The academic tweet: Twitter as a tool to advance academic surgery

Social Media Influence and Gender Are Correlated with Industry Payments to Orthopaedic Sports Surgeons

Social media, specifically Twitter, has become an increasingly used tool in academic orthopaedic surgery to help surgeons connect with patients and peers. This study seeks to understand correlations among social medial influence, academic influence, and gender among academic orthopaedic sport surgeons. A list of all orthopaedic sports surgeons serving as faculty of sports fellowships in the United States was compiled, along with publicly available demographic information. Their Hirsh indices (h-indices) were obtained using the Scopus database. The Physician Payments Sunshine Act Web site was used to determine their industry payments from 2014 through 2020. The number of Twitter followers was used as a measure of social media influence. Multivariable linear regression models were employed to explore the associations between these parameters and industry payments. Of the 633 surgeons, 33% had a Twitter account. Surgeons with > 1,000 followers (7.3%) were awarded 186% more in nonresearch funding (p = 0.01) and had a higher probability of receiving industry research funding compared with those with no followers (p = 0.03). Sports surgeons had an average h-index of 16, with 44% having ≤ 20 publications and 21% having ≥ 100 publications. Surgeons with ≥ 100 publications were awarded 453% more in nonresearch funding (p = 0.001) and had a 32% higher probability of receiving industry research funding (p < 0.001) when compared with their colleagues with ≤ 20 publications. Female sports surgeons accounted for only 7.9% of surgeons included in the study, and were awarded 65% less in industry nonresearch funding compared with their male colleagues (p = 0.004) when controlling for other factors. Both number of publications and a high level of Twitter activity (> 1,000 followers) had the strongest associations with the quantity of industry nonresearch funding and the highest probability of industry research funding. Female sports surgeons received significantly less industry nonresearch funding compared with their male colleagues. Future studies further exploring gender disparities in industry funding for orthopaedic surgeons may be warranted. LEVEL OF EVIDENCE:  Prognostic, Level III.

Social media use among French spine surgeons: an underrated tool?

PURPOSE

The goal of this study was to determine the use of social media (SM) among the French spine surgeons.

METHODS

In 2022, an online questionnaire has been sent to the community of French spine surgeons. All surgeons were asked to answer a 21-question survey about their use of SM in their daily practice.

RESULTS

Eighty-five surgeons were included, with 80% claiming to use SM. Mean age was 45 ± 10.7. Usage rate significantly differed among experience categories: 85% of younger surgeons and 69% after ten years of experience (p = 0.01). LinkedIn was the most commonly used (78% among SM users), then Facebook (46%). Instagram was less used by most experienced surgeons (p = 0.01). Time spent on SM was more important at home (p < 0.01). About 31% of participants' patients were able to contact their surgeon through SM, mainly through LinkedIn, professional websites and Facebook (respectively 15%, 13% and 12%). Pictural data were shared on SM by 29% of SM users, mainly on LinkedIn (19%), then professional websites (12%). Google reviews were significantly less valued by most experienced surgeons (p = 0.01) but more valued by private practice surgeons (p = 0.009).

CONCLUSION

80% of French spine surgeons use social media for professional purposes. However, SM may not be used to its full potential as only 25% of SM-using broadcast pictures and contact their patients through SM. The most popular network is LinkedIn, followed by Facebook. Most experienced surgeons use less SM, particularly Instagram, and value less Google reviews.

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.

Across the Twitter-verse: Is Twitter an equitable tool in academic medicine? A scoping review

The goal of this study was to investigate what is known about the demographic characteristics of Twitter influencers in academic medicine. We conducted a literature search and scoping review exploring the demographic characteristics of Twitter influencers in academic medicine. Included studies evaluated Twitter influence by any metric and reported associated demographic characteristics. There were no date or language restrictions. Data points included metrics of influence, demographics, and study characteristics. From 1656 records, thirteen met inclusion criteria. Influence was variably defined based on followers, measures of centrality, measures of engagement, or through third-party software. Studies were conducted at single time points and relied heavily on facial recognition for classification of sex or gender, with no studies exploring race as a variable of interest. Twitter influencers in academic medicine were found to be disproportionately male: significantly fewer influencers were female at all levels of professional status. Two studies identified more female influencers among trainee populations. Female users were less likely to develop influence based on followers, retweets, likes, or other measures of engagement at academic meetings, despite equal or greater representation at these meetings. Results on associations between Twitter influence and number of publications or h-index varied considerably. No included studies explored race or ethnicity in relation to Twitter influence, which presents a significant gap in the literature. Our findings highlight the need for larger, user-engaged studies of inequities related to social media influence in academic medicine, especially as social media is increasingly incorporated into academic portfolios.

