A randomized controlled trial of curated X exposure for cardiac point of care ultrasound education

Abstract Background X (formerly known as Twitter) is a social media platform with a robust online medical education community, including point-of-care ultrasound (POCUS) content. Objective Our study aimed to determine if following curated POCUS education accounts on X translated to improved cardiac image interpretation competency. Methods We conducted an unblinded parallel-group randomized controlled trial at three internal medicine residency programs and two medical schools. Participants were third- and fourth-year medical students or internal medicine residents. They followed either 10 POCUS education accounts on X (T) or 10 generic medical accounts on X (C) for three months. Participants took a survey and a 15 multiple-choice question assessment before and after the protocol. Results Twenty-nine participants completed the protocol, 13 T and 16 C. Mean changes in image interpretation scores were T: -0.02% and C: +0.02%, which did not significantly differ (p = 0.46). A simple linear regression evaluating for correlation between average time spent on X and change in image interpretation scores among the T participants did not show a significant correlation (R squared – 0.0002, p = 0.96). Conclusions Natural X exposure to educational POCUS accounts did not result in statistically improved image interpretation scores, but this outcome was likely affected by limited sample size, different participant experiences, and other variables. Data from this novel trial design can better inform future studies on medical education with social media.