Research article
Open Access

Social media use during residency training

Moza Al Kalbani[1], Marwan Al Raisi[1], Aisha Al Breiki[1], Samya Al Mazrooei[1], Abdullah Al Reesi[1]

Institution: 1. Oman Medical Speciality Board
Corresponding Author: Dr Moza Al Kalbani ([email protected])
Categories: Educational Strategies, Teaching and Learning, Technology
Published Date: 05/08/2019

Abstract

Social media plays a major role in the revolution of medical learning. Many training centers have incorporated it into their teaching curriculum. The aim of this research is to evaluate the current utilization of social media by residents and its effect on their learn- ing process during their residency training.

We performed a quantitative cross-sectional survey based study. A 20-questions survey was constructed and distributed to residents from all specialties and training levels registered under the national specialty board in training period 2014/2015. 

132 (69%) of the resident use social media as a platform for asking medical questions and half of them use it to consult experts in the field and to discuss cases. The most popular media for learning was YouTube 104 (55%) and free chat 49%. (71%) did not receive any course or guidance on how to use social media for educational purposes and 83.2% believe that a course or a formal lecture is needed.

In line of these results medical educators should pay attention to these sites and incorporate appropriate strategies to guide residents on effective use of social media.

Keywords: Medical education; Social media; Residency

Introduction

During the past decade, social media has become increasingly popular for personal and professional use. Its accessibility has made people from different professions depend on it not just as a mode of communication but as a way to exchange knowledge and even solve problems. In particular, there has been a recent explosion in the use of these technologies for scientific circles. (Klee, Covey and Zhong, 2015)

Twitter in particular has become a forum for rapid dissemination of breaking news in medicine. It is considered to be one of the strong tools. Within hours a topic can disseminate to very wide audience and be transmitted to the world in few seconds.

The role of social media in medical postgraduate training has been unknown until recently. Today we know that its use during residency is considered to be one of the most powerful learning tools. A recent report in the BJU International indicated their followers grew by one third from January to April 2013, with continued growth at a rate of ≈100 new Twitter followers per month. This has been accompanied by significant increases in both the Klout score and Peer Index rating, measures of social media influence.(Rivas, Socarrás and Blanco, 2016)

Medical education is trending towards extracurricular education and engaging in social networks. Recently in United statue, researches evaluated this point among the residents and found that 97.7% of their resident spent at least 1 hours using social media and majority of them prefer to learn using social networks especially listening to podcast.(Mallin et al., 2014) Majority of medical trainers have been involved in revolutionizing of social media use for training the residents. One of the most leading force were among the emergency medicine and critical care programs in the united statue, which recently integrate the social media in their residency curriculum. (Scott et al., 2014)

Many countries have recently created their own best practices for social media, recognizing its important potential for learning and contributing to advancement in the field of medicine. This best practice statement emphasizes the importance of transparency and professionalism, while avoiding any content that violates patient confidentiality.(Klee, Covey and Zhong, 2015)

There are some published data done globally about the use of social media in residency in specific specialties but no studies done to evaluate the utilization of social media by different specialties and none was done in the gulf countries.

The primary objective of the study was to assess the usage of social media among residents in residency program in the period between 2014-2015. The secondary objectives was to evaluate the impact of using social media on the learning process of residents in different specialties.

Methods

The study was conducted among Oman Medical Specialty Board (OMSB) residents in the period between 2014-2015. It targeted all residents from different 18 training pro- grams including both surgical and medical specialties and different years of training.

The primary investigator constructed a survey aiming to understand the use of social media during residency. It contained 20 questions designed to assess frequency of social media use by residents and their preferred learning domain. The survey also looked into the resident’s purpose of using social media and if they had any concerns preventing them from using it. Residents were asked if they were using any guidelines to help them use social media safely and if they would like it to be integrated as part of their learning curriculum. Demographic characteristics ware also looked at such as the sex, age, years of residency and training program.

Three experts in the field reviewed the survey before submission to the ethical board. Once approved, it was distributed to OMSB residents in all specialties. Two investigators distributed a total of 382 survey papers. Initially it was delivered by hand to all residents on OMSB research day and then during resident’s academic activity day of each special- ties. Finally, it was also distributed on OMSB workshops to ensure approaching maximum number of the residents. Before handing a survey paper, the responders were asked if they filled the survey previously, to minimize duplication. Online survey distribution was avoided since previous studies displayed a low response rate among OMSB residents.

Ethical consideration:
The research proposal was submitted to the ethical committee for approval. Consent was attached to the survey to ensure that the participant’s data will be confidential; participant’s anonymity was maintained throughout the study.

Data analysis:
Data was collected in epi –data entry software by 2 investigators and then converted to SPSS. Final analysis was done using SPSS version 19.

