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Research Techniques Made Simple: Scientific Communication using Twitter

  • Author Footnotes
    6 These authors contributed equally to this work.
    Roxana Daneshjou
    Correspondence
    Correspondence: Roxana Daneshjou, Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA.
    Footnotes
    6 These authors contributed equally to this work.
    Affiliations
    Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA
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  • Author Footnotes
    6 These authors contributed equally to this work.
    Leonid Shmuylovich
    Footnotes
    6 These authors contributed equally to this work.
    Affiliations
    Division of Dermatology, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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  • Author Footnotes
    6 These authors contributed equally to this work.
    Ayman Grada
    Footnotes
    6 These authors contributed equally to this work.
    Affiliations
    Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
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  • Valerie Horsley
    Affiliations
    Department of Molecular, Cellular, and Developmental Biology, Yale University, New Haven, Connecticut, USA

    Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
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  • Author Footnotes
    6 These authors contributed equally to this work.
      The scientific process depends on social interactions: communication and dissemination of research findings, evaluation and discussion of scientific work, and collaboration with other scientists. Social media, and specifically, Twitter has accelerated the ability to accomplish these goals. We discuss the ways that Twitter is used by scientists and provide guidance on navigating the academic Twitter community.

      Abbreviations:

      RTMS (Research Techniques Made Simple), TSSMN (The Thoracic Surgery Social Media Network)

      Introduction

      Science is a social endeavor. Whether it is trainees working as a team in pursuit of novel findings, investigators sharing work at conferences and inspiring each other, or scientists being invited to universities to present findings and forge new collaborations, social interaction is central to scientific progress. Social media offers an additional avenue for scientific communication, and Twitter has emerged as a medium for vibrant academic exchange. In this Research Techniques Made Simple (RTMS) article, we highlight ways in which Twitter can be utilized to amplify scientific communication and provide guidance on joining the academic Twitter community.

      Summary Points

      Advantages

      • Social media platforms create an environment for global discussion and analysis of science.
      • Social media platforms are a nexus for online journal clubs and sharing talks and conference presentations.
      • Social media platforms facilitate the creation of community and can lead to broadening scientific networks and collaborations.

      Limitations

      • Social media communication can lack nuance; communications can be taken out of context or misconstrued.

      What is social media?

      Social media platforms allow communication and information sharing across the globe (
      • Oltulu P.
      • Mannan A.A.S.R.
      • Gardner J.M.
      Effective use of Twitter and Facebook in pathology practice.
      ). These platforms can be leveraged for scientific communication and professional development; a few examples include Facebook, Instagram, Tik Tok, and Twitter. Both Facebook and Instagram allow the creation of webpages, particularly useful for academic journals and professional societies, which can be filled with relevant content and photos. Instagram, in particular, is a more image-focused platform, which may be appealing to visual fields such as dermatology. Facebook also allows the creation of groups, which can be public or private and can act as discussion forums. Tik Tok is a video-based platform that has gained traction for direct medical communication to the masses packed as short, lighthearted videos set to music. Twitter is particularly useful for microblogging, open discussions, and amplifying messages. Currently, Twitter is one of the most utilized social media platforms for scientific professional use and is the focus of this RTMS (
      • Hudson S.
      • Mackenzie G.
      'Not your daughter's Facebook': Twitter use at the European Society of Cardiology Conference 2018.
      ;
      • Mandavilli A.
      Peer review: trial by Twitter.
      ;
      • Oltulu P.
      • Mannan A.A.S.R.
      • Gardner J.M.
      Effective use of Twitter and Facebook in pathology practice.
      ).

      What is Twitter?

