August 9, 2023
From personal conversations to global collaborations, these platforms have fundamentally transformed the landscape of communication across various domains. One area that has been influenced profoundly by this digital revolution is surgical training.
Surgical training has long relied on traditional methods, such as didactic lectures, hands-on experiences, and mentoring by experienced surgeons. However, the emergence of communication platforms has ushered in a new era of learning and knowledge dissemination.
Social media platforms, with their immense reach and accessibility, have provided surgeons and trainees with unprecedented opportunities to share their experiences, exchange ideas, and engage with a global community of medical professionals. Notably, many surgical training programs have their own Twitter accounts, allowing them to engage with trainees, attendings, and medical students.
This article explores the impact of communication platforms, primarily social media, on surgical training, while also examining the related benefits, challenges, and ethical considerations. It delves into the transformative effects of these platforms on various aspects of surgical education, including knowledge acquisition, skill development, collaboration, mentorship, and professional networking.
Many different surgical specialties and disciplines, including urology, plastic surgery, and neurosurgery, have adopted social media to enhance their educational programs, technical training, and research opportunities.1-3
YouTube—often considered a social media platform because it features user-generated content and fosters interaction among users—provides access to procedural videos, many of which are high definition and narrated to dictate the operation.
Lima and colleagues performed a systematic review of general surgery procedural videos available on YouTube and found that while most videos are lacking crucial patient and operation information, it is possible to find “good-quality” videos on the platform.4
YouTube also can be used to amplify educational content found on podcasts, such as the collaboration between Behind the Knife and the ACS Resident and Associate Society (RAS), to create landmark paper summary videos, allowing viewers to learn the key points of hallmark surgical articles in just a few minutes.
Twitter is the most popular social media platform used for healthcare communication.5 It serves as an open-access platform that allows the rapid dispersal of the latest articles, current clinical trials, and established guidelines, as well as real-time discussion regarding related topics and issues.
Often, medical journals and authors tweet highlights from recent articles to share content, which can increase engagement.6 Visual abstracts and infographics are used to promote medical research through social media and have been shown to increase abstract views and Altmetric Attention Scores.7,8
Several medical societies and their committees, including the RAS, host virtual journal clubs to discuss recent literature, and through the use of Twitter Hangouts, members from across the world can participate in educational conversations, sometimes with the authors themselves.
It has been shown that social media rarely negatively influences applicants’ perceptions of a program, so creating and maintaining social media platforms are likely worthwhile for residency programs.
Social media and other communication platforms play a vital role in providing trainees and junior faculty with the mentorship they need to advance their careers. The importance of mentorship in surgical training cannot be overstated, and platforms such as Twitter and organization-based websites help connect individuals with similar goals, interests, and backgrounds who might not have otherwise crossed career paths.
Websites developed and managed by organizations such as the Association of Program Directors in Surgery, Association of Women Surgeons, and discipline-specific organizations frequently serve as repositories for job postings and feature open research positions. These organizations sponsor networking events and offer dedicated mentorship programs. For instance, The Society of Thoracic Surgeons offers a formal mentorship program whereby mentees are asked about their potential interests within the field and then matched with a volunteer mentor.
These opportunities, often enhanced by video platforms like Zoom, make the forging of long-term mentor-mentee relationships not only possible, but often easier than formal in-person gatherings.
Twitter, in turn, allows individuals the chance to connect with more senior trainees and faculty, making cross-country distances negligible in forming new connections. For example, at large national conferences such as the ACS Clinical Congress, attendees can use Twitter to connect with other attendees and arrange meetings between sessions to connect.
A Twitter user may ask a question to their own target audience, focusing in with a hashtag or Twitter handle, and retrieve guidance from others. In all capacities, whether through a simple question, chatroom, or formal meetup, Twitter has facilitated mentorship for hundreds, if not thousands, of surgeons and aspiring surgeons worldwide.
Many surgical disciplines also have been using social media as a recruiting tool since before the pandemic. Among orthopaedic surgery applicants who completed a survey, Instagram was found to be the most-used social media platform to learn about programs.9
Similarly, most integrated plastic surgery applicants who participated in an optional survey found that social media was an effective source of information on programs, with the majority of respondents using Instagram in particular.10
Since 2020, the social media accounts of general surgery residency programs have grown in popularity. While the idea of using social media as a recruitment tool is not new, it has new importance in the age of virtual interviews that have followed the pandemic.
Of note, there was a significant increase in residency social media accounts in 2020. During the 2020–2021 application cycle, most general surgery applicants reported using social media to learn about residency programs. It has been shown that social media rarely negatively influences applicants’ perceptions of a program, so creating and maintaining social media platforms are likely worthwhile for residency programs.11
In addition to fundamentally altering residency recruitment practices, the pandemic also threw into disarray many of the standard training techniques, including real-time instruction both in the operating room and simulation labs.
As many elective cases were canceled and face-to-face teaching was postponed, much of the traditional training methods were no longer available. A survey of surgical trainees during COVID-19 found that most institutions introduced new education and training solutions to the challenges brought on by the pandemic, including transitioning educational programming to a virtual format and recording lectures for later viewing; 21% of residents reported a positive or extremely positive impact on their didactic experience during this time.12
Innovative residency programs began to use communication platforms to directly facilitate surgical technique training. Loli and colleagues implemented telementoring into their surgical curriculum by using smartphone cameras to record EndoTrainer practice, allowing trainees to receive real-time feedback from mentors. All 40 participants who participated in the study reported this use of telementoring to be a “good educational tool.”13
While communication platforms offer undeniable advantages in surgical training, they also present several challenges and ethical considerations that must be addressed. Issues such as patient privacy, the reliability of shared information, and potential misinformation necessitate careful evaluation.
Social media has been touted as a way to improve the visibility of medical literature but there can be a selection bias in what is chosen to be publicized and what gains the most traction online.
As providers share anecdotal evidence related to specific presentations, it is important to be cognizant of a lack of peer review that would otherwise be expected for scientific findings.
There are examples of misinformation shared by physicians online, particularly surrounding antivaccine rhetoric,14 which is easily spread without any type of fact-checking process. Medical providers who share their experiences online may inadvertently include protected health information and be in violation of HIPAA, resulting in a loss of employment.15
For this reason, the American Medical Association and other healthcare associations have developed guidelines for professionalism in social media.16 Balancing the benefits with the potential risks and ensuring responsible use of these platforms are essential aspects that require in-depth examination.
It is crucial to examine the unique attributes that communication platforms bring to surgical training. Unlike traditional methods, which often restrict learning opportunities to local or limited networks, social media platforms offer a global stage for surgeons and trainees to connect, share experiences, and learn from each other’s diverse perspectives.
Furthermore, the multimedia capabilities of these platforms allow for the seamless exchange of surgical videos, images, and educational resources, enhancing the understanding of complex procedures and techniques. At the same time, it is important to consider the possible negative consequences of these platforms and strive to maintain accuracy, credibility, and professionalism throughout all communications.
Dr. Fedra Fallahian is a 2023 graduate from the Saint Louis University general surgery residency program in Missouri. She is an incoming fellow in breast surgical oncology at The University of Texas-Southwestern in Dallas and serves as Chair of the RAS Communications Committee.