Clinical Microbiology in the Time of Social Media

April 22, 2019

It’s a tremendously exciting time in clinical microbiology. Cutting edge techniques and technologies are being implemented, new pathogens and treatments are coming onto the scene, and the role of the lab in practicing evidence based medicine feels more important than ever. And thanks to the advent of social media, it’s never been easier to share and discuss our field with others.
Here’s a partial list of some of the things that happened in my Twitter feed in a single week:
  • A chemist posted pictures of a gram stain and culture plate asking what kinds of organism(s) it might be.
  • A biology graduate student from a middle eastern country privately messaged me to ask for advice about pursuing a post-graduate microbiology fellowship.
  • A hospitalist posted an amazing “tweetorial” summarizing a conference talk about syphilis.  
  • I posted about an exciting clinical cases I’d seen where challenging histopathology was resolved by pan-fungal sequencing.

As a graduate student and now as a clinical microbiology CPEP fellow, I’ve had numerous students, early- to late-career researchers and laboratory directors, and even clinicians either lament that they don’t know how to “do” social media for science, or straight up ask, “Is it worth trying to get into this?”
 
The kinds of interactions scientists have on social media mimic what scientists and researchers do whenever and wherever they get together: they talk about new findings, share stories about cases they’ve seen, teach and quiz each other, and build networks and connections. Is social media the same as being at a large scientific conference? Not exactly. But can it benefit you and others in similar ways? Absolutely!
 
Twitter is my preferred social media platform. Others have great success discussing procedures and cases on Facebook, posting clinically relevant images on Instagram, or videos on YouTube. During graduate school, I started to key into the potential (and frankly the enjoyment) of using social media for science. I even had the chance to curate the official Twitter feed for a scientific society and journal. Do I still use Twitter for news, socializing, and making dumb jokes? Yes. But Twitter has become an important avenue for clinical microbiology content and conversation.

HOW CAN CLINICAL MICROBIOLOGISTS USE SOCIAL MEDIA?

They can do this by contributing good content and having conversations. This can include some of the following practices:
  1. Following relevant individuals, organizations, and hashtags. This may sound obvious. But how do you go about finding which accounts to follow? You can start by seeing who is followed by or “tagged” in tweets of accounts you know and like. And look at who is using hashtags relevant to topics you’re interested in. For clinical microbiology some of these include #MicroRounds, #ASMClinMicro, #IDMedEd (infectious disease medical education), #FOAMed (free, open-access medical education), #TxID (transplant infectious disease) among others.
  2. Tweeting images, links, and pearls relevant to your science.  You can find images and info relevant to infectious disease laboratory work using the hashtag #MicroRounds. I tweet a daily image of something we’ve seen in the laboratory this way. Being a clinical microbiology fellow at a large national reference laboratory like ARUP, I’m lucky enough to see laboratory findings ranging from the relatively mundane (e.g. E.coli lactose fermentation on a MacConkey plate), to things you might only see in textbooks (e.g. Strongyloides larvae tracks left on a Legionella spp. sputum culture).
    1. Additionally, many twitter accounts from individuals, journals or societies share curated links to important, articles and posts. It’s a great way to crowdsource what are novel and important new publications.
  3.  “Live-tweeting" (when allowed) summaries, pictures or snippets of talks at scientific conferences.  Tweet using the conferences’ dedicated hashtags (for example, ASM’s annual meeting uses #ASMicrobe). It’s both a service for those can’t be at a conference/talk but also  way to organize notes and find and meet others at the conference in real life (a practice sometimes called “tweetups”).
  4. General education and advocacy. Many, if not most, of the people who share or discuss clinical microbiology on social media may be trainees, students, people with expertise in different scientific fields, or those with no science background at all. Not only does Twitter offer you a way to follow and learn about other disciplines, but this can make your expertise and advocacy in your own field especially meaningful. What kinds of important things can people in this field speak up about? A very partial list:
    1. The science and importance of vaccines.
    2. Context for (sometimes worrisome) news stories about disease outbreaks.
    3. The reality and cost of abusive behavior, including sexual harassment, that is too often ignored in science and healthcare, and the efforts to end it.
    4. Proposed legislation, budget changes or policies that will impact health outcomes and research.
    5. Enthusiasm for novel breakthroughs or discoveries.
    6. Threat of antibiotic overuse and drug-resistant pathogens.
What you choose to say and share is part of social media “branding.” Different from the traditional use of the term, your “brand” isn’t you selling a product; it’s just way of describing what you present publicly about you interests and your expertise.
 
