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Social Media and Medical Education
John Mandrola, MD
Baptist Health Louisville
@drjohnm
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Disclosures – None
Baptist Health Louisville
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AF ablation CRT HBP
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Life-Long Learning
• When I was young I had no idea how much there would be
to learn
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1996-2009 Anonymous
September 2009
I did not know how to write
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The American Scholar1837
Ralph Waldo Emerson
Academic has an obligation to….
• Think clearly -- not influenced by tradition or historic views
• Think publicly
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Translation of Evidence to the Bedside
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• Medicine’s first RCT in 1747
• Citrus (Vit C) in Scurvy
• Published in 1753
• Ignored until 1795
https://en.wikipedia.org/wiki/James_Lind
42 years
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Morris 2011 J Royal Society Medicine
Average time lag between published evidence and uptake
17 years
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Reversal of LBBB with His Bundle Pacing First Described in Animal Model
His Bundle Pacing in Humans
1978
El-Sherifet al
2000
Deshmukh et al
Then nothing happened until 2015-2016
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Translate EP –Twitter
Hashtag #DontDisTheHis
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Rise in Twitter impressions (A) and Twitter users (B) utilizing the
hashtag #dontdisthehis ...
Beer EHJ 2019
Twitter Impressions
Twitter Users
Sales of MDT 3830 lead
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Even More Rapid Translation on Twitter
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Note the dates
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Tweeting the Meeting:
Social Media at Cardiology Conferences
• 3 major cardiology
conferences
o ACC
o HRS
o TCT
• 80,0000 tweets over 3 years
223%
241% 134%
Courtesy of J Han
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Medical Journals
Fox CS, et al. Circulation. 2016;133:1978-1983
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Twitter Journal Clubs:
#NephJC
Nephrology Journal
Club
Started in 2014
Regularly scheduled
Virtual
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Tweetchats:
Scheduled
Regular or intermittent
1 hour
Discussion of topic
Moderated
Open forum
Key opinion leaders
Public participation
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Social Media as post-publication peer-review
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Little empirical evidence is available to support the use of editorial peer review as a mechanism to ensure quality of biomedical research
N = 28 Studies
Descriptive review
http://cochranelibrary-wiley.com/doi/10.1002/14651858.MR000016.pub3/abstract;jsessionid=2B478E634C4BE8F60B0A766E36F8BE30.f04t04
April 2007
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• Wisdom of the many > wisdom of the few• Publish everything and filter after the fact?
http://blogs.bmj.com/bmj/2011/01/26/richard-smith-twitter-to-replace-peer-review/
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Critiques/Flaws Posted on Twitter
Loading Dose of Atorvastatin Pre-PCI
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65-year-old w/ persistent Mitral Isthmus Flutter
4 previous ablations
• Me: “I cannot get this MI blocked.”
• My Partner: “You ever done an ETOH ablation of Vein of Marshal?”
• Me: “No.”
• My Partner: “I’ve seen one.”
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Partial block MI LAA Isolation
No further tachycardia ≈ 18 months
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Translate –EP YouTube
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55-year-old man with class 3 heart failure and wide LBBB and LVEF 20%
Snare Technique I learned online from Seth Worley
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Blogs
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Author of an influential book on regression modeling
Biostatistics Prof Statistician at FDA
Dr. Frank Harrell
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• “Independent” Blogger• No #FCOI • Medical School in Nepal • Now has an appointment at Harvard
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Translation – Blogs
“Blogs are a great translation tool. People see data but don't always know what it means.”
“I wish I could blog more often but when I do, I find it very satisfying as a teaching tool.
It also forces me to clarify my own thinking on complicated issues -- which is really helpful.”
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Partnerships SoMe – Journals
Lin Ann Em Med 2017 https://www.sciencedirect.com/science/article/pii/S0196064416313737?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb#bib21
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• Goal to encourage participation, and engagement w online community • Minimize barriers
Example of a New Model for Journal-SoMe collaboration
Journal Club of a Featured Article
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Free Open Access Med…education
#FOAMed
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Side Effect of Public Thinking…
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Podcasts?
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Translate -- Podcasts
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Mallin Acad Med 2014 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885578/
Survey study N = 226 EM residents
Most Beneficial:
• 70% Podcasts• 54% Textbooks• 36% Journals• 33% Google
Podcast
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Podcasts
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Why -- Social Media
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If “we” are not online -- other less informed people will fill the void
You cannot complain about bad content online if you are not creating content online
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The Beauty of #SoMe:
• You used to be able to teach your students, and patients.
• Now…
• You can teach the world!
• Good content rises up on its merits
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Finally
You don’t need permission or
an invitation
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Seriously
You don’t need permission or
an invitation
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Thank you – Please Stay in Touch
• @drjohnm
• www.drjohnm.org