From rounds to retweets: A digital media fellowship perspective

Digital media platforms are essential for knowledge generation, information dissemination, and learner collaboration.1, 2 Digital scholarship, although not formally peer-reviewed, also enhances peer-to-peer content sharing and networking. Digital media as a scholarship tool makes intellectual work accessible to a broader audience and bridges gaps across academic disciplines and between academic and nonacademic communities.3 Because social media presence is correlated with impact factor,4 more and more medical journals have begun creating Digital Media Teams to better engage with their audiences. In 2020, the Journal of Hospital Medicine (JHM) created a Digital Media Fellowship to develop leaders in digital engagement and outreach while advancing the journal's mission. A unique goal of this Fellowship centers on continually growing and enhancing the community around the journal (#MoreThanAJournal).5 This year-long mentored experience offers many developmental and networking opportunities. Fellows (1) Receive a hands-on, mentored experience in creating appealing and brand-consistent content; (2) Increase journal engagement through continuous improvement in the digital media strategy; (3) Learn about medical publishing through a longitudinal curriculum created for Editorial and Digital Media Fellows; (4) Forge mentoring relationships with journal editorial leadership team members; (5) Participate in the development of journal strategy and its execution through involvement in leadership meetings; (6) Foster peer mentorship and productive relationships among the Fellowship cohort; (7) Facilitate welcoming and inclusive conversations during the monthly JHM journal club (#JHMChat); and (8) Develop as national leaders in the use of digital media as a dissemination and engagement tool in academic medicine. Since its inception, the scope of the Digital Media Fellowship has widened substantially. Additionally, the program has had to remain cognizant of the rapidly evolving digital media landscape. Each cohort of Fellows, in partnership with the Digital Media Editors and the rest of the JHM leadership team, has contributed to improving the Fellowship and expanding the journal's presence on a variety of digital media platforms. Led by our third cohort of Fellows, we describe the opportunities and challenges of implementing, running, and sustaining a Digital Media Fellowship program using the SWOT (Strengths, Weaknesses, Opportunities, Threats) framework. A key program strength is the clear delineation of roles and responsibilities. For example, the Fellowship currently has four “rotations,” which span different digital media elements. Visual abstracts use eye-catching infographics with succinct text that summarize an article in a way that engages readers.6 While this medium may provide sufficient information for some readers, others may choose to access the article for additional detail.7, 8 Some types of articles (e.g., Original Research, Things We Do For No Reason™) are always highlighted with visual abstracts. During this rotation, the Fellow chooses additional articles to highlight and independently designs the visual abstracts in their own voice while remaining consistent with the journal brand. They also experiment with different ways of presenting the content in a visual abstract, quickly adapting or abandoning their innovations. Tweetorials are multiple posts threaded together that allow for deeper exploration and discussion of a topic.9 Each month, the responsible Fellow chooses an article to highlight and creates the Tweetorial, often leveraging visual abstracts to enhance engagement. #JHMChat is the journal's social media-based monthly journal club, hosted on X (formerly Twitter). Social media journal clubs increase papers' Altmetric scores and article downloads.10, 11 The #JHMChats have served an important community-building role for the journal. Fellows choose a recently published article on which to focus, reach out to experts to serve as guest moderators, and create conversation-provoking questions to encourage broad discussion, even beyond the field of hospital medicine. During #JHMChat, Fellows moderate the discussion through the JHM X account, then write and publish a recap in The Hospitalist, the monthly news magazine published by the Society of Hospital Medicine. The responsible Fellow schedules daily X posts highlighting JHM articles, visual abstracts, and Tweetorials, as well as advertise for upcoming JHMChats. In our journal's experience, these four products and roles represent the most important contemporary methods of disseminating scholarly work using social media. Each rotation provides an opportunity to practice and carries the responsibility of creating and leading, which ensures that Fellows gain the necessary skills and experience in these areas.1 While these skills are useful at a journal level, they are also applicable at the individual level. These skills and tools can be used to disseminate personal work, as well as the work of colleagues and other programs. Finally, we found that critically reading every JHM article to produce visual abstracts and thoughtful tweets significantly increases Fellows' skills in critically appraising and summarizing scholarly work. Fellows arrive with different skill sets and this Fellowship encourages peer-to-peer teaching, allowing Fellows to improve effective teaching methods and develop skills in sharing constructive criticism. Fellows' personalities and strengths quickly translate into innovations within and beyond creation of the aforementioned digital media elements. These hands-on teaching experiences are guided by the Digital Media Editors—all previous Fellows—who ensure effective exchange of information within the team. In its current form, the Digital Media Fellowship has several limitations, concrete and existential, that have the potential to limit its success. While the Fellowship was initially designed to be manageable while working as a full-time hospitalist, we have found that a primary limitation is the volunteer time investment needed from each Fellow. Depending on the rotation, approximately 8–10 h/month are spent on Fellowship tasks (between regular meetings and content creation)—a time commitment that we suspect will only increase as digital media continues to evolve and advance. Moreover, some Fellows have found that the rotations are just long enough to grasp the material and skill but do not allow for complete mastery unless extra time is spent in that particular domain. The Fellowship currently lacks a formal curriculum, learning objectives, and a guiding mission statement for the digital aspects of the Fellowship. We believe a formalized curriculum could make the onboarding process more efficient and allow for more effective collection and dissemination of knowledge. Additionally, a