Dear RWJF Clinical Scholar, Welcome to the Wonderful World of Twitter!



We live in a networked age. It's a new world. Social media is an incredible opportunity to meet, connect, converse, disseminate, and collaborate in ways we never thought possible. There’s a lot of skepticism about social media in the academic/healthcare world, but it’s no longer a choice. It’s the wave of the future. So get your head out of the sand, and stop living like it's the 1990's! I created this guide for my social media training at the 2014 RWJF Clinical Scholars Program National Meeting. It's for the novice all the way to the superuser! Enjoy! If you have suggestions about how to enhance it, please let me know! Also checkout the homework I made for this talk!


Yours Truly, @joyclee, Joyce Lee, MD, MPH, RWJF Core Faculty at University of Michigan, aka Doctor as Designer.


TWEET to spread the word about this guide!


Disclosure: I receive compensation as the JAMA Pediatrics Social Media Editor, but my views do not express those of the journal. Special thanks to Jianqi Chen and Wei Wang for their fantastic work!



Who uses Twitter?
Twitter Prominence
Why use Twitter?
Shaping Your Narrative
Twitter is a tool, not a lifestyle
The Social Media Ladder
Twitter: The Beginning
Your Twitter Profile
Twitter Homework
The Hashtag
Social Media Superuser Tools
Social Media Reading List
Nuances of Twitter
HOW TO COMMUNICATE
Scientists on Twitter
The Patient Experience
Tweetchat Guide
Media Campaigns
Storytelling on Twitter
ADDICTED TO TWITTER

Who uses Twitter?



Academics, Doctors, Researchers, Patients, Journalists, Students, Artists, Designers, Politicians, the President and the First Lady. @RWJF, the generous foundation supporting your development as a scholar, and the President Dr. Lavizzo Mourey @Risalavizzo are also Twitter. People are debating whether all journalists should be on Twitter (see here and here); will doctors ever have this debate? I believe the benefits of Twitter far outweigh the risks, and strongly encourage all of my colleagues and trainees to join.



Twitter Prominence



Twitter broke the news about the plane in the Hudson, powered a revolution, and held a town hall with the President. It also matches blood donors, reports food-borne illness to the Chicago Department of Health, and is used by the police to provide crime reports to the public. It’s even used brilliantly by the CIA and a very very witty famous Congressman from Michigan. You know something is important when it hits the movies. @aoscott is a movie critic for the New York Times and found his tweet about a movie included in a full page advertisement by the movie makers.



Why use Twitter?



Check out my Slideshare to learn more about how social media could be of use to you as a researcher and clinician. In short, you can and should use it to get real-time information about topics relevant to your clinical field and your research endeavors, disseminate your work, and network as a professional. Watch how @SeattleMamaDoc uses social media to listen, learn from, and communicate with her patients. Watch @DoctorNatasha stamp out misperceptions about vaccines. Learn about how social media makes @HKRoman a better physician, Read about the 10 things you should know about social media. Finally, @SusannahFox shares why social media is important to health care.



Shaping Your Narrative



You should follow Bryan Vartabedian, @Doctor_V of the blog 33charts, and buy his new book, The Public Physician. It's a great introduction to social media and he intelligently articulates the reality of being a physician in this networked age. Will you shape your narrative or will you let someone else do it for you? Beware of those Invisible Doctors. "Our white coat hid most everything….But something happened on the way to the clinic. The Internet appeared." And so did social media!!! Many physician bodies suggest that you should separate your private and professional identities online, but @MattDeCamp1 and colleagues suggest that it’s not possible to do this, and maybe even harmful.



Twitter is a tool, not a lifestyle



Ok, it's a lifestyle for me, but not for the rest of you. People assume that social media is an all or nothing phenomenon, but it's not! Don't give up on Twitter before you can even begin to understand its possibilities. The ROI on Twitter is long and you have to be patient. It takes time to get engaged and see the benefits. Drop in, and drop out, and then drop in again. Open an account, follow some interesting people, listen, and watch. Do not listen to the naysayers.



