Nuclear Medicine Education Via Instagram: A Viable Method for Informal Lifelong Learning

COUNTRY OF ORIGIN

Analysis showed that the proportion of @nuclear_radiology followers was 30.41% from North America, 15.65% from Asia, 13.72% from the Middle East, 12.61% from South America, 10.45% from Europe, 7.41% from the European Union, 5.12% from Africa, 2.69% from Central America, and 1.95% from Oceania (Supplemental Table 1; supplemental materials are available at http://jnmt.snmjournals.org).

The Instagram @nuclear_radiology is produced in English, and the data show that approximately half of its followers are from countries with a high proportion of English speakers. Thirty-eight percent of followers are from countries where English is spoken as the primary language: the United States, Canada, the United Kingdom, South Africa, Nigeria, Singapore, and Australia. The percentage of English-speaking followers increased to 47% when India—a country that has the second-largest English-speaking population of approximately 125 million—was added.

About 45% of followers are from the Americas (Central, North, and South America). English proficiency in many Latin American countries is high, including Argentina, Brazil, and Mexico (6). Near-equal proportions of followers are from the Middle East, Asia, and Europe or the European Union (13%–17%). No followers are from China or Hong Kong, as Instagram was banned there in 2014 after prodemocracy protests.

The international nature of the Instagram platform and followers nearly worldwide suggests that this type of informal learning may be useful in regions of the world that have limited educational resources and access. In a 2016 article in the American Medical Association’s Journal of Ethics entitled, “Medical Education and Global Health Equity,” the authors explain that there are efforts under way to “expand medical training in resource-constrained settings” to improve global health-care disparities and that innovative medical education is required for this effort. In short, “medical educators need to rethink both what they teach and how they teach,” the authors assert (7). Educational innovations, including social media–based efforts, could serve to improve global health equity by improving access to educational materials and strengthening ties between educators and students worldwide.

AGE AND SEX

Analysis of the age of @nuclear_radiology followers showed that 69.8% (5,387) are 18–34 y old. Worldwide, 64% of Instagram users are 18–34 y old (8). This suggests that Instagram-based nuclear medicine education may be useful in the age groups that is commonly undergoing technologist training, medical education, and residency and is in an early phase of their career. Some studies suggest that younger learners especially appreciate social media sites for medical education because of the “ease of use,…structure, and the breadth of information that these sites provide.” (9,10)

On the date of analysis, 13.2% (782) of users were 18–24 y old, 56.6% (3,360) were 25–34 y old, and 21% (1,245) were 35–44 y old. The remainder were 45 y or older (9.2%) (Table 3). On sex analysis, 51.5% of users were women and 48.5% were men.

PARTICIPATION ANALYSIS

Engagement levels on social media posts and sites seek to quantify the participation of users on single or multiple posts (11). Participation levels are determined by counting the number of actions performed by users in relation to a post, such as the number of likes, shares, comments, saves to user files, visits to the main profile, and followers gained. Although engagement rates for medical education sites are unknown, in 2019 there was an overall Instagram engagement rate of 3.96% for higher-education industries (alma mater organizations, fans, current students), 2.4% for nonprofit organizations, 1.22% for media sites, and 1.97% for influencers (people on social media who attempt to influence followers to buy products). The median engagement rate per post on Instagram in 2019 across all industries was 1.6% (12).

Participation (or engagement) analysis of a post that asked followers whether they self-identify as a nuclear medicine technologist led to 607 actions of participation (like, comment, share), a participation rate of 13.3%. This rate suggests the possibility for high levels of participation by nuclear medicine technologists and technology students on this forum.

Engagement analysis of followers on 10 educational posts on the @nuclear_radiology Instagram site showed an average participation level of 5.1%. The lowest participation rate was 2.7%, on a post about pleural mesothelioma on ¹⁸F-FDG PET. The highest participation rate was 6.5%, on a post about Takotsubo cardiomyopathy (broken-heart syndrome) on a ^99mTc-tetrofosmin cardiac stress test. Engagement was calculated as number of post-induced actions of participation divided by impressions (number of times the content was shown to users or could have been seen by users). For example, on the post in Figure 1, approximately 292 followers either liked, shared, commented, saved, visited the main profile, or followed the site after reading the post. This number was divided by 6,154 impressions tallied by InsTrack, for an engagement rate of 4.7% (Table 4).

The average participation rate of 5% for educational posts shows participation by up to 350 learners on each post. Although this level of active follower participation would seem positive relative to levels of engagement for overall Instagram use, engagement levels for Instagram sites dedicated to medical education have not been fully quantified as yet.

DISCLOSURE

No potential conflict of interest relevant to this article was reported.