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The impact of social media on a major international emergency medicine conference
  1. Andrew Neill1,
  2. John J Cronin2,
  3. Domhnall Brannigan3,
  4. Ronan O'Sullivan4,
  5. Mike Cadogan5
  1. 1Emergency Department, St Vincent's University Hospital, Dublin, Ireland
  2. 2Department of Emergency Medicine, National Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
  3. 3Emergency Department, Royal Hobart Hospital, Hobart, Tasmania, Australia
  4. 4Paediatric Emergency Research Unit (PERU), Department of Emergency Medicine, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
  5. 5Department of Emergency Medicine, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia
  1. Correspondence to Dr Andrew Neill, Emergency Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland; andyneill81{at}


Objective To report on the presence and use of social media by speakers and attendees at the International Conference on Emergency Medicine (ICEM) 2012, and describe the increasing use of online technologies such as Twitter and podcasts in publicising conferences and sharing research findings, and for clinical teaching.

Methods Speakers were identified through the organising committee and a database constructed using the internet to determine the presence and activity of speakers on social media platforms. We also examined the use of Twitter by attendees and non-attendees using an online archiving system. Researchers tracked and reviewed every tweet produced with the hashtag #ICEM2012. Tweets were then reviewed and classified by three separate authors into different categories.

Results Of the 212 speakers at ICEM 2012, 41.5% had a LinkedIn account and 15.6% were on Twitter. Less than 1% were active on Google+ and less than 10% had an active website or blog. There were over 4500 tweets about ICEM 2012. Over 400 people produced tweets about the conference, yet only 34% were physically present at the conference. Of the original tweets produced, 74.4% were directly related to the clinical and research material of the conference.

Conclusions ICEM 2012 was the most tweeted emergency medicine conference on record. Tweeting by participants was common; a large number of original tweets regarding clinical material at the conference were produced. There was also a large virtual participation in the conference as multiple people not attending the conference discussed the material on Twitter.

  • Communications
  • Education
  • Environmental Medicine

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International conferences have a key importance for any medical specialty. They provide a forum for education, research, collaboration and development of the specialty concerned. Despite the rise of modern communication technologies, physical conferences continue to grow and maintain popularity. Attendance and participation at such conferences is encouraged and credited as part of training programmes and continuing professional development.

The 14th biennial International Conference of Emergency Medicine (ICEM), the official scientific meeting of the International Federation for Emergency Medicine, was held in Dublin, Ireland in June 2012. The 4-day long conference is organised by a committee formed by the Emergency Medicine (EM) faculty of the host nation, in this case the Irish Association for Emergency Medicine, Approximately 2400 people (delegates, speakers and industry included) ultimately attended the conference.

Modern web-based communication technologies (eg, Twitter, Skype, blogs and podcasts) have the potential to add another dimension to the conference experience for speakers, delegates and others who are not able to attend in person. There have been several recent studies describing the presence and role of Twitter in education reflecting the idea that participation can be extended beyond the classroom or conference hall.1 However, there remains a paucity of data describing how emergency physicians (EPs) use such platforms. The activity of physicians at conferences using Twitter has been described previously2 but the activity of EPs specifically has only been described in brief.3

This study was designed to examine the role of social media technologies at ICEM 2012. We examined this in two parts: (1) the social media presence of the speakers at ICEM 2012; and (2) a demographic analysis of people who were actively tweeting about ICEM 2012; a content analysis of the tweets was produced regarding ICEM 2012. We aimed to demonstrate the use of Twitter in particular as a valuable resource for disseminating clinical information to an international audience and promoting and facilitating the ultimate aims of an international medical conference.


We obtained a list of all speakers at ICEM 2012 from the local organising committee. From this we created a database of conference speakers and using each platform's search facility, three of the authors (AN, JJC and MC) determined if each speaker had an account with the following social media services:

  • Twitter

  • LinkedIn

  • Google+

  • An independently run website or blog.

The presence of a conference speaker on any of these services was validated by either:

  • Self-identification in the profile section; or

  • Personal contact from the researchers.

We also determined if the speaker had an independent blog or website by searching for their name with Google or following links from personal profiles in any of the services mentioned above. Speakers were only considered in this category if they had an active and recognisable participation in the content of a website with or without interaction with an audience. Web pages with faculty profiles were excluded. This database was then reviewed by two other authors (DB and JJC) and any missing social media accounts were added.

