How Twitter has connected the colorectal community

Techniques in Coloproctology, Nov 2016

H. J. Logghe, G. Pellino, R. Brady, A. S. McCoubrey, S. Atallah

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How Twitter has connected the colorectal community

Using Twitter in academia - Emerald Group Publishing.'' How Twitter has connected the colorectal community H. J. Logghe 0 1 2 3 G. Pellino 0 1 2 3 R. Brady 0 1 2 3 A. S. McCoubrey 0 1 2 3 S. Atallah 0 1 2 3 0 Second University of Naples , Caserta , Italy 1 Florida Hospital , Orlando, FL , USA 2 South West Acute Hospital , Enniskillen, NI , UK 3 Salford Royal Foundation Trust , Salford , UK - twitter_academics.pdf) [11, 12]. Referred to as a form of ‘‘microblogging,’’ Twitter allows users to send and read short 140-character messages (i.e., Tweets). Tweets can include links to online resources, images/pictures, short videos/multimedia, and interactive polls. Users subscribe to others’ tweets by ‘‘following’’ their user accounts; all Twitter accounts are unique, starting with the ‘‘@’’character. In addition to posting original content, users can retweet others’ tweets, ‘‘like’’ them, and reply to them. Hashtags (#) serve as keywords and phrases, making them easily searchable and thus more likely viewed by a larger audience than one’s followers. It is important to note these hashtags commonly generate international participation. The ubiquity of the Internet allows hashtag communities to transcend geographical and temporal boundaries. Using Twitter and particularly with the aid of hashtags such as #colorectalsurgery, #colorectalcancer, and focused conference hashtags, colorectal surgeons worldwide can readily interact, disseminate research, and educate the general public (Table 1). Medical conferences, through specific event hashtags and live tweeting [13], have increasingly adopted Twitter to amplify the content of scientific meetings [14]. For example, live congress tweeting at the American College of Surgeons 2015 Clinical Congress reached over 55 million impressions on Twitter from 15 thousand tweets, with nearly 3 thousand participants tweeting its hashtag #ACSCC15. These numbers in themselves are noteworthy, but their significance is further highlighted when compared with the 2013 Congress, when the hashtag #ACSCC13 obtained 5 million impressions from 3000 tweets of only 200 participants [15]. The social media movement, #ILookLikeASurgeon [16], illustrated that Twitter engagement could mobilize a critical mass of surgeons on an international issue. Recently, a group of Twitter-active colorectal surgeons put forth the #colorectalsurgery hashtag to collate tweets related to colorectal surgery [13]. Launched on April 24, 2016, this campaign has united diverse international population and has been successful in gaining rapid adoption and consistently high levels of engagement. By using the hashtag, users share scientific ideas, research, concepts, and publications in colorectal surgery with a global audience. In the 16-week period since launch, #colorectalsurgery has linked tweets from more than 1200 individual accounts, who have tweeted more than 8200 tweets, resulting in more than 25 million impressions. Other hashtags serve to unite key online communities of relevance to colorectal surgeons. Hashtags such as #StrongArmSelfie, promoted during Colorectal Cancer Awareness Month, allow surgeons to engage the public, connect with patients, and promote public health. Other campaigns provide a locus for carers and patients to find support or information about chronic colorectal diseases, such as the #getyourbellyout campaign to destigmatize inflammatory bowel disease and stomas. Following and actively engaging with charitable organizations relevant to #colorectalsurgery such as @Bowel_Cancer_UK and @CrohnsColitisUK among others provides users with a platform to dynamically interact with patients and the public. This also serves to ensure the information being disseminated is accurate and contributes to patient education. Twitter is increasingly being utilized to recruit participation in clinical research in colorectal surgery. For example, Twitter has proved to be an indispensable tool in the development of the student- and trainee-led EuroSurg (@EuroSurg) collaborative, which includes more than 100 European Universities. The collaborative, supported by European Society of Coloproctology (ESCP) and the Italian Society of Colorectal Surgery (SICCR), is running its first study on patients with colorectal diseases (EuroSurg-1) [17], which has enrolled more than 3500 patients from a wide range of European countries. The ESCP also has a specific Twitter account (@ESCP_studies) dedicated to publicizing and informing followers of the various panEuropean studies promoted by the Society. Most colorectal journals now have Twitter accounts (see Table 2). The impact of social media in publishing is demonstrated through ‘‘Altmetrics.’’ Altmetrics are a measure of how many people have been exposed to and engaged with an article as well as a measure of dissemination, and it provides an indication of the impact and influence of the article. These are based on discussions on online blogs, mainstream media coverage, bookmarks on reference managers like Mendeley, and mentions on social networks such as Twitter (‘‘What are altmetrics? – Altmetric.’’ 2016. 10 Jul. 2016 https://www.altmetric.com/ about-altmetrics/what-are-altmetrics/). In this way, Twitter Table 1 Relevant hashtags in colorectal surgery Started by an international group of colorectal surgeons to label content pertinent to those interested in colorectal surgery Started by physicians in emergency medicine and critical care, now used for any ‘‘Free Open Access Medical education’’ resources International General Surgery Journal Club, mainly used during active journal club days Used for pictures and content celebrating the culture of surgery, particularly to showcase its diversity and humanity Tweets related to medical education (broadly defined) Tweets related to surgical education Anything surgery related Used during Colorectal Cancer Awareness Month to tag selfies with a ‘‘strong arm’’ pose in support of the fight against colorectal cancer Table 2 Essential Twitter accounts in colorectal surgery Organization or journal Table 3 Surgical societies represented by Techniques in Coloproctology Table 4 Tips for effective tweeting Much of the Twitter experience is defined by who one follows. For this reason, we recommend following liberally, but purposefully. See Table 2 for essential Twitter accounts in colorectal surgery. It