If you think 140 characters aren’t enough to get your brain churning, a study from Toronto might convince you otherwise. Researchers have found that anesthesiology-related higher-order thinking is, indeed, possible on Twitter. They noted, however, that more studies are needed to determine how these electronic interactions affect patient care.
“We all know that social media has become increasingly popular,” said Clyde Matava, MD, assistant professor of anesthesia at the University of Toronto. “The CJA [Canadian Journal of Anesthesia] published an article saying they’re going to be using Twitter for a lot of their communications around publications. That falls perfectly in line with what’s happening across the medical world, and in all professions.
“In the recent past, a few papers have been published regarding social media,” Dr. Matava said. “But all of them were descriptive studies, predominantly looking at who’s tweeting, what they’re tweeting and where they’re tweeting. But no studies as yet have gone beyond that to look at some of the impact of tweeting by users.”
To fill that knowledge gap, Dr. Matava, co-principal investigator Fahad Alam, MD, and their colleagues prospectively tracked and analyzed tweets that were posted between Feb. 1 and March 31, 2015, with the hashtags #anesthesia, #anesthesiology and #anaesthesia. Data were analyzed for tweet volume, frequency, sender, content, sentiment, acceleration and factors associated with use.
“More importantly, we wanted to see if the use of Twitter aligns itself with Bloom’s digital taxonomy,” Dr. Matava added. Bloom’s digital taxonomy is a progression from lower- to higher-order intellectual thinking skills: remembering, understanding, applying, analyzing, evaluating and creating. “We know that Bloom’s taxonomy has two major descriptions: lower- and higher-order thinking. We wanted to assess the level of higher-order discourse on Twitter.”
Tweets as Higher-Order Thinking
As Dr. Matava reported at the 2016 annual meeting of the Canadian Anesthesiologists’ Society (abstract 143302), a total of 4,021 tweets with #anesthesia hashtags were sent by 1,698 unique Twitter accounts during the study period. The tweets made a total of 8 million impressions.
The largest single tweeters by volume were individual anesthesiologists, who contributed 40% of tweets, followed by companies or industry (27%). “We also noted that of those that were tweeting, about 50% were professional organizations. Anesthesiologists as individuals constitute 14% or 15% of those tweeting, but generated 40% of tweets,” he explained.
More than one-third of the tweets (34%) were found to provide scientific information, 30% were commentary, 10% were advertisements and 5% were sharing experiences. Overall, 20% of tweets were part of conversations including academic/scientific topics, while about 75% expressed a positive sentiment.
“Then we went on to do a more in-depth analysis,” Dr. Matava explained. “We saw that approximately 39% of tweets involved higher-order thinking. That means they were either evaluating or suggesting new research within anesthesia itself.”
A multivariate analysis was then conducted to identify independent factors related to higher-order thinking, using tweets specifically generated by individual anesthesiologists. “We found that tweets by individual anesthesiologists regarding patient information and complications were more likely to generate higher-order thinking, inform new areas of research, and challenge or critique practice around the world,” Dr. Matava said.
Richard Cherry, MD, associate professor of anesthesia and perioperative medicine at Western University in London, Ontario, questioned how far the results of the study might reach. “I was just on Twitter, and the Mayo Clinic recently tweeted that it was going to include social media as an acceptable form for inclusion and promotion of documents for academic faculty,” he said. “How do you think your work might relate to that?”
“It’s still a new area,” Dr. Matava replied. “I think more research, including our own, will inform its acceptability. The danger that I see is if there are wrong suggestions of things that are perhaps not safe for patients that are being suggested and retweeted on Twitter,” he noted.
“I think that might be an area of concern. So, hopefully, one of the next aspects of research is to see that the use of Twitter doesn’t have any negative impact on education or patient outcomes.
“In the end, though, this study is the first to demonstrate that Twitter itself, in a small proportion of users, is being used for higher-order thinking,” he concluded, “and perhaps there are better ways of using Twitter for the dissemination of information, where it might have even more impact on patient care.”