Saturday, June 23, 2012

Social Media for Medical Students Part I: Why Engage?

Image by Rosaura Ochoa

This post is an excerpt from my complete, downloadable guide published here.

Part I: Social Media Strategy for Medical Students

Budding physicians are coming to recognize the power of a few good apps. Consider the following situation: your patient with right upper quadrant pain and abdominal distension needs a paracentesis today. Your senior resident is familiar with the procedure, but won’t be by to supervise the intern for a few minutes, during which time the intern is asked to prepare the patient for the procedure. The intern is almost as unfamiliar with the procedure as you are. Typically, you would witness the ongoing display of feigned competence, nursing frustration, and patient agitation. Later, during some down time or at home, you would reference paracentesis on the web so that you would be spared the embarrassment you had witnessed. Or, you could use an app.

Medscape is a mobile app designed for doctors that has a little known feature—a procedures tab that includes, among others, paracentesis. There, it describes the indications, preparation, technique, and interpretation of results, all supported with references. More substantive than Wikipedia, more available and too-the-point than UpToDate, you could soon be telling your intern how to prepare, assuring the nursing staff why the procedure is necessary, and explaining to the patient what he can expect when the procedure is finished.

Staying ahead of the information curve is a growing challenge. While medical school trains students to stay current with developments in the clinical and basic sciences, little attention is devoted to the latest point-of-care smartphone, tablet, and web applications. Until medical school curricula effectively modernize from its early 20th century roots, it is unlikely that they will provide guidance for staying abreast of the latest apps. Until that time, your best source will be social networking sites like Twitter, Facebook, blogs, Google+, and any other of the rapidly emerging two-way communication platforms.

A particularly effective method to stay up-to-date on these helpful new tools that are rarely incorporated into traditional medical education is to use Twitter. As of this writing, a useful source is  @iMedicalApps, the Twitter feed for the website In the form of once or twice daily short messages, or tweets, that include a web link, @iMedicalApps offers continual brief updates that are easy to peruse or search. The @iMedicalApps Twitter feed consists of very brief descriptions with a link, like this:

             “The top 20 free iPhone apps for medical professionals:”

On Twitter, @iMedicalApps is just one of many great resources. The best sources are often an individual physician from a student’s area of interest who can comment on an app’s value from the perspective of an experienced clinician.

What sounds like a time-consuming process is actually more efficient than traditional use of web surfing or email to stay current. Several time-saving features bear mentioning. 1- The content is “pushed” to one place, your Twitter feed, obviating the need to regularly check in on websites and scan through irrelevant material. 2- Since the service is social, particularly useful tweets get highlighted by people in your network who share your interests. If you are interested in primary care, your attention is appropriately drawn when a prominent family physician recommends an interesting patient management app. 3- As a social service, it is also quick and easy to communicate directly with information sources. 4- Unlike email, tweets don’t demand your attention. Instead, they’re simply available for use if you want them.

The purpose of this document is to introduce the value of social media in medicine, particularly for medical students. Contrary to perception, appropriate use of social media supports several requirements of genuine, sound medicine. By adopting tools like Twitter, Facebook, blogging, and a whole host of other interfaces, a medical student can advance their studies and understanding of central aspects of the medical profession. The following are several strategic areas for applying social media tools.

Staying up to date:
People whose career interests match your own and are active in social media tend to share relevant news and updates. By tuning in, you can save yourself much of the effort required to actively hunt up this information. Instead, you can create your own network of interesting sources. Topics can span the massive diversity of relevant medical topics, from basic and clinical developments to changes in policy or technology, only a few of which are genuinely supported by medical curricula. With the accelerating pace of innovation, the sheer volume of “new stuff” can be efficiently filtered with social media.
Example: The Institute of Medicine’s updated its vitamin D recommendations in late 2010. While these guidelines would take months or years to reach medical curricula, social media tools can easily catch these updates on the day they were released. More than that, the social nature allows access to the developing controversy about what the guidelines mean, a controversy and discussion that grows stale with time.

Mentoring and Advice:
Social media services offer a simple way to connect with people who share your interests, to network, and to gain advice. By sharing what others post and commenting on their content, students have a method to casually develop relationships.

Example: The process of students meeting mentors, and ultimately collaborators and letter writers, has already begun with Twitter. On scenario began with the offer of guest lecturing after the would-be mentor noticed his tweets were being shared by an engaged medical student.

Social media is a powerful tool to stay in touch with old colleagues. While email exchanges can become burdensome, they often trail off when people separate. Facebook and Twitter offer quick contact with minimal time obligations.

Being a member of a profession, rather than simply an independent service provider, means engaging with the broader issues of healthcare, both as an individual and as a member of a physicians’ organization.

Example: There are a number of physician-commentators who maintain blogs and post their writings on Twitter. By finding a few compelling voices, one can both keep tabs on developments like healthcare legislation and new provider models, as well as offer comments and share opinions.

Business of Medicine:
Medical schools and residency programs are notorious for releasing their trainees with little preparation for the business realities of managing a practice. Social media offers a way to gain insight into these realities in the absence of classroom content.

Example: New and innovative care models, like direct primary care, do not find their way into medical curricula until they are sufficiently established. However, such cutting-edge techniques often access social media channels to publicize their progress. By gaining exposure to these ideas long before residency, fellowship, and practice, savvy students can have a better idea of opportunities early on in their career planning.

Tools like Facebook or Yammer are excellent resources with which to ask and answer the vast number of questions arising in medical education. Rather than requiring a faculty member to answer individual questions repeatedly by email, open groups enable such answers to be visible to everyone logging in. Such interactive tools both improve feedback and leverage student answers, promoting active learning.

Example: The use of a Facebook group is very well received in a first-year basic science course at SUNY Upstate.

Clinical Applications (in the future):
Although this is largely uncharted territory, there are several examples of doctors who use patient relationships over social media tools to improve scheduling and to affect behavior change. By getting involved earlier, students can establish an understanding of social media tools so that they may become pioneers of these developments.

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