The Social Media Ladder



Have you heard of Forrester Research's social media ladder? There are multiple levels of participation with social media. You can start by listening, and then see if how far you want to go up the ladder. Some individuals may never reach the level of content creation, and that's okay. Don't bypass social media altogether, start small and listen to what's happening in the world. Then decide at what level you wish to participate. You can go up and down the ladder anytime; it's all in your hands! Don't see it as a chore, see it as an opportunity!



Twitter: The Beginning



Sign up for Twitter here. Check out these guides for Twitter newbies via @pfanderson and read this great guide to Twitter that one of my favorite designers @JessicaHische wrote for her mother called Mom this is how Twitter works. Dos: Be yourself. Listen. Participate in a conversation. It’s about connecting, not broadcasting or bragging. Don’ts: When you say something on Twitter you are broadcasting it to the world so be discreet. Remember HIPAA and the Mayo 12 word social media policy: Don’t Lie, Don’t Pry, Don’t Cheat, Can’t Delete, Don’t Steal, Don’t Reveal.



Your Twitter Profile



This article is spot on: Are you really a ninja? How to rock your twitter bio as hard as Hillary Clinton. Upload a picture of yourself so we know who you are! I am always skeptical of accounts with eggheads. Be yourself, and be professional. Go beyond the academic profile on your institution's website and reveal what you are passionate about, and why people might want to connect with you. You can even include hashtags about relevant topics related to your research. Check out the Healthcare Hashtag Project for relevant links. However, recognize that you can take this a little too far: @robdelaney's profile reads: "Mother. Wife. Sister. Human. Warrior. Falcon. Yardstick. Turban. Cabbage"



Twitter Homework



Retweet this tweet! Change RT to MT if you modify a tweet. Mention someone you know on twitter to directly communicate with them. Tweet an interesting article and give an H/T to the person who tipped you off! Follow interesting people through Twitter connections and serendipity. You can snoop in people's Twitter lists to see who they follow; it's sort of like the new age rolodex! Understand that Twitter is way more than 140 characters; @craigmod explains why much of the data associated with a tweet lies under the surface like an iceberg.



The Hashtag



Read about how the hashtag was born, to “improve contextualization, content filtering and exploratory serendipity” or put more simply, to improve the “eavesdropping” experience on Twitter. Hashtags can have multiple meanings: topics, groups, events, and even humor. @susanorlean explains the “semiology and phenomenology of hashtaggery” and it’s also been called “a fledgling art form.” Hashtags are user-generated, so you don’t ask for permission to use one. Just create one, and see if it catches on. However if you want to tap into health communities of interest related to your research, check out the Healthcare Hashtag Project. There you will find hashtags, tweetchats, influencers on more topics than you could have ever imagined. #hcsm is a popular hashtag which stands for healthcare social media. Here are some interesting #Hashtag Strategies.



Social Media Superuser Tools



If you want to become a Twitter ninja you need the right tools! Some of my favorite ones include Buffer for tweeting from multiple accounts and autoscheduling tweets. To help with workflow, use Bulk Buffer to bulk upload your tweets in one fell swoop to Buffer. Have you heard of tweetstorming? It's a controversial practice. If you want to try it, you should use this amazing tool from @davewiner called Little Porkchop which will divide paragraphs of text into a series of numbered tweets & can add hashtags and links! Hootsuite has a great dashboard for viewing different feeds of people you follow, lists, and hashtags. On my iPhone I use Echofon and Pastebot to manage clipboard items while tweeting.



Social Media Reading List



In addition to @Doctor_V’s book, check out @KevinMD’s Social Media Guide for Physicians and Medical Practices and Mayo Clinic’s Bringing the Social Media Revolution to Health Care. Subscribe to the Buffer blog, which is an awesome resource for learning everything about social media. The posts are very practical and incredibly helpful. Follow @garyvee on Twitter and read his book Jab Jab Right Hook. For you data-driven folk here is a guide on How to be Better at Twitter. Doublecheck that you are doing the 19 things successful people do on social media.



Nuances of Twitter



Is a retweet an endorsement? The answer seems to be yes for organizations like NPR and AP, but not at NYTimes. The FDA concurs and is cracking down on companies that "like" or tweet uses of medications that are not FDA-approved. Favoriting tweets has a variety of meanings, but is now being changed by Twitter. And you must be aware of the very important topic of algorithmic filtering. This post by@zeynep, What Happens to #Ferguson Affects Ferguson, is a #mustread about the consequences of algorithmic filtering. If you choose to disseminate your research, who will see it?



