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How academic physicians can benefit from social media
Cómo pueden beneficiarse los médicos académicos de las redes sociales
a Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Filadelfia, PA, United States
b Anesthesiology, Duke University School of Medicine, Durham, NC, United States
c Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United States
d Anesthesiology, Perioperative and Pain Medicine, Stanford University, School of Medicine, Palo Alto, CA, United States
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Schwenk, A.D. Udani, R.K. Gupta, E.R. Mariano" "autores" => array:4 [ 0 => array:3 [ "nombre" => "E.S." "apellidos" => "Schwenk" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "A.D." "apellidos" => "Udani" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "R.K." "apellidos" => "Gupta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:4 [ "nombre" => "E.R." "apellidos" => "Mariano" "email" => array:1 [ 0 => "emariano@stanford.edu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Filadelfia, PA, United States" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Anesthesiology, Duke University School of Medicine, Durham, NC, United States" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United States" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Anesthesiology, Perioperative and Pain Medicine, Stanford University, School of Medicine, Palo Alto, CA, United States" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cómo pueden beneficiarse los médicos académicos de las redes sociales" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Prior to online journal publication, physicians and researchers in academic medicine waited each month for hard copies of their latest journal issues to arrive in the mail. Articles in other journals were simply overlooked. Online publication and the proliferation of search engines increased exposure of scientific publications, but social media has taken this several steps further. New research articles are often published online prior to print and can be rapidly disseminated worldwide via social media. Twitter (San Francisco, CA, USA; <a href="https://twitter.com/">https://twitter.com/</a>) and Facebook (Menlo Park, CA, USA; <a href="https://www.facebook.com/">https://www.facebook.com/</a>) in particular have changed the way information is shared in academic medicine and anesthesiology. Since we cannot possibly cover all social media in this brief review, we will focus on how these two well-known platforms have been integrated into academic medicine through Twitter journal clubs, and have been used to enhance medical conferences and promote the sharing of clinical experiences and scholarship. We share our own original survey results in the subspecialty of regional anesthesiology and pain medicine. We also suggest some ways to improve effectiveness of social media communication and briefly introduce some less extensively studied platforms that may be useful to academic physicians in the future.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Twitter and Facebook in academic medicine</span><p id="par0010" class="elsevierStylePara elsevierViewall">Twitter is a social media platform that allows its users to create “microblogs,” known as tweets, with a maximum of 140 characters and the ability to attach photos, videos, or links. Although Twitter has existed since 2006, it only gained popularity in academic medicine circles relatively recently. Different medical specialties have embraced Twitter to varying degrees. In radiology, for example, a recent study reveals that 60% of survey respondents use Twitter for professional purposes.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> A cross-sectional study of Canadian plastic surgeons, on the other hand, shows that only 16% use Twitter.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">2</span></a> The reasons for this disparity are not completely clear and are beyond the scope of this review. However, the increasing importance of social media in facilitating communication among physicians and between physicians, other healthcare professionals, and patients is undeniable.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Twitter anesthesiology journal club–#AnesJC</span><p id="par0015" class="elsevierStylePara elsevierViewall">One way that Twitter promotes learning among physicians in academic medicine is through Twitter journal clubs. This concept builds on the traditional model of journal club but invites global participation from the Twitter community. Within the specialty of anesthesiology, the Department of Anesthesiology at Duke University School of Medicine has taken the lead in launching a regular Twitter anesthesiology journal club approximately three times a year. Udani and colleagues report that this Twitter-based anesthesia journal club, combining the model of a live meeting attended by residents and faculty and week-long interactive discussion online (Twitter “chat”) enhances the learning experience for residents and increases the rate of professional Twitter use.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">3</span></a> This Twitter-based journal club can be identified by the phrase “#AnesJC” which is one example of a “hashtag” on Twitter. A hashtag is a word or phrase beginning with the symbol “#” and is used on social media websites and applications to conveniently group comments and conversations with a common theme.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">4</span></a> A hashtag is akin to a keyword that participants can search for and use in their tweets to contribute to a specific discussion; in this case, including “#AnesJC” in a tweet instantly adds the user's comment or question to the anesthesia journal club conversation. Twitter journal club conversations are not constrained by traditional paradigms of a live meeting such as limited time frame or physical presence during the discussion. The weeklong #AnesJC facilitates meaningful education-focused discussions among anesthesiologists from around the world.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Twitter-enhanced medical conferences</span><p id="par0020" class="elsevierStylePara elsevierViewall">Another major way Twitter has been integrated into academic medicine is through its proliferation at major medical conferences. This has been well documented in multiple specialties such as anesthesiology, surgery, radiology, and urology, among others.