Grey’s Anatomy, Doctors, Educators & The Effects of Twitter?

Falling dominoes with twitter logo in lower left

Effects of Twitter?

I’ve had a couple health issues & have been in bed for about a week. (Nothing life threatening–if you were worried.) It gave me some time to catch up on Internet TV–when the 300 channels or so on my satellite were less than appealing. I hadn’t watched Grey’s Anatomy in about a year, but after a week, I’d about exhausted my options. So I watched season 7’s episode 13, “Don’t Decieve Me (Please Don’t Go)” http://watch.ctv.ca/greys-anatomy/season-7/greys-anatomy-ep-713-dont-deceive-me-please-dont-go/#clip412517 There are several plots running though the episode, but the subplot that interested me here was Bailey’s use of Twitter.

The Twitter Sub-Plot Summary

For those of you who don’t watch the show, all you need to know is that there are 2 surgeons in this part of the story–Bailey & Webber. Webber is older, the chief. Webber is doing a procedure in the OR while the residents looking on all have their mobiles out–apparently texting. When Webber tells them to put the things away, one resident explains that they are actually tweeting following another procedure in another OR on Twitter–an OR that was full. The full session being tweeted was Dr. Bailey’s. This gets Webber in a bit of a flap. He tells Bailey that she’s not allowed to tweet any more until he’s looked into this Twitter thing. Bailey points out that she has consent forms, she’s reaching a wide-audience of students–which is good for the teaching hospital, and that if the patient starts coding (going critical) she stops tweeting. [What she doesn’t mention, is that one of the observers actually does the tweeting and relays questions, comments, etc. to Bailey as Bailey does the procedure.] Regardless, Webber says no more tweeting until he looks into it and OK’s it.  

During her next procedure, Bailey is convinced to tweet when the doctor-observer in her OR points out that this is the 3rd procedure for the patient, Bailey now has a following–even from Australia, the followers want to know the outcome for the patient, and since Webber doesn’t use Twitter, he’d never know. As you can imagine, in typical TV fashion, Webber just happens to be researching Twitter at that particular time. With the help of a fellow doctor, Webber locates Bailey’s Twitter stream and sees the procedure being tweeted. He rushes into the OR to stop her. While he’s reprimanding her, something goes sideways in the operation. The doctor-observer continues to tweet and they get suggestions & questions from doctors at other hospitals via Twitter–one of whom was a previous resident under Webber. Basically, they get free consult and options they hadn’t considered–and are able to reach beyond the resources of their one hospital to save the life of a patient. During the surgery, Bailey leaves to get something from one of the hospitals who tweeted support, and Webber is left holding the bag and fielding tweeted questions on this procedure and others via Twitter.  Post procedure, it has him diving back into a fellow doctor’s old personal hand written journals to rediscover a procedure he had mentioned in a tweet but couldn’t remember entirely at the time. As you can imagine, he’s now hooked to an extent & Bailey gets permission to continue tweeting on her next procedure. As Bailey leaves his office, Webber asks her to tweet the procedure that he rediscovered in the hand written journal during her next procedure on Twitter.

Episode’s Twitter Use Reflect Reality?

You bet. There are numerous hospitals using Twitter to tweet procedures as done in this episode. You can read here how Henry Ford surgeons Twitter from OR:  http://www.healthcareitnews.com/news/henry-ford-surgeons-twitter-or. Here you can find the 2009 Top Hospitals on Twitter: http://ebennett.org/top-ten-hospitals-on-twitter/. To put this in professional perspective, imagine a teacher-observer, or student-teacher, in your classroom tweeting what you do from the moment you start class to the end of class.  For us, I think the closest parallel would be lecture capture systems–more prevalent at the post secondary levels–but alone it lacks the social networking aspect.

Episode’s Twitter Message

Clearly, Twitter is shown in a favourable light in this particular episode: 1) hospital and patient get access to more doctors’ knowledge, ideas, and suggestions; 2) the field is enlightened as various doctors can follow the procedure, ask questions, get answers, & learn; 3) the hospital–especially as a teaching hospital–has its profile raised especially among today’s mobile-friendly population; 4) the mention of Australia, gives us the notion of the global boundaries that can be transcended by technology; 5) the mention of reconnect with an old student, gives us the sense of the social connections & reconnections–as well as learning relationships–that can be built and maintained via technology–extending face-to-face professional learning networks. It’s all rosy–and when technology and social networking are used professionally and responsibly, I agree Twitter can be great.