mission statement would more clearly delineate the valuable role played by the Digital Media Team and clearly state the goals and purposes that drive our projects. Both a curriculum and mission statement are currently being created. Ongoing conversations about which social media platforms align with personal values, as well as JHM values more broadly, are taking place both among Fellows and on a larger scale across #MedTwitter. Recent changes to X's operating processes have led to an exodus of users from the platform. While this rapid evolution creates challenges, it also offers opportunities to explore the functionality of other platforms, though a successor platform for the medical community has not yet emerged. Newer communities, aptly named #MedicalThreads and #MedSky, have risen as #MedTwitter users migrate new newer apps Threads and BlueSky respectively. JHM and its readers seek a platform in which we can educate and advocate as we always have, and the Digital Media Fellowship will continue to inform and address JHM's strategy in this area of uncertainty. As social media platforms have become more visually based, visual abstracts have become a key component of the journal strategy to disseminate research and other journal content. To increase JHM's brand awareness, all posted material should be instantly recognizable as part of the JHM brand. Thus, the JHM Digital Media Team and the Society of Hospital Medicine's communications team developed a brand toolkit in Canva to ensure a unified look and feel for visual abstracts. The recent shake-ups in social media use have also created opportunities for the journal. The Digital Media Team has expanded the social media platforms and tools used to disseminate scholarly work and build its community. For example, information can be shared in multiple formats on Instagram, a platform that capitalizes on JHM's utilization of visual abstracts to garner engagement. LinkedIn, previously viewed as overly “professional” in the world of academic medicine, has become a platform where users share content and wield their expertise for engagement and networking. We believe visual abstracts and Tweetorials could be adapted to LinkedIn to facilitate engagement, generate discussion, and create additional opportunities for networking on this platform. While forming and establishing a meaningful presence on a new platform takes time, persistence, and patience, we believe the JHM Digital Media Fellowship is a program that can make this happen. As podcasts have become more ubiquitous, JHM has long considered creating a JHM-specific podcast. Other journals have enjoyed success discussing articles in an audio format timed with each issue.12-14 Most of the Digital Media Fellowship specializes in visual media, and this would require a substantial commitment in terms of time and production. Once established, however, a regular podcast could expand the journal's reach and promote discussion among readers who may not be as active on social media platforms but who enjoy or learn using audio formats. The Fellowship program is actively exploring the use of video abstracts or short videos created by authors or Fellows that highlight the main points of an article. While video-based material takes time, resources, and new skill sets to be used effectively, we believe such investments will keep JHM content engaging and attractive to younger viewers who now consume news and information in these ways.15, 16 Although we mention the lack of a curriculum or mission statement as a weakness of the program, we also believe this creates a unique opportunity to not only shape the future of the JHM Fellowship but also develop a “how-to-guide” for other journals, or residencies and fellowships, to start their own digital media training programs. Our goal is to create the structures that will advance the field of digital media scholarship. By joining other platforms, expanding our educational outreach via video abstracts and podcasts, and developing a digital media curriculum, we can cater to audiences with different learning styles (audio vs. visual), engagement levels in social media, and career stages. As the Digital Media Fellowship continues to evolve in a constantly changing social media environment, it can be difficult to fully articulate the Fellowship's scope. At many organizations, social media professionals advertise the company's product and garner engagement to drive sales or clicks. While Fellows may leverage some of the same marketing techniques to increase journal reach, our goal is not promotion of the journal as a product but rather to enhance education and promote scientific discussion. This distinction remains key in identifying tasks best suited for the Fellows to ensure that the focus remains on education and dissemination of scientific information. The biggest new frontier in social media and technology is AI. How will journals use AI, both in digital media and beyond? Many journals have crafted policies regarding the use of AI in both submissions and handling of articles.17-19 Online programs like Canva—which the Digital Media Team uses to create visual abstracts—now offer AI options for crafting infographics. While this seems simple in theory, the use of AI in scientific literature interpretation and visualization remains an unexplored territory, viewed with both excitement and apprehension. AI could potentially be categorized as a form of digital media, but to relegate it there without attention to the wider communication context leaves many questions (e.g., attribution, accuracy) unanswered. To answer these questions and apply them to JHM's outreach efforts, the Digital Media Team will need to continue expanding and retaining knowledgeable, thoughtful, and skilled leadership. Through this analysis, we have shown that the digital media landscape is full of opportunities for growth and advancement and that taking these opportunities can lead to not only individual development but journal-level development as well. Digital media scholarship and expertise is becoming more recognized as an academic niche that can be used for professional advancement, but there are few mentored experiences that provide hands-on experience. The JHM Digital Media Fellowship is a unique and innovative program that helps fill this gap. Performing this SWOT analysis brought us joy as we examined how much learning and growth had taken place in each class of Fellows. Moreover, it also inspired us as we look toward the Fellowship's next steps and future directions. We believe this reflection and analysis can serve as an example for other journals, societies, and programs that are interested in creating digital media training programs or teams. The authors would like to acknowledge Michelle Brooks, Mary Ann Kirkconnell Hall, Kristen Munoz, Brett Radler, Jennifer Readlynn, and Gian Toledanes. The authors declare no conflict of interest.