      Twitter is a microblogging platform with a reported 321 million users at the end of 2018, including many academic journals and scientists (
      • Daneshjou R.
      • Adamson A.S.
      Twitter journal clubs: medical education in the era of social media.
      ). Each user can choose who to follow, thereby creating a content stream unique to one’s interests. The currency of Twitter is the tweet (Figure 1), a 280-character message that allows users to share their thoughts with others. Tweets are amplified through likes and retweets, which allows a user to share another’s message with their own audience, who can further amplify the message by sharing it with their followers (
      • Oltulu P.
      • Mannan A.A.S.R.
      • Gardner J.M.
      Effective use of Twitter and Facebook in pathology practice.
      ). Users can engage with others by including the account names of other users in their own tweets or by replying to tweets with their own commentary (
      • Oltulu P.
      • Mannan A.A.S.R.
      • Gardner J.M.
      Effective use of Twitter and Facebook in pathology practice.
      ). Relevant Twitter definitions are listed in Table 1.
      Figure thumbnail gr1
      Figure 1A tweet from the @JIDJournals account describes a recently published research study and tags the handles (@StridLab and @ImperialImmuno) of the research team and institution involved. Hashtags, denoted with the # symbol, provide searchable tags on topics of interest. We also show the functionalities of different buttons at the bottom of the tweet. cSCC, cutaneous squamous cell carcinoma; JID, Journal of Investigative Dermatology.
      Table 1Definitions of Common Terms Used on Twitter
      Common TermsDefinitions
      TweetA 280-character message that allows users to share their thoughts with others. At this time, tweets are not editable.
      LikeIndicated by the heart-shaped button. This provides positive feedback on the tweet.
      RetweetAllows a user to share another’s message with their own audience, who can further amplify the message by sharing it with their followers.
      LivetweetingTweeting about an event such as a conference or a talk as it is happening.
      @This symbol is used before a username in order to tag them in a tweet.
      #Hashtags are keywords that indicate something about the content of the tweet. They are searchable.
      TweetorialA thread of tweets connected together to describe a concept.
      Twitter is designed to let users curate content to their interests. Tweets are searchable, and a common practice is to add hashtags within a tweet to make the search more intuitive. For example, hashtags such as #DermScience and #DermTwitter are employed by dermatology researchers and clinical dermatologists, respectively, and Twitter users can search for these keywords directly to find relevant authors and content (
      • Cheplygina V.
      • Hermans F.
      • Albers C.
      • Bielczyk N.
      • Smeets I.
      Ten simple rules for getting started on Twitter as a scientist.
      ). In effect, Twitter allows users to tailor their own experience by following accounts that provide relevant content and unfollowing accounts that do not provide content of value. This allows scientists on Twitter to craft a content stream that becomes increasingly curated to fit their particular research interests.

      Metrics of a tweet performance

      Twitter provides private analytics for assessing tweet performance: impressions and engagements (Figure 2). Impressions are the number of times a tweet shows up in somebody’s timeline (
      • Cheplygina V.
      • Hermans F.
      • Albers C.
      • Bielczyk N.
      • Smeets I.
      Ten simple rules for getting started on Twitter as a scientist.
      ). Engagements represent the number of times that a given tweet was engaged on by a viewer in an organic context, such as retweets, likes, replies, link clicks, and media views. Although analytics is a way to quantify tweet performance, they should not be the sole focus of one’s Twitter use.
      Figure thumbnail gr2
      Figure 2Twitter analytics showing metrics for tweet performance, impressions, and total engagements. JID, Journal of Investigative Dermatology.

      How is Twitter used by scientists?

