Are We Ready for “Academic Promotions Should Consider Social Media”?

Are We Ready for “Academic Promotions Should Consider Social Media”?

Michael A. Thompson, FASCO, MD, PhD

Oct 22, 2014
On October 14, 2014, the blogger @Skepticscalpel posted “Academic promotions should consider social media” on the popular blog site I tweeted this on the morning of October 20, 2014.

Soon after that tweet, Bob Miller, MD, asked “. . . any place really doing this yet??”

We know from previous ASCO Connection blogs that “Twitter Counts.” We know that others have noted the importance of patient and public engagement that extends beyond the traditional channels of peer-reviewed papers or online journals. Timothy Aungst, PharmD, discussed this in a March 14, 2013, blog post at iMedicalApps in “The movement to start evaluating blogging and tweets on par with academic publications.” Brian McGowan (@BrianSMcGowan) has commented on the importance of Twitter Impact (Twimpact) on predicting publication importance. For instance, he tweeted:

Pearson correlations between tweetations and citations were moderate and statistically significant #socialQI

There are differences in the level of importance and critical review between a 140-character original tweet or retweet (RT) and a high-impact manuscript in JCO, JOP, or Blood. One can imagine an aggregated, weighted metric that takes into account more than just the number of publications (or tweets) and manuscript impact factors.

In another KevinMD blog post, Deep Ramachandran, MD (@Caduceusblogger), looked at “How social media facilitates peer review” regarding a New England Journal of Medicine (@NEJM) manuscript on the number needed to treat (NNT). Dr. Ramachandran noted that this was a "relatively small blog in the outer rings of the healthcare galaxy, light years from the central galactic location," yet it led to the posting of a correction by NEJM.

A number of interesting tweets came out of the Mayo Clinic Center for Social Media (#MCCSM) summit, also on October 20, 2014:

“RT @sesaz Why physicians need to be involved in social media? ‘It's our moral responsibility to partner with our patients’ @FarrisTimimi #MCCSM”

and . . .

“RT @chrisboyer Change in social media attitudes in healthcare professionals will occur, one retirement at a time. - great quote from @doctor_v #mccsm”

After that, @Skepticscalpel pointed out to me additional commentary on “Reaction to post on academia and social media,” including:

“Most agreed that social media activity should count for something, but quantifying that something may be difficult. A certain number of followers or page views would not necessarily signify value.”

Please read those references and think about the rationale, mechanisms, and plausibility of incorporating social media into academic promotion. Asking Twitter users (Tweeps) or even readers of ASCO Connection blog posts may be a biased sampling, but it’s a start.

What do you think? What are barriers to the use of social media as academic credit? Any real-world use cases?

Please post here and consider commenting at the SkepticScalpel blog.


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James Randolph Hillard, MD

Oct, 26 2014 8:03 AM

Of course we are not ready to consider social media in promotion decisions.  But, that does not mean that we should not do so.

  In general, the farther away from patients a communication is, the more we value it. The "Inpact Factor" measures how many times an article, or a journal, is cited by other articles.  The higher the impact factor, the more we value a publication in terms.  Of promotion.

Recently, I have been obsessed with getting patients at high risk for stomach cancer tested and treated for H. Pylori.  I have made a conscious decision to publish in "low impact journals," i.e. those which are most widely read by practicing clinicians, rather than in "high impact journals," i.e. those most widely read by practicing researchers.  The science to support such an approach has been in the literature for a long time, but actual front line clinical practice has not implemented it.  I have recently been thinking about developing a "Clinical Impact Factor," which would take into account how likely a clinical article is likely to be read by a clinician who is in a position to put it into practice.

Social media are now probably reaching more professionals than print media.  Social media are certainly reaching more patients than print media.  One of the Facebook stomach cancer sites I am an admin for has about 1400 stomach cancer patients nd caregivers as members.  

 Yes, it is difficult to quantify the impact of social media contributions for the purpose of academic promotions.  But, hey, we in academic medicine are smart people (at least that is what we keep telling ourselves);  we should be able to figure it out.

