Introduction: Twitter has recently gained popularity in emergency medicine (EM). Opinion leaders on Twitter have significant influence on the conversation and content, yet little is known about these opinion leaders. We aimed to describe a methodology to identify the most influential emergency physicians (EPs) on Twitter and present a current list.

Methods: We analyzed 2,234 English language EPs on Twitter from a previously published list of Twitter accounts generated by a snowball sampling technique. Using NodeXL software, we performed a network analysis of these EPs and ranked them on three measures of influence: in-degree centrality, Eigenvector centrality, and betweenness centrality. We analyzed the top 100 users in each of these three measures of influence and compiled a list of users found in the top 100 in all three measures.

Results: Of the 300 total users identified by one of the measures of influence, there were 142 unique users. Of the 142 unique users, 61 users were in the top 100 on all three measures of influence. We identify these 61 users as the most influential EM Twitter users.

Conclusion: We both describe a method for identifying the most influential users and provide a list of the 61 most influential EPs on Twitter as of January 1, 2016. This application of network science to the EM Twitter community can guide future research to better understand the networked global community of EM.

Introduction: Twitter is growing in popularity and influence among emergency physicians (EP), with over 2200 self-identified EP users. As Twitter’s popularity has increased among EPs so too has its influence. While there has been debate about the value of Twitter as an effective educational delivery tool, little attention has been paid to the nature of the conversation occurring on Twitter. We aim to describe how influential EPs use Twitter by characterizing the language, purpose, frequencies, content, and degree of engagement of their tweets.

Methods: We performed a mixed-methods analysis following a combined content analysis approach. We conducted qualitative and quantitative analyses of a sample of tweets from the 61 most influential EPs on Twitter. We present descriptive tweet characteristics and noteworthy themes.

Results: We analyzed 1375 unique tweets from 57 unique users, representing 93% of the influential Twitter EPs. A majority of tweets (1104/1375, 80%) elicited some response in the form of retweets, likes, or replies, demonstrating community engagement. The qualitative analysis identified 15 distinct categories of tweets.

Conclusion: Influential EPs on Twitter were engaged in largely medical conversations in which most messages generated some form of interaction. They shared resources and opinions while also building social rapport in a community of practice. This data can help EPs make informed decisions about social media engagement.

Introduction: Educational podcasts are used by emergency medicine (EM) trainees to supplementclinical learning and to foster a sense of connection to broader physician communities. Yet residents reportdifficulties remembering what they learned from listening, and the features of podcasts that residents findmost effective for learning remain poorly understood. Therefore, we sought to explore residents’ perceptionsof the design features of educational podcasts that they felt most effectively promoted learning.

Methods: We used a qualitative approach to explore EM trainees’ experiences with educational podcasts,focusing on design features that they found beneficial to their learning. We conducted 16 semi-structuredinterviews with residents from three institutions from March 2016–August 2017. Interview transcripts wereanalyzed line-by-line using constant comparison and organized into focused codes, conceptual categories,and then key themes.

Results: The five canons of classical rhetoric provided a framework for thematically grouping the disparatefeatures of podcasts that residents reported enhanced their learning. Specifically, they reported valuing thefollowing: 1) Invention: clinically relevant material presented from multiple perspectives with explicit learningpoints; 2) Arrangement: efficient communication; 3) Style: narrative incorporating humor and storytelling; 4)Memory: repetition of key content; and 5) Delivery: short episodes with good production quality.

Conclusion: This exploratory study describes features that residents perceived as effective for learning fromeducational podcasts and provides foundational guidance for ongoing research into the most effective waysto structure medical education podcasts.

Introduction: Social media is a novel medium to host reflective writing (RW) essays, yet its impact on depth of students’ reflection is unknown. Shifting reflection on to social platforms offers opportunities for students to engage with their community, yet may leave them feeling vulnerable and less willing to reflect deeply. Using sociomateriality as a conceptual framework, we aimed to compare the depth of reflection in RW samples submitted by medical students in a traditional private essay format to those posted on a secure social media platform.

Methods: Fourth-year medical students submitted a RW essay as part of their emergency medicine clerkship, either in a private essay format (academic year [AY] 2015) or onto a closed, password-protected social media website (AY 2016). Five raters used the Reflection Evaluation for Learners’ Enhanced Competencies Tool (REFLECT) to score 122 de-identified RW samples (55 private, 67 social media). Average scores on two platforms were compared. Students were also surveyed regarding their comfort with the social media experience.

Results: There were no differences in average composite REFLECT scores between the private essay (14.1, 95% confidence interval [CI], 12.0-16.2) and social media (13.7 95% CI, 11.4-16.0) submission formats (t [1,120] = 0.94, p = 0.35). Of the 73% of students who responded to the survey, 72% reported feeling comfortable sharing their personal reflections with peers, and 84% felt comfortable commenting on peers’ writing.

Conclusion: Students generally felt comfortable using social media for shared reflection. The depth of reflection in RW essays was similar between the private and social media submission formats.