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SURGICAL PERSPECTIVES

A Medical Student's Perspective on Social Media in the Surgical Field

Herweck, Alexandra M. BBA; Ness, Abigail R. BA; Delamater, Jessica M. MS; Diez, Edgar Del Toro MD; Khosravani, Nima MD

Author Information
doi: 10.1097/SLA.0000000000003904
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The development and expanding usage of social media (SM) has played a critical role in exposing medical students to the various dimensions of surgery and its subspecialties. Before the existence of SM, medical students’ exposure to the field of surgery was limited by their time spent in the operating room, geographical location, variety of cases performed at their institution, and the type of specialists associated with their affiliated institution. Although these limitations still exist to some degree, SM has helped overcome these barriers by increasing access, streamlining information and providing an avenue to seek potential mentors and develop relationships with leaders in the field. Herein, we discuss how surgeons and medical educators utilize SM and how medical students interested in surgery can take advantage of these applications to heighten their exposure, establish social networks with leaders in the field, create opportunities for information exchange, and enhance their learning.

SM platforms have become an increasingly popular and efficient way for surgeons to rapidly communicate information to their peers, students, patients, and the lay public. In fact, many surgical fields are embracing SM as a necessary component of the practice of surgery.1 SM platforms such as Instagram, Facebook, Twitter, Snapchat, YouTube, and podcasts have effectively eliminated a barrier that previously existed in the field of surgery. Students are now able to gain insight into surgical topics both inside and outside of the operating room through a variety of outlets including stories, images, and videos; this information may include vignettes describing unique cases, instructions for novel surgical techniques, posts seeking crowd-sourced opinions or diagnostic suggestions for difficult cases, and information regarding the latest treatment recommendations or standards. This provides students information about surgical specialties even before their third-year clerkships and is beneficial for those who may be interested in surgery, but have limited exposure to it during their clerkships.

SM is being used to augment and complement traditional medical education. Medical students can follow accounts that discuss high yield concepts and provide study tips pertaining to USMLE Step 1 and 2 and shelf exams. Medical schools have recognized this trend and as a result, have started to use SM as a way to supplement their surgery clerkship curriculum. The University of Michigan used Twitter during the surgery clerkship by tweeting high yield facts, do's and don’ts, and surgical questions.2 When used correctly, SM serves as an outlet that students can access in real-time on mobile devices to enhance learning and stay up to date.3 Incorporating SM into traditional medical education keeps students engaged and thinking about surgery, outside of conventional studying.

Online SM videos are particularly important educational resources for medical students interested in surgery due to the hands-on nature of the field. During surgical clerkships, medical students commonly use YouTube videos to learn about procedures, examine technical details, review rarely-performed techniques or cases, and learn from experienced expert colleagues.4 Despite the obvious and accepted utility of YouTube videos in the education of medical students and general surgery trainees, several studies conclude that the content is not always accurate or reliable. For example, 1 study found that top-ranked videos demonstrating laparoscopic cholecystectomy cases exhibit suboptimal techniques, with only 1 in 10 having a critical view of safety that is adequate and half showing concerning maneuvers.5 Given the accepted utility of online surgical videos for educational use by both medical students and trainees, it will be important for surgical societies to prioritize vetting and improving the quality and accuracy of currently available online videos.

In addition to the inaccuracy of some YouTube videos, medical students must also consider that anyone can create a SM account. Consequently, information provided may be incorrect, unreliable, or skewed. For example, an institution, company, or individual may share information or promote a product to please certain stakeholders, establish a product endorsement relationship, or as a public relations strategy. Individuals posting from their personal accounts may share information that is biased towards their own beliefs and opinions. Similarly, institutional accounts may be managed by a single individual; thus, the information shared may be biased towards the individual's beliefs and not represent the institution as a whole. For these reasons, medical students must be wary and approach SM information in a thoughtful manner, similar to how one does when reading scientific literature. A systematic approach should be taken to identify the credibility of the author, the source and evidence behind the information presented, and the possible existence of an alternative motive or financial interest.