It can take time, years even, to accumulate online acquaintances and followers who interact with you and what you share (assuming that is something you even want to happen on social media). But this can lead to very positive outcomes! On Twitter I’ve seen people start collaborations that result in new research and publications, fellowships advertised and filled, and journalists asking scientists and clinicians questions about how to report stories. I even had a clinical microbiologist job offer that only came about thanks to a message on Twitter. What can happen because of social media relates directly to how you’re using social media.

THE IMPORTANCE OF LISTENING 

One of the most important aspects of social media isn’t what you share or say. It’s the opportunity to listen to people whose expertise and experiences are very different from your own. Even if you don’t have the inclination or time to post content, just by following experts (“listening in”) you can become informed and up to date. Try also to listen to people with intersecting or overlapping professional responsibilities. Can a clinical microbiologist benefit from listening to lab techs, researchers, infectious disease specialists, pharmacists, nursing staff, or infection preventionists? Absolutely!
 
And it’s not just about others’ scientific expertise. Listening to and understanding others’ personal perspectives can and should change how you provide clinical service, manage lab personnel, contextualize science, and aid in addressing challenges others face, even if they aren’t your own.
 
Because we tend to self-select into groups that are the most similar to us, go out of your way to follow and listen to perspectives from those who may be traditionally underrepresented in science and medicine: people of color, people who identify as LGBTQIA or gender non-conforming, native and indigenous scientists, individuals with disabilities, and those who fall into more than one of these categories.

EXPERIENCES FROM OTHER DISCIPLINES

Clinical microbiologists as a group may be relatively new to social media but groups of scientists and clinicians have been using, debating and publishing articles about social media use in their fields for years.
 
In clinical pathology, a group with hundreds if not thousands of active Twitter users, there have been published articles about the benefits and pitfalls of social media use, the risks of unprofessional behavior such as inadvertently identifying patients on social media and guidelines on ethically sharing pathology images.
 
In the last year alone, clinicians from infectious disease, rheumatology, internal medicine, and oncology have given (and sometimes tweeted!) grand round presentations they delivered to colleagues about the benefits of social media in their fields.
 
Can we find ways to productively incorporate social media into clinical microbiology education, interaction and practice? I believe we can.

SOME SOCIAL MEDIA DOS AND DON’TS

With that in mind some final key dos and don’ts:
  1. Protect patient identity. Obviously remove any identifying names from images or samples. But especially with rare and/or newsworthy cases be careful that locations (your hospital, system or state), dates (“today we saw”) and unusual organisms/presentations are not mentioned, or are generalized or changed to prevent connection to a patient. (For more information see Crane and Garnder 2016)
  2. Offer and seek advice or ideas, not conclusions. Don’t diagnose anything. Clinical decisions need to be made by those with access to appropriate history and charts, not via a Twitter snapshot.
  3. Follow guidelines by your employer. This may include rules of when during a workday social media use is allowed but also rules about physically showing locations (like the laboratory) at your institution
  4. Be yourself but be safe about what you share online. Not everyone feels comfortable even sharing their name and face. But even if you do, it’s worth being cautious about information you share about your family, schedule, and location.
  5. Don’t assume that anybody owes you an interaction and vice versa. Allow people time and space to reply (if they do so at all).  Interact respectfully and to someone’s level of familiarity.
  6. Engage judiciously. Don’t tag/include people in arguments they didn’t initiate and remove them from a conversation if they request.  
  7. Ignore judiciously. Remember that targeted harassment can happen (often, though not exclusively, targeting people who identify as women). You can mute, or better, block and report abusive tweets and accounts and request that others do the same.
  8. Apologize when called for. If you (hopefully inadvertently) cause someone distress, often the best course of action is to apologize and remove yourself from the conversation.
  9. Watch out for time suck. Don’t let social media consume more of your time than it ought to. Striking the appropriate balance between helpful and counterproductive is crucial.
 
Clearly social media use by clinical and laboratory personnel is here to stay. What remains is trying to take advantage of what it offers and being sure we’re using it responsibly.
 
 
FURTHER READING
 

Author: Richard Davis

Richard Davis
Richard Davis is currently a post-doctoral CPEP fellow at the University of Utah/ARUP Laboratories and a former medical technologist.