Thank you so much, Elliot, for the invitation. Nneka spoke earlier about the added benefits of Twitter, and I can tell you, a year ago, I would not have imagined speaking to an audience of hepatologists as a general internist. So if speaking to an audience of hepatologists is a benefit of Twitter, certainly I've received that benefit. What I want to talk about today is the use of Twitter as an educator, and specifically I'll be talking not really about the how, but the why. I really want to make a case, because many of you in the room may be skeptical, so I think it's important to convince you of the virtues as an educator. So I don't have any relevant disclosures as pertains to this particular discussion. I want to start with a question that I think it's worth posing and answering before I try to make my case, and the question is, why do you teach? I would argue there's at least six reasons. The most obvious, of course, is that we want others to learn, but that can't be the only one. I think by virtue of creating teaching content and delivering teaching content, we undoubtedly learn ourselves, and I think that's the second reason that we might teach. But there's even more than just these. I suspect that if you teach, you teach something because you think the message of your content is important, and I think that you want the message that you're trying to teach to reach as many people as possible, or else you wouldn't think it's important. And so we'll see, as you can imagine, why Twitter can be valuable for that. I personally find creating and delivering teaching content to be both invigorating and fun, and I think that's a fourth reason that we teach, and I think these four collectively can be seen as the internal drivers to teach. But there's also external drivers, things like promotion, and maybe a less charitable external driver is that people just basically force you to do it. So in total, there's at least six reasons why we teach, and I think what we have to do is explore where and how Twitter can help supplement these six because we certainly have traditional models. We have the lecture, the plenary, the small group teaching session, but I would argue that there's an additional one that is underutilized, and that's social media. And it's a little bit odd to think about this as being an educational encounter and you sitting in a machine and this gentleman sitting on a ledge fairly precariously consuming your educational content, but I think this is a modality that we should all be exploring a lot more. But importantly, I think it's something that we want to add to traditional models. I don't think Twitter and social media are replacements, but only additive to the plenaries, to the lectures, and to the small group sessions. There are a lot of different ways that one can teach with Twitter, and I want to spend my remaining time talking about the use of tutorials. And again, I'm not going to talk so much about the how, but instead the why. And you can see here I have the beginnings of one of Elliot's tutorials on paracentesis, one of the many that he has written, and we're going to break it apart a little bit so you can get a sense for it. But before we do that, I think it's important to just provide something of a definition. It may be a fairly obvious definition, but I think it's important to put it out there nonetheless. First of all, a tutorial is just a neologism of tweet and tutorial. And a med-ed tutorial, which is the ones that I think we as educators are going to concentrate most on, are collections of threaded tweets with an aim of teaching those who view it. It's a pretty simple definition, but I think it works. And if we come back to Elliot's tutorial, you start by noticing that there are a lot of tweets here. And here are the first 11. There are more that came after this. But importantly, what Elliot did is he created this content ahead of time, and he posted them simultaneously, so that if a viewer saw the first tweet, the fifth tweet, the 11th tweet, and it was interesting to them, they could actually open the entire thing and not be waiting for Elliot to post each tweet contemporaneously. So it does take preparation ahead of time, but that should be true really of any educational endeavor that we take on. Second, you'll notice that Elliot includes, at least in what I've posted here, two polls or surveys. And the virtue of this is it allows you to make use of things like the testing effect. It allows you to get a sense of whether or not the audience that is consuming this has any knowledge of the content. And you can even do things like a pre and a post to get a sense of whether or not they've learned from what you've posted. Elliot also makes, I would say, excellent use of pictures from both journal articles but also ones that he's created himself. But there's other forms of media that you don't see here that can be used, things like GIFs and videos, that I think are a lot harder to use in traditional models of teaching. And Elliot also includes a number of hyperlinks to the primary literature so that you don't have to take his word for it. You don't have to take my word for it. As an internist, you can download the article yourself and confirm that what he is saying, what I'm saying, what you're saying is accurate. There are a lot of different types of tweetorials out there. I specifically like to write about mechanisms of disease and pathophysiology. But there are others who teach other core concepts or use it to supplement traditional teaching. So, for example, they'll give a lecture, and at the same time that they're giving a lecture, they're going to be posting 10, 12, 15 threaded tweets on the content of that lecture. So as an audience member, you might be able to explore it further after the lecture has been completed. You can use it to supplement your research or supplement other forms of new media like podcasts. And then there's this really explosion of people who are telling stories on Twitter, which I really find fascinating, and they're using the tweetorials in the model. And undoubtedly, there's going to be other ways that people use this or are currently using it beyond these five. So the real question is, how does the traditional model on the left differ than this sort of maybe emerging model on the right? And so let's compare them a little bit. So first, the traditional model has a finite number of learners. It's really whomever is in the room with you. Whereas Twitter, I would argue that the 300-some-odd million Twitter users are not all interested in NASH and cirrhosis, but there's surely more users on Twitter available as learners than are the people in your room. In addition, the traditional model has parameters that are immutable. You cannot negotiate a noon conference hour. I wasn't able to negotiate with Elliot that I was going from 2.45 to 2.55 today, and in fact that I had those 10 minutes. But with Twitter and tweetorials, you can deliver the content at your leisure. You could do it at 2 a.m. on a Sunday morning. You could do it at 2 p.m. on a Wednesday afternoon. And your learners can consume it on their time and as fast or slow as they want and can come back to it as often as they want. Feedback in traditional teaching models, I would say, is sparse and a variable benefit. But the virtue of posting things on Twitter is you can get feedback from novices and from experts. And not only do you get the feedback from novices and experts, the other learners who are your audience get to see that as well. I posted something on the generation of urea, the increase in urea in pre-renal azotemia last week, and the world expert on how the vasorecta modulates urea secretion responded to it. That was fantastic for me, but it was also fantastic for the audience who was reviewing the tweetorial. As I mentioned, pictures and graphics can be used in traditional teaching, but I think they have a greater place and are actually more easy to use on Twitter and with tweetorials, and similarly for both polls and surveys. And then finally, as I mentioned earlier, hyperlinks, I think, are, you know, if you're sitting here in a lecture and someone puts a study up, yeah, you can take a picture of it and try to find it later, but that's a lot harder to do than when I'm consuming a tweetorial posted by Elliot, and I immediately want to read that paper that he's cited. So to close, I think it's important to come back to the six reasons why you teach and to see whether or not Twitter stacks up. So first, I will be honest, I am not convinced that any form of education teaches our learners, and certainly there's no literature to suggest that tweetorials do it, but the hope is that they will in the same way that we hope traditional teaching models teach our learners. I can tell you from firsthand experience, and I think others who have done this will agree, that you undoubtedly learn by putting these together. It is impossible not to. And if you have an important message, you want that message to be heard by as many people as possible, and so posting it on social media where you have thousands of people who can hear that message, I think, is a true benefit. I have personally found it to be fun and invigorating. I cannot tell you it's going to be used for promotion, although talk to Elliot in a year, this may be changing. And I'll say hopefully no one is forcing you to do this, but if they do, if we come back to the original reasons why you teach.

Twitter for educational purposes

tweetorials

social media teaching content

interactive learning experience

supplemental tool for teaching