Results/Analysis

From a total of survey invitations (382), 189 (49.4%) were completed (Figure 1), which included residents from different specialties and years of training. The majority of responders were from junior years, mainly internal medicine, family medicine and emergency medicine (Table 1).

Figure 1: Participants Survey papers distribution

 

Table 1: Characteristics of OMSB residents

Characteristics of OMSB residents

Number of resident (%)

Gender

Male

66 (35.3)

Female

121 (64.7)

Year of Residency

R1

43 (23)

R2

52 (27.3)

R3

43 (23)

R4

34 (18.2)

R5

15 (8)

R6

1 (0.5)

Training programs

Surgical

Anesthesia

3 (1.6)

ENT

12 (6.3)

General surgery

16 (8.5)

Obstetrics & Gynecology                                          

11 (5.8)

Ophthalmology                                                           

5 (2.6)

Oral and Maxillo-Facial Surgery

1 (0.5)

Orthopedics

9 (4.8)

Medical

Family medicine

30 (15.9)

Biochemistry

1 (0.5)

Hematology

2 (1.1)

Internal Medicine   

37 (19.6)

Microbiology 

2 (1.1)

Dermatology

8 (4.2)

Emergency medicine

29 (15.3)

Psychiatry                                                                   

5 (2.6)

Radiology

4 (2.1)

Pediatric                                                         

14 (7.4)

 

The number of resident using social media was 188 (99.5). When asked how often they accessed social media, almost half of the residents reported using it for more than 6 hours per week. With 9% using it for 25 hours per week. And 5% use it for more than 40 hours per week (Table 2).

 

Table 2: Social media devices and time

Social media devices and time

Number of resident (%)

Devices used for access for social media

 

Smart Phones

174 (92.1)

Notebook computers

52 (27.5)

Desktop computers

17 (9)

Tablet devices

94 (49.7)

Access time of social media

At work

66 (34.9)

At home

151 (79.9)

On move

29 (15.3)

0-6 Hours

95 (51)

Average hours spent using social media per week

7-15 Hours

50 (26.9)

16-24 Hours

16 (8.6)

25-40 Hours

16(8.6)

>40 Hours

9 (4.8)

 

In regard to most popular domain, YouTube (55%) was the most commonly utilized by the residents followed by free chat (49.2%), Google+ (34.9%) and Facebook (21.7%) (Figure 2).

Figure 2 : Frequency of resident preferred social media for learning (%)

 

When asked about the purpose of using social media professionally, 69.8% of residents used it to ask questions to colleagues, while 61.4% use it to share new information. (Table 3)The ease of use was one of the most important reasons for utilizing it for learning (83.1%). In addition, almost half of the residents preferred it due to its wide availability in many smart devices and it is faster to reply and post (49.7%) (Table 3).

 

Table 3: Reasons for using the preferred domain of social media for learning

    Reasons for using the  preferred  domain of social media for learning

Number /Percentage of resident

It is more easy to use

157 (83.1)

It is faster in reply and posting

94 (49.7)

The application is available in many smart

94 (49.7)

It is free of charge

87 (46)

It connects you with many people at the same time

81 (42.9)

More popular among people worldwide

73 (38.6)

It is more organized

56 (29.6)

 

The most common cited concern the residents had from using social media was patient’s privacy (36.5%), liability and lack of time (29.6%). Only 11% of the residents felt it was an inappropriate mode for medical learning (Table 4).

 

Table 4: Concerns that may hold residents back from interacting using social media in patient care

Concerns that may hold residents back from interacting using social media in patient care

Number /Percentage  of residents

            Concerns about patient privacy

69 (36.5)

Concerns about liability

56 (29.6)

Lack of time

56 (29.6)

            Feel such interactions are inappropriate

20 (10.6)

Just not that interested

13 (6.9)

            The technology is new to me

5 (2.6)

No concerns

27 (14.3)

 

Despite is being such a popular mode of learning for residents, 52% of the Residents did not receive any courses or lectures on how to use social media, while only 19% had rarely any. Majority if the residents (83.2%) believe that it would be beneficial to have a course or a lecture during residency on how to use social media (Table 5).

 

Table 5: Social media in residency curriculum's

Percentage of residents who had any guidelines /lectures on how to use social media in residency

Always

(6%)

Usually

(9%)

Sometimes

(14%)

Rarely

(19%)

Never

(52%)

Percentage of residents who think it will be beneficial to have a lecture/ course on how to use social media in their curriculums

Yes

(83.2%)

No

(16.8%)

Discussion

The global popularity of social media among physicians and countless teaching opportunities it offers demand its incorporation into the medical education. This study looked into social media use among Oman Medical Specialty Board residents. It demonstrated that ninety-nine percent of the residents from all the specialties were using social media. They stated that the ease of Social media use is one of the most important reasons for using it as a learning tool. They find it a very important platform for sharing and exchanging knowledge. YouTube was the most common platform residents used in contrast to USA emergency residents who preferred to use podcasts.(Mallin et al., 2014) Around fifty percent of the residents in our study accessed social media for more than six hours per week, twenty-seven percent accessed it for up to fifteen hours a week. In contrast, EM residents in Mallin M study described using SM for a much lesser time (1 hour 97.7% and 2-4 hours 34.5%).(Mallin et al., 2014) It would be interesting to understand the reasons behind such differences, however this would require another study.

