1. Using Twitter in undergraduate medicine – case study #fluscenario Dr Ellie Hothersall Theme Lead for Public Health Deputy Convenor Systems in Practice Locum Consultant in Public Health

2. Epidemiology Why Who When What How (Evaluation)

3. Public Health is “common sense” Easy Concepts rather than facts Hard to assess Difficult to get engagement from majority

4. The solution? Get ‘em while they’re young Try to develop conversations not teach facts Make it relevant and engaging

5. #fluscenario Online Done in Private Study Using familiar social media Low input required from staff Peer support

6. Purpose of #fluscenario To introduce you to pandemic ‘flu and emergency planning To develop an online learning conversation (To understand there is more to public health than drinking water and inequalities) (To understand how social media will influence your professional life)

7. Origins of #fluscenario Based on previous work by nhssm.org Original scenarios written by Mr Alex Talbott and Dr Chloe Sellwood Twitter chat with Social Media emphasis Easy to tweak to student focus

8. Warming up Introduced during Respiratory Block lectures “Introduction to Twitter” sessions from TILT team Encouraged to get Twitter account and start using in advance

9. Long leash… “You are reminded again that Twitter is a public forum, and professionalism is expected. There’s a useful article about Twitter dos and don’ts here [http://www.guardian.co.uk/culture-professionals- network/culture-professionals- blog/2011/dec/15/twitter-rules-etiquette]. You are further reminded that all students are expected to make the effort to engage with all the scenarios. Failing to contribute adequately will be viewed as a lapse in professionalism [https://mbchb.dundee.ac.uk/professionalism/lapses -in-professionalism/].”

10. Outline Phase 1 Background Preparation Phase 2 Early outbreak Communication and risk Phase 3 Late outbreak Prevention and mitigation Phase 4 Wrap up Lessons learned

11. Outline Phase 1 Background Preparation Phase 2 Early outbreak Communication and risk Phase 3 Late outbreak Prevention and mitigation Phase 4 Wrap up Lessons learned

12. Background/Early warning Assumptions in planning (e.g. 50% affected, 4% hospitalised) Link to early BBC coverage: http://news.bbc.co.uk/1/hi/world/americas/8017777.stm http://news.bbc.co.uk/1/hi/world/americas/8017777.stm http://news.bbc.co.uk/1/hi/world/americas/8021483.stm Spread internationally: http://news.bbc.co.uk/1/hi/world/south_asia/8019364.st m http://news.bbc.co.uk/1/hi/world/south_asia/8019364.st m Questions for discussion e.g. What could you be doing now to get ready?

13. Outline Phase 1 Background Preparation Phase 2 Early outbreak Communication and risk Phase 3 Late outbreak Prevention and mitigation Phase 4 Wrap up Lessons learned

14. Early epidemic Summary of early stages of 2009 pandemic BBC links e.g. Panic begins over drug availability: http://news.bbc.co.uk/1/hi/puffbox/hyperpuff/au diovideo/wales/wide_av_hyperpuff/8043300.st m http://news.bbc.co.uk/1/hi/puffbox/hyperpuff/au diovideo/wales/wide_av_hyperpuff/8043300.st m Questions, e.g. Where do you get reliable informaiton?

15. Outline Phase 1 Background Preparation Phase 2 Early outbreak Communication and risk Phase 3 Late outbreak Prevention and mitigation Phase 4 Wrap up Lessons learned

16. Late epidemic/pandemic Burden on intensive care Fear in healthcare workers Vaccination and antiviral strategy Pregnancy ECMO BBC links e.g. The doctor’s perspective: http://www.bbc.co.uk/news/uk-england- hampshire-15623927 http://www.bbc.co.uk/news/uk-england- hampshire-15623927 Example question: How do hospitals provide all that extra intensive care at short notice?

17. Outline Phase 1 Background Preparation Phase 2 Early outbreak Communication and risk Phase 3 Late outbreak Prevention and mitigation Phase 4 Wrap up Lessons learned

18. Wrap up Today “We know what we know” What have we learned? What do we hope will be different next time?

19. What happened? 2,987 Tweets using the hashtag #fluscenario Contributions from staff, students, others Mean number of Tweets per student was 13.8 (range 1-88). Peak Twitter activity was in the first 12 hours, with >1,000 Tweets within 8 hours of launching the first scenario.

24. Evaluation “did not understand the point of the exercise” “waste of time” “I enjoyed using twitter as a new way of teaching and I feel like I learnt a lot from the opportunity to discuss the flu scenario with my peers.”

27. “Whooping cough: Three more babies die in outbreak http://t.co/VXAIC5Bu #fluscenario” “Reading about the emergence of multidrug- resistant TB and automatically relating this to the spread of #fluscenario. Hello Library Weekends.”

28. View from the outside

29. Next time? Better evaluation Build ethics and communications in specifically Ask students to identify key learning points Get the students using Twitter earlier to “win them over” (e.g. #dundeeprn) PLUS content/context analysis of tweets