The Social Media Summit in Health Professions Education

“Big breakthroughs happen when what is suddenly possible meets what is desperately needed.” Thomas L Friedman The use of social media is a disruptive innovation that is fundamentally changing the landscape of health professions education. “Social media use internet-based communications technology to engage geographically dispersed groups or individuals to create or share content related to a common theme, thus forming a ‘virtual’ community”.1 Social media also promote the development and strengthening of communities around a common interest, in networks of 3–3000. In the case of health professions education, virtual communities distribute education resources and also actively engage in the production, modification and evaluation of education resources. The spectrum of social media platforms includes blogs, microblogs (eg, Twitter), networking websites (eg, Facebook), podcasts and online courses (eg, Khan Academy).2 Incorporation of social media into clinical and education practice has been rapidly growing in the last 50 years.3 4 Social media can be considered ‘disruptive’ because they leverage inexpensive emerging technology to promote learning via novel methods.5 These novel approaches to learning may either supplement or displace altogether existing education methods. However, educators must be cautious in the rapid adoption without critical appraisal of such new learning modalities.6 The novelty of technology could lead to the inappropriate incorporation of social media without appreciation of unintended consequences. Recognising the rapid adoption of social media and their disruptive influence on health professions education, the International Conference on Residency Education established a committee to plan an international consensus conference, the Social Media Summit in Health Professions Education, with the goal to determine best practices in the design and use of social media in health professions education. Members of the committee were from Canada, the UK and the USA. Committee members represented education experts, social media opinion leaders, senior education administrators (eg, dean) and (post)graduate medical education trainees. Four themes were identified for study (box 1) and a one-day consensus conference was held in Toronto, Canada on 23 October 2014 to explore each of these themes. ▸ How learning theory should inform social media use in health professions education ▸ Defining and evaluation social media-based health professions education scholarship ▸ Ethical and professional use of social media for health professions education ▸ Best practices for social media platforms in health professions education Ten months before the consensus, conference working groups were established for each of the four themes. Each group conducted a literature search and designed a consensus methodology to explore their theme during the consensus conference. Pre-conference materials, including draft consensus statements, key resources and audience engagement questions, were posted on an open-access moderated discussion board. The aim was to enable participants to link with materials and each other and to start discussion of ideas ahead of the conference. The consensus conference was an open access meeting held on the day before the 2014 International Conference on Residency Education which was promoted through multiple digital media streams including prominent medical education blogs, Twitter, medical education organisation websites, Google ads, health professions education listservs and by directly contacting opinion leaders in health professions education and encouraging snowball invitations.7 There were 83 in-person participants at the conference. Countries represented included Australia, Canada, Oman, Thailand, the UK and the USA, and participants included clinician educators, clinician teachers, education deans, education researchers, education programme managers and education administrators. In addition, 291 participants engaged in the virtual discussion via Twitter. There were 2241 tweets and more than 5.2 million Twitter impressions (ie, potential views of unique 140-character notifications (tweets) appearing in users’ Twitter streams, as calculated by the number of tweets per user and multiplying it by the number of followers of that user).8 Plenary sessions were video live-streamed with open access. All consensus sessions incorporated real-time engagement with a virtual audience using multiple large Twitter walls (ie, monitors with a live feed of all Twitter traffic linked by the hashtag SoMeSummit). In-person participants selected two themes to attend (two themes ran concurrently in the morning and in the afternoon). Each concurrent session consisted of approximately 40 people. A variety of methodologies were used during each 2 h session including: a modified Delphi method, a consensus process, an appreciative inquiry model and an iterative guided large group discussion (see the associated papers for more details). At the conclusion of each concurrent session the virtual and in-person participants reached conclusions regarding the specific theme addressed. After the consensus conference each working group authored a manuscript detailing the results of the work done at the conference. These manuscripts are published in the Postgraduate Medical Journal. The manuscripts are free so that the results can be widely shared with the health professions education community. In addition to the Postgraduate Medical Journal publisher website, the manuscripts are also posted on an open-access moderated discussion board to allow discussion of the consensus conference findings to continue after publication. The first lesson learned is that pre-conference virtual engagement with material was limited (table 1). One explanation is that before the consensus conference there was no active global community of practice9 connected or dedicated to pursing social media as a platform for health professions education. The conference design was to address a priori topics; it was not to provide a forum for an established education movement. However, the consensus conference process ultimately helped facilitate nascent community of practice formation, which hopefully carries forward. Lessons learned Lessons learned The second lesson was that virtual participation enriched the wider discussion of a topic. Dedicated Twitter facilitators were used in small group sessions to aggregate information and ensure that the group discussion incorporated themes and perspectives that were generated online. These parallel channels of discussion (in-person and online) provided diversity and richness in ideas and analysis.10 Hearing and reading, in parallel, multiple perspectives on a topic ensured the final position reached was not a function of limited input, but reflected complex aggregate opinions. Finally, the rapid cycle typical of social media discussion—where an idea is presented, debated and a refined solution agreed upon—was not matched by the pace of post-conference follow-up communication. The traditional publication cycle (although accelerated in this case when compared with other scholarship timelines) meant that the findings of the consensus conference were not distributed to the health professions education community for more than 10 months after the meeting. A traditional writing plan was followed that did not incorporate virtual updates on synthesised findings or interim drafts. While the publication cycle in social media is incredibly short—measured in days—nearly a year was required to disseminate the findings of the consensus conference. This lag led to a loss of momentum in acting on the recommendations and a slow disconnection between the consensus conference and the established and intended audience. Future steps for the consensus conference findings consist of promotion via multiple channels, including Postgraduate Medical Journal, the 2015 International Residency Education Conference, prominent education blogs, the KeyLIME (Key Literature in Medical Education) podcast11 and Twitter.12 The intent is that post-publication crowd-sourced comments (ie, post-publication peer review) can further refine the results that have already gone through both a consensus conference process and formal publication peer review. By archiving and responding to the post-publication comments via a moderated discussion board, the findings become a dynamic influence on the disruptive effect of social media on health professions education. The author wishes to acknowledge the participants in the consensus conference for their contributions to developing the consensus statements.