Matthew S. Katz, MD

Oct, 27 2014 6:29 AM

Health communications have value. Peer-reviewed articles and book chapters are more rigorous and scientific and should be accorded high value. But it's not in a format easily disseminated or shared to effect changes in practice, or to help with patient education.

Social media is very fluid and dynamic, but we still should be able to value the value to improving cancer care. I'm not in academics and participate because I love social media communications. But we need more physicians willing to commit time to educating the public, participating in advocacy and improving cancer care in innovative ways.  Academics shouldn't be limited from participating because it's yet another extra thing to do -- it has value, so it would be great to recognize the importance of less rigorous health communications in academic medicine.

Michael A. Thompson, FASCO, MD, PhD

Oct, 27 2014 11:45 AM

Matt & James - 

Thank you for your comments.


Michael A. Thompson, FASCO, MD, PhD

Oct, 27 2014 3:24 PM

In considering academic credit/promotion, a good question is: “What is academic?” I think academic is more a state of mind than a physical location or a title. People have heard me talk about this at the ASCO Community Research Forum, but…from a public utility standpoint, academic medicine may be thought of as research and thinking that increases our scientific understanding and expands our knowledge, not just in ivory towers, but for as many people as possible.

We have a crisis of lack of scientific education and thinking in the U.S. Social media is another media by which new knowledge can be disseminated. Should we publish or perish or educate or perish? Perhaps some of the loss in science funding has already happened because of our blind spot here?

In my MD Anderson Cancer Center CV format—which I don’t know how generalizable it is—there are areas for articles in peer-reviewed journals, invited articles, letters to the editor, abstracts, and grant reviewer/service on study sections, as well as a large section with subheadings for “Teaching.” These all have a different “weight.” Organizing a local, regional, national, or international conference to educate others IS given academic weight. It seems like doing that in a virtual way online is just an extension of that process.

I found the Journal of Clinical Oncology (#JCO) “Social Media Guidelines” interesting:

“Upon publication, we encourage authors to promote their article through social media posts and professional and academic communities to help reach the best and widest audience. Authors will find social media icons prominently displayed in the abstract, full text, and PDF views of JCO articles for easy dissemination through various platforms.”

The JCO and many other journals seem to realize the value of social media for their publications, the authors, and potentially to society.

Is publishing in a peer-reviewed journal, even those that few people read, the critical metric of “academic”? Or, is being curious and critical on social media platforms a model that should be encouraged? Of course, publishing original, high-impact, peer-reviewed material and then sharing it is optimal. Which brings up another question: Can the impact value of original research be improved pre-publication by sharing via crowdsourcing?

That, in turn, reminds me of a favorite tweet/quote: "must crowd-source the change we want to see in the world. Social media allows that to happen." @FarrisTimimi #MCCSM

An NCI (very academic) Working Group determined that social media can be used to overcome barriers to clinical trial accrual (Weiss et al. ASCO 2013 Abstract 8592). Clinical trial accrual certainly occurs in the community setting, but is a very academic activity. Clinical trial activity is seen as a positive for academic promotion. So, if an oncologist accrues a single patient to a trial, that “counts”; but, if he/she provides information and resources that help others accrue 10 participants, that doesn’t count?

Something is not adding up here, and we still have more questions than answers. For example—if we do decide to consider social media activity in promotions, what level of activity would be required? Facilitating an online chat group? Blogging? Or proof of impact? And if so, how is that impact measured?

What do you think?

Don S. Dizon, MD, FACP

Oct, 29 2014 12:37 PM

Hi Mike,
Provocative stuff indeed. While I do believe there is worth in social media activity (as well as risks), I would hate for the motivation for one to get involved to be "what's in it for me." There are many things that we enjoy and would do even if it didnt count towards that endowed professorship (eg, reading novels) and things we do because it is part of our everyday life (checking email). I believe this is where social media (inclusive of blogs and microblogs) should live. The chance to interact with others far away from the immediate professional circle, to make connections with others you would not have met otherwise is what I enjoy, and I think were I in private practice or an auto mechanic, I would still do them.
That's not to say that your questions aren't important- they definitely are. Perhaps measuring a tweet by its impressions (arbitrary cut-off of x impressions would not count on a CV, for example) would be one way to start. To me, the academic credit is the icing on the very rich cake that is social media engagement.

