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Year : 2021  |  Volume : 34  |  Issue : 1  |  Page : 43-44

Twitter as an educational tool for point-of-care ultrasonography in nephrology: A “Reach” analysis

1 Division of Nephrology, University of Texas, San Antonio, Texas, USA
2 Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, Florida, USA

Date of Submission09-Aug-2019
Date of Decision28-Sep-2019
Date of Acceptance02-Jun-2021
Date of Web Publication30-Jun-2021

Correspondence Address:
Abhilash Koratala
Division of Nephrology, University of Texas Health, San Antonio, Texas
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/efh.EfH_192_19

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How to cite this article:
Koratala A, Bhattacharya D, Kazory A. Twitter as an educational tool for point-of-care ultrasonography in nephrology: A “Reach” analysis. Educ Health 2021;34:43-4

How to cite this URL:
Koratala A, Bhattacharya D, Kazory A. Twitter as an educational tool for point-of-care ultrasonography in nephrology: A “Reach” analysis. Educ Health [serial online] 2021 [cited 2023 Jun 7];34:43-4. Available from:

Dear Editor,

As point-of-care ultrasonography (POCUS) is emerging within internal medicine and subspecialties as a potential means to improve patient care,[1] a novel educational tool may conceivably help its more widespread acquisition. Twitter is an appealing platform to succinctly share medical education-related material and is rapidly gaining popularity among health-care professionals.[2],[3] However, the factors leading to higher engagement of this group of users of tweets have yet to be identified.

In general, tweets containing hashtags and images are known to reach a larger audience.[4],[5] The potential reach of a tweet is estimated by the “impressions” (Io) and “engagements” (Eo) defined as the number of times users saw the tweet and interacted with it, respectively. One other helpful metric is the number of times a tweet has been reposted by another user, i.e. “retweets” (Ro).

Using a Twitter handle dedicated to POCUS (i.e. @NephroP), we sought to explore the impact of visual content (tweets with infographics vs. plain images), subtopic (renal POCUS vs. fluid volume assessment), and adding a well-known hashtag in medical education, i.e. #FOAMed (Free Open Access Medical education) to #POCUS on the reach of the tweets. We analyzed the “top 15” tweets from the @NephroP handle over a 90-day period (February 20, 2019, to May 20, 2019) using built-in Twitter analytics. The key elements of a tweet and the difference between an infographic and a plain image are illustrated in [Figure 1].
Figure 1: Illustration of the Anatomy of a Tweet as well as infographic versus a plain image

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Interestingly, 100% of the top 15 tweets contained an image. The mean number of Io, Eo, and Ro earned was 7823, 680.5, and 35.7, respectively. There was no difference in reach between tweets containing infographics and those without as indicated by Io (8362 vs. 6741, P = 0.35), Eo (785.2 vs. 471.2, P = 0.17), or Ro (38.4 vs. 30.4, P = 0.35). Tweets about urinary tract POCUS and those about volume assessment did not differ in Io (7788 vs. 8180, P = 0.88), Eo (594.8 vs. 752.4, P = 0.55), or Ro (36.2 vs. 37.1, P = 0.91). Similarly, there was no difference between tweets with or without the hashtag #FOAMed in Io (6969 vs. 8798, P = 0.26), Eo (557.4 vs. 821.3, P = 0.23), or Ro (32 vs. 40, P = 0.32).

In summary, similar to reported data from general users, all top POCUS-related tweets contained an image. However, contrary to what would be expected for an image-based communication, the presence of infographics or addition of an education-related hashtag does not seem to change the engagement of POCUS audience or dissemination of the content. Based on this observation, the Twitter's built-in analytics seem to represent a readily accessible means to enhance its educational value through identification of the factors that boost engagement of the audience in less well-established fields such as POCUS in nephrology.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

LoPresti CM, Schnobrich DJ, Dversdal RK, Schembri F. A road map for point-of-care ultrasound training in internal medicine residency. Ultrasound J 2019;11:10.  Back to cited text no. 1
Colbert GB, Topf J, Jhaveri KD, Oates T, Rheault MN, Shah S, et al. The social media revolution in nephrology education. Kidney Int Rep 2018;3:519-29.  Back to cited text no. 2
Koratala A, Bhattacharya D, Kazory A. Harnessing Twitter polls for multi-specialty collaboration in standardizing point-of-care ultrasonography in nephrology. Clin Nephrol 2020;94:50-2.  Back to cited text no. 3
Zarella D. Use “Quotes” and #Hashtags to Get More ReTweets. Available from: [Last accessed on 2019 Jul 27]  Back to cited text no. 4
Madrigal E, Jiang XS, Roy-Chowdhuri S. The professional Twitter account: creation, proper maintenance, and continuous successful operation. Diagn Cytopathol 2017;45:621-8.  Back to cited text no. 5


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