An exploratory study to understand how people use Twitter to share experiences or information about spinal stenosis

BACKGROUND

Spinal stenosis is a narrowing of the spinal canal that may compress neurological tissues resulting in pain and disability. Although previous qualitative studies have solicited data regarding the life experience of patients with spinal stenosis or their opinions on relevant non-surgical treatments, their data was collected from participants in a controlled setting. Therefore, it remains unclear whether patients' or caregivers' concerns/opinions about spinal stenosis would be different in a non-experimental environment. Since Twitter is a popular online platform for people to share information and interact, it may reveal people's thoughts and attitudes about spinal stenosis. This study aimed to identify tweets that are related to spinal stenosis on Twitter, and to categorize them into common themes.

METHODS

A social media monitoring and analysis software program (TalkWalker) was used to search relevant tweets using the keywords 'spinal stenosis' and 'stenosis' between 29 May 2019 and 24 June 2020. Two independent reviewers screened and conducted content analysis of the tweets and classified the tweets into different themes.

RESULTS

Of 510 identified tweets, 362 tweets met the selection criteria. Five themes were identified: (1) compromised physical, psychological, and social wellbeing (n = 173); (2) diverse treatment options (n = 69); (3) coping strategies (n = 30); (4) dissemination of scientific information (n = 86); and (5) health policy (n = 4). Most of the tweets revealed negative impacts of spinal stenosis on patients' physical and psychosocial wellbeing. People with spinal stenosis shared their experiences and sought helps from others, while some people used Twitter to disseminate relevant information and research findings.

CONCLUSIONS

This is the first study exploring Twitter using an online analytical tool to identify themes related to spinal stenosis. The approach not only helps understand people's concerns about spinal stenosis in an uncontrolled environment, but also can be adopted to monitor influences of diseases or public health education on Twitter users.

Participation of latin american surgeons in twitter using the hashtag #SoMe4Surgery and #SoMe4IQLatAm

Background

In medicine, social networks contribute to the professional training because it is a way to improve the knowledge and skills of students, residents and specialists; additionally, these networks allow the dissemination of evidence. However, Latin American surgeons' influence within this social network is not highlighted. In this study, using the hashtags #SoMe4Surgery and #SoMe4IQLatAm, the participation of Latin American surgeons in Twitter is established.

Study Design

This is a prospective cross-sectional study of the academic tweets published in the period between October 13 and October 19, 2020, on Twitter by the academic accounts @Cirbosque and @MISIRG1 who are users of the social network Twitter in Latin America who participate in the network with the hashtags #SoMe4Surgery and #SoMe4IQLatAm with academic use.

Results

A total of 56 tweets and 665 retweets were analyzed. Male sex presents greater interaction, as well as Mondays and Tuesdays week days. Geolocation was recorded as 37.1% in Latin America and 17.6% in Europe. #SoMe4Surgery was mentioned in 31 tweets and generated 211,700 impressions and 25,557 interactions, and #SoMe4IQLatam was mentioned in 25 tweets and achieved 57,585 impressions and 21,901 interactions. A growth of the participation rate of 6.5% in @Cirbosque and 10.5% in @ MISIRG1 was estimated for 2021.

Conclusion

The use of social networks, particularly Twitter, in the surgeon community has proven to be a valuable tool during the last decade. The tweet that needs to be shared among more surgeons should be linked to the hashtag #SoMe4IQLatAm and #SoMe4Surgery and Twitter surgeon leaders mentions.

Twelve-step Approach for Academic Development Planning in Academic Surgery: Climbing the Academic Uphill With Strong and Steady Steps

MINI-ABSTRACT

Surgical trainees and young academic surgeons should understand the specifics of the career they are pursing, and surgeon mentors should enhance their leadership roles and support the recruitment and retainment of academic surgeons through effective academic career support and strategic planning. Utilizing academic development planning can serve as an essential tool as both mentors & mentees navigate different career choices towards achieving a successful and sustainable academic career advancement.

Audience of Academic Otolaryngology on Twitter: Cross-sectional Study

BACKGROUND

Despite the ubiquity of social media, the utilization and audience reach of this communication method by otolaryngology-head and neck surgery (OHNS) residency programs has not been investigated.

OBJECTIVE

The purpose of this study was to evaluate the content posted to a popular social media platform (Twitter) by OHNS residency programs.

METHODS

In this cross-sectional study, we identified Twitter accounts for accredited academic OHNS residency programs. Tweets published over a 6-month period (March to August 2019) were extracted. Tweets were categorized and analyzed for source (original versus retweet) and target audience (medical versus layman). A random sample of 100 tweets was used to identify patterns of content, which were then used to categorize additional tweets. We quantified the total number of likes or retweets by health care professionals.

RESULTS

Of the 121 accredited programs, 35 (28.9%) had Twitter accounts. Of the 2526 tweets in the 6-month period, 1695 (67.10%) were original-content tweets. The majority of tweets (1283/1695, 75.69%) were targeted toward health care workers, most of which did not directly contain medical information (954/1283, 74.36%). These tweets contained information about the department's trainees and education (349/954, 36.6%), participation at conferences (263/954, 27.6%), and research publications (112/954, 11.7%). Two-thirds of all tweets did not contain medical information. Medical professionals accounted for 1249/1362 (91.70%) of retweets and 5616/6372 (88.14%) of likes on original-content tweets.

