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Social media use continues to gain momentum in academic neurosurgery. To increase journal impact and broaden engagement, many scholarly publications have turned to social media to disseminate research. The Journal of Neurosurgery Publishing Group (JNSPG) established a dedicated, specialized social media team (SMT) in November 2016 to provide targeted improvement in digital outreach.
The goal of this study was to examine the impact of the JNSPG SMT as measured by increased engagement.
We analyzed various metrics, including impressions, engagements, retweets, likes, profile clicks, and URL clicks, from consecutive social media posts from the JNSPG’s Twitter and Facebook platforms between February 1, 2015 and February 28, 2019. Standard descriptive statistics were utilized.
Between February 2015 and October 2016, when a specialized SMT was created, 170 tweets (8.1 tweets/month) were posted compared to 3220 tweets (115.0 tweets/month) between November 2016 and February 2019. All metrics significantly increased, including the impressions per tweet (mean 1646.3, SD 934.9 vs mean 4605.6, SD 65,546.5;
Social media has been established as a crucial tool for the propagation of neurosurgical research and education. Implementation of the JNSPG specialized SMT had a demonstrable impact on increasing the online visibility of social media content.
Social media use continues to gain momentum in both the general public and in academic medicine. When the Pew Research Center began tracking social media statistics in 2005, 5% of Americans were technology adopters, whereas 72% of the public currently uses some variation of social media (eg, Facebook, Twitter, Youtube, LinkedIn, Instagram) [
For neurosurgery specifically, there is particular interest in engaging younger surgeons, publicizing literature, and enhancing more global collaborations. The 2018 article “Millennials in neurosurgery: Is there hope?” [
Overall, social media presence for academic journals is important for greater outreach and engagement. The
The JNSPG SMT was created on November 1, 2016 and is comprised of editors who examine both new publications and previously published articles in the core and subtopic journals of the JNSPG. There have been 4-6 social media editors, all of whom are either neurosurgical residents or senior medical students committed to a career in neurosurgery. They identified interesting articles and appealing or representative figures and images, and created a brief headline or summary of the publication with hashtags corresponding to the article type. Each editor was responsible for creating content for 1-3 hashtags for the upcoming week. Post content was checked and verified by a social media manager who was also a neurosurgical resident. The posts were scheduled to be published via Hootsuite software (Hootsuite Inc, Vancouver, BC, Canada) [
We analyzed metrics from consecutive social media posts from the JNSPG’s Twitter and Facebook platforms between February 1, 2015 and February 28, 2019. All data were obtained from the analytics collected by Twitter and Facebook. Since all data used were publicly accessible, Institutional Review Board approval was not needed. Additionally, since no patient information was accessed, no patient consent was sought.
The variables collected describing the Twitter posts included the content of the tweet, the date and time the tweet was posted, and the number of impressions (number of times a post was viewed by a user, whether the post was clicked on or not), engagements (number of times a post was clicked on to magnify the image or text or view a video), retweets, likes, profile clicks, and URL clicks each post received. The definitions for each metric were obtained from the Twitter analytics data we received during data abstraction.
The text of each tweet was searched for hashtags and divided into 14 different categories: #FreeArticle, #HistoricalVignette, #JNS_Classics, #JNS_Edu, #NeurosurgicalAtlas, #OnlineFirst, #OperativeVideo, #VideoAbstract, #VisualAbstract, #JNS_History, #GoogleAlerts, #JNS75th, #NeurosurgicalFocus, and other (see
Examples of different types of Journal of Neurosurgery Publishing Group (JNSPG) Twitter posts.
The variables collected describing the Facebook posts included the content of the post, date and time the content was posted, number of impressions (number of times a post was viewed by a user, whether the post was clicked on or not), number of engagements (number of times a post was clicked on to magnify the image or text or view a video), and total number of unique people who received each post. The definitions for each metric were obtained from the Facebook analytics data we received during data abstraction
The text of each Facebook post was searched for hashtags and divided into 13 different categories: #FreeArticle, #HistoricalVignette, #JNS_Classics, #JNS_Edu, #NeurosurgicalAtlas, #OnlineFirst, #OperativeVideo, #VideoAbstract, #VisualAbstract, #JNS_History, #JNS75th, #NeurosurgicalFocus, and Other. The date the content was posted was dichotomized into weekdays (Monday through Friday) and weekends (Saturday and Sunday). The time the Facebook post was sent was also split into content sent during the workday (7 am to 5 pm) and after the workday (5:01 pm to 6:59 am) in Eastern Standard Time/Eastern Daylight Savings Time.