Joseph Kim, MD, MPH, MBA

Oct, 30 2014 9:14 PM

With the power of analytic tools that can process all the "big" data generated by social media platforms like Twitter, we're sure to find quantifiable evidence that blogs, tweets, and other user-generated posts will count towards something both valuable and meaningful.

"IBM, Twitter forge partnership on data analytics"

Aaron Logan, MD, PhD, MPhil

Nov, 01 2014 2:50 PM

This is indeed a very provocative discussion, Mike.

I think the problem is that there is no inherent value quantum with twitter (or other forms of social media).

It can't be number of posts for a number of reasons, most relating to the fact that different people use twitter differently. Some docs have twitter streams that are strictly devoted to professional content. Some have that and an abundance of photographs of their breakfast and other content that can't be deemed academic in nature. Clearly the former and the latter do not have equal value as academic productivity, but there is presently no way to evaluate the content of a twitter stream.

What about tweet chat activity, which can add dozens or hundreds of posts to a user stream in one sitting? Is that activity inherently more valuable than a real-life conversation with a working group or at a conference (which isn't currently considered for academic promotion)? Sure, tweets during a tweet chat are "published," but they aren't terribly useful retrospectively to those who didn't participate in the chat due to the disjointed, stuttering nature of tweet chats that result from character limits and parallel conversations.

What about "The Twitterrhea Daily is out!"-type automated link aggregators? They probably deserve no merit as academic activity, since they are fully automated bot postings requiring zero user intervention.

Lastly, if the volume of tweets in a faculty member's stream were a metric of academic social media activity that would qualify for advancement, it would unfortunately encourage the production of more flotsam in twitter streams (and there is already enough of that for many).

So what about using the "reach" of an twitter stream (ie, the number of followers and/or the number of retweets/favorites)?

Sadly, that also would be a poor metric, since no one vets their follower list for legitimacy and a significant portion of twitter accounts are zombie protocols that follow users without a real person being on the other end. Many of these "followers" are simply accounts used to advertise their own services or content by following other accounts.

Additionally, the number of followers/retweets/favorites can be gamed by any user, another reason there is no inherent value in these metrics.

Put these issues together and it becomes very difficult, I think, to envision how academic advancement committees would evaluate the merit of a specific user's twitter stream.

Michael A. Thompson, FASCO, MD, PhD

Nov, 12 2014 9:42 AM

Don, Joe, Aaron -

Thank you for all of the comments.
I think the original blog posts I noted at the beginning have sparked conversation and possibly thinking about this for the first time for some people.

It seems clear that this isn't happening now and most people aren't ready for it.
However, I think looking back at this blog post in 1, 2, 5 years will show movement toward thinking differently about what "academic" and what academic promotion looks like.

We'll see...

Thanks again.


PS - Now getting ready for... 

Fall #EAOnc meeitng (@EAOnc) and then #ASH14. 

Michael A. Thompson, FASCO, MD, PhD

Apr, 08 2016 11:40 AM

Any new thoughts since I posted this 10/22/2014?

- Mike  @mtmdphd

PS - Some recent thoughts on social media metrics and networks from my recent #EBMT talk in Spain...

#EBMT16 - Social Media in Hematology / Oncology / BMT [4/4/16] - by @mtmdphd via @SlideShare #bmtsm

Michael A. Thompson, FASCO, MD, PhD

May, 29 2016 8:41 AM

.@MayoClinic  incl Social Media Scholarship Activities in Academic Advancement [5/2016] @CabreraERDR HT @subatomicdoc  


Mayo Clinic includes Social Media Scholarship Activities in Academic Advancement

Posted by @cabreraerdr4 days ago

On Friday, Mayo Clinic's Academic Appointments and Promotions Committee (AAPC) announced that it is integrating social media and digital activities in the criteria matrix for academic advancement. (Mayo staff can view the announcement here.)

This is a game changer for digital academics.

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