Enriching the Toxicology Experience through Twitter
Enriching the Toxicology Experience through Twitter
Peter R. Chai 0
0 Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School , 55 Lake Ave North, Worcester, MA 01655 , USA
Nearly a year ago, the University of Massachussetts’
Division of Medical Toxicology entered the world of Twitter in
order to participate in an increasingly online virtual
classroom. Each day, we tweet our way through weekly
toxicology conferences, national journal clubs sponsored by the
American College of Medical Toxicology (ACMT), and
toxicology-related events in the media. Tweets help us gather
the most pertinent information we are learning. We group
them by relevant topics through hashtags and save ideas for
review at a later date. It is without question that Twitter has
become important in medicine as a tool to educate trainees,
respond to current events, and inspire each other .
Additionally, partnerships between academic blogs and major
scientific journals show the relevance and importance of social
media, like Twitter, as a teaching tool in the new digital age
of medical education .
Twitter is an online, microblogging platform that allows
creation of unique user identifiers (Twitter handles) through
which short, 140-character messages can be composed
(Tweets). Tweets are disseminated through a user’s followers
and can be marked as a favorite message or broadcasted to
another group of followers (retweet). The addition of a
hashtag (#) within the message permits aggregation of
historical tweets (mining). Twitter is one of several social media
platforms in existence.
A recent editorial in this journal predicted the future of
Twitter in our field as an engine of education and improved
patient care . Medical toxicology has always been at the
forefront of technology, utilizing novel filing systems and
telephones to establish a network of poison centers across
the USA and pioneering an expansion into telemedicine to
reach institutions without poison expertise [4, 5]. Twitter can
enrich toxicology by enhancing education and broadening
exposure to conference content. At the same time,
toxicologists need to be cognizant of patient privacy concerns and how
Twitter is redefining the idea of academic impact.
Twitter and Toxicology Education
Within medical toxicology, popular blogs and Twitter users
have aggregated information into the Free Open Access
Meducation Toxicology (#FOAMTox) movement that readily
gives students access to experts in toxicology [6, 7]. Tweets
containing links to useful websites and podcasts supplement
traditional toxicology education. Hashtagged tweets through
#FOAMTox create the opportunity for learners to reach out to
experts in real time, crowd sourcing their education and
filtering toxicology information through leaders in our specialty.
Participation in a vibrant online community of students,
bloggers, physicians, toxicologists, journalists, and
organizations is now commonplace among our peers.
As I tweet during our division’s toxicology conference at
the University of Massachusetts, I am greeted by favorites and
retweets from toxicologists throughout the world. We pose a
question regarding the management of snake bites and turn to
our experts at another toxicology fellowship. Soon, Twitter
explodes with comments, links to literature, and up-to-date
clinical practice guidelines from experts in envenomation. A
rare poisoning in our fellowship is commonplace in another
part of the country, and we are privy to the clinical experience
of regional experts at a moment’s notice through Twitter.
These discussions contribute to our academic growth and
grow the toxicologist presence on social media.
Generating an online discussion is also useful and effective
to disseminate information learned through national and
regional conferences to our colleagues [1, 8]. Real-time tweets
during academic conferences are an effective method to
spread and catalog information for those at the conference
and those who follow conference hashtags through Twitter
. Social media aggregators, such as Symplur can be used
to gather valuable hashtag-oriented metrics that reflect the
reach and influence of academic conferences. In the past year,
123 toxicologists on Twitter at the ACMT Annual Scientific
Meeting generated over 500,000 impressions (views from
unique users on Twitter) through 911 tweets . Improving
conference penetrance gives our specialty exposure in key
media outlets allowing us to provide valuable insight in
conversations with the public and other professionals.
The Twitter Case Report
Toxicologists continue to use the case report as a method for
disseminating management strategies in esoteric exposures
. When adapted to social media, the Twitter case report
becomes a teaching tool, an instrument of public health
outreach, and another method for us to connect to patients. Our
weekly conference at the University of Massachusetts begins
with tweets about an interesting case—just enough to generate
a broad differential diagnosis from our live audience and our
Twitter audience . Subsequent case history streams in
tweets and draws participants and learners to our conference.
Questions posed through Twitter can be answered through
tweets by remote toxicologists and discussed during
conference. Pertinent journal articles explaining viewpoints of
toxicologists participating in an online Twitter conference are
shared, favorite, retweeted, and archived for reading. Mining
tweet history allows retrospective review in a free and public
forum to study pertinent toxicology content.
Social media is a powerful tool for medical education, but
unstructured use can be a venue for ethical and legal violations
to occur. Compliance with the Health Information Portability
and Privacy Act (HIPAA) must remain paramount, and
Twitter use in any medical field should include a commitment to
protect the identities of patients . Our obligation to patient
privacy must remain in our minds as we tweet, blog, and
podcast toxicology education. We must be conscious that
subtle case information like the location of poisoning or patient
gender and age can be used to determine the identity of the
patient with a unique exposure. Withholding age, sex,
location, and other demographic information can protect patients
while providing enough case details in engaging an
educational lesson through Twitter .
The Twitter Effect on Academics
Intercalating our literature and opinions as toxicologists
through social media can improve popular exposure to our
specialty, broaden our outreach, and provide us with
opportunities to discuss pertinent topics. Article sharing on Twitter
also drives increased views and exposure to literature .
In addition to serving as a repository for specific literature
for a toxicology fellowship, tweets can be used to drive
viewership towards important articles in our specialty while
improving article metrics. Novel metrics, like altmetrics, are
frequently used as an alternative measure of academic impact.
Altmetrics integrate traditional exposure to literature through
medical library subscriptions with tweets on journals and
article downloads to provide an alternate assessment of article
For toxicologists with academic careers, viewership
and social media shares of manuscripts will invariably
become important aspects of education, outreach, and
possibly promotion. Instead of continuing to use
traditional methods for ranking and promotion by accounting for
publications and citations, academic institutions may
consider altmetrics. This could include curation of an
influential social media profile and other novel determinants
which regard the impact of published papers such as the
H-index or Eigenfactor score . Going forward,
integrating the social media exposure of published literature
must be interpreted in conjunction with traditional
measures of academic productivity.
Where do We Go from Here?
Twitter was recently called a Bvast, underutilized tool that has
the potential to transform, expand, and improve our field^ .
One hundred forty characters may seem short, but the message
contained can expand exponentially, exposing readers to our
great specialty. A careful and directed social media strategy
can help us flourish, educate, and promote ourselves through
Twitter. So go on, if you have yet to create a Twitter account,
do it—join the growing community of toxicologists on
Twitter. For those with Twitter accounts, follow us, tweet
responsibly, and favorite, retweet, and hashtag your way to an
enriched toxicology experience.
Acknowledgments Special thanks to Dr. Trevonne Thompson
(@trevthomps) and Dr. Christine Murphy (@cmurphytoxdoc) for their
assistance in writing this editorial.
Compliance with Ethical Standards
Conflict of Interest I have no conflicts of interest to report.
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