|Year : 2018 | Volume
| Issue : 2 | Page : 93-97
From “pearls” to “tweets:” How social media and web-based applications are revolutionizing medical education
Theresa T Stawicki1, Gregory L Peck2, Sagar C Galwankar3, David P Bahner4, James S Papadimos5, Stanislaw P Stawicki1, Thomas J Papadimos6
1 OPUS 12 Foundation, Inc., Bethlehem, Pennsylvania, USA
2 Department of Surgery, Rutgers University School of Medicine, New Brunswick, New Jersey, USA
3 Department of Emergency Medicine, University of Florida School of Medicine, Jacksonville, Florida, USA
4 Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
5 College of Health and Human Services, University of Toledo, Toledo, Ohio, USA
6 Department of Anesthesiology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
|Date of Web Publication||30-Aug-2018|
Dr. Thomas J Papadimos
Department of Anesthesiology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Stawicki TT, Peck GL, Galwankar SC, Bahner DP, Papadimos JS, Stawicki SP, Papadimos TJ. From “pearls” to “tweets:” How social media and web-based applications are revolutionizing medical education. Int J Acad Med 2018;4:93-7
|How to cite this URL:|
Stawicki TT, Peck GL, Galwankar SC, Bahner DP, Papadimos JS, Stawicki SP, Papadimos TJ. From “pearls” to “tweets:” How social media and web-based applications are revolutionizing medical education. Int J Acad Med [serial online] 2018 [cited 2019 Jan 23];4:93-7. Available from: http://www.ijam-web.org/text.asp?2018/4/2/93/240138
Social media (SM) has revolutionized not only the way humans communicate but also the way we share our experiences, including learning and propagation of knowledge. This applies to all levels of education, from elementary to postgraduate.,, As a consequence of the SM revolution, increasing volumes of information are reaching larger and more diverse audiences, with noteworthy adoption rates and efficiency.,
Over the last 5 decades, computer technology has evolved significantly, surpassing many predictions in terms of processing speed, miniaturization, and cost. The overall process of societal transition to using electronic devices has been referred to as the analog to digital transformation. This process now impacts virtually all aspects of our lives, including medical education. Introduction of the Internet provided a powerful impetus for further amalgamation of computing resources, wherein ever more efficient (and smaller) computing machines functioned synergistically, effectively enabling unrestricted sharing of information around the globe., As end-users transitioned from large, slow, cumbersome, and expensive desktop computers to small, handheld, and inexpensive devices, both the overall adoption rate and the number of specific practical applications increased markedly.,
As predicted decades ago, the above factors cumulatively contributed to an exponential growth of information available to end-users on the Internet, with steadily decreasing “information doubling times.”, Despite its relatively recent adoption by the broader public, the World Wide Web has evolved into an intricate network for the exchange of knowledge, culminating with academic faculty gravitating away from analog “pen-and-paper tools” to entirely digital-based methods of scholarly exchange that both enhance end-user experience and help ensure that active learning is taking place through interactive assessments and feedback mechanisms., Given the totality of the above-described changes, it can be reasonably expected that the amount of classically understood “classroom time” will be significantly reduced, with the majority of learning done using increasingly interactive didactic tools (e.g., immersive simulation) requiring the student to spend the better part of his or her learning experience in front of a computer or portable device screen., This concept has been referred to as the flipped classroom where fundamental learning can occur through digital media before coming to the class to learn more about the context and practical application of the informational content.