Twitter and Facebook posts were dichotomized into pre- and postintervention groups using the date that the social media team was initiated (November 1, 2016) as the intervention start time. Standard univariate descriptive statistical analyses, including
Between February 2015 and February 2019, a total of 3390 tweets were posted from the JNSPG Twitter account. In the preintervention period (February 2015 to October 2016), 170 tweets or 8.1 tweets per month were posted. After implementation of the SMT, 3220 tweets or 115.0 tweets per month were posted between November 2016 and February 2019.
The impressions per tweet significantly increased following creation of the SMT (
Twitter analytics before and after creation of a social media team.
Metric | Before social media team, mean (SD) | After social media team, mean (SD) | |
Impressions per tweet | 1646.3 (934.9) | 4605.6 (65546.5) | .01 |
Engagements per tweet | 35.2 (40.6) | 198.2 (1037.2) | <.001 |
Retweets per tweet | 2.5 (2.8) | 10.5 (15.3) | <.001 |
Likes per tweet | 2.5 (4.0) | 18.0 (37.9) | <.001 |
Profile clicks per tweet | 1.5 (2.0) | 5.2 (43.3) | <.001 |
URL clicks per tweet | 13.1 (14.9) | 38.3 (67.9) | <.001 |
Interactions between JNSPG tweets varied significantly depending on the content and hashtags used for different tweets. In almost all categories (engagements, retweets, likes, profile clicks, and URL clicks per tweet), tweets with the hashtags #JNS_Edu, #NeurosurgicalAtlas, #OperativeVideo, and #VisualAbstract were significantly more likely to receive high levels of interaction from users (
Twitter analytics, mean (SD) per tweet, by hashtag.
Hashtag | N | Impressions | Engagements | Retweets | Likes | Profile clicks | URL clicks |
#FreeArticle | 701 | 3750.6 (2892.6) | 215.6 (231.2) | 11.7 (9.1) | 19.6 (16.7) | 4.5 (5.9) | 43.8 (37.9) |
#Historical Vignette | 60 | 5157.8 (4489.8) | 234.5 (193.9) | 14.7 (10.7) | 24.5 (16.2) | 5.0 (6.0) | 30.0 (21.2) |
#JNS_Classics | 66 | 3518.0 (3123.7) | 217.4 (385.8) | 12.1 (12.0) | 22.0 (25.7) | 5.1 (9.5) | 27.7 (29.5) |
#JNS_Edu | 15 | 6159.1 (2236.1) | 503.7 (326.3) | 24.1 (7.3) | 39.7 (12.8) | 9.9 (7.2) | 65.7 (46.9) |
#NeurosurgicalAtlas | 220 | 6726.9 (4147.6) | 447.7 (385.5) | 23.6 (13.8) | 48.4 (27.9) | 11.5 (13.1) | 83.6 (68.0) |
#OnlineFirst | 1173 | 3174.2 (2824.2) | 169.3 (214.1) | 9.5 (8.3) | 15.1 (14.3) | 3.9 (5.7) | 32.5 (36.5) |
#OperativeVideo | 89 | 4832.3 (22936.4) | 724.4 (6080.7) | 14.3 (68.9) | 34.2 (199.2) | 29.8 (257.3) | 55.6 (318.5) |
#VideoAbstract | 111 | 1863.1 (1105.7) | 35.5 (31.1) | 3.5 (1.9) | 5.0 (3.6) | 1.5 (1.8) | 10.0 (8.2) |
#Visual Abstract | 12 | 8049.3 (3555.6) | 347.8 (173.5) | 25.8 (13.3) | 32.3 (16.8) | 10.1 (4.4) | 43.5 (28.9) |
Other | 588 | 8873.8 (153016.6) | 103.1 (171.5) | 6.8 (9.9) | 9.0 (13.2) | 3.7 (6.9) | 27.3 (39.7) |
#JNSHistory | 15 | 3611.3 (2406.4) | 161.7 (146.0) | 10.1 (7.3) | 16.5 (15.2) | 5.7 (4.9) | 7.3 (10.5) |
#GoogleAlerts | 405 | 1620.8 (1848.0) | 47.2 (70.3) | 4.0 (5.5) | 6.2 (8.4) | 1.6 (3.7) | 27.2 (41.1) |
#JNS75th | 15 | 5277.2 (2087.4) | 255.2 (141.2) | 16.0 (10.9) | 32.1 (18.7) | 10.7 (6.4) | 23.3 (21.7) |
#NeurosurgicalFocus | 20 | 4435.7 (1860.7) | 253.1 (194.3) | 13.1 (9.2) | 28.9 (18.7) | 7.4 (5.2) | 39.8 (28.6) |
.98 | <.001 | <.001 | <.001 | <.001 | <.001 | <.001 |
Differences in retweets and likes between #OnlineFirst and #NeurosurgicalAtlas.
Users were significantly more likely to retweet content that was posted from the JNSPG Twitter account after work hours (
Twitter analytics, mean (SD), as a function of time and day.