      Sharing scientific work with specialized and general audiences

      Scientists use Twitter to disseminate their work to multiple different audiences, including specialized scientific communities, journalists, policymakers, and the lay public. Studies suggest that sharing research through social media can increase both Altmetrics and citations (
      • Eysenbach G.
      Can tweets predict citations? Metrics of social impact based on Twitter and correlation with traditional metrics of scientific impact [published correction appears in doi:10.2196/jmir.2041].
      ;
      • Husain A.
      • Repanshek Z.
      • Singh M.
      • Ankel F.
      • Beck-Esmay J.
      • Cabrera D.
      • et al.
      Consensus Guidelines for digital scholarship in academic promotion.
      ;
      • Luc J.G.Y.
      • Archer M.A.
      • Arora R.C.
      • Bender E.M.
      • Blitz A.
      • Cooke D.T.
      • et al.
      Does tweeting improve citations? One-year results from the TSSMN prospective randomized trial.
      ). A randomized controlled trial through The Thoracic Surgery Social Media Network (TSSMN), a collaborative effort among cardiothoracic surgery journals, randomized journal articles being tweeted by TSSMN versus those not being tweeted by TSSMN and followed outcomes over a year. Citations were significantly increased for the TSSMN-tweeted group, even after controlling for Altmetrics and open-access status (
      • Luc J.G.Y.
      • Archer M.A.
      • Arora R.C.
      • Bender E.M.
      • Blitz A.
      • Cooke D.T.
      • et al.
      Does tweeting improve citations? One-year results from the TSSMN prospective randomized trial.
      ).
      In addition, consensus guidelines are being developed for the impact of digital scholarship with respect to promotion and tenure (
      • Husain A.
      • Repanshek Z.
      • Singh M.
      • Ankel F.
      • Beck-Esmay J.
      • Cabrera D.
      • et al.
      Consensus Guidelines for digital scholarship in academic promotion.
      ). Recommendations for including Twitter contributions in promotion and tenure packets include creating a digital scholarship statement that outlines the work and providing metrics around measurable reach and impact (
      • Husain A.
      • Repanshek Z.
      • Singh M.
      • Ankel F.
      • Beck-Esmay J.
      • Cabrera D.
      • et al.
      Consensus Guidelines for digital scholarship in academic promotion.
      ).
      Scientists use several approaches to synthesize findings into bite-sized 280 character tweets. For example, a tweet may consist of a single sentence summary of a paper, an image of a key figure, the Twitter account names of any scientists involved in the work, and a hashtag providing a relevant keyword (Figure 1). Twitter accounts of academic journals and institutions often employ this approach to feature newly published manuscripts.
      To overcome the character limitations of a single tweet, multiple tweets can be weaved together into threads called tweetorials, which allow authors to share more in-depth descriptions of their work (Figure 3). Tweetorials can provide rich context; authors may share, for example, a vignette describing an interaction with another researcher that led to the initial kernel for a study or may share the long process of review and resubmission. Furthermore, images or videos may be included to help visualize research techniques or simply to add humorous interludes. One of the many examples of effective tweetorials was written by Jason Sheltzer in announcing a new work published in Science Translational Medicine (https://twitter.com/JSheltzer/status/1171850294910750721?s=20). At the time of writing this RTMS, this tweetorial was liked 2,400 times and retweeted 1,400 times, which is an impressive amount of engagement for content that typically would be consumed through manuscript downloads alone.
      Figure thumbnail gr3
      Figure 3An example of a tweetorial from @JIDJournals highlighting one of our Research Techniques Made Simple articles. JID, Journal of Investigative Dermatology.

      Discovering (and sharing) the work of others

      Following the Twitter accounts of academic research institutes, individual laboratories or principal investigators, high impact journals, and journals specific to one’s field is one strategy for keeping up with scientific advances and finding inspiration journals that may be of interest to the dermatology scientific community, including @NEJM, @ScienceMagazine, @Nature, @CellCellPress, @JAMADerm, @JAADJournals, @BrJDDermatol, and @JIDJournals. These journals regularly share soon-to-be-published manuscripts, and thus following them is akin to having an up-to-date merged table of contents from multiple journals of interest.

      Commentary and analysis of scientific work

      Twitter creates an environment for real-time global discussion and analysis of papers with clinicians and scientists. Over the last several months, the #DermTwitter community has dissected numerous papers on the cutaneous manifestations of COVID-19. These discussions provide different viewpoints for consideration; however, ultimately, it is up to the reader to evaluate the primary literature and make their own conclusion. The fast pace of feedback on Twitter about papers can be both positive and negative: rapid online peer review can bring issues to light when letters to the editor can take months to be published (
      • Mandavilli A.
      Peer review: trial by Twitter.
      ).

      Scientific journal clubs, talks, and conferences

      Twitter has become a nexus for journal clubs and livetweeting talks and conferences. Twitter journal clubs provide forums for academic discussion (
      • Daneshjou R.
      • Adamson A.S.
      Twitter journal clubs: medical education in the era of social media.
      ). An article is selected by a moderator to be read in advance, and at the time of the journal club, participants share tweets and responses covering key points, scientific or clinical advances, and shortcomings of the selected paper. Journal clubs can also promote interaction between specialties. For example, the Dermatology Journal Club (@DermatologyJC) and Nephrology Journal Club (@NephJC) hosted a joint journal club on the use of sirolimus in kidney transplant recipients with a history of squamous cell carcinoma (
      • Daneshjou R.
      • Adamson A.S.
      Twitter journal clubs: medical education in the era of social media.
      ).
      Twitter can allow the wider sharing of grand rounds talks and other seminars, introducing a wider audience to a speaker or topic of interest. For example, the recently launched Global Dermatology Talks (@DermTalks) have been livetweeted (https://twitter.com/RoxanaDaneshjou/status/1328385299777392645?s=20), introducing audiences outside of dermatology to broadly applicable dermatology science topics.
      Twitter can also amplify conference content by providing real-time feeds of conference proceedings. The European Society of Cardiology conference attendees, for example, embraced the use of Twitter, with a 2018 analysis showing that 1,200 conference participants generated 12,000 tweets and 42,000 retweets with over 80% of the content being educational in nature (
      • Hudson S.
      • Mackenzie G.
      'Not your daughter's Facebook': Twitter use at the European Society of Cardiology Conference 2018.
      ). In addition, livetweeting of conferences allows people who are unable to attend to follow along and engage with attendees and conference content (
      • Oltulu P.
      • Mannan A.A.S.R.
      • Gardner J.M.
      Effective use of Twitter and Facebook in pathology practice.
      ).