CONCLUSIONS

The majority of Twitter usage by OHNS residency programs is for intra and interprofessional communication, and only a minority of tweets contain information geared toward the public. Communication and information sharing with patients is not the focus of OHNS departments on Twitter.

A look to the future: Pandemic-induced digital technologies in vascular surgery

Like many areas of medicine, vascular surgery has been transformed by the COVID-19 (coronavirus disease 2019) pandemic. Public health precautions to minimize disease transmission have led to reduced attendance at hospitals and clinics in elective and emergency settings; fewer face-to-face and hands-on clinical interactions; and increased reliance on telemedicine, virtual attendance, investigations, and digital therapeutics. However, a “silver lining” to the COVID-19 pandemic may be the mainstream acceptance and acceleration of telemedicine, remote monitoring, digital health technology, and three-dimensional technologies, such as three-dimensional printing and virtual reality, by connecting health care providers to patients in a safe, reliable, and timely manner, and supplanting face-to-face surgical simulation and training. This review explores the impact of these changes in the delivery of vascular surgical care.

Power of the collective: A review of multimodal internet-based surgical education resources in the 21st century

Electronic resources have changed surgical education in the 21st century. Resources spanning from digital textbooks to multiple choice question banks, online society meetings, and social media can facilitate surgical education. The COVID pandemic drastically changed the paradigm for education. The ramifications of Zoom lectures and online surgical society meetings will last into the future. Educators and learners can be empowered by the many available electronic resources to enhance surgical training and education.

Understanding colorectal twitter: A comparison of its highest and lowest rank influencers

The distribution of content related to colorectal surgery in social media is steadily increasing. Social media influencers possess large audiences and are frequently viewed as authority; however, their credibility is often unchecked. In our commentary we present our analysis and comparison of the most and least influential accounts on Twitter within the field of colorectal surgery. Additionally, we discuss the current literature, role and importance of social media for the modern surgeon.

Surgeons Underestimate the Importance of Surgical Topics for Non-Surgeons: Results of a National Survey

OBJECTIVE

To determine if surgeons and non-surgeons agree on the importance of surgical topics covered in the surgical clerkship to the daily practice of non-surgeons.

DESIGN

An IRB-approved anonymous survey ranking the relative importance of 35 topics drawn from surgical clerkship curricula asking physicians to rank the relative importance of each topic, using a five-point Likert scale, to the daily practice of non-surgeons.

SETTING

Online anonymous survey.

PARTICIPANTS

Convenience sample of practicing physicians and trainees. The survey was offered to physicians in all specialties via social media and professional connections, responders identified their practice specialty.

RESULTS

295 physicians completed the survey. Two hundred thirty-one (85%) were from non-surgical specialties: emergency medicine (EM, n = 100); primary care (PC, n = 71 - included internal medicine, family medicine, and pediatrics); a variety of others (n = 60).  Surgeons and non-surgeons agreed on the relative importance of the acute abdomen, breast disease, inguinal hernias, inflammatory bowel disease, morbid obesity, sinusitis, thyroid and parathyroid disease, and wound care; surgeons believed colorectal cancer and diverticulitis to be more important. Surgeons rated all other topics as less important to non-surgeons than non-surgeons. EM rated most acute problems more important that PC; both groups ranked most topics higher importance to the practice of a non-surgeon than surgeons (p < 0.05).

CONCLUSIONS

Surgeons consistently underestimate the importance non-surgeons place on surgical topics in their practice.  These results reinforce the perceived importance of a wide exposure to surgery in the surgical clerkship to all medical students - but topics could be focused differently depending on acute or non-acute non-surgical care career plans.

The importance of social media to the academic surgical literature: Relationship between Twitter activity and readership metrics

BACKGROUND

Social media has an increasing role within professional surgical practice, including the publishing and engagement of academic literature. This study aims to analyze the relationship between social media use and traditional and alternative metrics among academic surgical journals.

METHOD

Journals were identified through the InCites Journal Citation Reports 2019, and their impact factor, h-index, and CiteScore were noted. Social media platforms were examined, and Twitter activity interrogated between 1 January to 31 December 2019. Healthcare Social Graph score and an aggregated Altmetric Attention Score were also calculated for each journal. Statistical analysis was carried out to look at the correlation between traditional metrics, Twitter activity, and altmetrics.