Analytic | Tweet sent during work hours |
Tweet sent after work hours |
Weekday tweets |
Weekend tweets |
||
Impressions per tweet | 3186.3 (3107.6) | 6340.3 (10,0562.0) | .25 | 4517.8 (72,448.4) | 4248.8 (8368.4) | .85 |
Engagements per tweet | 165.6 (234.0) | 226.3 (1567.5) | .16 | 157.8 (232.0) | 301.1 (2084.2) | .06 |
Retweets per tweet | 9.3 (9.7) | 11.4 (20.4) | <.001 | 9.2 (9.8) | 13.4 (25.6) | <.001 |
Likes per tweet | 16.0 (18.1) | 19.0 (54.1) | .05 | 15.3 (17.9) | 23.7 (70.4) | .001 |
Profile clicks per tweet | 3.9 (6.3) | 6.6 (66.1) | .14 | 4.0 (7.0) | 8.5 (87.9) | .16 |
URL clicks per tweet | 35.5 (42.5) | 39.3 (91.0) | .15 | 33.4 (40.5) | 49.5 (117.3) | <.001 |
Between November 2015 and February 2019, a total of 2331 Facebook posts were sent from the JNSPG Facebook account. Between November 2015 and October 2016, when the specialized SMT was created, 49 posts or 2.3 posts per month were sent. Between November 2016 and February 2019, after implementation of the SMT, 2282 posts or 81.5 posts per month were sent.
After implementation of the dedicated SMT, average impressions for Facebook posts, average engagements, and average reach per post increased significantly (
Mirroring the trend found in the Twitter data, users were most likely to engage with posts with the hashtags #JNS_Edu, #NeurosurgicalAtlas, and #OperativeVideo compared to hashtags such as #OnlineFirst, #VideoAbstract, and #JNS_History (
There were no significant differences in the number of impressions, engagements, or total reach of Facebook posts based on whether the post was sent during work hours or after work hours (
Facebook analytics, mean (SD), before and after creation of a social media team.
Analytic | Before social media team (n=49) | After social media team (n=2282) | |
Impressions per post | 5475.9 (5483.0) | 8506.1 (13,113.9) | <.001 |
Engagements per post | 119.3 (194.8) | 283.8 (733.8) | <.001 |
Total reach per post | 2266.6 (2388.3) | 5344.1 (8399.2) | <.001 |
Facebook post analytics, mean (SD), by hashtag.
Hashtag | N | Impressions | Engagements | Total reach |
#FreeArticle | 670 | 9088.3 (12012.8) | 297.8 (501.6) | 5644.3 (7379.7) |
#Historical Vignette | 57 | 7769.6 (6208.1) | 203.1 (195.1) | 229.1 (389.7) |
#JNS_Classics | 62 | 5644.3 (7379.7) | 4862.3 (3600.6) | 4849.3 (4894.9) |
#JNS_Edu | 17 | 21131.5 (12633.4) | 735.7 (529.5) | 12474.6 (7441.6) |
#NeurosurgicalAtlas | 220 | 11997.4 (8087.2) | 442.0 (356.6) | 7718.1 (4896.9) |
#OnlineFirst | 960 | 6677.1 (6365.1) | 196.1 (259.5) | 4197.7 (3925.4) |
#OperativeVideo | 83 | 13890.4 (40761.4) | 653.4 (2949.7) | 8787.3 (26849.9) |
#VideoAbstract | 8 | 4468.6 (2696.0) | 141.4 (109.6) | 2863.9 (1829.5) |
#Visual Abstract | 7 | 8796.0 (7721.9) | 228.0 (296.5) | 5402.0 (4650.2) |
Other | 208 | 8360.3 (20484.6) | 303.3 (1005.6) | 4964.1 (13524.1) |
#JNSHistory | 11 | 4046.7 (2941.9) | 128.8 (95.3) | 2629.2 (1957.6) |
#JNS75th | 8 | 8146.1 (4647.8) | 294.6 (241.4) | 5462.6 (3079.1) |
#NeurosurgicalFocus | 20 | 8428.2 (6108) | 319.5 (329.0) | 5592.9 (3881.2) |
N/Aa | <.001 | <.001 | <.001 |
aN/A: not applicable.
Facebook post analytics, mean (SD), as a function of time and day.
