Summary: The AMEE E-Learning Committee reflects on the use of Social Media in Medical Education. This is aimed at both at novices and the more experienced. Description: A Reflection on Social Media in Medical Education

A great deal has been written on the use of social media in medical education.  For both the novice and experienced user, there are so many different aspects to consider, and so many new media emerging, while others lose prominence, that the environment and how best to survive and thrive in it can be rather daunting.

This reflection encourages one to step back a little, and take an overview of some essentials when using social media in medical education.  It is aimed mostly at the novice, but also at those who have used social media for a while, and are feeling a little overwhelmed.

1.    Don’t use everything
There is a temptation for people to want to use all the media.  This is usually motivated by the fear of being left out, because everyone else seems to be using them, so you want to get in early, show that you’re up to date with latest technology, that you’re not uncool, and you wish to stake out your little piece of real-estate.

Using social media is not a competition to see who can paste their face on as many internet sites as possible.  There are simply too many to use effectively, and if you try to use too many, you will end up not using any of them properly.  And those that you use poorly will reflect poorly upon you.  Rather do not use a site at all than use it badly.

2.    Investigate a wide range
That said, investigate a wide range of tools.  Beginning with the most popular is an obvious starting point.  They are popular for a reason, and that reason may be relevant to you and your students.  Currently, the most popular are Facebook, Twitter, and YouTube.  (You will notice that we include YouTube in this list – some writers feel that YouTube does not qualify as social media.  Don’t get hung up on the theory and definitions – just look at it as an educator and make up your own mind).

Others that you can consider at this stage are LinkedIn, Pinterest, Tumblr and Instagram.

When you are looking at these, think about how you could use these in medical education – not only in direct teaching, but also your research and other facets of your academic life. Watch how other people are using the tool, especially if you know the people and can identify with their work.

3.    Consider your needs
Make a wish-list of the sorts of things you need to do, and would like to do with social media.  Try to prioritise them.  If you have a good rapport with some of your students who are used to social media, you may want to sound them out.  (If you’re really fortunate, the best is when a student approaches you unsolicited, and suggests using a tool to assist in the teaching of something.  Give that student credit for a great idea, and seriously consider using that tool).

One can mount a plausible argument to have this step come before Step 2 outlined above.  After all, one should be strongly needs-driven rather than technology-driven.  In reality, these two steps follow an iterative process: upon investigating the tools, you will gain ideas and possibilities; they will allow you to reconsider your needs and to expand upon those that you discounted because you thought them too extreme.

4.    Make your selection based on needs
Once you have an idea of your needs and the characteristics of the different tools, make your selection based on
•    the priorities of your needs
•    the ease of use.

Begin by confining yourself to only three tools.

Ideally, only these needs should determine the choice.  In reality, we are creatures that wish to balance long-term rewards with at least a little bit of low-hanging fruit, so choosing a lower priority need that is easier to match is good for your motivation, and will help to ease you into the concept of using social media in your professional life.

5.    Look to integrate, not add-on
The social media you choose to use need to be integrated, and should not be add-ons.  The reason for this is rather obvious: a large motivation in learning begins by answering the question: “Why should I learn this anyway?”  With social media, the question is “Why should I use this anyway.”  If you are using the tool in your teaching, and wish for interaction with your students, the relevance and value of the tool to their studies must be obvious.  Sometimes, especially if they know and trust you, they will take your word for it, and the initial “wow” factor will hold them, but for a short while only; don’t rely on this too much – the benefits must soon be obvious; if not, you will lose them.

6.    Online ethics – yours and your students’
Medical ethics has been taught for many years, but the online world has brought its own complexities into the arena.   Ethics in social media falls under Medical Informatics Ethics, and you need to bring yourself and your students up to speed on the pertinent issues.  An open access chapter on the background and ethics in the online world is available at: http://tinyurl.com/MedInfEthics6thEd

More specifically, your own institution and country may have rules or laws governing online behavior – ensure that you know what those are.

7.    Use it
“If you build it, they will come” might work for baseball fields of dreams, but it doesn’t work for social media.

Once your presence has been established, and the students see the need for use, make sure that you use it.  And it needs to be used repeatedly.

8.    Beware of being a space-invader and the “creepy treehouse effect”
Your students already use social media.  But they use it primarily for its intended purpose – to be sociable, to mix with friends.  Now that you have decided to use it to teach, you run the risk of being perceived as a space-invader, or the creep who builds the tree-house and invites little children to play.  To see more about this, see the Chronicle’s short article on it at: http://chronicle.com/blogs/profhacker/the-creepy-treehouse-problem/23027
See also the discussion in point 3 above about needs and involving your students.

9.    Don’t over-commit
Just as you wish to have a narrow selection of tools, so you need to have a specific and attainable commitment  to using those tools.  Yes, the tool must be integrated, yes it will require a lot of thoughtful participation from you, yes you wish to interact as much as possible, but don’t over commit yourself to the point that you are trying to reply to every point and every idea.  If the social media are being used properly by the students, you simply will not have the time to respond to everything, and, if you try to respond to everything, you will eventually resent having it as it intrudes on every moment of your time.
 