RESULTS

Journals with a higher impact factor were more likely to use a greater number of social media platforms (R² = 0.648; P < .0001). Journals with dedicated Twitter profiles had a higher impact factor than journals without (median, 2.96 vs 1.88; Mann-Whitney U = 390; P < .001); however, over a 1-year period (2018-2019) having a Twitter presence did not alter impact factor (Mann-Whitney U = 744.5; P = .885). Increased Twitter activity was positively correlated with impact factor. Longitudinal analysis over 6 years suggested cumulative tweets correlated with an increased impact factor (R² = 0.324, P = .004). Novel alternative measures including Healthcare Social Graph score (R² = 0.472, P = .005) and Altmetric Attention Score (R² = 0.779, P = .001) positively correlated with impact factor.

CONCLUSION

Higher impact factor is associated with social media presence and activity, particularly on Twitter, with long-term activity being of particular importance. Modern alternative metrics correlate with impact factor. This relationship is complex, and future studies should look to understand this further.

Communication, collaboration and contagion: "Virtualisation" of anatomy during COVID-19

COVID-19 has generated a global need for technologies that enable communication, collaboration, education and scientific discourse whilst maintaining physical distance. University closures due to COVID-19 and physical distancing measures disrupt academic activities that previously occurred face-to-face. Restrictions placed on universities due to COVID-19 have precluded most conventional forms of education, assessment, research and scientific discourse. Anatomists now require valid, robust and easy-to-use communication tools to facilitate remote teaching, learning and research. Recent advances in communication, video conferencing and digital technologies may facilitate continuity of teaching and research activities. Examples include highly-interactive video conferencing technology, collaborative tools, social media and networking platforms. In this narrative review, we examine the utility of these technologies in supporting effective communication and professional activities of anatomists during COVID-19 and after.

Social Media in Surgery

Social media has become a permeating form of communication with billions of daily users. Twitter in particular has become a tool for the surgical community to engage with other providers, as well as patients, through active online discussions, sharing of research, and highlighting opportunities for community outreach. Twitter can help with personal branding, mentorship, and international collaboration on multiple types of academic endeavors. Likewise, institutional and residency programs can harness the power of social media to develop an online presence and aid in resident recruitment.

Surgical Training 2.0: A systematic approach reviewing the literature focusing on oral maxillofacial surgery - Part II

PURPOSE

Many technologies are emerging in the medical field. Having an overview of the technological arsenal available to train new surgeons seems very interesting to guide subsequent surgical training protocols.

METHODS

This article is a systematic approach reviewing new technologies in surgical training, in particular in oral and maxillofacial surgery. This review explores what new technologies can do compared to traditional methods in the field of surgical education. A structured literature search of PubMed was performed in adherence to PRISMA guidelines. The articles were selected when they fell within predefined inclusion criteria while respecting the key objectives of this systematic review. We looked at medical students and more specifically in surgery and analysed whether exposure to new technologies improved their surgical skills compared to traditional methods. Each technology is reviewed by highlighting its advantages and disadvantages and studying the feasibility of integration into current practice.

RESULTS

The results are encouraging. Indeed, all of these technologies make it possible to reduce the learning time, the operating times, the operating complications and increase the enthusiasm of the students compared to more conventional methods. The start-up cost, the complexity to develop new models, and the openness of mind necessary for the integration of these technologies are all obstacles to immediate development. The main limitations of this review are that many of the studies have been carried out on small numbers, they are not interested in acquiring knowledge or skills over the long term and obviously there is a publication bias.

CONCLUSION

Surgical education methods will probably change in the years to come, integrating these new technologies into the curriculum seems essential so as not to remain on the side. This second part therefore reviews, social networks, serious games and virtual reality. This Systematic review is registered on PROSPERO (CRD42020181376).

Characteristics of General Surgery Social Media Influencers on Twitter

BACKGROUND

The influence of social media and Twitter in general surgery research, mentorship, networking, and education is growing. Limited data exist regarding individuals who control the dialogue. Our goal was to characterize influencers leading the discussion in general surgery.

METHODS

Right Relevance Insight API was searched for "general surgery," and individual influencers were ranked by a comprehensive assessment of connections (followers/following) and engagement (likes, retweets, and comments). Profession, specialty, gender, and location were collected utilizing Twitter, Doximity, LinkedIn, ResearchGate, and institutional websites. American Board of Surgery and Royal College of Physicians and Surgeons of Canada were queried for board certification and academic h-index scores were acquired from Scopus.

RESULTS

Eighty-eight individual influencers in general surgery were identified, with 73 holding positions in general surgery. Attending level general surgeons comprised 50%, of which 91% are board certified, and 94% completed a fellowship (surgical oncology, laparoscopic surgery, critical care/trauma, and colorectal surgery). Residents comprised 31%; 11% were nonsurgeons and 3% were not physicians. The majority of residents and fellow influencers were female (72%). Many general surgery influencers were international (51%), particularly Canadian (28% overall). The academic h-indices for these influencers (n = 73) ranged from 0 to 73 (mean 14.5 ± 8.2; median 9.5).

DISCUSSION

Our data describe the positions, backgrounds, and research contributions of the top Twitter influencers in general surgery. Those engaged in social media should consider the background, expertise, and motivation of these influencers as the utilization and impact of this platform grows.