Analytic | Posts sent during work hours (n=1700) | Posts sent after work hours (n=631) | Weekday posts (n=1706) | Weekend posts (n=625) | ||
Impressions per post | 8533.0 (12,758.6) | 8198.3 (13,659.0) | .59 | 7967.9 (9901.0) | 9737.8 (19,013.4) | .03 |
Engagements per post | 284.3 (749.5) | 269.8 (663.1) | .65 | 259.2 (456.0) | 338.1 (1183.6) | .10 |
Total reach per post | 5330.5 (8107.4) | 5142.0 (8904.7) | .64 | 4975.8 (6309.8) | 6108.2 (12,219.7) | .03 |
Social media, especially Twitter and Facebook, are increasingly utilized for the dissemination of neurosurgical research. There are many potential strategies for journals to increase their social media presence, including frequent postings, the creation of a general marketing team, and the creation of a specialized SMT. Our study illustrates the success of implementing a specialized SMT for the JNSPG. All key outcomes (the quantity of content published, impressions, likes, retweets, engagements, profile clicks, URL clicks, and total reach) were significantly increased after development of a dedicated, specialized SMT.
Social media use among neurosurgeons, neurosurgical departments, and neurosurgical journals has increased exponentially over the past few years [
Given the complex and unique knowledge base from which neurosurgery draws, it would be difficult for a general marketing team to develop the expertise necessary to produce content that engages and challenges the neurosurgical community. There is a distinct need for a specialized group of neurosurgical students, trainees, and attending surgeons to help create and moderate the content on the social media platforms of neurosurgical journals. Given the large amount of time needed to manage a major social media presence on top of a busy clinical practice, it is necessary to maintain a fairly large team of volunteers to appropriately divide the workload. For many trainees, the ability to “get their foot in the door” and work directly with a specialized journal in their field is sufficient motivation to provide the enthusiasm needed for sustained teams with necessary longevity. After the JNSPG created their SMT, there was a significant increase in all metrics that indicate greater engagement with the posts.
There was a significant difference in the engagement level based on the different types of posts and hashtags used. Universally, posts with impressive illustrations or videos (#JNS_Edu, #NeurosurgicalAtlas, #OperativeVideo) were significantly more likely to produce high engagement levels compared to other, less visually appealing posts (#OnlineFirst, #GoogleAlert, or Other). Having a specialized, dedicated team that is focused on optimizing the visual presentation of social media content and knowing what specific types of content are most likely to resonate with the neurosurgical community is imperative. Additionally, if feasible, it may benefit journals and institutions to have staff dedicated to medical illustrations.
Overall, there was no significant difference in the average number of impressions, likes, profile clicks, URL clicks, or total reach for Twitter or Facebook content based on whether the post was sent during typical work hours or after hours. There were significantly more retweets for after-hour posts. However, there were significantly more retweets, likes, and URL clicks for Twitter posts, along with more impressions and a higher total reach for Facebook posts if they were posted on the weekend compared to a weekday. While the time of day may not affect the likelihood of a surgeon perusing social media, these results indicate that neurosurgeons are able to take more time to not only quickly like or retweet interesting content on the weekend, but to also spend additional time engaging with the original research articles by clicking on the URLs embedded in the tweets. The time of day that content is posted may not significantly affect neurosurgeons’ engagement patterns because their busy operative schedules may allow only sporadic scrolling through their feeds at random times of the day. However, on weekends, many surgeons have extra time to more fully engage with interesting manuscripts and images that are produced for social media. Again, a dedicated SMT can take advantage of this knowledge to target especially high-impact content to the weekend when a neurosurgeon is most likely to have sufficient time to engage with the social media content.
As online resources and social media continue to play a greater role in research dissemination and clinical trainee education, it is important to emphasize the need for free educational sources that can be easily distributed via social media channels. Online educational resources such as The Neurosurgical Atlas have partnered with neurosurgical journals, including
As the
The main limitation of this study is that the data are from a single, neurosurgical journal’s experience. In the future, additional studies that compare and contrast the experiences of multiple journals with and without SMTs would strengthen the results presented in this study. Additionally, this study analyzed the JNSPG’s experience with only Twitter and Facebook. Many other journals and neurosurgical departments utilize Instagram and other social media platforms that are not reflected in these analyses. Furthermore, there is currently no strong, accepted method to correlate increased social media visibility with traditional bibliometric data. Altmetrics utilize social media engagement levels to create a score, but it is unclear if higher altmetric scores correlate with more citations in neurosurgical research. We found an association between post timing and post engagement; however, we do not have any data on when the posts were actually viewed by the user. This association is further hindered by the large international following of the JNSPG’s social media platforms, which introduces variability with different time zones. Additionally, we do not have any data on the specific metrics resulting from individual members of the SMT using their personal accounts to comment or boost the visibility of specific posts. Given the relative lack of followers that individual members of the SMT have compared to the
Social media is established as a crucial tool for the propagation of neurosurgical research and education. Implementation of a specialized SMT has a demonstrable impact on increasing the online visibility of social media content.
Additional examples of the 14 categories of Journal of Neurosurgery Publishing Group (JNSPG) Twitter posts.
Journal of Neurosurgery Publishing Group
social media team
None declared.