The growth of SM platforms as an educational tool for medical students has prompted general surgery training programs to utilize SM in a similar fashion. In 2016, 32 general surgery training programs in the US had SM accounts that were used as both promotional and educational tools.6 These accounts not only provide prospective applicants with details of the program, but highlight the culture of the institution. Students are able to learn what goes on during training hours, and outside the medical chambers. This is of value to medical students given the increasing concern for physician burnout and the emphasis on one's overall wellbeing. It is exciting to see that our current home institution has created an Instagram account, in an attempt to show the community everything it has to offer. Moreover, as a medical student it is both inspiring and unsettling that SM can be skewed to demonstrate a perception that may not depict actual fact, but could very well highlight the good and bad of said community.

Academic journals have also embraced SM as a way to interactively connect with their audience. The Journal of Thoracic and Cardiovascular Surgery in conjunction with The Annals of Thoracic Surgery formed a SM collaborative called the Thoracic Surgery Social Media Network (TSSMN).7 The Thoracic Surgery Social Media Network hosts Twitter Chats to bring attention to their various publications and facilitate discussion amongst medical professionals in the field. These collaborations are highly beneficial to medical students because we too can participate in these discussions, which concomitantly facilitates active learning and exposes us to faculty-SM-users who share our clinical interests.

In addition to providing educational resources and broad exposure to surgical topics, SM allows for networking opportunities between surgeons and medical students on local, national, and even international levels. These connections cultivate mentorships and therefore expand the pool of available mentors beyond those present at the student's home institution. One study illustrated that female residents used SM to connect with same-sex, outside institution, mentors in their male-dominant surgical specialty.8 These findings remain true for many medical students interested in surgery, evidenced by anecdotes of students connecting with faculty through SM platforms. In 1 example, students from our institution in attendance at a surgery meeting met a prominent bariatric surgeon, connected with her on Instagram, and have since gained valuable insight and guidance into both her surgical specialty and the lifestyle of a woman in medicine. In this anecdote, SM was critical to facilitate the mentorship relationship.

Surgeon utilization of SM allows providers to directly share evidence-based practices with end-users, including medical students and the general public. Content is categorized through use of hashtags, which allows users to easily identify content of interest. Plastic surgery in particular has recognized the value of hashtags to educate, elevate ones brand, maximize exposure, and create a conversation in the academic world.9 These hashtags can be further utilized by medical students and the lay public to disseminate knowledge rapidly and create a sea of interconnectedness. As students, we can either search using broad terms such as: #generalsurgery, #generalsurgeons, #surgery, #surgerylife, or we can be more specific with any subspecialty: #colorectalsurgery, #plasticsurgery, and so on. Once the desired content is found, we can then establish connections with the creator and increase our exposure exponentially. Similar to how hashtags are used, SM allows users to search by location. This provides medical students the opportunity to connect globally with surgeons in other countries or continents. These connections aid in the development of cultural competence and can be used to create opportunities for those that embark on international rotations.10

Through algorithms, SM platforms are able to provide recommendations of similar pages, thereby expanding exposure to the particular field. Based on these tailored suggestions, medical students can learn about new techniques, and better understand the field through different accounts and viewpoints. The advantage of these recommendations is that medical students can catalytically build their surgical network.

The advent of SM has increased access to vital educational information pertaining to the field of surgery, and allowed for trainee connection with a global crop of potential faculty mentors. Due to the popularity of SM, medical students are becoming increasingly accustomed to using different platforms as an educational and professional tool. Medical schools or surgeons that lack SM may seem antiquated. Therefore, it is imperative for medical schools to incorporate SM into their curriculums, as those institutions without SM risk missing opportunities to learn and connect with students, colleagues, and prospective applicants. For these reasons, we encourage all surgical individuals and institutions to consider integrating SM. Surgical experiences are no longer confined to the operating room. As medical students, we can access a vast network of information, across multiple SM platforms to bolster our medical education, connect with colleagues across the globe, and help guide our surgical careers. It is possible that a trainee's future specialty or their next mentor, including ourselves, will emerge after a mere, albeit thoughtfully crafted, 160 characters.

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