Social Media Perceptions of Surgical Cancer Care in the Era of COVID-19: A Global Cross-Sectional Study

PURPOSE

The rapid dissemination of information through social media renders a profound lens to evaluate perceptions of emerging topics, especially in the context of a global pandemic. The primary objective of this cross-sectional study was to elucidate trends on social media in the setting of surgical cancer care affected by the COVID-19 pandemic across the globe.

METHODS

A public search of Twitter from April 1 to 30, 2020, was conducted, which yielded 996 posts related to COVID-19 and cancer. Two authors (E.J.K. and H.S.) individually reviewed all posts and recorded the post category, engagement, author category, and geographic location. Data were then analyzed through descriptive analyses. Only English-language posts were included, and any noncancer- or non-COVID–related posts were excluded from the analysis.

RESULTS

A total of 734 unique authors from 26 different countries wrote 996 relevant posts that averaged 12.0 likes, 4.7 retweets, and 0.5 hashtags per post. Only 2.3% (23 of 996) of posts included a video. Authors of the included tweets most frequently were friends and families of patients (183; 18.4%), academic institutions or organizations (182; 18.3%), and physicians (138; 13.9%). Topics of importance were cancellations of surgeries (299; 40.1%), COVID-19 education (211; 121.2%), and research studies (93; 9.3%). The United Kingdom and the United States made up 81.5% of the cohort, followed by Canada (6.6%) and India (2.4%). Of posts where a specific type of surgery was identified (196), the most common type mentioned was breast cancer (50; 25.5%), followed by lung cancer (37; 18.9%) and urologic cancer (22; 11.2%).

CONCLUSION

This analysis provides insight into the resulting impacts of COVID-19 on the global discussion of surgical cancer care.

This Surgical Life - An Exploration of Surgical Department Podcasting

OBJECTIVE

Surgical departments are increasingly utilizing media to disseminate knowledge, discuss ideas, and mentor future surgeons. Podcasts are a form of media where digitally recorded content can be downloaded or streamed. This study aims (1) to describe the audience reached by a single surgical department podcast and (2) to evaluate what sources of information surgery residency applicants use to formulate a rank list.

DESIGN

In Fall 2017, the Rocky Mountain Surgery Podcast (RMSP) was created, produced, and edited by 2 general surgery (GS) residents at a large academic training program. Each episode discussed a topic within GS training and/or educational experiences specific to the program. Interviewing GS applicants for the 2019 match were asked to complete an anonymous voluntary survey on their familiarity and opinion of RMSP and the role of podcasts in the application process.

RESULTS

Twenty-two episodes were completed over a 16-month period (October 4, 2017 - February 11, 2019). A total of 7002 individual listens occurred in 644 cities across 46 states. Ninety-eight interviewing applicants responded to the survey (99% response rate), and one-fourth had previously listened to the RMSP. Only half felt that the traditional interview experience provided enough information about a GS program, and a significant majority (97%) stated they would listen to one or more podcast episodes to gain information regarding a GS residency program.

CONCLUSIONS

Applicants to GS residency commonly feel inadequate information is gained during the interview process. Podcasts are a tool familiar to applicants that allow for exploration of topics which cannot be adequately addressed in a typical interview day, thus expanding an applicant's knowledge of a GS training program.

The "secret sauce" for a mentored training program: qualitative perspectives of trainees in implementation research for cancer control

BACKGROUND

Mentored training approaches help build capacity for research through mentoring networks and skill building activities. Capacity for dissemination and implementation (D&I) research in cancer is needed and mentored training programs have been developed. Evaluation of mentored training programs through quantitative approaches often provides us with information on "what" improved for participants. Qualitative approaches provide a deeper understanding of "how" programs work best.

METHODS

Qualitative interviews were conducted with 21 fellows of the National Cancer Institute-funded Mentored Training for Dissemination and Implementation in Cancer to gain understanding of their experiences with mentoring received during the program. Fellows were selected from all 55 trained participants based upon their gain in D&I research skills (highest and lowest) and number of collaborative connections in the program network (highest and lowest) reported in previous quantitative surveys. Phone interviews were recorded with permission, transcribed verbatim, and de-identified for analysis. Codes were developed a priori to reflect interview guide concepts followed by further development and iterative coding of three common themes that emerged: 1) program and mentoring structure, 2) importance of mentor attributes, and 3) enhanced capacity: credentials, confidence, credibility and connections.

RESULTS

Interviews provided valuable information about program components that worked best and impacts attributed to participation in the program. Fellows reported that regular monthly check-in calls with mentors helped to keep their research moving forward and that group mentoring structures aided in their learning of basic D&I research concepts and their application. Accessible, responsive, and knowledgeable mentors were commonly mentioned by fellows as a key to their success in the program. Fellows mentioned various forms of impact that they attributed to their participation in the program including gaining credibility in the field, a network of peers and experts, and career developments (e.g., collaborative publications and grant funding).