The Internet provides instant access to limitless amount of information. Although web usage is embraced increasingly by all segments of the population, the more recent generations X, Y, and especially Z (those born after 1990) enmesh virtually every aspect of their lives in “continuous connectedness.”, Knowledge management, entertainment, and communication are among the many areas completely transformed by the implementation of the World Wide Web and subsequent layers of applications that supplement and enhance this primary resource., Currently, more information can be accessed within seconds – after typing a question or speaking it out loud toward a “smart device” – than ever before. Computers, laptops, cell phones, touch screen devices, “smart homes,” and “virtual assistants” are all becoming pervasive throughout our lives, giving rise to the “Internet of things.”, In the past, hours could be spent in a library researching a topic, finding appropriate sources, and cross-referencing and double-checking scholarly information. Nowadays, the same process may take seconds, with complete literature search reports being available almost instantaneously, featuring custom sorting and stratification tools that can “slice and dice” the data in every way imaginable. At this juncture, several important questions emerge: How can academic medicine and medical education benefit from – and contribute to – such developments? Should further incorporation of web-based tools be encouraged in medical education? How do we go about sorting and categorizing information according to its contextual relevance and quality standards? And finally, how do we set appropriate limits and standards of “online behavior and integrity” to optimize the user experience while minimizing negative interactions
Selected practical uses of Internet-based tools in medical education include but are not limited to: (a) management and application of predetermined didactic content; (b) self-assessment and other testing tools, including interactive participation; (c) SM-based platforms for instantaneous sharing of small bits of high-yield information; (d) lifelong learning and continuing professional development; and (e) immersive simulation involving remote stakeholders.,,,,,,, How can the next generation of physicians not only learn but also effectively reinforce their knowledge, skills, and reputation through multimodality didactic approaches? One possibility is the incorporation of Internet-based SM platforms to disseminate knowledge that in the past was the primary foundation for what may be termed “quick facts” or “clinical pearls.”,, After all, experience- or problem-based learning is one of the most effective educational approaches and, when combined with virtual platforms and spaces, may result in better knowledge retention, access, and reproducibility than other didactic methods.,,
Due to the vastness of the general topic of Internet-based education, we will now focus strictly on the much smaller domain of using SM to disseminate targeted, high-yield “clinical pearls” and “shared experiences” as approaches to facilitating experience- and problem-based learning and improvement. People tend to learn from experiences – both their own and others' – and synthesize these experiences into a unique, highly personalized framework of growth and self-improvement.,, According to the US National Library of Medicine National Institutes of Health, “clinical pearls are best defined as small bits of free-standing, clinically relevant information based on experience or observation. They are part of the vast domain of experience-based medicine and can be helpful in dealing with clinical problems for which controlled data do not exist.” “Clinical pearls” are often formatted as “mnemonic devices” – a way of framing things that facilitate recall and application of information. They are also meant to be conveyed and/or transferred in a memorable and readily recognizable fashion, much like a catchy song or humorous joke. Finally, “clinical pearls” tend to target new learners, primarily through their general appeal and content simplicity. Not infrequently, educational experiences incorporating “clinical pearls” through the use of SM will also include lifelogging or an activity that involves end-users sharing aspects of their lives through visual abstracts, images, videos, or text entries., The latter aspect may present a unique set of challenges to active users of SM in the context of medical education, as discussed in subsequent paragraphs.
The first and perhaps most difficult challenge is the fact that SM provides an active interface between the “real world” and the “virtual world.” It is easy to forget – as we are often reminded by various news reports and anecdotal stories – that the “virtual-to-real world” interface can be quite blurry, and one's activities and/or statements in one will readily affect the other.,,, The so-called “online disinhibition effect” has been described in the early 2000s by Suler, who found that online presence tends to be associated with self-disclosure or acting out more frequently or intensely than comparable “in-person behaviors.” Examples of unacceptable “online behaviors” include cyberbullying, stalking, and harassment.,, The authors of this editorial recommend the “think before you type/send” approach to minimize any unintended consequences associated with such “online disinhibition effect.” The second major challenge is the necessity to ensure patient confidentiality and privacy while discussing case-based experiences in an online format. Consequently, all medical personnel, students, and