Pandemic reveals possibilities of social media for new forms of medical education
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A speaker at the Renal Physicians Association virtual meeting addressed how the COVID-19 pandemic has expanded the way social media is utilized, specifically as it pertains to innovative forms of medical education.
Joel Topf, MD, FACP, assistant clinical professor at Oakland University William Beaumont School of Medicine, marks March 11, 2020 as the date the pandemic became a reality for everyone across the United States.
“You started to realize this was not just an infection you saw on the news,” he told the audience. “That meant that traditional medical education ground to a halt.”
He explained how, at his hospital, all medical students were sent home due to social distancing restrictions and a scarcity of personal protective equipment. This was a critical change to medical education, as both lectures and bedside teaching were no longer happening.
“I think the COVID-19 pandemic is the most challenging medical education problem we have ever faced,” he said. “One, it’s a massive global problem. Two, how do we teach about it if we don’t even know the truth? We’re starting from zero trying to learn about this virus. Three, it’s intensely political, making what you say very charged.”
Furthermore, Topf stressed the immediacy of needing to gain a solid knowledge base and to share this knowledge.
Peer review
“We didn’t have the luxury of taking 3 or 4 months to work out a curriculum. We needed to come up with solutions on the fly,” he said, adding that while there were experts on respiratory infections or epidemiology, no one had expertise specifically related to COVID-19. Therefore, he explained, building medical knowledge – traditionally done through the manuscript system and peer-review – became a challenge. New modes of peer reviewing articles had to be created.
According to Topf, the peer review process underwent challenges as the process of journal publication usually takes about 3 months from submission to publication. Education needed to be disseminated quicker than this, he argued.
While he commended publications like the Clinical Journal of the American Society of Nephrology for expediting the process, he pointed to two examples that exemplified the spread of misinformation during the pandemic.
The first was a paper published in The Lancet which used data collected by Surgisphere (allegedly from 671 hospitals across six continents); it concluded that hydroxychloroquine may increase mortality risk in patients with COVID-19 and caused several clinical trials of the drug to be stopped or suspended. The second paper, published in the New England Journal of Medicine, also used data from Surgisphere and was related to the “harmful” impact of angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) on COVID-19 outcomes.
“This was all fiction,” Topf said. “None of this existed. [The company] was able to convince a couple of key people in a couple of key areas and get some publications printed.”
Topf discussed the way people joined together in comments and blogs to evaluate the data, and they subsequently questioning what had been published; social media, through a new form of peer review, played a central role in the articles being retracted.
“This was a crisis,” he said. “The Lancet had essentially published fraud. This is just an example of blogging for peer review. It’s quick, it’s collaborative and it’s viral. People used the comments section on a really obscure blog to bring down The Lancet.”
He said that although some might dismiss the credibility or the influence of this method because it was done through comments on a blog, this misses the point.
“This was a group of people that trusted each other, that worked together,” he said. “And we see this all over. Whether it’s NephJC, NephMadness or any other small pocket of people that are working together and collaborating, we can get a lot of positive things done.”
Free, open access medical education
Similarly, readers created a community and network on NephJC in response to the article on antihypertensive medications; two experts investigated and wrote a document that became a “viral sensation” on the blog. NephJC’s monthly pageviews increased 10-fold, according to Topf, after the document critiquing the study was made available.
Despite the challenges posed by the pandemic to traditional medical education and the peer-review process, Topf argued that social media education and free, open access medical education (known as FOAMed) “never missed a beat.”
“In medical education’s darkest hour, social media answered the call,” he concluded. “We went from an area where we lost our ability to do traditional teaching, and we engaged in post-publication peer review. In this great medical education crisis, FOAMed showed creativity, flexibility and ingenuity. The solutions borne of COVID-19 will outlast the pandemic and indelibly change medical education.”
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Topf J. Social media during a pandemic. Presented at: RPA Annual Meeting. March 18-20 2021 (virtual meeting).
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