      Collaboration and relationship building

      Twitter allows communities to form, and one of the benefits of these communities is the ability to network and discover new colleagues and collaborators. In a recent publication,
      • Lepe M.
      • Oltulu P.
      • Canepa M.
      • Wu R.I.
      • Deeken A.
      • Alex D.
      • et al.
      #EBUSTwitter: novel use of social media for conception, coordination, and completion of an International, Multicenter Pathology Study.
      discuss how an entire multi-institute international research study developed from Twitter after two different pathologists discussed a previously undescribed biopsy site change after ultrasound-guided transbronchial needle aspiration. This initial Twitter conversation led to further collaboration across the platform, and in approximately 1 year, 24 pathologists from 14 institutions came together to analyze 297 cases and publish their findings (
      • Lepe M.
      • Oltulu P.
      • Canepa M.
      • Wu R.I.
      • Deeken A.
      • Alex D.
      • et al.
      #EBUSTwitter: novel use of social media for conception, coordination, and completion of an International, Multicenter Pathology Study.
      ). More recently, when the COVID-19 pandemic hit, Twitter was one of the methods used to disseminate information about the American Academy of Dermatology’s COVID-19 registry, which cataloged cutaneous findings of COVID-19 (
      • Freeman E.E.
      • McMahon D.E.
      • Fitzgerald M.E.
      • Fox L.P.
      • Rosenbach M.
      • Takeshita J.
      • et al.
      The American Academy of Dermatology COVID-19 registry: crowdsourcing dermatology in the age of COVID-19.
      ). These examples highlight how Twitter discussions can lead to entire research projects.

      Limitations

      Although there are many benefits to engaging professionally on social media, it is important to be aware of the pitfalls as well.
      Broadly, social media use has been associated with increased feelings of loneliness and depression (
      • Hunt M.G.
      • Marx R.
      • Lipson C.
      • Young J.
      No More FOMO: Limiting social media decreases loneliness and depression.
      ). Harassment on social media is also a major issue; racism, sexism, homophobia, and other forms of discrimination can cause real harm to mental well-being. Accounts that engage in this kind of egregious behavior can be reported to Twitter.
      Communication on Twitter is designed to be concise, and as such, a nuance of complex scientific research can be hard to convey. Tweets may be taken out of context or misconstrued, and the tone of the discussion can quickly devolve. We strongly encourage scientists on social media to assume that other scientists on social media are arguing in good faith and without malicious intent—if you disagree with someone, discuss the weaknesses in their argument and do not engage in ad hominem attacks. Maintain the same professionalism that is expected for in-person interaction; you can always consider addressing any major disagreements offline if the discussion is becoming unproductive through social media. If an individual is not interested in civil discourse, Twitter has a block button that allows you to keep that individual from seeing your content.

