key: cord-1036343-3r05bwgq authors: Baldwin, Cassidy S.; DeMarinis, Anthony R.; Singh, Nikhi P.; Khoury, Charles A. title: Evaluation of Emergency Medicine Residency Programs’ use of social media in the setting of the COVID‐19 pandemic date: 2022-01-06 journal: J Am Coll Emerg Physicians Open DOI: 10.1002/emp2.12637 sha: 09ec550a9b557f6b89dff62bf082a0dc1b500df3 doc_id: 1036343 cord_uid: 3r05bwgq OBJECTIVES: The coronavirus disease 2019 (COVID‐19) pandemic significantly affected the ability of residency programs and applicants to interact using traditional methods of in‐person interviews and visiting rotations. We examined the social media presence of emergency medicine (EM) residency training programs and how programs responded to the COVID‐19 pandemic. METHODS: The Electronic Residency Application Service (ERAS) identified EM residency programs that participated in the 2021 match. Programs were reviewed for the presence of a website and social media accounts on Twitter, Instagram, and Facebook, as well as foundation date. Data were collected after the ERAS application deadline. RESULTS: All programs, except one, had some sort of online presence. A total of 258 websites and 476 social media accounts were identified. The majority of programs maintained an account on Twitter (75%), Instagram (61%), or Facebook (38%). Most Twitter and Facebook accounts were established before the onset of the COVID‐19 pandemic. However, 46% of Instagram accounts were created after March 1, 2020. During 2020, there was a 34% increase in total social media account development, higher than in previous years. CONCLUSION: EM residency training programs have a robust online presence. Account development continued to grow in 2020, after the onset of the COVID‐19 pandemic, and growth on Instagram was noted to be substantial. Interactions through online platforms may supplement the residency application process, but their efficacy is unclear. Over the last decade, there has been a growing number of emergency physicians and emergency medicine (EM) residency programs on social media. These accounts are used for education, discussion, networking, outreach, and advocacy within the medical community and beyond. [1] [2] [3] On Twitter, the popular hashtag #MedTwitter broadly links medical students, residents, attendings, and other contributors for easy interaction. Furthermore, the popular "Free Open Access Medical Education (FOAMed)" campaign encourages the use of online platforms to disseminate medical knowledge. [4] [5] More specifically, the academic EM community has used Twitter in various ways, from sharing clinical pearls to linking national conference attendees. 6 Social media's role in medicine continues to evolve and may become increasingly popular as a residency recruitment tool. If medical students use social media at similar rates to other young adults, then roughly 70% are Facebook and Instagram users, and roughly 40% are Twitter users-making these potentially strong communication channels. 7 After the onset of the COVID-19 pandemic, necessary social distancing guidelines altered the traditional residency application cycle. In May 2020, the Coalition for Physician Accountability released a statement recommending the suspension of most visiting rotations and encouraged programs to implement virtual interviews. 8 The academic EM community subsequently supported these recommendations and transitioned to virtual interviews for the 2020-2021 cycle. 9 Although one benefit of virtual interviews is monetary savings amounting to thousands of dollars, previous studies have shown that personal interactions during interview day are significant for both applicant and program rank list determination because of the many factors assessed during the interview day or at the preinterview social event. [10] [11] [12] With these opportunities limited, social media may have increased importance, serving as one way for applicants to get a sense of the unique opportunities at programs as well as the applicant's overall fit. Although the literature is limited, a previous study of EM residents and faculty at several programs found that a majority of both groups would be interested in using social media to promote their residency program. 3 However, there is a paucity of literature examining whether EM programs actually use social media as an advertisement and recruitment tool for prospective residents. Given the newly present limitations of in-person interactions, the current authors posit that COVID-19 may encourage more EM residency programs to use social media. In this article, we describe EM residency programs' current presence on 3 popular social media platforms-Twitter, Instagram, The COVID-19 pandemic has changed the way emergency medicine residency programs have recruited applicants. Many programs had an online presence before the pandemic with an exponential growth of 34% in social media accounts in 2020 as recruitment moved virtually. The use and efficacy of these accounts for recruitment remains unclear. and Facebook-and evaluate whether there is significant growth in the presence of EM residencies on these platforms associated with the early parts of the COVID-19 pandemic. An official list of accredited EM residency programs was obtained from the Electronic Residency Application Service (ERAS), identifying 262 total programs, of which 260 participated in the 2021 match. The websites and social media pages of these 260 programs were individually identified and analyzed. All data were collected in November 2020 after the ERAS deadline of October 21, 2020, ensuring that all accounts created with an intent to engage applicants were included. Institutional review board exemption was received for this investigation. The Google search engine was used in conjunction with each social media platform's search engine to identify program and department accounts. When using the Google search engine, department and residency programs pages were ascertained using the corresponding school name followed by "emergency medicine department" or "emergency medicine residency program" and one social media platform. For example, if searching for State University's emergency medicine residency program on Instagram, the search phrase "State University emergency medicine residency program Instagram" was typed into the Google search bar. If no account was found through this search, specific social media searches were conducted using the school's name followed by "emergency medicine department" or "emergency medicine residency program." Results of the search were reviewed by our team and were determined to represent either a residency program or an EM department. This difference was signified by the title or key phrases used on the page. Any account associated with an EM residency program or EM department TA B L E 1 Use of 4 online platforms by emergency medicine residency programs and departments Electronic Residency Application Service listed emergency medicine residency programs participating in 2021 match Programs with an associated Twitter account 196 (75) • Departmental account 51 (20) • Residency program account 162 (62) • Both departmental and residency program account 17 (7) Programs with an associated Instagram account 158 (61) • Departmental account 14 (5) • Residency program account 148 (57) • Both departmental and residency program account 4 (2) Programs with an associated Facebook account 98 (38) • Departmental account 23 (9) • Residency program account 78 (30) • Both departmental and residency program account 3 (1) Programs with an associated website 258 (99) was counted in our data, regardless of the amount of account activ- Of the 260 EM residency programs participating in the 2021 match, 259 programs (99.6%) used program websites and Twitter, Instagram, or Facebook accounts. In total, 258 websites and 476 social media accounts were found to be affiliated with an EM residency or department. Most programs maintained a departmental or residency specific account on Twitter (75%), Instagram (61%), or Facebook (38%). Sixty-five programs (25%) were found to have an account on all 3 platforms. Most accounts (82%) were residency specific. These findings are detailed in Table 1 . Most Twitter (85%) and Facebook (90%) accounts were created before the onset of the COVID-19 pandemic. Nearly half (46%) of Instagram accounts were created after March 1, 2020. An increase of 34% in total social media account development was observed between January 1, 2020, and November 1, 2020. The growth in the number of social media accounts over time is shown in Figures 1 and 2. 7 In addition, Instagram's overall user base is significantly larger than that of Twitter, with 300% more monthly users. 7 Although our study was limited to 3 of the more common platforms, other popular social networking sites like Snapchat and TikTok could be examined for EM program presence. Our study focused on programs' presence on social media with no assessment of medical student engagement with these platforms. Future studies may determine the utility of medical student engagement through these platforms. Specific questions of interest include how residency-related social media is received by applicants and how these virtual interactions affect decisions on where to apply and whom to rank. Exploration of organizational policies toward social media may explain trends observed in this article. In addition, examination of the content of programs' social media posts may prove useful. 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