Education Research: A Qualitative Analysis of the Role of Social Media in Neurology Trainees' Professional Identity Formation

Background and Objectives: Professional Identity Formation (PIF) is a dynamic process by which students and trainees integrate the professional values, expectations, and community norms of the medical community into their personal identity. PIF is often understood as occurring through socialization into a Community of Practice (CoP). Despite the growing use of social media by medical trainees, little is known about how PIF unfolds in virtual environments and the extent to which social media use can influence the career development of trainees. In this study, we explored how participation in a social media community ("#NeuroTwitter") influenced PIF and career development among neurology trainees. Methods: Informed by CoP theory, we developed a semistructured interview guide. We used purposive criterion sampling and snowball sampling to identify and recruit neurology trainee "superusers" on X, the social media platform formerly known as Twitter. Eligible participants were invited to complete a one-on-one virtual semistructured interview between August and November 2024. We used inductive thematic analysis to identify key themes and interpreted these through the lens of PIF. Results: We interviewed 18 X superusers (13 residents, 3 fellows, and 2 first-year attendings) from 17 institutions in the United States. We identified 4 key themes of how the #NeuroTwitter community influenced the trainees' PIF: (1) Access to Neurology, (2) #NeuroTwitter as a CoP, (3) Translation of #NeuroTwitter involvement into "in real-life" achievements, and (4) Challenges in navigating the digital environment. Many neurology trainees shared how the #NeuroTwitter Community was equitable, nonhierarchal, and generous and described how involvement accelerated professional opportunities. However, accruing these benefits required navigating the platform and tensions between their professional self, digital self, and "real" self. Discussion: #NeuroTwitter functioned as a CoP which fostered a sense of belonging and accelerated PIF among deliberate superusers. However, participants also described identity friction and platform concerns. Although PIF that happens in virtual communities is important, it should be viewed as complementary-rather than a replacement-to PIF occurring in real-life.