      Joining the Twitter science community

      Getting started

      Engaging with the scientific community on Twitter requires only a few steps, starting with the creation of an account on Twitter.com. First, you choose a unique Twitter identification called a Twitter handle. Handles begin with an @ character followed by a string of text, often a name such as @AymanGradaMD or a memorable phrase such as @itchdoctor. It is important to consider that tweets that mention your work could include your Twitter handle, and therefore using a more professional tone to one’s handle is prudent.
      When creating your profile, make sure to include a photo. In general, profiles without photos are less likely to be followed. It is important to also craft a concise bio (maximum of 160 characters) that includes information about your institution and research interests. Some individuals may choose to include personal interests in their bio as well.
      After creating a profile, you can start by following other scientists and dermatology journals. Exploring hashtags such as #DermTwitter, #Dermatology, and #DermScience can also help identify individuals of interest. Twitter allows for the organic discovery of content: individuals you follow will often retweet the content of others, allowing for the discovery of new voices. Note that you do not need to actively tweet by yourself in order to follow individuals and consume content on Twitter. Examples of ways to begin tweeting include introducing yourself or your research. Figure 4 illustrates the mechanics of sending a tweet.
      Figure thumbnail gr4
      Figure 4The process of starting and writing a tweet. JID, Journal of Investigative Dermatology.
      Finally, include one’s Twitter handle to the correspondence field in papers and to title slides of talks. This can ensure that if someone tweets about your work, they will tag you.

      Best practices

      Much has been written about Twitter's best practices; however, the following are some guidelines for dermatology scientists to abide by for Twitter use (
      • Freeman E.E.
      • McMahon D.E.
      • Fitzgerald M.E.
      • Fox L.P.
      • Rosenbach M.
      • Takeshita J.
      • et al.
      The American Academy of Dermatology COVID-19 registry: crowdsourcing dermatology in the age of COVID-19.
      ):
      • 1.
        Use your real identity: Using Twitter to promote your science and meet new colleagues requires using your real name and photo.
      • 2.
        Although you can start off with following familiar names, branching outside of your field will introduce you to new, interdisciplinary work.
      • 3.
        Avoid forming a bubble; be open to following accounts you disagree with. Engaging with opposing viewpoints may help solidify or modify your own views.
      • 4.
        Do not focus on follower count. Create engaging content by providing commentary on new research or your own work. Followers are pulled in by interesting content. Having followers who engage and are interested in your content can be more valuable than the number of followers.
      • 5.
        Use hashtags relevant to your community to help others discover your account. For dermatology scientists, these hashtags include #Dermatology, #DermTwitter, and #DermScience. Put hashtags at the end of a tweet.
      • 6.
        Tag individuals who may be interested in your work or are coauthors using the @ symbol, followed by their username in the tweet.
      • 7.
        Engage constructively. Remember everything you say is public. Criticism of ideas helps to move the discussion forward, but ad hominin attacks are unhelpful and unprofessional.
      • 8.
        Use images and figures when possible. Include links to the mentioned work. If you use images, there is an option to add an image description or alt text, which aids those using screen reader tools.
      • 9.
        Use accessible language or define any inaccessible terms. Do not assume everyone knows acronyms.
      • 10.
        Use tweetorials (Figure 3) to convey longer messages, with each tweet containing a single key point. However, limit tweetorials to a maximum of 10 tweets.
      • 11.
        If you tweet scientific content, make sure you have read and evaluated it yourself. Do not assume another person’s commentary is accurate.
      • 12.
        Never tweet patient’s photos without written consent for social media use. Do not share stories with protected health information. A good rule of thumb is that if the patient could identify themselves in a vignette, then that story should not be shared. Note that even published patient’s photos in academic journals may not be consented to for social media use.
      • 13.
        When livetweeting conferences or talks, make sure the speaker has given permission to share the information on social media. Be respectful of unpublished data that is not meant for broad dissemination.
      Getting started on Twitter may feel daunting; however, the easiest way is to share interesting scientific articles with commentary on the basis of your expertise. The same domain expertise that is useful in real life can be leveraged on Twitter. Feel free to experiment with your own style and approach to Twitter; we have all found Twitter to be a net positive in engaging with science and the scientific community and look forward to interacting with you as colleagues on social media and beyond.

      Conflict of Interest

      RD is on the advisory board for VisualDx. RD, LS, and AG are social media editors of the Journal of Investigative Dermatology.

