Social Media for Radiology Education in Gross Anatomy – Two Years of Experience – Liwei Jiang, B.A.Christopher R. Bailey, M.D.Krishna Juluru, M.D.Donna Magid, M.D., M.Ed.

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Social Media for Radiology Education in Gross Anatomy – Two Years of Experience – Liwei Jiang, B.A.Christopher R. Bailey, M.D.Krishna Juluru, M.D.Donna Magid, M.D., M.Ed.

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Presentation given at the 2016 Institute for Excellence in Education Conference at Johns Hopkins University School of Medicine

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Social Media for Radiology Education in Gross Anatomy

Two Years of Experience

Liwei Jiang, B.A.Christopher R. Bailey, M.D.Krishna Juluru, M.D.Donna Magid, M.D., M.Ed.

The Johns Hopkins University School of Medicine

March 11, 2016

No relevant disclosures

Objectives

After attending this presentation, the participant will

  • Appreciate the potential of social media tools in delivering content to learners
  • Recognize the capabilities and limitations of social media metrics in data analysis

Facebook needs no introduction.

It is where you and your Friends can comment on cat pictures and mourn the death of special cats.

As you know, each of you can have a personal profile, …

… but you may be less familiar with the concept of the Facebook Page (with a capital “P”), which is different from your regular Facebook Profile. Any organization or individual craving attention, in this case Taylor Swift but can also be any of you, can create a Facebook Page for the express purpose of self promotion. Other users don’t “Friend” this organization or celebrity in the usual fashion; instead, they “Like” the Page to start receiving updates. So when Taylor Swift posts on her Facebook Page to say happy birthday to her friend, all of her 74 million Fans can potentially sing Happy Birthday along with Taylor. By the way, in Facebook parlance, a “Fan” is a user who has “Liked” a Page. And speaking of the number of Fans, when you run a Page you can see detailed metrics such as how many people saw the post, how many people clicked on it, and so forth.

What all this means is that a Facebook Page has the power to reach hundreds, thousands, or millions of people at once, and this reach is measurable. This is the kind of power we want to harness for education—in our case, the education of anatomy and radiology.

Anatomy + Radiology

Radiology: the way most clinicians see anatomy

Gross Anatomy and Introductory Radiology are taught concurrently at many medical schools. If done well, anatomy-radiology integration fosters multi-modality learning, highlights clinical relevance, and may promote an early interest in the field of radiology. It is also important to remember that, aside from surgeons and pathologists, most physicians see anatomy through the perspective of radiology.

Here at Hopkins, we have fancy computers in our anatomy lab, but they are rarely used to study radiographic images during dissections.

Instead, the learning of radiology occurs during radiology lectures and even more so at home. For homework, students are instructed to go to TeamRads.com, our online radiology education resource, …

…and work through some of the Tutors and Quizzes. TeamRads is a nice resource, but this whole process is far from ideal.

Pull Learning: Significant Effort Required

TeamRads.com: separate, non-integrated site

  • “Yet another system”
  • “Go to Section X, click on Case Y…”
  • Challenge to attention span and willpower

Need to invert the flow of educational resources

We are making students engage in what I call “pull learning,” where they have to expend significant effort to bring learning material to the front of their consciousness.

Technology often doesn’t make it easier. Students complain about Blackboard because it takes way too many clicks to log into JHED, launch Blackboard, find the course link, click “Course Materials,” open several layers of folders, download the slides, and then open the file. It’s insanity; I’d rather have a single binder in front of me.

TeamRads.com, while better organized, contributes to the same problem. It’s yet another system to click through when students are told to go to Section X, click on Case Y. It’s not as easy as a Google search. As one of the Webmasters of TeamRads.com, I dread it when I have to go on there to find something specific. (Sorry, Donna, but it’s true.)

We need to change the learning paradigm. We need to invert the flow of educational resources.

Push Learning

We need to create “push learning.”

Goals

Push daily imaging cases in step with anatomy curriculum, directly to the hands of students

  • Learning on multiple devices
    • Phone
    • Tablet
    • Computer
  • Reinforce high-yield anatomic relationships
  • Reinforce key concepts in image interpretation
  • Author once, deliver automatically
  • Foster and measure student engagement
Specifically, our goal with this project is to [slide contents]

Target Demographic

Students in JHUSOM Human Anatomy course, 2014 and 2015

  • Medical
  • Biomedical Engineering
  • Medical & Biological Illustration

N ≈ 140

Opt-in participation

We created a Facebook Page, JH Team Rads, and we encouraged our target demographic to “Like” the Page.