other trainees must be educated regarding the proper use of SM platforms in the context of the Health Information Portability and Accountability Act (HIPAA)., Optimally, “clinical pearls” should focus on concepts and avoid describing actual cases. However, if case-based context is required to better or more effectively convey content, such cases should be purely fictional and should not include any identifiable information (including photographs and/or other visual aids). Third, “clinical pearls” often rely on individual or collective “memory of an event,” which has the potential to introduce significant bias into the didactic content being conveyed. Thus, “clinical pearls” should be considered with a healthy degree of skepticism and categorized under “anecdotal evidence” in terms of their medical value., Finally, all users of SM should have rudimentary understanding of intellectual property rights (and associated laws). Unlicensed use of materials – although protected to some extent in the educational setting – can result in serious legal ramifications for the individual(s) involved.,
There are many different forms of what is broadly defined as “SM,” from various text-based applications, to video-based platforms, to hybrid concepts that incorporate elements of all types of “multimedia.”,, Moreover, an increasing number of web-based educational materials are dedicated to knowledge management and testing, including “virtual notecards,” “online quizzes,” “content gamification,” surveys/questionnaires, and other more advanced/adaptive forms of medical content-based interactive assessment.,,, SM-based offerings are often bundled with promotional content in the forms of “daily clinical pearl” or “clinical trivia of the day,” although the authors caution users to take such offers with a dose of healthy skepticism. The ability to discern facts from fiction or hyperbole is essential when viewing any online media from nonpeer-reviewed sources. Moreover, web-based applications have been created to help distribute medical information to the public in format similar to that of “clinical pearls,” often augmented by “online patient communities.” Such developments will likely result in patients having better baseline knowledge about their disease and bringing a much more informed perspective to individual health-care encounters.,,, Finally, web-based consultative services are being made available to patients who wish to seek independent medical advice., Such endeavors should be viewed with extreme caution, primarily due to obvious limitations of “remote medical evaluation” but also because the regulatory environment surrounding online medical consultations is nebulous at best.,,,
Another very important aspect of incorporating SM-based approaches into medical education is the growing problem of quality and validity of health-care-related information available on the Internet., Within this broader context, it is critical to ensure that the content is used responsibly and that inadvertent propagation of unhealthy behaviors or habits does not occur.,, Finally, how should medical schools incorporate faculty SM contributions in the broader context of academic promotion and tenure? There is growing support for formal recognition of SM as a valid avenue for faculty advancement.,,
The authors of this editorial hope that they have provided a sufficient high-level overview of key topics involving SM in medicine [Figure 1], more specifically focusing on medical education. With the adoption of web-based interactive technologies, including emerging virtual reality tools, it is expected that the concept of “clinical pearl” will continue to evolve and take on new forms within the broader context of experience- and case-based medical education. As always, with any great opportunity comes great responsibility. As we continue along this analog-to-digital metamorphosis, we should remember that knowledge dissemination happens much faster and more efficiently when using SM, the Internet, and various digital devices. This is only the beginning of a significant transformational megatrend in medical education.
|Figure 1: Key concepts involved in the process of adaptation of social media-based approaches in medical education. The complexity of the topic far exceeds considerations typical to traditional curriculum development|
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| References|| |
Collins A, Halverson R. Rethinking Education in the Age of Technology: The Digital Revolution and Schooling. America: Teachers College Press; 2018.
Whyte W, Hennessy C. Social Media use Within Medical Education: A Systematic Review to Develop a Pilot Questionnaire on How Social Media can be Best used at BSMS. Dundee, Scotland: MedEdPublish 2017. p. 6.
Venkatesh S, Chandrasekaran V, Dhandapany G, Palanisamy S, Sadagopan S. A survey on internet usage and online learning behaviour among medical undergraduates. Postgrad Med J 2017;93:275-9.
Duderstadt JJ, Atkins DE, Van Houweling DE. Higher Education in the Digital Age: Technology Issues and Strategies for American Colleges and Universities. Westport, CT: Greenwood Publishing Group; 2002.
Gerbaudo P. Tweets and the Streets: Social Media and Contemporary Activism. New York, NY: Pluto Press; 2018.
Brown JS, Duguid P. The Social Life of Information: Updated, with a New Preface. Boston, MA: Harvard Business Review Press; 2017.
Brock DC, Moore GE. Understanding Moore's Law: Four Decades of Innovation. Philadelphia, PA: Chemical Heritage Foundation; 2006.
McCarthy H, Miller P, Skidmore P. Network Logic: Who Governs in an Interconnected world. London, UK: Demos; 2004.
