Effect of a Novel Engagement Strategy Using Twitter on Test Performance

Introduction

Medical educators in recent years have been using social media for more penetrance to technologically-savvy learners. The utility of using Twitter for curriculum content delivery has not been studied. We sought to determine if participation in a social media-based educational supplement would improve student performance on a test of clinical images at the end of the semester.

Methods

116 second-year medical students were enrolled in a lecture-based clinical medicine course, in which images of common clinical exam findings were presented. An additional, optional assessment was performed on Twitter. Each week, a clinical presentation and physical exam image (not covered in course lectures) were distributed via Twitter, and students were invited to guess the exam finding or diagnosis. After the completion of the course, students were asked to participate in a slideshow “quiz” with 24 clinical images, half from lecture and half from Twitter.

Results

We conducted a one-way analysis of variance to determine the effect Twitter participation had on total, Twitter-only, and lecture-only scores. Twitter participation data was collected from the end-of-course survey and was defined as submitting answers to the Twitter-only questions “all or most of the time”, “about half of the time”, and “little or none of the time.” We found a significant difference in overall scores (p<0.001) and in Twitter-only scores (p<0.001). There was not enough evidence to conclude a significant difference in lecture-only scores (p=0.124). Students who submitted answers to Twitter “all or most of the time” or “about half the time” had significantly higher overall scores and Twitter-only scores (p<0.001 and p<0.001, respectively) than those students who only submitted answers “little or none of the time.”

Conclusion

While students retained less information from Twitter than from traditional classroom lecture, some retention was noted. Future research on social media in medical education would benefit from clear control and experimental groups in settings where quantitative use of social media could be measured. Ultimately, it is unlikely for social media to replace lecture in medical curriculum; however, there is a reasonable role for social media as an adjunct to traditional medical education.

Parental compliance with home apnea monitoring

Until now, compliance with home apnea monitoring (HAM) has been assessed by parental recall. The availability of monitors with electronic memory allows a more objective evaluation of HAM. Fourteen premature infants discharged home from the hospital and receiving theophylline and 15 infants not receiving medication were studied. Medical and birth records, parent questionnaires, and 1 month of electronically recorded data were analyzed. Birth weights of the infants ranged from 850 to 2400 gm and gestational age from 26 to 34 weeks. Of 26 parents who recalled never leaving their infants unmonitored, 70% missed at least one night, 30% three or more. During the first month, treated infants were left unmonitored 21% of the days and 9% of the nights, and untreated babies were unmonitored 32% of the days and 15% of the nights. Average daily HAM use was 18 hours for treated and 16 hours for untreated (p = 0.19). Two weeks after discharge, the decline in use for treated babies was 5% (day and night), whereas for untreated infants the decrease was 20% during the day and 15% at night. Lead-related alarms occurred with similar frequency (one to two times per day) in both groups. Non-lead-related alarms were somewhat more frequent for treated (four times per day) than for untreated infants (twice daily). Parents' perception of the likelihood of severe apnea at the time of discharge influenced HAM use. Little risk prompted 13 hr/day use and moderate risk 16 hr/day, whereas great perceived risk resulted in 18 hr/day of monitoring.(ABSTRACT TRUNCATED AT 250 WORDS)