CONCLUSIONS

These findings suggest that mentored training works best when mentoring is structured and coupled with applied learning and when respected and dedicated mentors are on board. Increased scientific collaborations and credibility within a recognized network are important trainee experiences that should be considered when designing, implementing, and sustaining mentored training programs.

Understanding Discussions of Health Issues on Twitter: A Visual Analytic Study

Social media allows for the exploration of online discussions of health issues outside of traditional health spaces. Twitter is one of the largest social media platforms that allows users to post short comments (i.e., tweets). The unrestricted access to opinions and a large user base makes Twitter a major source for collection and quick dissemination of some health information. Health organizations, individuals, news organizations, businesses, and a host of other entities discuss health issues on Twitter. However, the enormous number of tweets presents challenges to those who seek to improve their knowledge of health issues. For instance, it is difficult to understand the overall sentiment on a health issue or the central message of the discourse. For Twitter to be an effective tool for health promotion, stakeholders need to be able to understand, analyze, and appraise health information and discussions on this platform. The purpose of this paper is to examine how a visual analytic study can provide insight into a variety of health issues on Twitter. Visual analytics enhances the understanding of data by combining computational models with interactive visualizations. Our study demonstrates how machine learning techniques and visualizations can be used to analyze and understand discussions of health issues on Twitter. In this paper, we report on the process of data collection, analysis of data, and representation of results. We present our findings and discuss the implications of this work to support the use of Twitter for health promotion.

Ethical Use of Public Networks and Social Media in Surgical Innovation

The use of social media among surgeons is increasing in the professional domain as a result of the benefits of rapid communication for advertising, professional development, advocacy, and innovation. Social media allows for collaboration and consultation on cases that may be difficult or uncommon, drawing on collective wisdom but also bypassing traditional privacy protections and other regulatory firewalls. The expanded access that comes with social media produces challenges, including the management of information dissemination and ensuing perceptions, the risk of biased patient/research participant recruitment, the potential for overlap between personal and professional lives, and the precarious nature of self-interest in professional social media use. The ethics of surgical innovation in the context of social media has not been extensively discussed. The nature of social media favors attention grabbing, sensationalized content. Innovation is inherently sensational and demands attention. The alignment of these intrinsic characteristics forms a basis for its appeal and contagion on social media. Despite strict regulatory clinical research environment, many surgical innovations and subsequent evolution in practice arise from a longitudinal surgical culture of trial and error that happens every day. The difficulty in distinguishing innovation from research and the precarious nature of interactions found on social media create a unique ethical dilemma to be addressed for the innovative surgeon. Therefore, the use of social media in surgical innovation thus requires a more robust ethical analysis.

#Cleftlip/Palate: What Is the World Talking About?

Objective:

Studies have begun analyzing how the world converses on social media platforms about medical/surgical topics. This study’s objective was to examine how cleft lip and palate, two of the most common birth defects in the world, are discussed on the social media platform Twitter. No study to date has analyzed this topic.

Methods:

Tweets were identified using any of the following: cleft, cleft lip, cleft palate, #cleft, #cleftlip, #cleftpalate. Eight months between 2017 and 2018 were analyzed.

Main Outcome Measures:

The primary outcome was the tweet subject matter. Secondary outcomes were author characteristics, tweet engagement, multimedia, and tweet accuracy

Results:

A total of 1222 tweets were included. #Cleft was the most common hashtag (71%), and it was significantly associated with more retweets ( P = .03). Twenty-seven countries tweeted, with the United States (34%) and India (27%) producing the most. Charities (36%), hospitals (14%), and physicians (13%) were the most common authors. Over three-quarters of tweets were self-promotional. The top content included charity information (22%) and patients’ cleft stories (14%). Tweets about patient safety/care and surgical service trips generated the most engagement. The accuracy of educational tweets was 38% low accuracy and 1% inaccurate. One hundred forty-nine tweets (12%) discussed a published research article, but 41 tweets did not share a link.

Conclusions:

Charities dominate the cleft lip/palate “Twitterverse.” Most tweets were self-promotional, and over a third of educational tweets were low accuracy. As the cleft social media community continues to grow, we recommend using the hashtag #cleft to reach a wider audience.

Analysis of #PlasticSurgery in Europe: An Opportunity for Education and Leadership

BACKGROUND

Prior studies demonstrate that social media are used by plastic surgeons to educate and engage. The hashtag #PlasticSurgery has been studied previously and is embraced by American plastic surgeons and journals; however, no studies have examined its use or adoption across Europe.

METHODS

A retrospective analysis of 800 tweets containing the words "plastic surgery" or the hashtag #PlasticSurgery in four of the most spoken European languages worldwide excluding English (Spanish, #CirugiaPlastica; French, #ChirurgiePlastique; Portuguese, #CirurgiaPlastica; and German, #PlastischeChirurgie) was performed. The following were assessed: identity of author, subject matter, use of the hashtag #PlasticSurgery in each language, whether posts by surgeons and academic institutions were self-promotional or educational, and whether a link to a journal article or a reference in PubMed was provided.