Stromquist NP. Education in a Globalized World: The Connectivity of Economic Power, Technology, and Knowledge. Lanham, Maryland: Rowman & Littlefield; 2002.
Madden M, Lenhart A, Duggan M, Cortesi S, Gasser U. Teens and Technology 2013. Pew Internet & American Life Project; 2005.
Smith A. Americans and their Gadgets. Pew Internet Research; 2010. p. 56.
Prothero J.D. The Political Science of the Internet. Technical Report, University of Washington; 1996.
Morse K. LEARNING ON DEMAND, in The Challenges of Educating People to Lead in a Challenging World. Cham, Switzerland: Springer; 2007. p. 33-49.
Chen J. Enhancing Student Engagement and Interaction in e-Learning Environments Through Learning Analytics and Wearable Sensing; 2016.
Mazza R. Using Information Visualisation to Facilitate Instructors in Web-Based distance learning. Università della Svizzera Italiana; 2004.
Rosen LD. Rewired: Understanding the iGeneration and the Way They learn. New York, NY: St. Martin's Press; 2010.
Selingo JJ. College (un) Bound: The Future of Higher Education and What it Means for Students. Boston, MA: Houghton Mifflin Harcourt; 2013.
Barber NA. Investigating the potential influence of the internet as a new socialization agent in context with other traditional socialization agents. J Mark Theory Pract 2013;21:179-94.
McCrindle M, Wolfinger E. The ABC of XYZ: Understanding the Global Generations. Sydney, Australia: University of New South Wales Press, Ltd.; 2009.
Buhalis D, Law R. Progress in information technology and tourism management: 20 years on and 10 years after the Internet – The state of eTourism research. Tour Manag 2008;29:609-23.
Miorandi D, Sicari S, De Pellegrini F, Chlamtac I. Internet of things: Vision, applications and research challenges. Ad hoc Netw 2012;10:1497-516.
Baron NS. Always on: Language in an Online and Mobile World. New York, NY: Oxford University Press; 2010.
Lambrechts J, Sinha S. Ubiquitous Computing: Distributing Mobile Computing to Build a Global Network of Things, in Microsensing Networks for Sustainable Cities. Cham, Switzerland: Springer; 2016. p. 201-35.
Stawicki SP, Firstenberg MS, Papadimos TJ. What's new in academic medicine? Blockchain technology in health-care: Bigger, better, fairer, faster, and leaner. Int J Acad Med 2018;4:1.
Weinberg L. From Mass Culture to Personalization. Santa Cruz, California: UC Santa Cruz Electronic Theses and Dissertations; 2018.
Aškerc K, Cvetek S, Lorjancic V, Klemencic M, Pozarnik BM, Rutar S. Improving the quality of teaching and learning in higher education. Ljubljana, Slovenia: National University Press. 2016.
Pillai JB, Dennick R. Contemporary pedagogy within surgical education websites: A review of the literature. Int J Med Educ 2012;3:21-36.
Neimeyer G, Taylor M. Ten trends in lifelong learning and continuing professional development. In: Johnson WB, Kaslow N, editors. The Oxford Handbook of Education and Training in Professional Psychology. New York, NY: Oxford University Press; 2014. p. 214.
Brug J, Oenema A, Campbell M. Past, present, and future of computer-tailored nutrition education. Am J Clin Nutr 2003;77:1028S-34S.
Simon M, Ercikan K, Rousseau M. Improving Large-Scale Assessment in Education: Theory, Issues, and Practice. New York, NY: Routledge; 2012.
Ruiz JG, Mintzer MJ, Leipzig RM. The impact of E-learning in medical education. Acad Med 2006;81:207-12.
Cant RP, Cooper SJ. Simulation in the internet age: The place of web-based simulation in nursing education. An integrative review. Nurse Educ Today 2014;34:1435-42.
Grunwald T, Corsbie-Massay C. Guidelines for cognitively efficient multimedia learning tools: Educational strategies, cognitive load, and interface design. Acad Med 2006;81:213-23.