The website provides an archiving and analytic service for all tweets produced about a specific healthcare conference. Prior to ICEM 2012 one author (MC) registered the hashtag #ICEM2012 with Symplur and people tweeting at or about the conference were encouraged to include the hashtag (see table 1) #ICEM2012 in every tweet related to the conference. Following the conference we obtained a pdf file from containing every tweet produced with the hashtag #ICEM2012. This included date, time and a link to the Twitter account of the user who produced the tweet. Using this file and data collected from the Symplur and Twitter websites we were able to determine the number of individual people tweeting about the conference. We also determined the country of origin of the individual and whether they were attending ICEM 2012 through either personal contact at the conference or from the explicit nature of the tweet produced. If it was unclear whether or not the individual had attended the conference we considered them to be absent.

Table 1

Glossary of Twitter terms

The total number of people tweeting about the conference included those who ‘re-tweeted’ a tweet produced by someone at the conference. During the conference it was noted that some people were using the hashtag #ICEM12 when tweeting about the conference and these tweets were retrieved separately using the Twitter website.

We divided tweets into five different categories based on content using the following definitions:

  • Session related

    •  – Tweets related to a specific track/session of ICEM 2012 including discussion on Twitter between those attending and those not attending ICEM 2012

  • Social

    •  – Tweets relating to meeting new people and/or arranging unofficial ICEM 2012 meetings

    •  – Tweets that were jokes/humour not related to a specific session

    •  – Tweets on the general atmosphere of ICEM2012

    •  – Tweets about Twitter

  • Logistic

    •  – Tweets alerting participants to official ICEM2012 events/sessions/talks/activity

    •  – Includes tweets promoting an individual's research/poster presentations

  • Advertising

    •  – Tweets by companies/persons advertising and promoting commercial products/services, especially those companies present at ICEM2012

  • Other

    •  – Tweets not falling into these categories

Only original tweets or replies were included in this analysis. Re-tweets were not included. To ensure reproducibility of categorisation, two researchers (AN and JJC) performed the same categorisation on tweets from day 1 and a comparison was made to demonstrate inter-rater agreement.


There were 212 speakers at ICEM 2012. The vast majority (94.8%) of the speakers had a background in EM. The number of speakers with an active social media account with one of the studied providers is shown in figure 1; 15.6% were on Twitter, 41.5% had a LinkedIn account, 0.9% were on Google+ and 9.4% had an active website or blog. In those with Twitter accounts, followers ranged from 0 to 4890 (median=12), representing a wide range of activity, influence and reach on Twitter.

Figure 1

Social media accounts of International Conference on Emergency Medicine 2012 speakers.

There were a total of 4692 tweets about including the hashtag #ICEM2012 in the 8-day period before, including and after the conference. Of these, 3224 (68.7%) were original tweets and 1468 (31.3%) were re-publishing of a tweet written by someone else (known as re-tweets).

There were a total of 401 individuals who tweeted using the hashtag #ICEM2012. There was an average of 11.48 tweets per individual with the top 10 tweeters providing 52.4% of the tweets at the conference. Seventy-three (34.4%) of those tweeting were physically in attendance at ICEM 2012. From the information available there were 19 different countries represented in the tweeters.

Content analysis of the tweets (not including re-tweets) is shown in figure 2. Of 3224 tweets, 74.4% were session related, 19.6% were social, 3.8% were logistic, 1.7% were advertising and 0.5% were unclassified. The agreement on day 1 of the conference (622 tweets, representing 19% of total tweets analysed) is presented in table 2.

Table 2

Agreement between reviewers on tweet content

Figure 2

Content analysis of International Conference on Emergency Medicine 2012 tweets. tracks both the author and reader of any individual tweet. Every time a tweet is read with a specific hashtag it is recorded as an impression. A user with more followers on Twitter will create more impressions. There were a total of 3 123 304 impressions with the hashtag #ICEM2012.


EPs have shown a keen interest in incorporating new media, such as blogs, podcasts and Twitter into both their clinical practice and for educational purposes. A recent study found 672 self-identified EPs on Twitter4 and since initial publication this number has now risen to over 750.5 The EM and critical care website maintains a directory of EM blogs and podcasts. It has documented a rise in the number of EM blogs and podcasts from 67 to 132 over an 18-month period.6 At least one EM training programme is now incorporating such online educational activity into their residency programme in a process sometimes referred to as ‘asynchronous learning’.7

There is currently no published data to compare new media use by EM as a specialty compared with other medical specialties, but several published studies have looked at the use of Twitter at medical conferences.

