Descriptive data of community engagement with the Twitter hashtag #AnesJC were gathered using Symplur (Upland, CA) and TweepsMap (Toronto, Ontario, Canada).
The TraditionalJC took place over 7 days. On day 1, all residents were e-mailed electronic copies of the journal article to be discussed. On day 7, a 1-hour, moderated classroom session took place. This session included critical review of the journal article and supporting literature.
The TwitterJC took place in January 2015. Over 7 days, 149 tweets were generated using #AnesJC by 26 unique Twitter users located in 3 countries. Each participant generated an average of 6 tweets. No tweets with #AnesJC compromised patient, physician, or institutional privacy or were deemed unprofessional by the moderators.
Thirty-eight of 41 anesthesiology residents enrolled and completed 1 survey, 17 of 41 completed 2 surveys, and 9 of 41 completed all 3 surveys. The average age of participating residents was 31 years. On enrollment, 26 of 36 (72.2%) residents did not use Twitter. Residents who used Twitter (10 of 36 [27.8%]) reported using Twitter professionally for an average of 0.7 minutes (SD, 1.5) per day.
Controlling for prior professional Twitter use, 1 of 16 (6.3%) residents surveyed initiated the use of Twitter before entering the classroom portion of the TwitterJC, 3 of 16 (18.8%) used Twitter in the classroom, and 12 of 16 (75.0%) responded “yes” or “maybe” when asked whether they planned to use Twitter to follow the journal club discussion after the classroom portion ended.
Two months after TwitterJC, controlling for professional use of Twitter before enrollment, 2 of 8 (25.0%) residents surveyed initiated professional use of Twitter. Also 2 months after the TwitterJC, 9 of 15 (60.0%) surveyed residents reported using Twitter professionally for an average of 29.4 minutes (SD, 38.5) per day. Four residents were new users of Twitter since implementing TwitterJC.
Twenty-one residents surveyed spent an average of 61.4 minutes (SD, 33.5) over 1.2 days (SD, 0.5) preparing for the TwitterJC. These residents planned to spend an average of 29.8 minutes (SD, 29.5) over 1.1 days (SD, 1.6) discussing the TwitterJC after the classroom portion. Fifteen residents surveyed spent an average of 40.0 minutes (SD, 28.2) over 0.8 days (SD, 0.4) preparing for TraditionalJC. They planned to spend an average of 25.0 minutes (SD, 24.6) over 0.7 days (SD, 0.9) discussing the TraditionalJC after the classroom portion.
A TwitterJC provides a platform for residents and the global anesthesiology community to engage in education, share expertise, and generate an enduring resource for the anesthesia community. The amount of tweets generated and users participating in the inaugural TwitterJC supports widespread engagement beyond the residents’ home institutions, including participants spanning 3 countries. Our results are consistent with other inaugural medical journal clubs using Twitter.5–8 To date, however, we are the first to couple Twitter-generated discussion with a classroom event and describe the impact on resident education and social media use.
The emergency medicine specialty group Academic Life in Emergency Medicine (ALiEM) uses a blog and Twitter to host monthly journal clubs that span 7 days.6 The Journal of General Internal Medicine and the British Journal of Obstetrics and Gynaecology host an hour-long “live” Twitter journal club; the latter is followed by a weeklong discussion, which is curated and published online.7,8 In urology, Twitter journal clubs are held monthly for 48 hours each time.5
Mehta and Flickinger7 list advantages to Twitter’s platform, including ease of participation and diversity of users. In their journal club, they invited authors of the article to participate. One of the article authors commented “It was great to see physicians from across the country converge…passionately.” Thangasamy et al.5 recommend inviting article authors and using recently published articles to help engage users.
The amount of time residents spent using Twitter professionally increased over the time of this study. In addition, residents who previously did not use Twitter began to use it for professional purposes. It is not surprising that residents of the Millennial generation would use a familiar technology such as social media for educational purposes. A survey of emergency medicine residents across 12 different programs showed that 98% used some form of social media for learning for at least 1 hour per week.12 Maintaining the materials’ quality, moderating discussion, and encouraging participation are important faculty responsibilities.
Compared with the TraditionalJC, residents spent more time preparing for and discussing the journal club after the classroom portion ended in the TwitterJC. The Twitter platform provides 24/7 connectivity, push notification, and a broad, diverse user group. Preparation for a TraditionalJC is often done independently. The Millennial learner seeks connectivity and collaboration.13 Twitter offers instant connectivity to peers, patients, and experts. In this way, discussion and education are no longer limited to classrooms or certain times of day. The student can prepare or continue discussion whenever, wherever, and with whoever they please.
We report a descriptive study, but there are limitations. The implementation of the TwitterJC was at a single institution. Also, the resident survey response rate decreased over time, and we report our findings on a limited sample size. The survey was voluntary, and our results could be susceptible to response bias. We controlled for prior use of Twitter before enrollment to best calculate the impact of the TwitterJC. The analytics gathered from Symplur did not include an accurate impact of retweets. As mentioned, retweets signify acknowledgment of a tweet and can guide Twitter users to best content. We were unable to quantify this impact of crowdsourcing in our study. Finally, the TraditionalJC and TwitterJC used different articles. The topic itself may have affected the engagement of residents and eventual educational impact. To help mitigate, both journal clubs were moderated by the same faculty and were anesthesia-related.
Our inaugural anesthesia TwitterJC succeeded in engaging the anesthesia community and increasing residents’ professional use of Twitter. Notably, our experience so far suggests that anesthesia residents are willing to use social media for their education.
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© 2016 International Anesthesia Research Society
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