Social media in medical education: Can you trust it? Yes

For more than a decade, a veritable cornucopia of online educational resources, combined with the interactive exchange of ideas and knowledge in virtual communities of practice, has led to the influence of social media in emergency medicine education. Protagonists of social media have availed the reduction in knowledge translation (the process of synthesis, dissemination and integration of scientific knowledge into clinical practice), a levelling of hierarchy in discussions of evidence validity and applicability, and the ready access to information at points of care. However the ease of online publication of blogs or podcasts, sometimes without erudite editorial oversight, has cast doubts as to whether this disruptive technology can be trusted. Recognition of potential faults in established methods of evaluating educational materials, the development of robust online resource appraisal tools, and the involvement of educators as online mentors guiding to the best resources, provides reliable means in which clinicians can put faith into the use of social media for their own professional development, as well as guide patient care. Traditional educational resources, both primary (original works published in journals) and secondary (textbooks and lectures) have benefited from a belief of superior quality control because of the established concept of peer review during publication. Generally two or more reviewers independently evaluate submitted material prior to publication. Reviewers may not be readily identified or contactable and it is often difficult to assess their criteria or motivations to permit publication. The validity of this process of quality control is not without fault. Jefferson et al. in their Cochrane review found little evidence of improved educational quality of editorial peer review, other than enhanced readability. Highlighting the failings of this process, Bahonnon (2013) managed to get over 150 journals out of 304 approached to publish his article that was intentionally erroneous, in part factitious and knowingly contained fatal scientific flaws. In contrast, social media publications benefit from crowd-sourced review of the published information. Criticism, feedback and dialogue can occur in near real time. Controversies can be instantly discussed and dissected to give the reader more information to evaluate the resource’s accuracy and applicability to clinical situations. In addition, content can be rapidly updated. Traditional educational resources lack such immediate discourse. Nevertheless, in acknowledgement of the current paradigm – despite its incomplete evidence base – many social media resources also now undergo external peer review before publication, to demonstrate transparency and quality in publication. Even though it aligns with a learner-centric model of education, social media can provide a volume of information that is overwhelming for an experienced and sceptical clinician, let alone the ebullient novice. ACEM’s ‘Best of Web’ initiative provides peer reviews of a curated list of online resources. Best of Web not only evaluates the quality of the resource using reviewer gestalt on a five point Likert scale, but also its alignment to ACEM’s curriculum domains, content themes and target audience. Disclaimers, suggested use and a short resource review summary helps guide the user to more effective online resources that compiles with their learning needs. This tool roughly correlates with the checklist developed by Paterson et al. that has been developed from an initial systematic review to acquire quality indicators, distilled to a smaller number in survey with medical education producers and finally aligned with expert medical educators opinions. This extensive effort to define and identify educational quality in online educational resources, speaks to the desire of the authors and producers of social media to create resources that readers can trust. Gestalt ratings are the most readily available means to evaluate online resources accuracy, but they appear unreliable when using a small numbers of raters. However, a large number of raters (>42) does appear to provide the desired reliability, and gestalt ratings from users across the spectrum from medical student to consultant are found to be consistent. This would mean that a large crowd-sourced rating of a blog or website from a range of users of any experience could advise whether a resource can be trusted. What better means to acquire such a large review set than from social media. This, combined with popularity or number of viewers as a surrogate of faith in Correspondence: Dr Matthew Nettle, Emergency Department, The Prince Charles Hospital, Rode Road, Chermside, QLD 4032, Australia. Email: matthew. nettle@health.qld. gov.au