"Instagram offers radiology a unique opportunity to educate the younger generation and to potentially inspire more medical professionals to pursue the specialty," noted Javier Azcona Sáenz and colleagues from the Marqués de Valdecilla University Hospital (known as Valdecilla) in Santander, Cantabria. "Social media can help radiologists to find useful profession-related information, share and discuss radiological images, improve communication with clinicians and patients, advertise themselves and their specialty, and humanize their profession."
Radiology was the first department in the Marqués de Valdecilla University Hospital to launch an Instagram account.
Instagram is a smartphone- and tablet-based social networking service designed for mobile sharing of pictures and videos, and radiology's image-centric focus makes it an ideal specialty for the platform, they explained in an RSNA 2019 digital poster. Educators can easily upload medical images and videos displaying radiological cases on an international scale, but measures must be taken to ensure the protection of patient privacy when using social media for educational purposes, they warned.
Overall, success with Instagram depends on content and timing, according to the authors, who gave the following practical tips:
- All images and videos should relate to radiology education.
- Followers prefer a regular posting pattern.
- When posting, give priority to quality over quantity of images and videos.
- Instagram no longer converts images to a square format, so unwanted cropping of uploaded photos isn't a problem.
- The default setting for Instagram videos is autoplay with sound off, so viewers should turn up the volume before the video starts.
- Images should retain a degree of variety. Multimodality findings in a single disease, multiple imaging exams in a single patient, inclusion of advanced postprocessing display, and illustrations related to anatomy and pathology are all worth considering.
- Hashtags create a link from the posted picture to other pictures in the same category. Multiple hashtags increase the likelihood that the post will be viewed.
- When publishing patient cases, images must be anonymized. The patient's name and data should not be visible on the image.
- Set your account to public mode so that potential followers can see the account content and decide if they're interested in following.
Growing popularity of Instagram
Instagram is steadily climbing the social media ranks in terms of monthly active users (MAUs). According to the Buffer Marketing Library 2019 (cited 28 September 2019), Facebook has 2.23 billion MAUs, YouTube has 1.9 billion MAUs, WhatsApp has 1.5 billion MAUs, Instagram has 1 billion MAUs, and Twitter has 0.35 billion MAUs.
There is increasing awareness that social media can contribute to greater visibility and engagement of radiologists in the online virtual community. Yet many radiologists are still unaware of the wide spectrum of information and interaction available via social media and of the added value these platforms can bring to their daily practice, stated Azcona Sáenz and colleagues.
There are several popular radiology feeds on Instagram, some with more than 20,000 followers, including radiopaedia, thexraydoctor, pediatricradiology, and radiologyacr. These feeds use different techniques to teach, including sharing video content, annotating images, and providing quizzes, and most posts share images with focused teaching points in their captions, they explained.
Instagram stories is a useful feature launched in 2016 that allows users to post images and video content in a slideshow format that is only available for 24 hours from the time of posting. Instagram stories have quickly become one of the most popular features of the platform, allowing the display of more content while maintaining a clean main account, the authors added.
This feature allows the content creator to insert polls, quizzes, and GIFs on the posted images and videos to make learning as interactive and dynamic as possible. Also, Instagram allows users to communicate their ideas and exchange opinions by commenting on posts, sending private messages, and giving likes to both posts and comments from other users.
"Instagram is an incredibly intuitive and easy-to-use platform," they wrote. "It is ideally suited for radiology education because its primary content consists of images, unlike other social media networks."
Legal and privacy issues
Privacy and legal matters are important. Radiologists use free and accessible open-cloud storage services and social media platforms to share radiological images. These methods constitute a risk to the patient's privacy, since they were not created to distribute nor store protected patient-related information.
"Radiologists using these public platforms for work reasons cannot guarantee that no one else is able to access this information," Azcona Sáenz and colleagues noted. "Information that could identify a patient could be used for fraudulent purposes."
Legal concerns are driving many medical doctors' reluctance to participate in Instagram accounts, but the use of social media networks for radiology education should be embraced under clear guidelines and proper security mechanisms, they stated.
Social networks remind clinicians that behind the radiological images they use in their everyday practice to assist patients, there is a team who performs the imaging and reports the findings.
"Instagram also allows patients to understand that imaging examinations require a radiologist for correct interpretation," the authors wrote. "It also facilitates the radiologist and radiology technicians to be humanized; often they remain unknown."
Additionally, Instagram can act as an effective advertising showcase to publicize the best aspects of a radiology department. It has the potential to reach across professional boundaries between students, residents, technologists, and physicians, and it can inspire more medical students to pursue radiology as a career by reaching them early in their premedical and medical school education, they continued.
A potential downside is that material must be selected and uploaded only by the administrator of the account, and this person generally decides on the type of content and posting pattern. Only the positive aspects of the service tend to be highlighted, yet there is a greater ease for public criticism because the service is directly exposed. Also, Instagram tends to attract a predominantly younger audience.
The Spanish experience
At Valdecilla, the radiology department started an Instagram account in January 2019 as part of its modernization program. The aim was to bring radiology closer to society, humanize the radiologists, and document important events in the department.
Called rayos_valdecilla, it has now made 52 posts and has 253 followers, while following 94 others. The most successful posts include ones on CT-guided biopsy ("practice makes perfect!"), how a 7-tesla MRI can impress you, and the possibility of learning and building teamwork while playing board games together.
Feedback on the Instagram account has generally been positive. It has allowed nursing assistants, technicians, nurses, and radiologists to be more united, commented one staff member. It has led to greater visibility and sets an example that we are an up-to-date and very dynamic department, said another.
"The creation of our Instagram account made other departments realize the importance of advertising themselves on social networks by creating their own accounts," the authors pointed out. "We were the first department to create an Instagram account in our hospital and thus served as a role model for other departments, such as the anesthesia and oncoradiotherapy departments. Many other departments are now thinking about how to create their own account."
The creator of the Instagram account has understood the impact this could have nationally and decided to create an account for all radiology residents in Spain: residentes.seram.
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