      Multiple Choice Questions

      • 1.
        The # symbol in a Twitter message is most closely related to which of the following?
        • A.
          A keyword related to the content of the message that other users are likely to use when sharing similar content.
        • B.
          A strategy for numbering individual messages within a longer connected thread of tweets.
        • C.
          The cell phone number of the Twitter user sending the message.
        • D.
          A way to turn the text of a message bold.
      • 2.
        You are writing a Tweet to share your thoughts about a virology paper that Kizzmekia Corbett (@KizzyPhD) previously published. Which tweet would correctly tag her Twitter account?
      • 3.
        What is the name for the common technique of threading together multiple tweets in order to convey a message that exceeds 280 characters?
        • A.
          Tweetorial
        • B.
          Twitteratti
        • C.
          Tutoritweet
        • D.
          TweetTweet
      • 4.
        You are attending a grand rounds presentation on an interesting, cutting-edge research topic. You are interested in tweeting about the talk. What is the first thing you should do?
        • A.
          Start tweeting about the talk without photos of the slides.
        • B.
          Start tweeting about the talk and include photos of the slides.
        • C.
          Ask permission from the speaker about tweeting their talk. Ask whether there are any unpublished data that should be left out and whether it is okay to include photos of the slides.
        • D.
          Tweet about the talk and ask permission after. Delete any tweets if the speaker does not give you permission.
      • 5.
        You are at a grand rounds presentation that includes photos of a really rare disease presentation. You want to teach your followers about the disease. You should
        • A.
          Take a photo of the presentation slide that includes the patient photos and share it on Twitter.
        • B.
          Use photos from a different patient that you have seen in the clinic with the same disease.
        • C.
          Use links to journal publications and clinical case reports that have published photos of the disease.
        • D.
          Not tweet about the disease.

      Acknowledgments

      RD is supported by the National Institutes of Health T32 5T32AR007422-38. VH is funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases R01 AR076938 of the National Institutes of Health , National Institutes of Arthritis and Musculoskeletal and Skin Diseases R01 AR0695505 and R01 AR075412 of the National Institutes of Health. LS is supported by a Dermatologist Investigator Research Fellowship from the Dermatology Foundation and by the National Institutes of Health T32 1T32EB021955-01A1.

      Author Contributions

      Conceptualization: RD, LS, AG, VH; Supervision: VH; Writing - Original Draft Preparation: RD, LS, AG; Writing - Review and Editing: RD, LS, AG, VH

      Supplementary Material

      Detailed Answers

      • 1.
        The # symbol in a Twitter message is most closely related to which of the following?
      • CORRECT ANSWER: A. A keyword related to the content of the message that other users are likely to use when sharing similar content.
      • The # symbol is used to call out keywords, also called hashtags, which can be used to search for related content. Searching for the hashtag #DermScience, for example, will reveal many messages written by members of the dermatology science Twitter community. This is a convenient way to find content and accounts relevant to one’s interests.
      • 2.
        You are writing a Tweet to share your thoughts about a virology paper that Kizzmekia Corbett (@KizzyPhD) previously published. Which tweet would correctly tag her Twitter account?
      • CORRECT ANSWER: A. “Fascinating to review @KizzmekiaCorbett work on high throughput screening of coronavirus antibody interactions pre covid 10.1016/j.jviromet.2018.11.009 #virology.”
      • To tag another account in a tweet, simply use the user’s Twitter handle. Doing this will send a notification to that user within their Twitter application, showing them your message as well as showing any subsequent replies or retweets to that message.
      • 3.
        What is the name for the common technique of threading together multiple tweets in order to convey a message that exceeds 280 characters?
      • CORRECT ANSWER: A. Tweetorial.
      • A set of connected, related tweets is often called a Tweetorial. Alternatively, this technique is called a Twitter thread.
      • 4.
        You are attending a grand rounds presentation on an interesting, cutting-edge research topic. You are interested in tweeting about the talk. What is the first thing you should do?
      • CORRECT ANSWER: A. Start tweeting about the talk without photos of the slides.
      • One should always ask permission before livetweeting a talk. Make sure to ask whether there are any unpublished data that should be excluded.
      • 5.
        You are at a grand rounds presentation that includes photos of a really rare disease presentation. You want to teach your followers about the disease. You should
      • CORRECT ANSWER: C. Use links to journal publications and clinical case reports that have published photos of the disease.
      • One should never tweet out photos, even if deidentified, of either their patients or others’ patients without explicit, written consent from the patients to use their photos on social media. This means that interesting patient’s photos seen at grand rounds presentations or conferences should not be tweeted out. Instead, link directly to published case reports or journal articles that include photos of the diagnosis. For describing patient’s cases on social media, we recommend describing cases in such a way that the patient or their family member would not recognize them if they saw the social media post. This often means changing key details in order to create a vignette that is inspired by a case.

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