You know what happens after that: whenever we post an imaging case, our Fans receive a push notification on their phones, tablets, and computers the instant it happens.

Now, Buffer is the linchpin in all this.

Buffer is a Web application that manages social media accounts. One useful function is to post to multiple social networks at once, which at the moment we are just posting to Facebook.

But what we find extremely useful is the ability to write a bunch of posts ahead of time, save them into a queue, and then set the exact schedule by which posts will be released onto Facebook.

All cases are carefully de-identified

So here is our workflow. We put together a series of imaging cases that correlate well with each day of the anatomy curriculum. We stored the cases in the correct order in Buffer, and we set Buffer to post the cases to our Facebook Page every weekday. Then each day all of our Fans get a push notification, and they go to town on that case.

Structural Limitations

  • Not everyone uses Facebook
  • Previous year’s participants not excluded
  • Facebook Page is public; anyone could
    • “Like” the Page
    • View the questions
    • Be tracked by Facebook’s metrics
Let me tell you up front that there are some limitations inherent to this appraoch. Not everyone uses Facebook. We did run the study twice, in 2014 and again in 2015, and we found in 2015 that there was no easy way to just boot everybody from 2014 off to start over. If you think about it, Facebook is probably more concerned about you getting more Fans as opposed to you controlling who exactly your Fans are. So if people from 2014 somehow decide to participate again, then they’ll be counted in the metrics as well. In the same fashion, because a Facebook Page is public, anyone outside our target demographic could become a Fan and participate. They’ll be counted in the metrics, too.

In fact, to give you example of this phenomenon, here are some demographics data from 2014. Note that we have a number of people clearly not from Baltimore or even from the United States.

Here are some metrics we actually got. [Explain legend.] Note that the count is unique users, so if someone views the Page multiple times it only gets counted once. It is immediately apparent that on some days we have many more Page views than the number of Fans. We think this is due to Facebook’s algorithm of maximizing the Page’s exposure, where Facebook users who are not our Fans or who are Friends of our Fans are also shown our posts.

It is also interesting to see that despite all the views only a small percentage of people actually clicked on the links to the imaging cases.

Here is the specific plot that shows link clicks as a percentage of Page views in 2014.

Here is our 2015 data. Same basic patterns.

When we asked our target demographic each year what they thought of this project, more than 70% of responders each year agreed that the cases were [walk through figures]. The only exception was whether the cases increased one’s desire to explore radiology as a field practice. We got lower numbers there, and I would not expect to convince students that easily.

Limitations

  • Not everyone uses Facebook
  • Previous year’s participants not excluded
  • Facebook Page is public; anyone could
    • “Like” the Page
    • View the questions
    • Be tracked by Facebook’s analytics
  • Facebook algorithm may limit and broaden audience of content
    • Neither desirable in controlled environment
  • Participants free to ignore content being delivered
  • Currently unable to directly assess learning enhancement

Future Directions

  • Reach: Find additional mechanisms of case delivery
    • Other social networks
    • Non - social media channels
  • Control: Consider limiting content accessibility strictly to target demographic
    • “Tighter” metrics
    • Creation of closed group may conflict with openness
  • Quality: Continue to improve and add imaging cases
  • Connection: Link cases to related cases or tutorials
  • Responsibility: Incorporate testing to assess educational impact
Last point included to address reviewer comments. Testing would be *very* difficult to do given the many other factors that would contribute to differences in test scores.

Conclusions

  • Facebook and Buffer: powerful, information-rich, and synergistic tools
    • Push learning integrated with daily habits
    • Simplified administration with scheduled posts
    • Highly revealing participation metrics
    • Caution: content reach may not be what is intended
  • Well received by students
    • Interesting, relevant cases
    • Greater understanding of both anatomy and radiology
    • Increased appreciation of imaging

Widely applicable to other educational scenarios

Acknowledgments

Facebook, Inc.

Buffer

Foundations of Human Anatomy, The Johns Hopkins University School of Medicine

Institute for Excellence in Education

Supported by the M.R. and Evelyn Hudson Foundation

Thank You!

Liwei Jiangliwei.jiang@jhmi.edu

Mentor

Donna Magid, M.D., M.Ed.dmagid@jhmi.edu

Social Media for Radiology Education in Gross Anatomy Two Years of Experience Liwei Jiang, B.A.Christopher R. Bailey, M.D.Krishna Juluru, M.D.Donna Magid, M.D., M.Ed. The Johns Hopkins University School of Medicine March 11, 2016