologists with Twitter, and how we leveraged this platform to boost scholarly activities within and beyond our subspecialty, and as a powerful medium for worldwide dissemination of educational material and to promote our remote teaching activities during the COVID-19 pandemic.

The Network That Never Sleeps

This review describes how Twitter is currently used by laboratory professionals for education, research, and networking. This platform has a global audience. It enables users to post information publicly, easily, rapidly, and free of charge. The absence of hierarchies enables interactions that may not be feasible offline. Laboratory professionals teach thousands of people using text, images, polls, and videos. Academic discussion flourishes without paywalls. Published research is shared faster than ever before, articles are discussed in online journal clubs, and research collaborations are facilitated. Pathologists network globally and make new friends within and beyond their specialty. Pathology departments and residency programs showcase trainees and faculty and celebrate graduations. As users in one time zone go to bed, others who are just waking up begin to read and tweet, creating a 24/7/365 live global online conference. We encourage others to plug into the power of Twitter, the network that never sleeps.

Overcoming Educational Challenges and Impact of COVID-19 in a Pathology Residency Program

Our program in is a 4-year combined anatomic pathology (AP) and clinical pathology (CP) program located in New Hampshire. Prior to the novel coronavirus (COVID-19) pandemic, double-headed sign-outs and multi-headed scope didactic conferences took place daily. On the autopsy service, cases were performed in-house under attending supervision, and forensic cases were performed at the off-site Office of the Medical Examiner. In CP, residents engaged in weekly didactic CP lectures and engaged in in-person resident-attending discussions, laboratory rounds, and direct patient contact on a daily basis. Institutional Universal Guidelines from the Emergency Order from New Hampshire were imposed at the beginning of the pandemic. These included exposure mitigation and employee screening strategies. Changes to resident rotations and didactic sessions, strategies to maintain resident wellness, and the program director perspectives are described. Amid the pandemic, digital pathology, teleconferencing platforms, and social media became important resources for pathology education. Digital platforms allowed groups of people to communicate and watch live presentations while social distancing. In AP, whole slide imaging allowed both attendings and residents to scan slides for personal learning, slide conferences, and didactic learning sessions. Following these measures, we supported the clinical needs of our medical center and learning needs of our residents while enacting social distancing and prevention guidelines early in the pandemic. Although the full impact of COVID-19 on pathology residency programs is still unknown, we incorporated new facets of communication technologies. These were immensely helpful in maintaining social distancing and helping to reduce the spread of disease.

Leveraging Technology for Remote Learning in the Era of COVID-19 and Social Distancing

The ongoing global pandemic of coronavirus disease 2019 (COVID-19) has rapidly disrupted traditional modes of operation in health care and education. In March 2020, institutions in the United States began to implement a range of policies to discourage direct contact and encourage social distancing. These measures have placed us in an unprecedented position where education can no longer occur at close quarters-most notably, around a multiheaded microscope-but must instead continue at a distance. This guide is intended to be a resource for pathologists and pathologists-in-training who wish to leverage technology to continue collaboration, teaching, and education in this era. The article is focused mainly on anatomic pathology; however, the technologies easily lend themselves to clinical pathology education as well. Our aim is to provide curated lists of various online resources that can be used for virtual learning in pathology, provide tips and tricks, and share our personal experience with these technologies. The lists include videoconferencing platforms; pathology Web sites; free online educational resources, including social media; and whole slide imaging collections. We are currently living through a unique situation without a precedent or guidebook, and we hope that this guide will enable the community of pathology educators worldwide to embrace the opportunities that 21st century technology provides.

Smartphone-assisted tele-gynepathology: A pilot study

INTRODUCTION

Traditional telepathology techniques like whole slide imaging require expensive equipment and are currently out of reach of the developing countries. However, the improvements in smartphone camera resolution and availability of faster internet have made smartphone-assisted telepathology possible.

METHODS

A total of 186 cases pertaining to gynecologic pathology reported by single consultant (NT) were retrieved from the records of the histopathology department. A trained histopathologist then photographed representative areas of each case by using the smartphone camera. After a wash off period of 6 months, the images along with the clinical details were sent by Whatsapp Messenger to the same reporting pathologist. The reporting pathologist replied with the diagnosis of each case by using Whatsapp.

