Sharing information through social media platforms has become a part of everyday life. However, there's more to social media than duck-face selfies and cat memes. Physicians have increasingly used social networking sites as alternatives to traditional learning via textbooks, journal subscriptions, and in-person conferences. At the same time, with the explosion of largely unregulated, freely available online medical content, some have questioned: Is this material of educational value? We believe the answer is a solid “yes.”

Table: Common Social Media Platforms in Medical Education

Table: Common Social Media Platforms in Medical Education
Table: Common Social Media Platforms in Medical Education

The core feature of medical education via social media is the connectivity and the ability to reach a very large audience quickly by successive (and sometimes viral) sharing throughout a network. Typically, social media medical education (#MedEd) is free and open access (#FOAMed), generated by users for users and shared in a collaborative manner. For example, an anesthesiologist in India may post a “tweetorial” (a thread of connected short posts on X that together form a mini-tutorial) on a new airway management technique; a Brazilian trainee likes and “retweets” (e.g., shares) the thread, adding additional comments and perspectives; dozens of her followers do likewise, attaching video clips, images, and tagging other anesthesiologists with a similar interest; a follower in Norway debates a minor point and posts references with links to peer-reviewed articles to support his position; within hours, the original post (and all of the subsequent informative interaction) has been seen by tens of thousands of physicians across five continents. The conversation is not limited to anesthesiologists, but also physicians from other specialties, other health care practitioners, and our patients, who can all contribute and share their valuable perspectives.

While X has evolved as a favorite platform for many anesthesiologists for its succinct “micro-blogging” structure, others prefer the image-based Instagram or TikTok, particularly for sharing videos and quick tips. The most popular social media site in the U.S. is YouTube, which is similarly well-suited for visual learning, as well as longer narrative lectures and slideshows (asamonitor.pub/4bqF7WJ). Trainees can make use of YouTube for “just-in-time” learning by watching an instructional video on a nerve block or line placement technique in preparation for beside teaching. Facebook remains a dominant social network that anesthesiologists are involved with, often in a community or “group” that allows users with common interests to share cases and articles, pose questions, and gather opinions on clinical dilemmas. Finally, podcasts allow learners to digest a short segment of high-quality information in an offline setting (e.g., at the gym or on a plane). These are often presented in a more conversational style, allowing for exploratory discussion of scientific concepts or anesthetic practice. Regardless of the platform, hashtags are a key to keeping discussions organized by topic: learners can quickly search a platform for specific threads using hashtags such as #POCUS, #intubation, #OBanes, etc. (Adv Med Educ Pract 2020;11:53-61).

In addition to being a novel way to learn, there are four key reasons why medical education via social media should be seen as a valid and valuable modality:

Using social media for sharing new innovations, the latest study, or a useful “how-to” video removes the barriers of time zones, geography, and expense, leveling the playing field for physicians across the globe. For example, rather than learning point-of-care ultrasound at an expensive workshop in another state or country, audiences from every socioeconomic and geographic corner of the globe can acquire knowledge and refine their diagnostic skills by watching YouTube instructional videos while posting and commenting on case discussions via X or Facebook. Anesthesiologists from under resourced areas need only an internet connection to have access to the same high-quality knowledge as their colleagues in London or Sydney.

Social media has also leveled an “eminence” barrier. While a student may feel intimidated to ask a question of the attending in a hierarchical hospital setting, that power imbalance is rendered largely moot with the informality of the social media world (N Am J Med Sci 2016;8:268-78). Things that an authority “knows” to be true will not simply be accepted by others online. They will rightly demand evidence for that opinion. It might be that the “truth” learned 20 years ago as a medical student has been updated. This forces the more senior to question their assumptions and gain a more up-to-date understanding of a given topic.

Fifteen years ago, an investigator would have to wait six months or longer to find his/her manuscript in print, with no guarantee that anyone would actually read it. Journals now routinely post preprints and infographics on X in advance of publication so that clinicians can more rapidly benefit from the results. This was particularly relevant during the early days of the COVID-19 pandemic, when new information about viral transmissibility and clinical management of infected patients was being generated daily (PLoS One 2024;19:e0298741).

Studies have shown that scientific papers achieve more visibility and are more highly cited when shared on X (J Med Internet Res 2011;13:e123). Journals that have a successful X account are more likely to experience an increase in impact factor than those without, underscoring the value of sharing peer-reviewed literature early and widely via social media (Br J Anaesth 2015;115:940-1). Journals have embraced the tracking of alternative metrics (“altmetrics”), which quantify impressions on social media platforms.

