Problem

There is significant institutional and public value in academic physicians and researchers having a public social and digital media presence. Highlighted by the COVID-19 pandemic, access to timely opinions and contributions of professional experts is necessary to combat misinformation that is often present on social media and in popular culture. Social and digital media has been shown in numerous studies to be a highly efficient vehicle to disseminate scientific information both in and outside of the academic community1 and has a complimentary role to that of traditional published work, which is often subject to paywalls outside of academic institutions. Additionally, multiple publications across various fields of study have demonstrated that posting academic articles on social media can increase their citations and impact2 and that academic journal social media editors can help to increase the readership.3 In addition to being a more timely way of adding to the public discourse, social and digital media also serves as an online footprint of public contributions that a faculty member has made on behalf of their institution, and should be considered significant and meritorious in a promotion package.

Increasingly, the digital presence of academic institutions has been associated with increased community trust.4 Social and digital media may also help to accelerate diversity, equity, and inclusion (DEI) work, serve as a public commitment to DEI, and serve as an equalizer for the academic recognition of under-represented individuals and groups; for example, a social and digital media presence may lead to opportunities for scholastic leadership (i.e., editorships) that are both beneficial to the academician and the institution that they represent. At the individual level, practicing clinicians have an online presence that is outside of their control in the form of patient ratings and reviews; however, having a professional online presence allows a clinician to create a publicly accessible record of their clinical, advocacy, and/or research work. Indeed, metrics related to physicians’ professional online presences, such as the Healthcare Social Graph Score,5 are already being collected by third parties.

To incentivize, credit, and reward scholarly social and digital media contributions made toward the betterment of public health and to their field, academicians sharing their expertise online should be able to report objective measures of social and digital media impact or influence so that these can be accounted for in their promotion package, a practice which has been increasingly adopted throughout academia.6 This report presents a worksheet, produced via consensus, for including social and digital media contributions in an institutional promotion package that could be used or adapted at other institutions.

Approach

A committee composed of a diverse group of 6 University of Pittsburgh School of Medicine academics from varying specialties, training pathways, and academic ranks, including the chair of the faculty promotions and appointments committee, dean of faculty affairs, associate dean of DEI, and clinical and research faculty members with expertise in social and digital media use, was assembled to create a consensus worksheet for the inclusion of social and digital media contributions as part of a promotion package. The committee reviewed existing literature on historical criteria for what constitutes scholarship, including modifications of Glassick’s criteria,7 as well as the quantification of social and digital media impact and the current promotion practices at our institution. Examples from the existing literature,6,8 as well as examples shared with our committee members from outside institutions,9 were collated and vetted for applicability and adaptability. Due to the ever-changing nature of the digital landscape, the creation of consensus guidelines for capturing various forms of media contribution requires a certain degree of iteration to both remain relevant and also to capture high-quality and high-impact contributions. There is limited data available to determine the cutoffs and benchmarks for follower count, view count, impressions, etc., that should be used for promotion purposes. The cutoffs and benchmarks suggested in this report were vetted by the committee described above, as well as by 2 external independent social and digital media experts who found the pilot worksheet to be applicable at their own institutions.

At our institution, products resulting from the scholarship of education and service that are not accounted for by traditional publications can be presented as publication equivalent scholarly products (PESPs). PESPs represent the effort and impact of an indexed publication and can be counted toward the suggested publication requirements for promotion in various pathways. PESPs include clinical practice guidelines, web-based curricula, peer-reviewed published abstracts, etc. For example, the activity of volunteering time at a community clinic is the activity of service. However, developing and defining that service activity into a standing free clinic that will exist indefinitely and disseminating the written blueprint for it so that it can be built on by others represent the scholarly product of service and count as a PESP. For a social and digital media product to be considered a PESP, we considered Glassick’s criteria (clear goals, adequate preparation including up-to-date knowledge and material to support the goals of the product, effective presentation in a public domain, etc.),7 which are widely used as a rubric for scholarly product evaluation in academia.

To quantify the scholarly products of social and digital media as PESPs, a worksheet was created and piloted by the 6-member committee and the 2 external experts mentioned above in 4 separate feedback sessions/rounds and then vetted among members of the committee using a modified Delphi technique between January 2022 and March 2023. It should be noted that the developed worksheet reflects the guidelines and values of a single institution but was designed to be widely applicable. The worksheet requires faculty members to explain their social and digital media philosophy, which should reflect (1) their mission as a university faculty member, (2) their academic niche, (3) their intended audience, (4) a clear objective, (5) their career development plan, and (6) their patient education, advocacy, epidemiology, research, health care professions education, or DEI work. All submitted worksheets must meet the institution’s criteria for best practice social and digital media postings per the institution’s social media posting policy. For social and digital media contributions to be considered a PESP, they must align with Glassick’s criteria (see above).7 Various forms of social and digital media were considered for applicability and impact as were third-party metrics for health care impact5 that are based on engagement with other health care stakeholders and that prioritize quality over quantity. Determinations as to whether social and digital media contributions were PESPS were made by the expert consensus of the committee. Ultimately, the utility of the worksheet in the setting of a faculty promotions and appointments committee was evaluated using faculty examples.