RESULTS

The smartphone diagnosis was concordant in 179/186 (96.2%) cases. The intraobserver concordance rates varied with the organ involved - it was highest for endometrial and myometrial pathology (123/126, 97.6%) lowest for ovarian lesions (08/10, 80%). For cervical pathology, it was 97.2% (35/36) and for fallopian tube pathology it was 92.9% (13/14).

CONCLUSION

Although the initial results of this pilot study are encouraging, there is a long way to go before smartphone-assisted telepathology can be put to routine use for the second opinion. More experience of the pathologists with this technique and faster internet and better smartphone cameras will further improve the concordance of smartphone-assisted telepathology diagnosis with conventional microscopy diagnosis.

Social media trends in dermatology, dermatopathology, and pathology publications: The social construction of medical subdisciplines

BACKGROUND

An increase in the number of publications on social media has paralleled the growth of social media use in the past decade. Our study examined the trends in these publications relating to the fields of dermatology, pathology, and dermatopathology.

METHODS

PubMed was searched for relevant literature from 2009 to present, using the following key terms: "social media", "dermatology", "dermatopathology", and "pathology." Topics of articles, years of publication, countries of origin, and contributing journals were compiled and analyzed.

RESULTS

A total of 99 publications was retrieved during the period between January 2009 and November 2019. Top publication years included 2019 (n = 21), 2018 (n = 24), 2017 (n = 20), and 2016 (n = 13). The most common topic areas noted were related to dissemination of information (n = 17; 17.2%), knowledge exchange for physicians (n = 16; 16.2%), and social networking (n = 15; 15.2%).

CONCLUSION

The number of published articles on social media in these specialties has increased since 2009, signifying the widespread use of social media for professional networking, knowledge exchange, real-time communication with patients and colleagues, and patient care. Social media in the areas of dermatology, dermatopathology, and pathology has undergone social construction during the past decade because of changes in technology and ideologies surrounding the use of social media within medicine.

Using a Facebook group to facilitate faculty-student interactions during preclinical medical education: a retrospective survey analysis

BACKGROUND

Strong learner-teacher relationships are associated with more successful learning outcomes. With shortened modular curricula and increased availability of online resources, fostering faculty interaction with preclinical medical students has become more challenging. We sought to enhance learner-teacher relationships by engaging in discussion with preclinical medical students in their own online space.

METHODS

We utilized a closed Facebook discussion group, where faculty and students voluntarily joined in informal discussions and shared announcements related to their courses. The closed discussion group allowed only participating students and faculty to see others' posts within the group. This provided a platform to freely interact within the confines of the group while maintaining privacy for the personal Facebook accounts of both faculty and students. We utilized the discussion group through three separate organ system-based modules for 14 weeks. Afterward, students were asked to complete an anonymous, voluntary online survey about their experience.

RESULTS

94.1% (160/170) of enrolled second-year medical students joined the voluntary FB discussion group. There were 214 posts, 628 comments, and 4166 reactions in this discussion group during the three modules. Of the students in the group, 74.4% (119/160) responded to the online survey. Overall, students strongly agreed that the Facebook discussion group fostered better rapport with faculty, helped content learning, and improved emotional well-being. Also, they felt more comfortable seeking academic help after using the discussion group. They reported a slight preference for Facebook over email as a medium for asking questions, but no preference for either as a medium for distributing announcements. Students overwhelmingly recommended that the discussion group should be continued in future years.

CONCLUSION

The Facebook discussion group was a free, efficient, and effective method of cultivating the learner-teacher relationship with the preclinical medical students, resulting in reported enhancement of learning and morale.

Analyzing the relationship between Altmetric score and literature citations in the Implantology literature

BACKGROUND

The influence of research has long been studied using citations and impact factors (IFs). Electronic media is changing how people interact with the scientific literature. There are few investigations into these trends.

PURPOSE

To explore whether Altmetrics correlate with traditional bibliometrics in the Implantology literature.

MATERIALS AND METHODS

Five Implantology journals with the highest IF and the 10 most highly-cited articles within those journals from 2013 to 2016 were reviewed. Altmetric score, citation count, and media "mentions" were recorded. Comparisons were conducted between Altmetric score, citations, and IF by performing Pearson correlation coefficients and descriptive statistics. Twitter accounts were studied and compared to other metrics.