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">5–9</span></a> It has been suggested that a focused pre-meeting social media campaign may increase Twitter engagement at such meeting.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a> A few of the benefits of a robust social media presence at national meetings include continuation and expansion of scientific discussions from meeting sessions with Twitter participants not in attendance, dissemination of learning points from multiple concurrent sessions, the ability to interact in real-time with international experts on Twitter and draw them into conversations on topics discussed at the meeting, and possibly increased publicity for the medical conference itself and host society. To take this further, Stanford University's Medicine X<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a> conference deliberately includes patients in the virtual discussion and live meeting as speakers, thereby helping to forge relationships and potentially lay the groundwork for patient-centered innovation in healthcare. Novel ideas involving social media like this may shape the future of medical conferences. There are theoretical concerns about “virtual attendance” through social media negatively affecting live conference registration, so this may be an important metric to track as conference social media use continues to grow.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Twitter-enhanced anesthesiology conferences</span><p id="par0025" class="elsevierStylePara elsevierViewall">In academic anesthesiology, there has been a concerted effort to measure and increase social media engagement. Many anesthesiology meetings worldwide have a dedicated conference hashtag (e.g., #ANES17 for the 2017 American Society of Anesthesiologists annual meeting, #ESRA2017 for the 2017 annual meeting of the European Society of Regional Anesthesia and Pain Therapy). In their recent publication, Schwenk and colleagues provide important data showing trends in social media engagement and onsite attendance for two consecutive spring annual meetings of the American Society of Regional Anesthesia and Pain Medicine (ASRA).<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a> A comparison of the 2015 and 2016 meetings showed that live attendance had decreased by 154 registrants. However, the number of original tweets generated from 2015 to 2016 using the hashtags #ASRASpring15 and #ASRA_RA16, respectively, increased by 279 (73.6%), and total number of impressions (a measure of delivery to Twitter users) increased by 795,673 (120%).<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a> The majority of tweets produced from these meetings are scientific in nature (77% in 2015 and 73% in 2016) which suggests that Twitter use during medical conferences promotes much greater dissemination of meeting content than can ever be expected from live attendance alone.</p><p id="par0030" class="elsevierStylePara elsevierViewall">At the 2017 ASRA spring meeting, a social media survey was distributed to all attendees in their packets as well as via email. The Thomas Jefferson University Institutional Review Board determined that this survey was exempt from review on March 31, 2017. The survey is shown in supplementary material, and included questions like “Do you currently use Twitter or Facebook?” and “If you do not use Twitter and/or Facebook, why not?” Of the 46 respondents, 88% were practicing physicians with most of the remainder being trainees, and 84% used Twitter or Facebook in some capacity. Professional use of social media favored Twitter with 53% of respondents saying they use Twitter for professional purposes for more than 5<span class="elsevierStyleHsp" style=""></span>min daily versus only 17% who said they use Facebook professionally more than 5<span class="elsevierStyleHsp" style=""></span>min daily. For personal use for more than 5<span class="elsevierStyleHsp" style=""></span>min daily, however, the opposite was true: 34% of respondents use Twitter versus 72% for Facebook. Although we cannot draw definitive conclusions from this single survey, regional anesthesia and acute pain medicine physicians in the United States may be more likely to employ Twitter over Facebook when it comes to professional uses of social media. This observed preference is consistent with previous results in other specialties,<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">11</span></a> and may be reflective of academic medicine in general.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Facebook, with the largest number of social media users worldwide,<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a> provides exposure to a potentially larger audience and has features that allow users to share clinical pearls, comments, and advice via Facebook posts that are not constrained by a 140-character limit like Twitter. On Facebook, there is greater control over who views the content through privacy settings, and users can set up static pages that other Facebook users can visit. These group pages can be established as open or closed groups with members such as “Regional Anesthesia Guided by US” (<a href="https://www.facebook.com/groups/regionalanesthesia/">https://www.facebook.com/groups/regionalanesthesia/</a>) or as organizations such as the New York School of Regional Anesthesia (NYSORA, <a href="https://www.facebook.com/nysora/">https://www.facebook.com/nysora/</a>) that users “like” and follow. These pages can be designed to contain useful educational resources including photos, videos, and updates on future events, such as regional anesthesia workshops hosted by these groups. One disadvantage of Facebook for academic medicine is the potential difficulty in separating personal and professional profiles; this may be the reason why physicians in the United States still turn to Twitter over Facebook for professional purposes, as indicated by both our survey results and those in other medical specialties. In our opinion, researchers should consider sharing new research publications and presentations on both platforms for maximum visibility if possible. A wider network maximizes the chance that another researcher or colleague will view, read, and cite the study but also, most importantly, increases the likelihood that it will affect clinical practice.