is simple and common to unfollow a user, should you find you do not appreciate their tweets Search #colorectalsurgery to find relevant Twitter accounts you may be interested in following Pay attention to Twitter-generated ‘‘Who to Follow’’ suggestions Do not worry about your ratio between ‘‘following’’ and ‘‘followers’’. You will accrue followers over time Do not feel obligated to follow back users who follow you if you are not interested in the content of their tweets Do not worry if you are followed by promotional and spam accounts. This is part of the public nature of Twitter Consider creating a Twitter-specific interest ‘‘list’’ which gathers users into groups in which only their output can be viewed Italian Society of Colorectal Surgery Mediterranean Society of Coloproctology Israel Society of Colon and Rectal Surgery Colorectal and Anal Group of the Surgical Section of the Chinese Medical Association Mediterranean Society of Pelvic Floor Disorders Hong Kong Society for Coloproctology International Society of Coloproctology Eurasian Colorectal Technologies Association Many surgeons new to Twitter worry about what to tweet. Chances are if it interests one colorectal surgeon, it will be of interest to other colorectal surgeons as well Educational points from conferences, including pictures of key presentation slides and posters (be sure to include conference hashtag) Positive pictures representing the profession (such as #ILookLikeASurgeon) Opportunities that may be of interest to other colorectal surgeons Public health and general patient education Whenever possible include relevant surgeons’ usernames in tweets or linked to images (you can attach a maximum of 10 user accounts to each image). This serves to give them credit and make them aware of the conversation Retweet any tweets you find interesting and relevant to colorectal surgeons If you seek more information from a tweet, ask the user by using the ‘‘reply’’ function Think twice, tweet once In addition to normal tweets and retweets, the third type of tweet surgeons should be familiar with is direct messaging. Direct messages have no character limit and allow users to initiate and conduct private one-onone and group conversations with those who follow them. Direct messages can be a There have been cases of unethical conduct [22] which have led regulatory authorities such as the General Medical Council (GMC)a and the American Medical Association (AMA)b to establish specific guidance for the use of social media by doctors The ultimate rule is respect patient privacy and confidentiality. The same standards of professional conduct expected offline are expected of surgeons online. A simple ‘‘12word social media policy’’ has been popularized for physicians; ‘‘Don’t lie; don’t pry. Don’t cheat; can’t delete. Don’t steal; don’t reveal.’’ (‘‘A 12-Word Social Media Policy | Mayo Clinic Social Media Network.’’ 2016. 21 Jul. 2016 https:// socialmedia.mayoclinic.org/discussion/a-12word-social-media-policy/) Although all tweets should be regarded as permanent records online, should you regret a tweet (e.g., a typographical error, wish to modify content, or have tweeted in error), it is never too late to delete, although inevitably some will have likely seen and possibly captured the tweet While concern for the scientific credibility of tweets may be argued, 80,00 [23] analyzed nearly 80,000 tweets containing colorectal cancer-related keywords, posted over a 3-month period and found that the vast majority were medically correct Table 4 continued powerful tool for connecting with experts and developing relationships for collaboration. In fact, the idea generation and writing coordination of this article were accomplished through Twitter direct messaging a General Medical Council GMC (2013) Doctors’ Use of Social Media. http://www.gmc-uk.org/Doctors__use_of_social_media.pdf_51448306. pdf b American Medical Association AMA (2011) Professionalism in the Use of Social Media. http://mededu.jmir.org/article/downloadSuppFile/ 4886/28296 is becoming key to expanding and measuring the reach of research by the modern academic surgeon. Moving beyond predictable tweets with links to recent journal articles, many journals have published social media strategies and social media editors [18–21]. Techniques in Coloproctology started its Twitter account in June 2015 and accrued more than 400 followers in the first year. To date, tweets have consisted mainly of journal content, with no retweets or engagement through ‘‘replies.’’ The account is managed by a social media coordinator, who receives approval from the editor in chief prior to all tweets. In coming weeks, the journal plans to increase its tweet frequency and broaden the content of its tweeting follow more colorectal surgeons and other colorectal-focused Twitter accounts and increase engagement with its followers. Additionally, the account aims to increase the journal’s visibility through three main goals: Disseminate content, expanding the reach, and impact of individual articles beyond the journal’s traditional readership. Encourage interactions between current authors and readers in real time. Share opportunities from the surgical societies represented by Techniques in Coloproctology (Table 3). These include courses, congresses, campaigns, and clinical trials. Social media offers many benefits to surgical education and practice. The key qualities of this technology include content that is constantly updated, ubiquitous accessibility, and a diverse user population. Harnessing knowledge and expertise on a portable device with a dynamic platform such as Twitter enables colorectal surgeons global access and the ability to interact with experts, peers, and patients. This enables discussion and debate about the science of the profession and the art of surgery. It allows for collaboration among surgeons who are able to bridge distances and learn about developments and surgical news in real time (see Table 4 for tips for effective tweeting). #Colorectalsurgery has established itself as a collaborative, dynamic, and global network of colorectal surgeons further enriched by every participant that joins the conversation. Compliance with ethical standards Ethical approval All applicable international, national, and/or institutional guidelines for the care of human participants were followed. 1. 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H. J. Logghe, G. Pellino, R. Brady, A. S. McCoubrey, S. Atallah. How Twitter has connected the colorectal community, Techniques in Coloproctology, 2016, 805-809, DOI: 10.1007/s10151-016-1542-3