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West J Emerg Med. 2015 Nov;16(6):961-4. doi: 10.5811/westjem.2015.10.28869. Epub 2015 Nov 12.

Effect of a Novel Engagement Strategy Using Twitter on Test Performance.

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University of Kentucky College of Medicine, Lexington, Kentucky.
University of Kentucky, Department of Statistics, Lexington, Kentucky.
University of Kentucky, Department of Emergency Medicine, Lexington, Kentucky.



Medical educators in recent years have been using social media for more penetrance to technologically-savvy learners. The utility of using Twitter for curriculum content delivery has not been studied. We sought to determine if participation in a social media-based educational supplement would improve student performance on a test of clinical images at the end of the semester.


116 second-year medical students were enrolled in a lecture-based clinical medicine course, in which images of common clinical exam findings were presented. An additional, optional assessment was performed on Twitter. Each week, a clinical presentation and physical exam image (not covered in course lectures) were distributed via Twitter, and students were invited to guess the exam finding or diagnosis. After the completion of the course, students were asked to participate in a slideshow "quiz" with 24 clinical images, half from lecture and half from Twitter.


We conducted a one-way analysis of variance to determine the effect Twitter participation had on total, Twitter-only, and lecture-only scores. Twitter participation data was collected from the end-of-course survey and was defined as submitting answers to the Twitter-only questions "all or most of the time", "about half of the time", and "little or none of the time." We found a significant difference in overall scores (p<0.001) and in Twitter-only scores (p<0.001). There was not enough evidence to conclude a significant difference in lecture-only scores (p=0.124). Students who submitted answers to Twitter "all or most of the time" or "about half the time" had significantly higher overall scores and Twitter-only scores (p<0.001 and p<0.001, respectively) than those students who only submitted answers "little or none of the time."


While students retained less information from Twitter than from traditional classroom lecture, some retention was noted. Future research on social media in medical education would benefit from clear control and experimental groups in settings where quantitative use of social media could be measured. Ultimately, it is unlikely for social media to replace lecture in medical curriculum; however, there is a reasonable role for social media as an adjunct to traditional medical education.

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