RESULTS

Seventeen percent and 3 percent of analyzed tweets came from plastic surgeons or academic institutions, respectively; only 17.5 percent of them were for educational purpose. None of them had any digital link to a peer-reviewed article or a scientific journal.

CONCLUSIONS

This study demonstrates the low participation of plastic surgeons and academic institutions in social media (especially for education) in four of the major world languages. Social media should be considered in Europe as an opportunity to increase leadership, improve education, and spread knowledge of plastic surgery by board-certified plastic surgeons.

Digital Medicine in Rheumatology: Challenges and Opportunities

The exponential growth in technology has had a significant effect on the practice of medicine and will likely transform the practice of medicine. In this article, the authors review select technologies that are already influencing the practice of rheumatology. Social media Websites such as Twitter are now important sources of information and discussion for health care professionals interested in rheumatology. Virtual reality is an innovative technology with great potential for acute and chronic pain management. The authors also review several low-cost technology alternatives to commonly used tools used in rheumatology.

Who should you be following? The top 100 social media influencers in orthopaedic surgery

BACKGROUND

Social media has been credited with the potential to transform medicine, and Twitter was recently named “an essential tool” for the academic surgeon. Despite this, peer-to-peer and educational influence on social media has not been studied within orthopaedic surgery. This knowledge is important to identify who is controlling the conversation about orthopaedics to the public. We hypothesized that the plurality of top influencers would be sports medicine surgeons, that social media influence would not be disconnected from academic productivity, and that some of the top social media influencers in orthopaedic surgery would not be orthopaedic surgeons.

AIM

To identify the top 100 social media influencers within orthopaedics, characterize who they are, and relate their social media influence to academic influence.

METHODS

Twitter influence scores for the topic “orthopaedics” were collected in July 2018 using Right Relevance software. The accounts with the top influence scores were linked to individual names, and the account owners were characterized with respect to specialty, subspecialty, practice setting, location, board certification, and academic Hirsch index (h-index).

RESULTS

Seventy-eight percent of top influencers were orthopaedic surgeons. The most common locations included California (13%), Florida (8%), New York (7%), United Kingdom (7%), Colorado (6%), and Minnesota (6%). The mean academic h-index of the top influencers (n = 79) was 13.67 ± 4.12 (mean ± 95%CI) and median 7 (range 1-89) (median reported h-index of academic orthopaedic faculty is 5 and orthopaedic chairpersons is 13). Of the 78 orthopaedic surgeons, the most common subspecialties were sports medicine (54%), hand and upper extremity (18%), and spine (8%). Most influencers worked in private practice (53%), followed by academics (17%), privademics (14%), and hospital-based (9%). All eligible orthopaedic surgeons with publicly-verifiable board certification statuses were board-certified (n = 74).

CONCLUSION

The top orthopaedic social media influencers on Twitter were predominantly board-certified, sports-medicine subspecialists working in private practice in the United States. Social media influence was highly concordant with academic productivity as measured by the academic h-index. Though the majority of influencers are orthopaedic surgeons, 22% of top influencers on Twitter are not, which is important to identify given the potential for these individuals to influence patients’ perceptions and expectations. This study also provides the top influencer network for other orthopaedic surgeons to engage with on social media to improve their own social media influence.

Social Media Skills for Professional Development in Psychiatry and Medicine

Social media use is increasing in the United States. Because psychiatrists and physicians are becoming more active online, Twitter is emerging as a leading platform for professional development. Social media can enhance networking, serve as a tool for mentoring trainees and colleagues, introduce journal articles to new readers, and allow psychiatrists and physicians to advocate for health care issues. Psychiatrists and physicians should observe ethical standards for digital citizenship on Twitter and other social media platforms.

Are You on the Right Platform? A Conjoint Analysis of Social Media Preferences in Aesthetic Surgery Patients

BACKGROUND

Social media has become an indispensable tool for patients to learn about aesthetic surgery. Currently, procedure-specific patient preferences for social media platforms and content are unknown.

OBJECTIVES

The authors sought to evaluate social media preferences of patients seeking aesthetic surgery.

METHODS

We utilized a choice-based conjoint analysis survey to analyze the preferences of patients seeking 3 common aesthetic procedures: breast augmentation (BA), facial rejuvenation (FR), and combined breast/abdominal surgery (BAB). Participants were asked to choose among social media platforms (Facebook, Twitter, Instagram, Snapchat, Pinterest, Tumblr, YouTube), information extent (basic, moderate, comprehensive), delivery mechanism (prerecorded video, live video, photographs, text description), messenger (surgeon, nurse/clinic staff, patient), and option for interactivity (yes/no). The survey was administered using an Internet crowdsourcing service (Amazon Mechanical Turk).