We found that most of the residents in our study have major concerns regarding using social media, patient’s privacy being the most predominant one. More than half of the residents from different specialties stated that they did not receive any lectures or courses on how to use social media safely. Eighty-three percent of them reported that it is very important to have courses or some proper guidelines on how to use social media safely during their residency training.

Our study was the first of its kind in the region and it included all the medical and surgical specialties with different years of residency training, which strengthen our result and make it unique.

Since survey response rate was low, study bias over-reporting social media use may be present which may be a limitation of the study.

Conclusion

In conclusion, residents use social media for sharing and exchanging knowledge. While awareness and activism are important, information reliability and maintaining patient privacy can be challenging for residents if not used properly. Published guidelines on using social media provide a useful platform for the safe exchange of medical knowledge. (Pillow et al., 2014) Residency programs should revise their curriculum to incorporate such guidelines and capitalize on the power of social media into a stronger and modern system.

Take Home Messages

Social media is an important tool in residents education. Educators should pay attention to social media and put strategies to incorporate it in the residency programs.

Notes On Contributors

Dr. Moza Al Kalbani, MD, EM OMSB, Emergency Physician, Oman Medical Speciality Board.

Dr. Marwan Al Raisi, MD, FRCP-EM, FRCP-PEM, Senior Consultant Emergency Physician, Sultan Qaboos University Hospital.

Dr. Aisha Al Breiki, MD, EM OMSB, Emergency Physician, Sultan Qaboos University Hospital.

Dr. Samya Al Mazrooei, MD, Emergency Physician, Oman Medical Speciality Board.

Dr. Abdullah Al Reesi, MD, MSc, FACEP, FRCPC, Senior Consultant Emergency Physician, Head of Emergency Medicine Department, Sultan Qaboos University Hospital.

Acknowledgements

To Oman Medical Specialty Board for supporting the study conduction.

Bibliography/References

Klee, D., Covey, C. and Zhong, L. (2015) 'Social media beliefs and usage among family medicine residents and practicing family physicians', Fam Med, 47(3), pp. 222-6.

Mallin, M., Schlein, S., Doctor, S., Stroud, S., et al. (2014) 'A survey of the current utilization of asynchronous education among emergency medicine residents in the United States', Acad Med, 89(4), pp. 598-601. https://doi.org/10.1097/acm.0000000000000170

Pillow, M. T., Hopson, L., Bond, M., Cabrera, D., et al. (2014) 'Social media guidelines and best practices: recommendations from the Council of Residency Directors Social Media Task Force', West J Emerg Med, 15(1), pp. 26-30. https://doi.org/10.5811/westjem.2013.7.14945

Rivas, J. G., Socarrás, M. R. and Blanco, L. T. (2016) 'Social Media in Urology: opportunities, applications, appropriate use and new horizons', Central European journal of urology, 69(3), pp. 293-298. https://doi.org/10.5173/ceju.2016.848

Scott, K. R., Hsu, C. H., Johnson, N. J., Mamtani, M., et al. (2014) 'Integration of social media in emergency medicine residency curriculum', Ann Emerg Med, 64(4), pp. 396-404. https://doi.org/10.1016/j.annemergmed.2014.05.030

Appendices

None.

Declarations

There are no conflicts of interest.
This has been published under Creative Commons "CC BY-SA 4.0" (https://creativecommons.org/licenses/by-sa/4.0/)

Ethics Statement

Ethical approval was obtined from the Research and Ethical Review Committee, Directorate of Research and Studies, Royal Hospital, Muscat, Oman. MESRC#47/2014. 17 November 2014.