Role of the Technologically Cautious & Issues for Rising Professionals

If you are a committed “bleeding edger” with regard to technology, you may never understand the important balance that the technologically cautious like Webber or the technologically fearful can provide. Their voice, in my opinion, is a critical check & balance in the technology adoption process. They help us to move beyond the rosy picture to think about what could go wrong, why people might be fearful, weigh the potential concerns. Sometimes those extra moments of consideration help us to envision what other relevant issues might arise–issues only the technologically savvy might envision when they take the time. In my opinion, when implementing newer technologies, we need to think about what could go sideways, BEFORE it does, in order to prepare for it, prevent it, or at the least mitigate it if it does happen.

As the episode was unfolding, I found myself at first judging Webber for his slower uptake of technology–but then asked myself, as “Chief” what would be his concerns beyond personal discomfort with learning a new technology. One issue that extra moment rasied for me was, what happens when a doctor makes a decision that could be considered “problematic” or “wrong” by others. If it’s tweeted, it’s permanently out there for the world to see & critique; it would reflect on the the hospital, the Chief, and the doctor’s colleagues–ultimately the profession as a whole. It could be fodder in a malpractice suite. People make mistakes all the time–it’s part of our learning process. Experienced professionals tend to make fewer of these–especially public ones–otherwise their professional longevity is questionable. What about as we’re rising up through the ranks of a profession? What then? Do we have ‘allowances’ for errors or misjudgement? As professional elders, or administrators, are we more constrained in dealing with these errors or misjudgement when they become a matter of the digital public record?  Do we ask students and rising professionals to stay off social media where their every posting is open to public, global, scrutiny? What training do we provide? What guidelines?

Tweeting Affect Decision Making Processes & Professional Behaviour?

This led me to other questions. Does Twitter effect choices made by doctors in a tweeting OR? Would doctors tend to take fewer risks, be less innovative if their every action could be scrutinized by professionals around the world via twitter? If a doctor has a personal need for fame, would it make that doctor more inclined to take risks? Would tweeting from an OR make doctors more thoughtful in their choices–more carefully weighing outcomes now that their actions and decision-making processes are revealed & set in digital stone for later review? Would they second-guess themselves and thereby have confidence issues? Have doctors and the tweeting hospitals considered these factors and accounted for them by setting parameters re. what procedures may be tweeted, by whom, and when?

It has been the claim that putting students’ content on the internet can make for higher quality product–students know the world is watching and want their work to reflect well upon them, but students have the time to make drafts, edit, and post polished work. Tweeting from an OR is the professional equivalent of  having a teacher-observer, or student-teacher, in your classroom tweeting what you do from the moment you start class to the end of class–fielding comments, questions, suggestion based on the parameters you may outline–or maybe you didn’t. You’d know they’d be tweeting–but still what would be the effects on your instructional style and interaction with the students? What happens when you forget they are there? What happens if you make an error in judgement? What if you had a bad day?

Perhaps in the education profession, our closest parallel is today’s lecture capture systems (primarily at post-secondary) at least as far as the issue of what happens when things go sideways and it’s captured in the digital public record.  Does lecture capture affect your inclination to take instructional risks? What if you have a bad day–and it’s the day you forget that there’s a lecture capture system running because you’ve gotten so used to it? Case in point is that of Carnegie Mellon University’s  Professor Talbert when he went sideways about an “overly loud yawn” during a lecture to HA 1174. If you haven’t seen the video, watch it and see for yourself: http://www.youtube.com/watch?v=QuLaQoQP9oo  I was so stunned by it, that I quickly dragged 2 colleagues to see it. One thought it was a hoax. This was not a hoax video–research revealed it was taken from a lecture capture system. I’ve had bad days in class as I’ve come up through the ranks. What if they were captured for posterity and came to define my teaching? I recently read an article that some US States will start recording class sessions for teacher evaluation–where a 3rd party goes into the class and records it for others to review and critique. These are pilot projects leading toward a wider scale US evaluation process. 

Ultimately, lecture capture is a poor cousin to Tweeting in respect to immediate feedback, suggestions, questions, and support when dealing with an instructional issue, procedure, or strategy for our students. In education, it is far more likely that we will be gaining this kind of support asynchronously in face-to-face situations, though digital or blended instructional environments may lend themselves more toward synchronous, real-time, discussions about at class and its students as it unfolds–much like the OR.

 The are interesting questions, that have me pondering what the implications might be for both the medical and educational professions.

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