“Live tweeting” is another well-established way in which social media brings knowledge to physicians immediately. Conference attendees post notes, learning points, photos, and images of slides in real time while a speaker is delivering a lecture, usually accompanied by the conference hashtag (e.g. #ASRASpring24). This process allows remote learners and even non-attendees to gain from the experience and engage in the discussion (Reg Anesth Pain Med 2017;42:283-8).

The interactive nature of social media has been shown to facilitate retention of information and improve performance in medical education by enhancing learner engagement. A commonly observed pattern is that a learner will seek information from one platform (e.g., YouTube) then do a similar search on Facebook and then X in order to gain a more comprehensive and contextual answer to the question. This is an example of “distributed practice,” whereby learning occurs more effectively in the form of multiple smaller sessions rather than one long session (Acad Radiol 2023;30:565-6).

The formal implementation of social media into a traditional curriculum can also have positive results. Studies have shown that the implementation of blog-based discussion groups (e.g., Facebook) and/or X quizzes has a significant positive effect on medical school grades (Med Teach 2010;32:270). X-based journal clubs provide a fun and useful means to augment learner engagement, collaborate widely outside institutions, and increase trainee satisfaction with the journal club process (Adv Med Educ Pract 2020;11:53-61).

While continuing medical education credits for engaging with educational content on social media are not common, some podcasts offer AMA Category 1 credits to add extra value to the learner's experience (e.g., Block It Like It's Hot, a regional anesthesiology podcast).

The quality of content posted on social media is naturally quite variable. In one survey of YouTube videos depicting neuraxial procedures, 10% of videos contained erroneous information (Clin Neurol Neurosurg 2012;114:655-8). However, one advantage of social media is a true “peer review”: high-quality content that is accurate and relevant will tend to get upvoted, liked and shared, quickly rising to the top of users' feeds, while information that deviates from accepted standards or contains questionable statements will be called out in the comments section and will, over time, fail to be promulgated. This online peer review can lead to contact with the journal with either a letter to the editor or a retraction if there is a major problem with the science. The value of science is enhanced when false research is removed sooner. YouTube recently began a verification system for creators who are licensed health care providers as a step toward setting a quality standard in health-related video content.

Some in #MedTwitter have left major platforms for other smaller sites such as Mastodon or Bluesky, citing concerns around misinformation, disinformation, privacy, and online hate. It is difficult to predict what will happen in this rapidly evolving space. The only constant thing is change. Generative artificial intelligence, virtual reality, and augmented reality will change how we converse online. Perhaps these innovations will make sites more acceptable, maximizing the education and social value and minimizing the risk. Or perhaps issues such as deep fakes or voice cloning will introduce additional problems. We hope the changes will facilitate intelligent, respectful, safe, and accessible medical education for all.

Social media is a powerful tool for peer-to-peer sharing, collaborating, and learning and is increasingly a principal source for trainee and continuing medical education (Curr Anesthesiol Rep 2017;7:238-45). How else would a Brit, a Canadian, and a Kiwi who were strangers before find, meet, and write a paper together? Education via social media eliminates barriers to learning, accelerates dissemination of new information, and promotes learner engagement. In the words of one author, “the power of social media really lies in cultivating a sense of excitement in learning” (Acad Radiol 2023;30:565-6).

Disclosures: Dr. Gadsden is a consultant for Pacira Pharmaceuticals Inc. Dr. Pawa is a consultant for Pacira Pharmaceuticals Inc. and has received honoraria for teaching from GE HealthCare.

Jeff Gadsden, MD, FRCPC, FANZCA, Professor of Anesthesiology, Duke University, Durham, North Carolina.

Jeff Gadsden, MD, FRCPC, FANZCA, Professor of Anesthesiology, Duke University, Durham, North Carolina.

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Tanya Selak, BHB, MBChB, FANZCA, MHA, GAICD, Consultant Anaesthetist, Wollongong Hospital, Vice President, Australian and New Zealand College of Anaesthetists (ANZCA), New South Wales, Australia.

Tanya Selak, BHB, MBChB, FANZCA, MHA, GAICD, Consultant Anaesthetist, Wollongong Hospital, Vice President, Australian and New Zealand College of Anaesthetists (ANZCA), New South Wales, Australia.

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Amit Pawa, BSc, MBBS, FRCA, EDRA, Consultant Anaesthetist, Guy's and St Thomas' NHS Foundation Trust and Cleveland Clinic London, and Interim Clinical Professor of Anesthesiology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, London, United Kingdom.

Amit Pawa, BSc, MBBS, FRCA, EDRA, Consultant Anaesthetist, Guy's and St Thomas' NHS Foundation Trust and Cleveland Clinic London, and Interim Clinical Professor of Anesthesiology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, London, United Kingdom.

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