Outcomes

The social and digital media worksheet (see Supplemental Digital Appendix 1 at https://links.lww.com/ACADMED/B510) is composed of 4 sections (see Figure 1): (1) Scholarship Philosophy; (2) Reputation, Influence, and Leadership; (3) Digital Content; and (4) Media Appearances, Quotes, and Other (i.e., content or notable digital contributions not otherwise listed). While these sections could each easily be incorporated into a traditional CV format, the worksheet was designed to help the faculty member seeking promotion demonstrate to the faculty promotions and appointments committee that they have a well-considered social and digital media presence that is in alignment with both the university’s guidelines and values and their own career development plan. The worksheet also helps to clearly document for the faculty promotions and appointments committee that the faculty member is contributing to patient education, advocacy, epidemiology, research, health care professions education, or DEI via their social and digital media presence.

Figure 1:

Illustration of the sections (see items on edges) included in the social and digital media worksheet for faculty appointments, promotions, and conferrals of tenure and the types of work social and digital media content could contribute to (see items in center), piloted and vetted by a 6-member committee (see main text for more information), University of Pittsburgh School of Medicine, January 2022–March 2023. Abbreviation: DEI, diversity, equity, and inclusion. aOther is composed of content or notable digital contributions not otherwise listed.

To determine the weight of the applicant’s reputation, influence, and leadership, we determined that a Healthcare Social Graph Score5 of > 70 and a professional social media (i.e., applicant identifies themselves as a faculty member at their home institution) following of > 5,000 followers would be the equivalent of 1 PESP. These cutoffs were determined based on the consideration that most academicians will be considered “nano” or “micro” influencers in a specific field, with 1,000–50,000 followers on their primary platform, though this number is largely arbitrary. To capture the impact and weight of individual pieces of digital content, the content had to be archived and publicly available; the content had to contribute to patient education, advocacy, epidemiology, research, health care professions education, or DEI; and the faculty member either had to be the featured expert or the creator, manager, or administrator of that content. Examples of content include video or audio clips that are at least 2 minutes long or that have >25,000 views, podcasts, blog posts, invited commentaries on websites, non–peer-reviewed articles, “tweetorials” (or a string of tweets that taken together provide a tutorial on a topic), or virtual journal clubs.10 As one example, the worksheet counts 10 videos that are each at least 2 minutes long or that have >25,000 views as 1 PESP (for complete metrics, see Supplemental Digital Appendix 1 at https://links.lww.com/ACADMED/B510). Finally, 5 media appearances or notable quotations in subject matter interviews in which the applicant gave their university credentials were considered to be equal to 1 PESP. Other contributions not specified in the worksheet require evidence of their impact and would holistically be assigned a PESP value by the faculty promotions and appointments committee. An upper limit of social or digital media PESPs included in a promotions committee’s consideration of a candidate was left to the discretion of the institution.

The strengths of the metrics in the worksheet are that they are based on existing evidence, they include objective third-party metrics, and the benchmarks used for them skew conservative in their capture of the effort, quality, and influence of contributions. Another strength was that the worksheet was acceptable for use to the faculty committee members who piloted it. Drawbacks and challenges of this worksheet include the use of expert consensus where existing data were not available and the need to iteratively determine evidence-based cutoffs and benchmarks of success in an ever-evolving digital landscape. The metrics presented here (e.g., Healthcare Social Graph Score5) are proprietary, and other nontraditional metrics may need to be used in the future. Faculty in smaller academic niches may have a smaller audience, and this would have to be considered when using the worksheet within these niches. It is also possible that a piece of digital content could be widely viewed for negative reasons and the metrics in the worksheet would not reflect this; such pieces of content would be subject to an institution’s social media posting policy and thus should be identified during the promotions package review process. Finally, we acknowledge that online contributions are, as of now, not captured in institutional ranking schema, which prioritize traditional indexed publications and grants.

Next Steps

With institutions increasingly incorporating social and digital media contributions into academic promotion packages, it will be important to longitudinally gather and publish data on the demographics and type of institutional contributions that were previously uncaptured. It will also be important to track the trend of social and digital media adoption among academics and how this trend impacts other metrics used in promotion packages, such as peer-reviewed publications, invited lectures, media appearances, grant applications and fundraising, and community engagement. As our university begins to incorporate the social and digital media worksheet in promotion packages to calculate PESPs that can be used toward promotion, experts in social and digital media will be made standing ex officio members of our faculty promotions and appointments committee. These experts will be used to review faculty promotion portfolios that include social and digital media PESPs and advise the committees on the validity of the scholarly contribution of these PESPs.

The presented worksheet is designed to be adaptable to a rapidly changing social and digital media landscape, and the metrics used in it are likely to be iterative and ever evolving. Transparency will be imperative when assessing candidates’ promotion portfolios. Ultimately, this initiative is intended to be broadly beneficial to all stakeholders; academics will be incentivized to make scientific expertise accessible, the public perception of academic and health care institutions will benefit, and academics’ efforts will be captured and rewarded.

Acknowledgments

The authors would like to acknowledge Andrew Althouse, PhD, for his contributions to this article.

Funding/Support

None reported.

Other disclosures

None reported.

Ethical approval

Reported as not applicable.

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