Bahner DP, Adkins E, Patel N, Donley C, Nagel R, Kman NE, et al.
How we use social media to supplement a novel curriculum in medical education. Med Teach 2012;34:439-44.
Forgie SE, Duff JP, Ross S. Twelve tips for using twitter as a learning tool in medical education. Med Teach 2013;35:8-14.
Choo EK, Ranney ML, Chan TM, Trueger NS, Walsh AE, Tegtmeyer K, et al.
Twitter as a tool for communication and knowledge exchange in academic medicine: A guide for skeptics and novices. Med Teach 2015;37:411-6.
De Freitas S. Serious Virtual Worlds: A Scoping Study. Bristol, UK: SGI Serious Games Institute;2008.
Dornan T, Boshuizen H, King N, Scherpbier A. Experience-based learning: A model linking the processes and outcomes of medical students' workplace learning. Med Educ 2007;41:84-91.
Ricoy MC, Feliz T. Twitter as a learning community in higher education. J Educ Technol Soc 2016;19:237.
Lorin MI, Palazzi DL, Turner TL, Ward MA. What is a clinical pearl and what is its role in medical education? Med Teach 2008;30:870-4.
Yip J, Wilson MS. Learning from experience. Handbook of leadership development. Vol. 122. Greensboro, NC: The Center for Creative Leadership; 2010. p. 63.
Paris SG, Paris AH. Classroom applications of research on self-regulated learning. Educ Psychol 2001;36:89-101.
Chau J, Cheng G. Towards understanding the potential of e-portfolios for independent learning: A qualitative study. Australas J Educ Technol 2010;26:932-950.
Wallace P. The Psychology of the Internet. New York, NY: Cambridge University Press; 2015.
Kraut R, Patterson M, Lundmark V, Kiesler S, Mukopadhyay T, Scherlis W, et al.
Internet paradox. A social technology that reduces social involvement and psychological well-being? Am Psychol 1998;53:1017-31.
Meyrowitz J. No Sense of Place: The Impact of Electronic Media on Social Behavior. New York, NY: Oxford University Press; 1986.
Moorhead SA, Hazlett DE, Harrison L, Carroll JK, Irwin A, Hoving C, et al.
A new dimension of health care: Systematic review of the uses, benefits, and limitations of social media for health communication. J Med Internet Res 2013;15:e85.
Suler J. The online disinhibition effect. Cyberpsychol Behav 2004;7:321-6.
Lindsay M, Krysik J. Online harassment among college students: A replication incorporating new Internet trends. Inf Commun Soc 2012;15:703-19.
Hinduja S, Patchin JW. Cyberbullying: A review of the legal issues facing educators. Prev Schl Fail Altern Educ Child Youth 2011;55:71-8.
Griffiths M. Internet abuse in the workplace: Issues and concerns for employers and employment counselors. J Employ Couns 2003;40:87-96.
Azizi T. The issues surrounding social network sites and healthcare professionals. J Perioper Pract 2013;23:233-6.
Kaczmarczyk JM, Chuang A, Dugoff L, Abbott JF, Cullimore AJ, Dalrymple J, et al.
E-professionalism: A new frontier in medical education. Teach Learn Med 2013;25:165-70.
Panahi S, Watson J, Partridge H. Social media and physicians: Exploring the benefits and challenges. Health Informatics J 2016;22:99-112.
Nuland SB. The Uncertain Art: Thoughts on a life in Medicine. New York, NY: Random House; 2008.
Frankovich J, Longhurst CA, Sutherland SM. Evidence-based medicine in the EMR era. N Engl J Med 2011;365:1758-9.
Kietzmann JH, Hermkens K, McCarthy IP, Silvestre BS. Social media? Get serious! understanding the functional building blocks of social media. Bus Horiz 2011;54:241-51.
Kaplan AM, Haenlein M. Users of the world, unite! The challenges and opportunities of social media. Bus Horiz 2010;53:59-68.
Schaper E, Ehlers JP, Dilly M, Crowther E. Using youTube to share teaching resources. J Am Vet Med Assoc 2014;245:372-3.
