In an age when the surgical community is increasingly dispersed, social media sites can serve as platforms where surgeons can interact with one another to acquire new knowledge and skills, according to experts writing for the Harvard Business Review.
The piece is written by Christopher Myers, an assistant professor at the Johns Hopkins University Carey Business School and Armstrong Institute for Patient Safety & Quality; Yusef Kudsi, an assistant professor of surgery at the Tufts University School of Medicine and a practicing surgeon; and Amir Ghaferi, an associate professor of surgery and business at the University of Michigan and a practicing surgeon.
The importance of interacting
According to the authors, peer-to-peer interaction is a critical method of professional development among surgeons. For instance, academic surgical departments hold weekly Morbidity and Mortality meetings to review cases and improve care, and research suggests that surgeons in solo practice, who may have less peer interaction, score lower on the American Board of Surgeons Maintenance of Certification exams than do their group practice counterparts—except when the solo practitioners reported higher levels of social engagement with colleagues.
But as the field of surgery has increasingly specialized in practice, grown in number, and become more geographically diverse, "surgeons are less able to rely on casual hallway conversations, conferences, or other informal knowledge sharing strategies to learn from each other and stay sufficiently up to date with new techniques or practices," the authors contend.
What social media offers
In turn, the authors write, social media platforms, such as Facebook and Twitter, "have emerged as powerful tools for keeping surgeons connected."
For instance, Facebook groups like the International Hernia Collaboration (IHC) and the Robotic Surgery Collaboration (RSC), which Kudsi founded, let surgeons worldwide share de-identified cases, ask questions, and share their experiences about certain practices and techniques, the authors explain. They cite research that indicates surgeons are actively and intentionally engaging in at least one of the groups, RSC, with surgeons checking in with the group during workdays and text-only posts generating back-and-forth commentary (which at least one study indicates helps foster vicarious learning).
One RSC user described the group as "a safe space to challenge ideas, post videos to get tips on how to do things better, and generally advance medicine collectively." But the social media groups' benefits can go beyond an exchange of ideas and actually help surgeons learn new techniques. For instance, Ghaferi was able to use the IHC Facebook group to learn a new surgical technique which had positive clinical outcomes among his patients.
The authors also discuss the value of Twitter, citing instances when stakeholders have had "TweetChat[s]" to discuss surgical treatment and disease management or used hashtags such as #NYerORCoverChallenge and #ILookLikeASurgeon to bring attention to the underrepresentation of women and minority groups in the surgical field.
According to the authors, online forums such as Facebook and Twitter also offer the opportunity for diverse input that might be absent in a clinical setting. The settings allow non-surgeons to participate and garner benefits—for instance, according to the authors, a surgical assistant member of the RSC said participation in the group "has made [the user] a better assistant."
Challenges and how to address them
Despite these benefits, the authors acknowledge that "significant managerial and legal barriers" can impede "the broad adoption of these platforms."
For instance, the authors note that while leading social media groups call for "dedicated effort and oversight," such a role "does not fit neatly into existing paradigms or leadership structures in the field of surgery." Those in the health care industry "will have to determine how to recognize, validate, and reward these learning-oriented efforts," the authors write, suggesting a new provider role that would manage social media similar to the chair of a Morbidity and Mortality conference.
At the same time, however, the authors note that the benefits these groups afford—such as their size, reach, and cross-institutional composition—make them "inherently more difficult to govern and manage." On this front, the authors call for "dedicated guidelines from major professional organizations or support from hospital leadership."
The authors acknowledge that some physicians may be hesitant to "engage professionally on social media," for several reasons, with perhaps "the most pressing and anxiety-producing" reason being "how a surgeon's social media activity would be treated in a malpractice lawsuit." The authors point out that while conventional peer review and quality improvement efforts are traditionally protected from being subject to legal discovery—which they say suggests that social media discussions might be similarly shielded—"there are no state or federal statutes that specifically protect social media groups."
Ultimately, the authors acknowledge that "social media will never completely replace in-depth, face-to-face interactions as a forum for vicarious learning in the surgical community." Nonetheless, "in an era where the practice of surgery is evolving faster, spreading farther, and involving greater numbers of people, social media provides a scalable tool that can augment in-person learning opportunities," the authors write. They conclude by calling for health care leaders and professional organizations to "embrace [social media's] potential and work to combat its current limitations" (Myers et al., Harvard Business Review, 10/30; MacDonald, FierceHealthcare, 10/31).
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