External Funding

This article has not had any External Funding

Reviews

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Raúl Sampieri Cabrera - (09/09/2019)
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The manuscript shows the use of social networks by students, in that sense the work corresponds to the methodology. However, it is incompatible to postulate that the purpose of the work is "to evaluate the impact of the use of social networks in the learning process of residents in different specialties", because that is not evaluated. I think it is a document that does not contribute anything new to medical education and is a preliminary report. To have a greater impact on the scientific community, the results must be discussed in detail and explain how they contribute to the advancement of medical education.
Possible Conflict of Interest:

None

Alexander Woywodt - (23/08/2019) Panel Member Icon
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I saw the title of this manuscript and thought that's a really interesting topic. On reading this I was a little disappointed. I am not sure how much a study on social media behavior can add once its 4 years out of date. The social media habits and platforms change very quickly these days. The authors could have added a lot of value through doing the same study again and comparing social media habits in 2014/15 with a contemporary cohort - that could be quite interesting. I was also struck by the low Twitter use - perhaps that might be more in a 2018/2019 cohort? In addition the manuscript is not terribly well written as pointed out by other reviewers. Another great idea I think would have been to compare residents' social media habits between different countries. Surely there will be a multitude of cultural factors influencing social media use. Some social media platforms aren't even available everywhere which some of them curtailed for example in China. It might be interesting to tease out differences in social media use between different countries.
Kitiyot Yotsombut - (07/08/2019)
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Dear Authors,

Although the social media are useful in many ways, appropriate practice should be constantly exercised. Your manuscript demonstrates roles and patterns of social media using among residents. It is interesting and informative for faculty instructors in medical schools as well as other professionals.

The information in the manuscript was appropriately organized and suitable presented in the abstract. However, the methods should be elaborated since some essential information such as validating and pretesting of the questionnaire were not described.

In order to increase the usefulness of the manuscript, the authors are recommended to separately analyze and present the information based on year of residency training. The clinical experiences are increased when the junior residents become the senior. Using practice and perception regarding the social media might be different and should be discussed.

The social media provided in the manuscript are diverse in their functions, lead to different purposes of using each social media. It would be more usefully informative if the frequency of use (figure 2) is separately presented according to the purpose of using.

Best regards,
Yotsombut K.
Ken Masters - (06/08/2019) Panel Member Icon
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The paper deals with social media use during residency training in Oman. Although the paper is interesting, the authors do need to address some problems:

• In the Introduction, the statements about Twitter require citation substantiation.

• A major limitation of the study is that it was conducted in 2014/2105. A study of social media that is already five years old is severely limited in two areas, and this limitation does need to be mentioned at the end of the Discussion:
o Social media usage has changed in five years. For example, the third-highest social media platform in this study, Google+, is no longer available for usage, so is irrelevant today.
o Medical school training changes, and so the figures on whether or not the residents have been trained in social media usage are very out of date.

• FreeChat should be more clearly identified. The only system I know of is a front-end for WhatsApp, so it may be a little obscure.

• It would be useful if the authors could supply a copy of the questionnaire as an appendix.

• In Table 2, the 0-6 hours row should come below the “Average hours spent using social media per week” heading.

• Abstract: Please give the raw number of the 71% who “did not receive any course or guidance…” In fact, throughout the paper, where statistics are reported in the text, the raw number should be given, followed by the percentage (to one or two decimal points).

• The paper suffers from many minor language errors (e.g., the sentence beginning “Recently in United statue, researches…” appears to be erroneous and should be corrected; “1 hours using…” should be 1 hour using…” and many others. Sometimes these are simply irritating (requiring a re-read for understanding) and, at other times, the meaning is not clear.

• There is inconsistency in the naming of the various social media. The authors should visit the respective social media sites, establish the correct official name, and use only that name.

• After Table 4, it appears that the formatting of the text is the same as the heading; this needs to be corrected.

• The Discussion is extremely weak, and is almost entirely merely a summary of the Results. The Discussion does really need to expand upon the Results, reflecting on these in light of the literature, and trying to answer an overall question of “So what?” or “Why does this information matter?”

• “activism” is first introduced into the paper in the Conclusion. There does not appear to be a discussion of activism earlier in the paper. It should either be removed from the Conclusion, or, if it is discussed elsewhere using other terminology, then this needs clarification.


So, an interesting paper, but it is a pity that the authors waited five years before publishing their data, making the study interesting from a historical viewpoint, but questionable beyond that. The Discussion also requires substantial expansion. In addition, the manuscript does require careful proof-reading to correct many language errors.
Possible Conflict of Interest:

For Transparency: I am an Associate Editor of MedEdPublish

BALAJI ARUMUGAM - (06/08/2019) Panel Member Icon
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Thanks for the invite to review the article.
This is the simple survey about the social media usage pattern and the purpose of usage and learning aspects.
The important result that I consider from this study is 52% of the Residents did not receive any courses or lectures on how to use social media, while only 19% had rarely any. Majority if the residents (83.2%) believe that it would be beneficial to have a course or a lecture during residency on how to use social media. So a formal interactive sessions regarding the usage of social media to be given to all medical students and residents by IT people which is not a part at all in any medical institutes globally I guess.
Suggestions: Survey instrument questionnaire should be validated before starting the study because its just a questionnaire based study.