Deasi et al examined Twitter activity at a nephrology conference in 2011 with 10 000 participants. They considered over a third of the 1000 tweets produced at the conference to be advertisements, whereas our study only found 1.7% of tweets were advertising-related despite the significant number of vendors being present at ICEM 2012.2 Nomura et al reported on activity at the recent American College of Emergency Physicians (ACEP) 2010 Scientific Assembly and the Society for Academic Emergency Medicine (SAEM) 2011 conference, and found that there were 846 and 766 tweets produced respectively. This was significantly lower than that produced at ICEM 2012 despite nearly 6000 attendees at the ACEP conference and 2300 at SAEM. They found a similar number of original tweets (50.5% and 67.1%, respectively) and session related tweets (78.7 and 85.2%, respectively).3

With regard to the specific context of ICEM 2012, we have shown that multiple people were engaged in talking about ICEM 2012 on Twitter and that the vast majority of tweets and conversations were regarding the clinical and research activity taking place at the conference. Sixty-five per cent of those engaging online with the conference on Twitter were not at the conference, demonstrating that new media can extend the geographic reach of an international conference far beyond the bounds of the conference hall.

There were significantly more tweets produced at ICEM 2012 compared to the two studies mentioned above (ICEM 2012: 4692; Kidney Week 2011: 993; ACEP 2010: 846; SAEM 2011: 766). ranked ICEM 2012 as the 4th most tweeted medical conference on record and the most tweeted medical conference on a pro-rata basis.

The potential significance of Twitter as an educational tool was examined in a recent review of 21 studies.1 Of the 21 studies reviewed, all found a positive response to the use of micro-blogging platforms such as Twitter. Multiple facets to the benefit were found, including student–instructor interaction, the asynchronous nature of learning and the importance of socialised adult learning.

Figure 3 is an illustration of the connections and conversations produced around the #ICEM2012 hashtag. This is constructed by using replies to tweets, and illustrates the connections formed between different users on a specific topic. The size of any particular point on the image demonstrates the number of connections and conversations focused around that user's tweets.

Figure 3

Network centrality analysis.

The use of Twitter to communicate and share educational ideas is only one facet of what has been collectively termed ‘free open-access meducation’ (FOAM). There are multiple websites, blogs, videos and podcasts all freely available in the public domain that provide the educational and information sharing role traditionally confined to textbooks, journals and conferences.

Various websites provide continuously open access ‘webtexts’8 ,9 and there are multiple online ‘journal club’ style websites10 ,11 that discuss, respond and critique the peer-reviewed literature (something traditionally confined to the ‘letters’ section of most journals). Such activity has been recently recognised in the appointment of Michelle Lin as the first academy chair in emergency education which has direct links to her online educational activity on her website.12 It is important to note that the growth of FOAM has been largely independent of traditional publishing models. Furthermore, there has been criticism of traditional peer-reviewed journals for their hesitancy and reluctance to embrace the new media,13 though it should be noted that most major journals now have an active Twitter account, website and occasionally even podcasts.

Anecdotally, numerous physicians have raised concerns that the lack of traditional peer-review in free, open-access, online medical education may lead to incorrect or poor quality information being provided. While this is a reasonable concern there is currently little evidence either to refute or support the claim.


While separate authors reviewed the database of ICEM 2012 speakers to ascertain social media presence, it is of course possible that we missed some accounts and underestimated the presence of speakers on contemporary social media services. With regard to content analysis of tweets, we did not have sufficient data to provide a κ value on agreement between reviewers but the raw data suggests that there was substantial agreement. We have demonstrated that participants at ICEM 2012 were highly active on Twitter and that the discussions were largely related to the clinical material of the conference, but it is harder to determine the significance and impact of such conversations with regard to changing clinicians’ practice. Such a question would be better answered with a qualitative analysis of the tweets produced and specific conversations about certain clinical questions.


At ICEM 2012 there was significant use of the social media platform Twitter for communication of research findings and clinical teaching. This activity was substantially greater than that reported at other large, recent EM meetings. This activity was led mainly by a relatively small number of participants but had significant extension to people not attending the conference. Speakers at ICEM 2012 had limited online presence and activity in the various web platforms examined.


We would like to thank the organising committee of ICEM 2012 for providing the list of speakers. We would also like to thank Audun Utengen of for help with clarifying certain statistical details.



  • Contributors MC, AN and JJC conceived the study and developed the databases. AN, JJC and DB provided the content analysis. AN drafted the manuscript with direction from ROS, JJC and DB.

  • Competing interests AN, JJC, DB and MC run freely provided, open-access websites and podcasts that provide EM educational material.

  • Provenance and peer review Not commissioned; externally peer reviewed.