RESULTS

Analysis revealed no correlation between citations and Altmetrics (r = .096,P = .506) or IF and Altmetrics (r = .111,P = .443) in 2013. Altmetrics were also not significantly correlated with citations (r = 0.148,P = .305) or IF (r = .145,P = .315) in 2016. Total Altmetric scores were nine times higher in 2016 compared to 2013, with news outlets and Twitter seeing large increases in mentions. Twitter was the top medium receiving mentions across the two cohorts.

CONCLUSIONS

Compared to other fields, Implantology articles received lower Altmetric scores, noting an area of improvement. Altmetrics at this time are insufficient to replace traditional bibliometrics, but may provide helpful real-time information concerning article dissemination.

[Pathologist versus social media: A survival guide]

Social networks have changed the communication tools among healthcare professionals, enabling instantaneous and globalized sharing and monitoring of information. While more and more pathologists are taking advantage of these tools, some do not yet know them well, or have concerns about their use. These platforms have many advantages and the potential risks can be minimized by appropriate use. A pathologist community is very active, especially on Twitter and Facebook. They share and discuss interesting cases, communicate around our specialty or simply strengthen links between pathologists around the world. Professional organizations and pathology journals are also present. This article aims to present social networks, their pros and cons and to give some good practice tips and examples of uses of the 2 main social networks used in pathology: Facebook and Twitter.

Improvement in the implementation of Helicobacter pylori management guidelines among primary care physicians following a targeted educational intervention

Background

Consensus guidelines recommend that in regions with a high rate of clarithromycin resistance, Helicobacter pylori (H. pylori) infection be treated with 4 drugs. Compliance with this recommendation among primary care physicians (PCPs) is low. We aimed to examine whether PCP compliance with H. pylori treatment recommendations increased following a targeted educational intervention.

Methods

A questionnaire assessing H. pylori treatment was sent to >2000 PCPs in June 2015 and June 2018. In the interim, 3 interventions were performed: distribution of printed materials, educational outreach visits, and education over a social media platform.

Results

A total of 635 PCPs returned questionnaires, including 314 in 2015 and 321 in 2018 (148 [46.3%] male, age 44.7±10.9 years). The number of PCPs who recommended a 4-drug treatment protocol increased from 12 (3.8%) in 2015 to 119 (37.1%) in 2018 (P<0.001). The number of PCPs who recommended bismuth- or levofloxacin-based therapy for second-line treatment increased from 95 (30.3%) in 2015 to 247 (77.1%) in 2018 (P<0.001). Independent predictors for a 4-drug treatment protocol included central clinic location (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.38-5.60; P<0.003), exposure to printed educational materials (OR 1.64, 95%CI 0.99-2.72; P=0.04) and exposure to the social media platform (OR 6.60, 95%CI 3.08-14.13; P<0.001. There were no independent predictors of compliance with second-line treatment.

Conclusions

PCP compliance with H. pylori guidelines remains suboptimal. Educational initiatives may be effective in increasing PCPs’ knowledge and compliance with guidelines. Direct web-based interaction between PCPs and gastroenterologists may be particularly effective.

Keep Calm and Tweet On: Legal and Ethical Considerations for Pathologists Using Social Media

Recent privacy breaches by a major social media company have again raised questions from some pathologists regarding the legality and ethics of sharing pathology images on social media. The authors examined ethical principles as well as historic and legal precedents relevant to pathology medical photography. Taking and sharing photographs of pathology specimens is embedded into the culture of the specialty of pathology and has been for more than a century. In general, the pathologist who takes the photograph of a gross or microscopic specimen owns the copyright to that photograph. Patient consent is not legally or ethically required to take or use deidentified photographs of pathology specimens. Current US privacy laws (Health Insurance Portability and Accountability Act [HIPAA] of 1996) permit public sharing of deidentified pathology photographs without specific patient consent, even on social media. There is no case law of action taken against pathologists for sharing deidentified pathology images on social media or elsewhere. If there is any legal risk for pathologists or risk of patient harm in sharing pathology photographs, it is very small. The benefits of professional social media use for pathologists, patients, and society are numerous and well documented in the literature.