December 4th, 2014

Intent to Tweet and a Failure of Communication

This article was adapted from a piece originally written by Larry Husten for Forbes.

For more than 15 years I’ve been trying to figure out how physicians can get involved with social media without devolving into Beliebers. It’s not easy. I often joke that the job is a bit like being the social director on a cruise for people with Asperger’s. But here’s the twist: it’s easy to be the social director on a cruise for sorority sisters and fraternity brothers, but you’re not really going to bring anything to the party that they won’t bring themselves. By contrast, those Asperger’s cruisers, just like many doctors, really need help making good use of social media.

A new study published in the venerable medical journal Circulation is a great example of the problems traditional medicine is having trying to figure out social media. In this study, the editors of the journal report on a social media experiment. For one year they randomized articles published in Circulation to social media promotion on Facebook and Twitter or no such promotion. The primary endpoint was 30-day page views. The results were very clear. They found no significant difference in the two groups. Here is their conclusion:

A social media strategy for a cardiovascular journal did not increase the number of times an article was viewed. Further research is necessary to understand the ways in which social media can increase the impact of published cardiovascular research.”

First, let me say that this study was very well performed and that the results are almost certainly valid. Click here to read an excellent, detailed summary of the study by co-author John Ryan. But the study is also extremely limited. Lee Aase, the director of the Mayo Clinic’s Center for Social Media, wrote an insightful and thoughtful critique of the study. Among his other observations, he points out that

This wasn’t really a ‘social media’ vs. ‘no social media’ test. Circulation has icons at the bottom of every online article, encouraging readers to share with their social networks.

Removing those buttons from below the ‘no promotion’ posts would have been a fairer test of social networking’s contribution. Facilitating sharing via these icons is itself a social strategy (and, I would submit, a good one.) The study also didn’t take into account that other institutions may have promoted their authors’ publications via social media.

The study did test the unique contribution of the Journal’s social accounts to article views. Those selected for promotion were tweeted once by @CircAHA and posted to Circulation‘s Facebook page. Given the diminishing organic reach for Facebook pages and the short half-life of tweets, it’s understandable that posts from one source may not make a statistically significant difference.”

Aase makes other very useful points. If you are interested in the role of social media in this sphere, then you should read his entire post.

I am in complete agreement with Aase. He demonstrates that, like so many other old-fashioned (and just plain old) members of the medical establishment, the Circulation editors don’t really understand social media.

Where did the Circulation editors go wrong? Here’s an example of one recent Circulation tweet:

PLN R14del mutation carriers are at high risk for malignant ventricular arrhythmias and end-stage heart failure

— Circulation (@CircAHA) August 28, 2014″

Taylor Swift has nothing to worry about. Of course this kind of tweet won’t drive page views. That should be obvious. Look at the last phrase of the conclusion of the study. The goal of the study was to “increase the impact of published cardiovascular research.” In this antiquated view, the whole point of social media is to amplify the size of the megaphone that the editors already have. As traditional academic leaders, it is their role to tell people in their profession what to read and what to think about when they read it. In other words, to be another example of the top-down model in which they sit at the top.

I’m not going to argue that metrics like page views don’t count, but social media should be about more than quantity. At a more fundamental level, it’s about the quality of engagement, the relationship of the site with the user, and vice versa. And it was this aspect that was missing from the Circulation twitter feed and, of course, wasn’t measured in the study. Tweets like this won’t — can’t — build a social media community. They offer no opportunity or invitation to interact or respond. They take the “social” out of the “media” and leave most people with… well, little or nothing.

It’s important to acknowledge again that social media in this traditional setting is really difficult. For many reasons, the overall numbers will never approach — by several orders of magnitude — the numbers seen in popular media and the general culture. But, as I started off by saying, it’s important to understand that social media has a crucial role to play in this much smaller sphere. It is precisely because the community is intrinsically small that social media can be valuable. In even the smallest town, Benedict Cumberbatch fans can find people who share their interest. But even at a large research university it’s likely there will only be a very small handful of people who will be interested in precisely the same Circulation papers.  At its best, social media can allow people with extremely narrow interests to find each other, share ideas, and communicate.

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