Grajales FJ 3rd
, Sheps S, Ho K, Novak-Lauscher H, Eysenbach G. Social media: A review and tutorial of applications in medicine and health care. J Med Internet Res 2014;16:e13.
Scott KR, Hsu CH, Johnson NJ, Mamtani M, Conlon LW, DeRoos FJ, et al.
Integration of social media in emergency medicine residency curriculum. Ann Emerg Med 2014;64:396-404.
Zichermann G, Cunningham C. Gamification by Design: Implementing Game Mechanics in Web and Mobile Apps. Sebastopol, CA: O'Reilly Media, Inc.; 2011.
Chapman DD, Stone SJ. Measurement of outcomes in virtual environments. Adv Dev Hum Res 2010;12:665-80.
Kibble J. Use of unsupervised online quizzes as formative assessment in a medical physiology course: Effects of incentives on student participation and performance. Adv Physiol Educ 2007;31:253-60.
Reed S, Shell R, Kassis K, Tartaglia K, Wallihan R, Smith K, et al.
Applying adult learning practices in medical education. Curr Probl Pediatr Adolesc Health Care 2014;44:170-81.
Frost JH, Massagli MP. Social uses of personal health information within patientsLikeMe, an online patient community: What can happen when patients have access to one another's data. J Med Internet Res 2008;10:e15.
Wasson JH, MacKenzie TA, Hall M. Patients use an internet technology to report when things go wrong. Qual Saf Health Care 2007;16:213-5.
Sonnenberg FA. Health information on the internet. Opportunities and pitfalls. Arch Intern Med 1997;157:151-2.
Shuyler KS, Knight KM. What are patients seeking when they turn to the internet? qualitative content analysis of questions asked by visitors to an orthopaedics web site. J Med Internet Research 2003;5:e24.
Ziebland S, Chapple A, Dumelow C, Evans J, Prinjha S, Rozmovits L. How the internet affects patients' experience of cancer: A qualitative study. BMJ 2004;328:564.
Umefjord G, Sandström H, Malker H, Petersson G. Medical text-based consultations on the internet: A 4-year study. Int J Med Inform 2008;77:114-21.
Umefjord G, Hamberg K, Malker H, Petersson G. The use of an internet-based ask the doctor service involving family physicians: Evaluation by a web survey. Fam Pract 2006;23:159-66.
Terry NP. Cyber-malpractice: Legal exposure for cybermedicine. Am J Law Med 1999;25:327-66.
Miah A, Rich E. The Medicalization of Cyberspace. London, UK: Routledge; 2008.
Zembowicz A, Ahmad A, Lyle SR. A comprehensive analysis of a web-based dermatopathology second opinion consultation practice. Arch Pathol Lab Med 2011;135:379-83.
George DR, Rovniak LS, Kraschnewski JL. Dangers and opportunities for social media in medicine. Clin Obstet Gynecol 2013;56:453-62.
Scanfeld D, Scanfeld V, Larson EL. Dissemination of health information through social networks: Twitter and antibiotics. Am J Infect Control 2010;38:182-8.
Chang PF, Bazarova NN. Managing stigma: Disclosure-response communication patterns in pro-anorexic websites. Health Commun 2016;31:217-29.
Syed-Abdul S, Fernandez-Luque L, Jian WS, Li YC, Crain S, Hsu MH, et al.
Misleading health-related information promoted through video-based social media: Anorexia on youTube. J Med Internet Res 2013;15:e30.
Barton CJ, Merolli MA. It is time to replace publish or perish with get visible or vanish: Opportunities where digital and social media can reshape knowledge translation. Br J Sports Med 2017. pii: bjsports-2017-098367.
Gruzd A, Staves K, Wilk A. Tenure and promotion in the age of online social media. Proc Am Soc Inf Sci Technol 2011;48:1-9.
Cabrera D, Vartabedian BS, Spinner RJ, Jordan BL, Aase LA, Timimi FK. More than likes and tweets: Creating social media portfolios for academic promotion and tenure. J Grad Med Educ 2017;9:421-5.