title: An exploration of the use of social media by surgical colleges.
abstract: BACKGROUND
  Social media use has become common for organisations in surgery, however the nature and reach of these communications is unknown. This study aimed to characterise and compare the use of "Twitter" by five prominent organisations in surgery.
  
  
  METHODS
  Data were collected from Twitter and the scale, reach, nature and sentiment of messages analysed. Message influence was determined and content analysed by frequency and association using hierarchical clustering and network analysis. Poisson regression was used to compare institutional message and "re-tweet" counts.
  
  
  RESULTS
  7712 messages were analysed from a four-year period up to 13th April 2013. The American College of Surgeons (ACS) had tweeted most and posted the greatest number of messages per day (3.3/day). The number of followers reflects social reach and the Royal College of Surgeons of England (RCSEng) had the greatest number (11,600) followed by the ACS (7320). The number of "retweets" a message receives is a measure of influence with the RCSEng (2.0) demonstrating a significantly greater count than the Royal College of Surgeons of Ireland (RCSI; 0.8, p < 0.001) and the ACS (1.3, p < 0.001). Followers of the RCSEng and ACS appeared most influential. Terms relating to education feature prominently in messages posted by the RCSEng and RCSEd, but less so in those from the RCSI and ACS. Education and training terms were highly correlated with "events".
  
  
  CONCLUSIONS
  Surgical colleges have significant international reach through social media. UK colleges frequently communicate about education/training opportunities while the ACS focuses on patient-related matters. Only one organisation was found to have an explicit social media policy, which would be considered best practice and can focus on-line activity.
authors.affiliation: College of Medicine & Veterinary Medicine, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
authors.forename: Maximilian R
authors.initials: MR
authors.lastname: Ralston
authors.affiliation: Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: O'Neill
authors.affiliation: Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Wigmore
authors.affiliation: Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK. Electronic address: ewen.harrison@ed.ac.uk.
authors.forename: Ewen M
authors.initials: EM
authors.lastname: Harrison
mesh_terms: D003142:Communication; D004739:England; D013502:General Surgery / Q000706:statistics & numerical data*; D006801:Humans; D007494:Ireland; D016012:Poisson Distribution; D061108:Social Media / Q000706:statistics & numerical data*; D012955:Societies, Medical / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States
keywords: Education & training; Organisational policy; Public influence; Social media; Surgical colleges