RESULTS

A total of 647 participants were recruited: 201 in BA, 255 in FR, and 191 in BAB. Among attributes surveyed, participants in all 3 groups (BA, FR, BAB) valued social media platform as the most important (30.9%, 33.1%, 31.4%), followed by information extent (23.1%, 22.9%, 21.6%), delivery mechanism (18.9%, 17.4%, 18%), messenger (16%, 17%, 17.2%), and interactivity (11.1%, 9.8%, 11.8%). Within these attributes, Facebook ranked as the preferred platform, with comprehensive information extent, live video as the delivery mechanism, and surgeon as the messenger as most preferred.

CONCLUSIONS

The choice of social media platform is the most important factor for patients, and they indicated a preference for comprehensive information delivered by the surgeon via live video on Facebook. Our study elucidates social media usage in common aesthetic populations, which can help improve aesthetic patient outreach.

La incursión del Congreso Nacional de Cirugía de Colombia en la red social Twitter™

Introducción. Hemos ingresado en una nueva era en la forma de comunicación y en la difusión de los contenidos que se generan en las diferentes reuniones y congresos científicos de Medicina y Cirugía.Objetivo. Analizar los resultados de la difusión en Twitter™ del XLIV Congreso Nacional “Avances en Cirugía” realizado en Cartagena, Colombia, del 14 al 17 de agosto de 2018.Método. Se recopilaron los datos obtenidos por la pagina Symplur.com en el XLIV Congreso Nacional “Avances en Cirugía” con la etiqueta (hashtag) #CirugíaColombiana.Resultados. Se generaron 761 tuits (tweets) durante todo el tiempo que duró el congreso, con 178 participantes activos en Twitter™, los cuales representan el 10,8 % del total de asistentes al congreso, con una relación de nueve asistentes por cada participante en Twitter™. En cuanto a la media de tuits por usuario, fue de cuatro y la cantidad de impresiones fue de 1´250.000. A medida que el congreso fue avanzando, aumentó el número de tuits, hasta el más alto, un total de 230, el 16 de agosto.Discusión. El uso de twitter como herramienta de difusión por los cirujanos colombianos fue similar al publicado en otras series; sin embargo, son mediciones desde 2013, en las cuales la participación y actividad han aumentado progresivamente. La canalización de los contenidos por medio de una etiqueta común permite la interacción asincrónica de todos los participantes, rompiendo las barreras de comunicación entre los mismos.

The surgical blog: An important supplement to traditional scientific literature

BACKGROUND

Blogging is a new and innovative means of information exchange in the surgical community. We examined the Association of Women Surgeons (AWS) blog to understand its audience and most read content.

METHODS

Google Analytics was used to assess the AWS blog site data. A search was performed from February 2018 to February 2019. Demographic data, blog posts, and tags sorted by unique pageviews were recorded.

RESULTS

There were 31,221 unique pageviews during the search period. The AWS Blog readership was mostly women (75%), ages 25-44 years (70.3%). The three tags that elicited the most pageviews were "residency (16.95%)," "medical students (12.12%)," and "family life (10.38%)." The most read blog post was responsible for 9.7% of total pageviews.

DISCUSSION & CONCLUSION

Most of the AWS Blog readership are young, women, and interested in content related to graduate and postgraduate medical education or family life. Blogging may be a good vehicle for topics not covered in traditional scientific literature.

Analysis of social media use among Australian and New Zealand otolaryngologists

BACKGROUND

Social media's rapid worldwide growth has permeated surgical practice. To date, no study has evaluated social media use amongst Australian and New Zealand otolaryngologists.

METHODS

Cross-sectional study of all members of the Australian and New Zealand Societies of Otolaryngology Head and Neck Surgery with comprehensive searches of websites and social media platforms (Facebook, Twitter, LinkedIn, ResearchGate and Instagram) was performed.

RESULTS

A total of 498 otolaryngologists were identified with 81.7% working in Australia; 79.1% had some form of online presence - either professional website or activity on ≥1 social media platform and 53.0% of otolaryngologists had a professional website and mean number of social media profiles averaged 1.35 per surgeon. LinkedIn was the most widely used social media platform (51.6%). 38.8% of otolaryngologists had Facebook accounts with 11.9% of those 'public' accounts used for business purposes. Otolaryngologists with a research and authorship interest had the highest mean number of social media accounts (1.78) and were more likely to be associated with ResearchGate, LinkedIn and website ownership. Facial plastic surgeons averaged the second highest mean number of social media accounts per surgeon (1.71) and were most active on Facebook, Instagram and YouTube. There was a linear decline in the mean number of social media accounts per surgeon and rate of professional website ownership with increasing years in practice.

CONCLUSION

Social media uptake amongst otolaryngologists appears consistent with colleagues in other surgical specialties. Otolaryngologists with fewer years in practice and specialty interests in facial plastic surgery and authorship and research are significantly more active on social media.