Communicating on Twitter



Communicate like a real person on Twitter. That’s all. Be nice, be conversational, don’t be mean, and don’t talk about yourself all the time. Just how you would want people to be in real life. Know that each social media tool has its own communication rules: check out the social media donut! The more connected you are, the better the experience on Twitter. @SteveButtry has nice tips on how to build followers. Just remember, “Give more than you ask for.” Here is a list of Twitter accounts that will help make your day. Representative John Dingell demonstrates that Twitter is not age-dependent, even for upstanding senior politicians. It’s a communication tool that you should take advantage of as a scholar.



Scientists on Twitter



Check out the Kardashian Index, which correlates the citation index with the number of Twitter followers. Are you a Science Kardashian? The author writes: “if your K-index gets above 5, then it’s time to get off Twitter and write those papers” but I don’t believe in that dichotomy. Don’t make social media the strawman, as it’s not a zero sum game. @JFGariepy addresses this head on: “Science is advancing and being disseminated on social media…Twitter is not different from the conference room of a University where knowledge is being exchanged.” Check out Nature’s survey on how scientists use Twitter as well as the PhD Comics version. Realize that peer-reviewed journals are now displaying the Almetrics index for published papers, which measures impact in the public sphere, not just citations.



The Patient Experience



There are many amazing communities of patients/caregivers online who are sharing their health experiences, which is a great opportunity to learn as an observer, and to engage in conversations with a community. @sixuntilme talks about how social media has saved lives in the diabetes community. @SusannahFox writes about how the “Network is our Superpower ”. Kellergate was a recent social media controversy, that you must read about. The tweet from Ken Jennings says it all. I personally admire and thank @AdamsLisa for bravely sharing her story of metastatic breast cancer online. All medical trainees should read her blog as part of their medical education.



Tweetchat Guide



I have run a couple of tweetchats for@JAMAPeds (The journal has nothing to do with this website!). If you plan on doing tweetchats at regular intervals, decide on a hashtag and register it at http://www.symplur.com/ so that you can get metrics about the chat. Here is a tweetchat guide I prepared to orient the average user to how a chat works. Here is an example of a script of tweets you can use to kickoff a tweetchat. I usually queue all of the tweets ahead of time in Buffer so that I can release them during the chat with the click of a button, and can then focus on participating in the conversation. Once the chat is over, use Storify to archive the chat.



Social Media Campaigns



One of the most heartwarming social media campaigns was the story of a little boy with leukemia who wanted to be Batkid, sponsored by the Make-a-Wish Foundation. Here are some examples of successful social media campaigns for public health. I love following Hello Flo, which sells monthly care packages that contain feminine hygiene products. All health themed marketing should be as witty as this Camp Gyno video and this First Moon Party video!



Storytelling on Twitter



Twitter is a firehose of information; your tweets will be forgotten minutes after you post. However, you can capture a story by embedding a series of tweets into a blog post, or by using Storify. Here’s my story about Baby Erik's journey to get SCHIP health insurance. Here are some interesting articles about new opportunities in storytelling using Twitter, how Twitter is reshaping the future of storytelling, and the fictional escapades of @ElliotHolt. Twitter can even be used for crowdsourcing. Twitter bots tell funny and interesting stories on Twitter. How might we leverage this creative form of communication for health and research?





Addicted to Twitter



Who, me? @kathrynschulz writes about how twitter hijacked her mind. Where else could you befriendd @HerdyShepherd1 who loves Twitter! Some people write love letters to Twitter. Take this quiz from the @Oatmeal to see measure your addiction. I was a 71%; I bet you can’t beat me. If you do, however, then I will have succeeded in my mission. My last piece of advice to you from @Doctor_V's book the Public Physician: “I want the content I write, think, and play with to be visible so it can grow. I want it to bring in like-minded people so we can make and do things…The people I follow create a human signal. All of the things that they think are important come together in one brilliant stream.” Go find your human signal young scholar, you will be amazed at the community that you will discover! Yours Truly, Doctor as Designer