From the Oxford Dictionaries, social media is defined as “Websites and applications that enable users to create and share content or to participate in social networking.” Common platforms include YouTube, Facebook, Twitter, LinkedIn, Instagram, TikTok, blogs, and many others. Given this broad definition, and unfortunately not enough time or space to do justice to this topic, this brief review will focus on specific reasons to engage in social media and the use of Twitter for regional anaesthesia knowledge translation. For a broader discussion of the potential benefits of using social media within the practice of regional anaesthesia, please refer to the article by Schwenk and colleagues, “How social media is changing the practice of regional anesthesiology.”1
Data from the Pew Institute show that 70% of Americans use some form of social media, and the most common platforms are YouTube and Facebook.2 Social media represents a powerful learning tool that can aid the regional anaesthetist in keeping up with the ever-growing body of literature. As one example, the number of PubMed citations containing “plane block” in the title has increased exponentially from 2007 to 2020 with hundreds of article published per year just on this topic.3 When it comes to choosing a social media platform for professional networking and continuing education, results from a survey of ASRA annual meeting attendees show a preference for Twitter while Facebook remains popular for personal use.4
Twitter is an online social media platform launched in 2006 and based in San Francisco, CA, USA, that allows its users to post “micro-blogs” of 280 characters or less (referred to as “Tweets”).5 Through Twitter, users can interact with people and organizations from around the world with similar interests. ASRA (@ASRA_Society), ESRA (@ESRA_Society), and Regional Anaesthesia UK (@RegionalAnaesUK) have Twitter accounts. Searching hashtags (keywords or phrases preceded by “#”) such as #regionalanaesthesia and #regionalanesthesia can help the user identify other accounts with similar interests.5
Medical journals have identified the benefits of social media and have also become active users. Journals relevant to regional anaesthesia with Twitter accounts include: Regional Anesthesia and Pain Medicine (@RAPMOnline), Anaesthesia (@Anaes_Journal), Anesthesiology (@_anesthesiology), and Pain Medicine (@PainMedJournal). Highly tweeted articles are 11 times more likely to be cited by future publications than articles that are not tweeted.6 In a study of Cochrane reviews, articles randomized to Twitter promotion received nearly three times as many page visits compared to controls.7 Altmetric scores which reflect the reach of an article through social media and lay press outlets can be found on the article pages of major journal websites.1
The traditional journal club has become much more advanced with the incorporation of Twitter.8 The Twitter journal club is a moderated discussion focused on an article of interest to the specialty and open to the global Twitter community. #AnesJC was started by Dr. Ankeet Udani (@ankeetudani) and colleagues at Duke University School of Medicine (@Duke_Anesthesia) and covers articles relevant to the specialties of anesthesiology and pain medicine.8
Social media, when used professionally, can be considered as a means of content curation. Users can even create lists of accounts around common themes for further curation. Followed accounts on Twitter form a learning community which provide content to the user’s feed that is most likely to be relevant to the user’s scholarly interests and clinical practice. In addition, innovating educational initiatives such as #Blocktober created by Dr. Jeff Gadsden (@jeffgadsden) can become annual events that the regional anaesthesia Twitter community looks forward to every year. For every day of October, the regional anaesthesia group at Duke posts a video tutorial on one nerve block procedure along with relevant references.
A popular trend at medical conferences is “live-tweeting” the meeting.5,9-16 One of known difficulties when attending scientific conferences is choosing between simultaneous activities that have interesting topics or speakers, and no one can possibly attend every meeting. Before social media, it was impossible to be in more than one place at a time. Through Twitter, any user can pick up key learning points from conferences by searching the meeting hashtag. During the COVID-19 pandemic, all continuing medical education around the world pivoted to the virtual format. Despite the lectures and demonstration-focused workshops being livestreamed, conference Twitter activity has continued. At the most recent Regional Anaesthesia UK annual scientific meeting held virtually in 2021, over 700 Twitter users tweeted and participated in conversations including the hashtag #RAUK21 with potential reach to over 20 million Twitter user accounts (Figure 1)! As a comparison, the ASRA spring meeting in 2016 (#ASRA_RA16) was a live in person event with 999 onsite conference attendees but generated only 1.5 million impressions on Twitter,17 demonstrating tremendous growth in Twitter activity within the regional anaesthesia community worldwide.
Figure 1. Tweet from Dr. Amit Pawa (@amit_pawa) presenting the Twitter analytics from the Regional Anaesthesia UK 2021 annual scientific meeting.
The first step is to start download the Twitter app on your phone and create an account. A new user may be assigned a default username (also known as a “handle”) that can be changed later through the user’s account settings. I recommend uploading a photo and writing a brief description of yourself so people you choose to follow will know who you are (Figure 2).
Figure 2. Sample profile complete with a user photo, background photo, and short biography.
This also helps identify you if you are a conference speaker as attendees who tweet learning points from your lectures may wish to mention you in their tweets. When I give lectures, I include my Twitter handle on all my slides to make it as easy as possible for attendees to find me on the platform in case they wish to mention me in a tweet or follow me (Figure 3).
Figure 3. Sample slide featuring a user’s Twitter handle in the upper left corner. This slide provides a “To Do List” of practical tips when starting a new Twitter account.
The next important thing to do is start following a few accounts. You can follow me (@EMARIANOMD) or many others specialising in regional anaesthesia who are active on Twitter. Many of these Twitter users are shown in Figure 3. If you search the hashtags #RAUK21 or #ASRASpring21, both regional anaesthesia conferences that have taken place recently, you can find additional accounts representing individuals or organisations interested in this subspecialty. Spend some time observing how these Twitter users tweet and interact with each other, and remember that observation is a key part of the scientific method. It is very common for Twitter users to merely use the platform as a consumer of information and not tweet at all. Up to 44% of Twitter accounts have never sent a tweet!
If you decide to tweet, here are a few practical tips (Figure 4): 1) Include relevant hashtags (e.g., conference hashtag if applicable); 2) Mention Twitter users who may be interested in your tweet, especially the speaker if you are tweeting about a lecture; 3) Include a relevant image; and, if an image is included, 4) Tag interested Twitter users to give them a notification of your tweet, thereby increasing your reach and generating engagement.
Figure 4. Sample tweet from Dr. Jeff Gadsden (@jeffgadsden) from the 2021 ASRA spring meet demonstrating some practical tips for tweeting.
Of course, to be a physician actively engaged on Twitter requires respect for patient privacy and professionalism. I recommend following Dr. John Mandrola’s 10 rules for doctors on social media. I will admit that getting started is intimidating, but I encourage you to check out this list of social media resources. I promise that you will not regret joining Twitter, and chances are that you will be very happy that you did. At the very least, sign up to reserve your handle and observe.
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