10.    Keep you information and usage current
Just as one revisits the curriculum, lesson plans, teaching materials, so one should re-visit the material posted into social media, and update it as required.  Just because something worked once does not mean it will work again – it may have worked because it was new and innovative; over-use will make it boring and stale.

If something was a good idea, but failed, try to re-engineer it.  But there may come a time when you realize it wasn’t actually a good idea at all, and needs to be thrown out.  In spite of the hard work you put into it, be prepared to throw it out.

11.    Have a backup plan
While integration is essential, it will, of necessity, lead to reliance.  The danger is that, when it fails, you need a backup plan that will rescue any work you are trying to do.  Your backup plan may mean another tool, or another way of presenting.

This is standard in any technology-enhanced learning.  With social media, however, there is the added complication: you are your own tech support.  (See next point).

12.    Know that you are on your own
At your institution, you are probably used to having some degree of technical support.  When the Learning Management System (LMS) goes down, or behaves unexpectedly, you expect somebody to work on it and get it working properly as quickly as possible.

Social media are external to the organisation.  This has several implications:
•    If your connection is lost, or if it behaves unexpectedly, you have to deal with it yourself.  You will find that those who recommended it to you are not available to assist you in any way.
•    The media may change: The layout, the functionality, the rules of usage – all of these are subject to change without notice, and you will have to be on your toes and adapt to the changes.
•    Your use of it may not be recognised by your institution for performance reviews and promotion.  In a worst-case scenario, telling an administrator that you use Twitter and Facebook in your teaching, when that administrator equates these with time-wasting rather than productive work, might even be counter-productive.

To use it effectively, and to receive due recognition, you might wish to find out a little more about the institutional attitudes towards social media usage before investing your time and effort into it.  In addition, ask other staff for assistance, but do not over-burden them (See the next point).  You might wish to rather join online discussion areas where questions and problems can be addressed as people have time.

13.    Others are on their own, and you might be the boffin
Conversely to point 12, after you have used the social media for some time, other staff who wish to use it may look to you for advice.  Sharing your experiences and knowledge is part of your job.  Be careful, however, that you do not suddenly find yourself to be the Facebook helpdesk at your institution with people flooding your mailbox with questions.

14.    Get the personal vs. professional balance right
The bad news is that you will not get the balance between online personal and professional perfect all the time.  This can be daunting to the point that some back out of social media entirely.

Getting this balance right is often based upon individual circumstances such as your own personality, the level and type of course you teach, the institutional and class culture.

Some people may prefer to have two different accounts, one personal, one professional; some might prefer only a professional.  Others find juggling in a mixture fairly easy.  Feel your way, but know that it is difficult.

15.    Use social media for more than teaching
Use social media for more than merely teaching, so that you can be a role model to your students for using the media professionally in a range of areas.  Again, however, ensure that you are using them correctly.  Begin by checking your user profiles, ensuring that they are accurate and current.

The integrated use of these social media tools across all your professional activities promotes scholarly teaching, and is a starting point for educational scholarship (making public, dissemination, allowing for peer review and critique, self-reflection, allowing others to build upon by citing and providing feedback and commentary, etc.)

Start with something simple: For your next conference presentation, don’t think of the presentation as the entire product.  Think of it merely as a single node in a network of delivery, and your social media activities are other nodes in that network.  So, some activities may include:
•    Closer to the conference, tweet, using the conference hashtag, about your presentation, using a question or important catch to interest people.
•    Raise the topic in a blog or personal website.  This will ensure this will ensure that topic is fresh in the minds of the delegates, so that your name and issue mentioned in the title of your presentation will be recognised.  Here are examples from Goh Poh Sun at http://designingeffectivelearning.blogspot.sg/  and http://telroundtable2014.blogspot.sg/
•    If you don’t have a personal blog or webpage, try to find other areas.  For example, for the AMEE conferences, you can use the MedEdWorld forums or the MedEdWorld Reflections.  See the MedEdWorld forums at: http://www.mededworld.org/Forums.aspx and reflections at http://www.mededworld.org/reflections.aspx
•    After the conference, use these areas to continue the conversation.

16.    Use some of the management tools to assist you
If the usage takes off, you might find the management of the media is a little over-burdening.  There are many tools that can be used to manage and track usage and responses.  While you should guard against being caught up in the tech and the data, these can generally prove valuable.

A useful list is found at:
http://blog.sumall.com/journal/15-best-free-social-media-dashboards-tools.html

17.    Explore other possibilities
Once you have got to grips with the basic sites, you might wish to expand slowly into other areas.  For example, if you are feeling brave, take a look at Reddit. A warning, though: Reddit is very diverse and reflects most of the world’s population (though not in the same proportions).  Just as humans are diverse, you can expect the unexpected (sometimes not entirely pleasant) on Reddit.

18.    Be strong
You will make mistakes, you will mess up from time to time.  Take stock, limit the damage if you can, and try again.  Education has never been for the faint-hearted; using social media in medical education adds pressure.  The benefits, however, can be extremely rewarding.

Where to from here?
This Reflection should serve as a useful overall guide.  There is far more to explore, and the next useful jumping-off point is the AMEE Method of the Month for November 2014 document.