key: cord-0801366-y6273guo authors: Born, Hayley title: Update on social media and otolaryngology: Pertinent positives and definite downsides date: 2021-07-20 journal: Laryngoscope Investig Otolaryngol DOI: 10.1002/lio2.620 sha: fad1fde9313e943e3d27a0bc027171b3844896e0 doc_id: 801366 cord_uid: y6273guo Professional society guidelines are useful as a starting point as well. 9-12 It should be pointed out that the otolaryngology leadership has not yet released any such guidelines. In an age when misinformation is spreading faster than ever, highlighted especially during the COVID 19 pandemic, it can be argued that countering falsehoods is a professional responsibility. 13 Happily, it has been shown that social media really can combat misinformation. 14-18 A best practice exemplified by many successful social media professionals is to cite primary sources for your content. Much of the established body of research looks at the spread of medical misinformation on social media and whether social media can be used to change patient perceptions, knowledge, or behavior. 19,20 A recent review examined the use of social media as a medical education tool for providers. 21 They review the rise of “knowledge translation” in social media friendly formats like infographics or visual abstracts. 22 Dr. Michael Johns (@laryngologist) and Dr. Jennifer Villwock (@jenvillwockmd), my co-panelists, have previously published about and encouraged the use of visual abstracts within the otolaryngology community. 22,23 This is one of very few articles within otolaryngology related to social media. Most examine the rise of social media by quantifying the number of accounts and content that exist in our field. 1,24-31 These publications typically review current uses of otolaryngology in our specialty and a majority Having moderated and participated in several social media panels and projects in the past, it was telling that the topics had evolved from simply "what is social media?," "how do I sign up?," or "what is a hashtag." We've moved beyond the basics. There has undoubtedly been a social media boom during this pandemic-induced period of remote learning, recruitment, and work. 1 Nearly all otolaryngology residencies have created social media Other community members have used social media to expand their professional networks. 1,2 My personal network of like-minded laryngologists has grown exponentially during this past year. Discourse on otolaryngologic topics as well as broader issues in medicine and public health has occurred across subspecialty, program, and even country lines. Discussing mutual challenges and setbacks has even been shown to decrease burnout by cultivating a sense of community. 3 It has certainly helped me feel more connected in this difficult year. Some accounts have targeted education as their purpose. Whether teaching patients how to recognize symptoms of a sinus infection or reviewing best practices in the care of complex skull base tumors, education through social media is likely here to stay. Journals share their newest content and accounts targeted at medical students and residents review board-testable content. One example of an educational account is Dr. Leslie Kim (@drlesliekim), a professor at the Ohio State University. She has garnered a large following on During our panel, we discussed the recent case involving a, now retracted, publication from the Journal of Vascular Surgery. 5 This widely criticized publication purported to evaluate the professionalism of members of the vascular surgery community based on their social media content. The controversy came due to some arguably biased and antiquated classification of behavior. 6 While I encourage all readers to delve into the details behind the #medbikini movement, the case highlighted a risk of being active on social media. We cannot control how others will react to our pictures, opinions, or, even, lack thereof. Professionalism is subjective and shifting and care should be taken when deciding what to post. 7 As I quipped during our panel, "the internet is forever" and content should be treated as though it will be taken out of context. Some employers and programs have even proposed reviewing applicant social media for any "red flags." Our Triological panel collectively concluded this would be a difficult practice to justify given the significant potential for biased evaluation (as exemplified by the #medbikini scandal). Formal evaluation may not become commonplace, however, it is inevitable that social media may come into play during evaluations of candidates. By presenting ourselves as part of the medical social media landscape, we open ourselves up to criticism and even culpability. Never giving out medical advice or conversing directly with patients via social media seems obvious, but there are other pitfalls that can result. Concrete advice that was given at a prior panel at the American Academy of Otolaryngology annual meeting 8 Careful fact checking and diligent research will help avoid some social media pitfalls we have seen from "experts." We must remember that patients and colleagues will take our posts at their face value and we have a responsibility to accurately reflect our understanding of the science and art of medicine. In an age when misinformation is spreading faster than ever, highlighted especially during the COVID 19 pandemic, it can be argued that countering falsehoods is a professional responsibility. 13 Happily, it has been shown that social media really can combat misinformation. 14-18 A best practice exemplified by many successful social media professionals is to cite primary sources for your content. It not only strengthens the point you are making, but also reiterates the importance of data and research in medicine. Some may recommend avoiding controversial or debated topics, but a more useful approach may be to present those subjects as exactly that: a scientific unknown. there is just one publication that suggests a standardized ontology, or terminology, within the field of otology to encourage seamless interaction around common otolaryngology topics. 