Twitter was estimated to have 330 million users in 2019, which highlights its impact and reach (1). Currently, many major medical institutions, societies, scientific journals, and healthcare conferences have a Twitter handle to disseminate information, promote engagement with followers, and strategically market services. This article aims to describe the impact and benefits of Twitter use and provide tips and tricks for getting started.
DEFINE YOUR GOAL FOR USING TWITTER
For those new to Twitter, the initial step is to identify your goals for use. These could range from wanting to stay up-to-date in medicine, networking, disseminating work or ideas, career advancement, or becoming a healthcare influencer. Moreover, it could be to promote your practice, market your program or institution, or provide patient education. Defining your goals a priori will allow focused branding and tailor groups or individuals to follow. For instance, if your goal is to advertise your fellowship program, then following other training programs and engaging in conversations with education leaders could be a helpful strategy.
SETTING UP A PROFILE
The first step in using Twitter is to set up an effective profile. Ideally, your profile should quickly convey your mission, interests, and persona. For providers, it is ideal to list your full name along with your degree and include a professional headshot.
The next step is to choose your Twitter handle, which is how you will be searched, mentioned, and tagged by others (Figure 1). The handle should ideally identify who you are; although most use one's name (@AmyOxentenkoMD), others have used interests to define their handle (@IBDMD).
A brief biosketch can be inserted into your profile, which allows a description of your background: role, institution, clinical or academic interests, and personal interests. This is limited to 160 characters. Finally, do not forget to include a background photograh on your profile because this allows an additional opportunity to showcase your brand.
WHO TO FOLLOW?
It is important to reflect on your initial goal for using social media and start following those who are aligned with your mission. For example, if you are a hepatologist, you can follow leaders in the field, liver societies (e.g., @AASLDTweets), and hepatology journals that have a social media presence. The same principle holds true for other clinical, research, or educational interests.
HOW TO EFFECTIVELY TWEET
To effectively use Twitter, it is important to understand the anatomy of a tweet (Figure 2). When viewing a tweet, it shows the profile picture, handle of the person who tweeted the material, the main tweet content, and may include hashtags, links, or pictures.
A single tweet is limited to a maximum of 280 characters. This allows tweets to be quickly read and requires messages to be succinct and eye-catching. Adding relevant images and tagging like-minded colleagues can increase the impact and reach of your tweet.
WHAT TO TWEET
You can build your social media presence by tweeting credible content regularly (2). Tweeting summaries of newly-published journal articles and live tweeting from conferences, including key conference slides and take-home messages, is well-received. Another powerful educational tool is through the use of a “tweetorial,” which is a collective thread of tweets from a single user that aims to convey multiple teaching points around a single topic (Figure 3) (3).
TAXONOMY OF TWEETING
Twitter can feel daunting when getting started, but akin to professional success, “slow and steady” is a safe approach. Similar to bloom taxonomy for learning theory, we suggest a similar “taxonomy of tweeting” for those new to Twitter (Figure 4). Start with “liking tweets,” then “retweeting” tweets of others, followed by “retweet with comment,” which allows you to add your own summary of another's tweet, and culminating in “creating your own tweet.”
THE IMPACT OF TWITTER—WHY SHOULD YOU GET INVOLVED?
The impact of effective use of social media can be immense and multifaceted.
Social media use is not purely for social means as the name implies; Twitter is a valuable way to promote science. Studies have shown that articles shared on social media tend to have increased citations and higher Altmetric scores (4,5). For this reason, many medical journals now have Twitter handles and use the Altmetric Attention Score to track published articles. Any Twitter user who clicks the linked article further impacts the Altmetric Attention Score for that study. Twitter has recently been used to carry out research using its “polling” feature (6).
Continued medical education
Twitter is being increasingly used for journal clubs and to disseminate cutting edge research by clinicians, educators, and researchers. Twitter has been a great tool for “unofficial continued medical education,” given posts are able to quickly distill take-home points from key articles and conferences. Recently, a popular gastroenterology (GI) Twitter chat “@MondayNightIBD” was recognized to grant official continued medical education.
Criteria for academic promotion
Many hospitals and academic institutions have a Twitter account. Some institutions have recognized that physician presence on social media is essential to their academic mission. This has led to the incorporation of social media scholarship into academic promotion criteria by Mayo Clinic (7). If you engage in social media use, you should prepare a social media scholarship portfolio, given this may become an important consideration in all cases of academic promotion (7–11). A social media portfolio should keep track of all social media activity by the author, such as original posts, tweetorials, links of educational/scientific tweets, and metrics related to social media use, such as tweet engagement, impressions, and Altmetric scores (11).
In today's world of excess online content, patients may turn to social media for information. Many gastroenterology organizations tweet patient education material on a regular basis. For example, the GI community has used Twitter effectively to dispel myths of colon cancer screening. Twitter also provides a platform where patients and physicians can interact regarding tweeted educational content, leading to active engagement. Patients and patient advocates (e.g., @Empoweringpts9) who deal with chronic medical illnesses provide valuable insight and offer peer-support to others dealing with challenges related to illness. In the current era, misinformation regarding disease and healthcare is amplified (12). Therefore, it has never been more important to have physicians and organizations dispel misinformation and to promote evidenced-based healthcare.
There has never been an easier way to interact with like-minded individuals and leaders in the field. Twitter allows for instant sharing of ideas, without limitations to when, where, and who you can connect with. For example, if a GI program is looking to improve their education curriculum, they can quickly get suggestions by asking other GI colleagues via Twitter.
Promoting your practice, department, or program
Twitter can be used to promote your practice, department, or program. A departmental newsletter or practice advertisement will have limited reach, but using the principles outlined above regarding effective tweeting, you can promote your program brand and its initiatives across the globe, cultivating broader impact.
Social media may have impact in ways that may not be anticipated—to inspire or be inspired. A great example is the success of certain hashtags, such as those that have resulted out of the work of @JulieSilverMD (e.g., “#SheLeadsHealthCare,” “#NeedHerScience,” and “#BeEthical”). Similarly, the hashtag “#BlackMenInMedicine” has been a source of inspiration for many minority students and physicians. The popular hashtag “#DiversityInGI” has promoted diversity and inclusion in the gastroenterology community (Figure 5). Twitter is also a great platform to amplify others, especially mentees or colleagues.
For some, the concern of potential Twitter pitfalls prevents engagement, but using sound judgement and following key principles should prevent issues. First, know your institutional and state social media policies. Second, to avoid attracting unwelcome attention, it is ideal to stay away from controversial topics. Third, always review a tweet before posting anything related to clinical care to ensure patient identifiers have been removed and there are no violations of Health Insurance Portability and Accountability Act (13).
Social media and Twitter use are exploding with inspiration, knowledge, and science. The power to have an impact in patient care, education, research, and worldwide collaboration is immense. Describing the true power of sensible social media use is beyond the scope of this article but hopefully this will entice nonusers to get involved and will allow those on Twitter to further enhance their social media experience. If you are not using Twitter, we hope to see you there soon!
CONFLICTS OF INTEREST
Guarantor of the article: Amy S. Oxentenko, MD, FACP, FACG, AGAF.
Specific author contributions: M.B. and A.O. were involved in concept design, drafting, editing, and writing of the manuscript.
Financial support: None to report.
Potential competing interests: None to report.
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