To tweet or not to tweet, that is the question: A randomized trial of Twitter effects in medical education

Autoři: Lauren A. Maggio aff001;  Todd C. Leroux aff002;  Anthony R. Artino, Jr. aff001
Působiště autorů: Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America aff001;  Defense Health Agency, Department of Defense, Falls Church, Virginia, United States of America aff002
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223992



Many medical education journals use Twitter to garner attention for their articles. The purpose of this study was to test the effects of tweeting on article page views and downloads.


The authors conducted a randomized trial using Academic Medicine articles published in 2015. Beginning in February through May 2018, one article per day was randomly assigned to a Twitter (case) or control group. Daily, an individual tweet was generated for each article in the Twitter group that included the title, #MedEd, and a link to the article. The link delivered users to the article’s landing page, which included immediate access to the HTML full text and a PDF link. The authors extracted HTML page views and PDF downloads from the publisher. To assess differences in page views and downloads between cases and controls, a time-centered approach was used, with outcomes measured at 1, 7, and 30 days.


In total, 189 articles (94 cases, 95 controls) were analyzed. After days 1 and 7, there were no statistically significant differences between cases and controls on any metric. On day 30, HTML page views exhibited a 63% increase for cases (M = 14.72, SD = 63.68) when compared to controls (M = 9.01, SD = 14.34; incident rate ratio = 1.63, p = 0.01). There were no differences between cases and controls for PDF downloads on day 30.


Contrary to the authors’ hypothesis, only one statistically significant difference in page views between the Twitter and control groups was found. These findings provide preliminary evidence that after 30 days a tweet can have a small positive effect on article page views.

Klíčová slova:

Medical education – Medicine and health sciences – Physicians – Social media – Social systems – Trainees – Twitter – Academic medicine


1. Maggio LA, Meyer HS, Artino AR. Beyond citation rates: a real-time impact analysis of health professions education research using altmetrics. Acad Med. 2017;92:1449–1455. doi: 10.1097/ACM.0000000000001897 28817430

2. Cheston CC, Flickinger TE, Chisolm MS. Social media use in medical education: A systematic review. Acad Med. 2013;88:893–901. doi: 10.1097/ACM.0b013e31828ffc23 23619071

3. Kind T, Patel PD, Lie D, Chretien KC. Twelve tips for using social media as a medical educator. Med Teach. 2014;36:284–290. doi: 10.3109/0142159X.2013.852167 24261897

4. Chan T, Trueger NS, Roland D, Thoma B. Evidence-based medicine in the era of social media: scholarly engagement through participation and online interaction. CJEM. 2018;20:3–8. doi: 10.1017/cem.2016.407 28077195

5. Choo EK, Ranney ML, Chan TM, Trueger NS, Walsh AE, Tegtmeyer K, et al. Twitter as a tool for communication and knowledge exchange in academic medicine: a guide for skeptics and novices. Med Teach. 2015;37:411–416. doi: 10.3109/0142159X.2014.993371 25523012

6. Amath A, Ambacher K, Leddy JJ, Wood TJ, Ramnanan CJ. Comparing alternative and traditional dissemination metrics in medical education. Med Educ. 2017;51:935–941. doi: 10.1111/medu.13359 28719136

7. Trueger NS. Medical journals in the age of ubiquitous social media. J Amer Coll Radiol. 2018;15:173–176.

8. Lopez M, Chan TM, Thoma B, Arora VM, Trueger NS. The Social Media Editor at Medical Journals: Responsibilities, Goals, Barriers, and Facilitators. Acad Med. 2018.

9. Wray CM, Auerbach AD, Arora VM. The Adoption of an Online Journal Club to Improve Research Dissemination and Social Media Engagement Among Hospitalists. J Hosp Med. 2018;13:764–769. doi: 10.12788/jhm.2987 30484779

10. Fox CS, Bonaca MA, Ryan JJ, Massaro JM, Barry K, Loscalzo J. A randomized trial of social media from Circulation. Circulation. 2015;131:28–33. doi: 10.1161/CIRCULATIONAHA.114.013509 25406308

11. Fox CS, Gurary EB, Ryan J, Bonaca M, Barry K, Loscalzo J, Massaro J. Randomized controlled trial of social media: effect of increased intensity of the intervention. J Am Heart Assoc. 2016;5:e003088. doi: 10.1161/JAHA.115.003088 27121850

12. Adams CE, Jayaram M, Bodart AY, Sampson S, Zhao S, Montgomery AA. Tweeting links to Cochrane Schizophrenia Group reviews: a randomised controlled trial. BMJ Open. 2016;6:e010509. doi: 10.1136/bmjopen-2015-010509 26956164

13. Trueger NS, Bokarius AV, Carroll S, April MD, Thoma B. Impact of a physician-led social media sharing program on a medical journal’s web traffic. J Amer Coll Radiol. 2018;15:184–189.

14. Hawkins CM, Hunter M, Kolenic GE, Carlos RC. Social media and peer-reviewed medical journal readership: a randomized prospective controlled trial. J Amer Coll Radiol. 2017;14:596–602.

15. COUNTER. Project Counter. Retrieved 17 May 2019

16. R Core Team. A language and environment for statistical computing. Retrieved 17 May 2019

17. Wickham H. ggplot2: Elegant graphics for data analysis. New York: Springer, 2016.

18. Venables WN, Ripley BD. Modern Applied Statistics with S. New York: Springer, 2002.

19. Haustein S, Peters I, Bar-Ilan J, Priem J, Shema H, Terliesner J. Coverage and adoption of altmetrics sources in the bibliometric community. Scientometrics. 2014;101:1–19.

20. Thoma B, Murray H, Huang SY, Milne WK, Martin LJ, Bond CM, Mohindra R, Chin A, Yeh CH, Sanderson WB, Chan TM. The impact of social media promotion with infographics and podcasts on research dissemination and readership. CJEM. 2018;20:300–306. doi: 10.1017/cem.2017.394 28899440

21. Cardona-Grau D, Sorokin I, Leinwand G, Welliver C. Introducing the Twitter impact factor: an objective measure of urology’s academic impact on Twitter. Euro Urol Focus. 2016;2:412–7.

22. Saxton GD, Niyirora JN, Guo C, Waters RD. #AdvocatingForChange: The Strategic Use of Hashtags in Social Media Advocacy. Adv Soc Work. 2015 Jul 27;16(1):154–69.

Článek vyšel v časopise


2019 Číslo 10