34 This uniformity of terminology has been used in other fields to increase discourse around their topics of interest. [35] [36] [37] The ontology has been integrated into some subspecialty social media guidelines to encourage a uniform message and terminology. Finally, there is one study within otolaryngology that suggested that residency ranking was correlated with increased social media presence, though reasons for this are unclear. 27 Future research in social media has huge potential. By going beyond the descriptive studies, formally establishing best practices, and evaluating the effects of social media participation, we can approach engagement in an objective way. As has been done in other specialties, proactive and formalized guidelines on social media use specific to otolaryngology would assist individual societies, journals, departments, and providers in effective and safe social media engagement. As part of the specialty guidelines, systematic establishment of a common ontology would assist in uniform messaging within and from our field. Other potential areas of study within otolaryngology and social media should address patient perceptions and interactions with our social media accounts. Quantification of patient education and outreach campaigns will establish best practices for future advocacy. Outcomes research related to implementation of social media and online-based medical education is necessary to justify and/or encourage a shift in traditional provider education. Correlation between social media engagement, or lack thereof, and promotion, citation, and leadership within otolaryngology would give tangible evidence for active participation. Prospective trials relating to implementation of formal guidelines in our field will assist in avoiding the aforementioned potential pitfalls. Formalized processes for evaluating providers' social media could allow content to be considered when evaluating candidates for positions or promotions. I have been excited and honored to be a part of the discourse relating to social media in otolaryngology. Serving on committees such as the Triological Society social media committee and co-managing institutional accounts has given me a unique perspective on engagement within our community. Panels such as this year's Triological Society panel push me to reflect on social media in my professional life. I will end with a call to action. Let otolaryngology be a leader in optimizing social media benefits and minimizing the downsides. Let us bring our established reputation of evidence-based practice to social media via rigorous study of the subject. Oh, and when we do, let us not forget to share what we discover via a tweet or Instagram post! Otolaryngology residency programs' rising social media presence during the COVID-19 pandemic Networking matters: a social network analysis of the Association of Program Directors of Internal Medicine Residency as a social network: burnout, loneliness, and social network centrality Social media and professional identity: pitfalls and potential Retracted: prevalence of unprofessional social media content among young vascular surgeons Social media and professionalism among surgeons: who decides what's right and what's wrong? How surgeons should behave on social media #What 2.0: The Dos and Don'ts of Social Media in Otolaryngology. Panel Presentation Professional guidelines for social media use: a starting point Statement on guidelines for the ethical use of social media by surgeons Professionalism in the use of social media Guideline of guidelines: social media in urology The spread of true and false news online Addressing parents' vaccine concerns: a randomized trial of a social media intervention Effects of a web based decision aid on parental attitudes to MMR vaccination: a before and after study Web-based social media intervention to increase vaccine acceptance: a randomized controlled trial Social media accompanying reading together: a SMART approach to promote literacy engagement The use of social media in healthcare: organizational, clinical, and patient perspectives Addressing health-related misinformation on social media Public health messaging in an era of social media Social media in knowledge translation and education for physicians and trainees: a scoping review A picture is worth a thousand views: a triple crossover trial of visual abstracts to examine their impact on research dissemination Professional and patient engagement, visual abstracts, and applications to otolaryngology-social Media's siren call Recommendations for the rising otolaryngology residency programs' social media presence In response to recommendations for the rising otolaryngology residency Programs' social media presence Evaluation of social media presence of otolaryngology residency programs in the United States Otolaryngology residency program rankings and social media usage: a longitudinal analysis Recruitment and networking with social media for the otolaryngology match in the COVID-19 pandemic #ENT: otolaryngology residency programs create social media platforms to connect with applicants during COVID-19 pandemic Social media presence of otolaryngology journals: the past, present, and future. The Laryngoscope The increasing role of social media in otolaryngology Social media's role in otolaryngology-head and neck surgery. Otolaryngol-Head Neck Surg Otolaryngology residency interviews in a socially distanced world: strategies to recruit and assess applicants Generating a social media ontology for otology and neurotology The Urology Tag Ontology Project Urology tag ontology project: standardizing social media communication descriptors Twitter and academic urology in the United States and Canada: a comprehensive assessment of the Twitterverse in 2019