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Other social media platforms for academic physicians</span><p id="par0040" class="elsevierStylePara elsevierViewall">The definition of scholarship in academics continues to evolve, and social media applications for the academic physician (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) may offer opportunities to share scholarly work and gather metrics that may be useful for appointment and promotion reviews. For most academic physicians, assembling and updating a curriculum vitae (CV) is a way of life, but most CV formats do not accurately reflect the impact of a publication or presentation. Most commonly, these items are included as a bibliography or in a section of invited lectures, respectively. However, appointment and promotion committees within a department and at the institutional level must be able to judge a candidate's influence or “reach” when considering someone for promotion. For researchers in academic medicine who actively publish results in peer-reviewed journals, platforms such as ResearchGate (Berlin, Germany; <a href="https://www.researchgate.net/home">https://www.researchgate.net/home</a>) may help quantify metrics such as number of article reads and citations as well as where in the world people are viewing the article. ResearchGate also helps to connect researchers in similar fields; researchers can contact each other for full-text access to articles and follow each other's projects.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">For clinician educator (CE) faculty,<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> a CV often falls very short of demonstrating the true value of an academic physician's scholarly contributions to medical education. One alternative to the CV for CE faculty is to develop an educator portfolio<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a> that may be designed and managed online using free blogging platforms (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Educational materials can be posted to the portfolio site; page views and other metrics can be gathered using free Google Analytics (Mountain View, CA, USA; <a href="https://analytics.google.com/">https://analytics.google.com/</a>). Full slide presentations can be posted to LinkedIn SlideShare (Sunnyvale, CA, USA; <a href="https://www.slideshare.net/">https://www.slideshare.net/</a>), which has been part of LinkedIn since 2012. SlideShare analytics are free and report the number of views of a slide deck, traffic sources (how people reach the content), and where the viewers reside anywhere in the world. Other free online applications and portals that academic physicians may wish to use to modernize their CVs are listed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="par0050" class="elsevierStylePara elsevierViewall">The increasing presence of social media in academic medicine allows for global interactions that may otherwise not be possible. Studies have established both the popularity and effectiveness of Twitter and Facebook to enhance the academic pursuits of researchers and clinicians. Additional applications like blogging platforms, ResearchGate, SlideShare, and others may enable clinician educators to design and promote their educator portfolios and gather metrics in ways that traditional curricula vitae cannot.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflict of interests</span><p id="par0055" class="elsevierStylePara elsevierViewall">Dr Mariano, through his institution, has received unlimited funding for educational programs from Halyard Health (Alpharetta, GA, USA) and B. Braun (Bethlehem, PA, USA). These companies have made no contribution to this manuscript.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Drs Schwenk, Udani and Gupta have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Introduction" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Twitter and Facebook in academic medicine" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Twitter anesthesiology journal club–#AnesJC" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Twitter-enhanced medical conferences" ] 3 => array:2 [ "identificador" => "sec0025" "titulo" => "Twitter-enhanced anesthesiology conferences" ] 4 => array:2 [ "identificador" => "sec0030" "titulo" => "Other social media platforms for academic physicians" ] ] ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Conclusions" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interests" ] 3 => array:2 [ "identificador" => "xack332721" "titulo" => "Acknowledgements" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-07-28" "fechaAceptado" => "2017-09-12" "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Schwenk ES, Udani AD, Gupta RK, Mariano ER. Cómo pueden beneficiarse los médicos académicos de las redes sociales. Rev Esp Anestesiol Reanim. 2018;65:103–107.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">This article is part of the Anaesthesiology and Resuscitation Continuing Medical Education Program. An evaluation of the questions on this article can be made through the Internet by accessing the Education Section of the following web page:</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0075" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article:<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0050" ] ] ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Platform \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Unique features and advantages \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Disadvantages \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Blog \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Freedom to customize website as much as desired<br>• Ability to create educator portfolio<br>• Free applications available (WordPress, Blogger, Tumblr, Medium, Wix, Squarespace, and others) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Must be regularly updated and maintained<br>• Quality of blog and website sometimes depends on user's familiarity with the platform and technical skills<br>• Creating an audience for the blog can be difficult \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ResearchGate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Ability to share publications among researchers with common interests worldwide<br>• Can directly contact researchers for full-text access to articles<br>• Not tied to a specific journal<br>• Members can receive notifications when other researchers post new publications or project updates<br>• Provides some free metrics such as reads (including location), citations, and composite “RG Score” and h-index that may be useful for comparing similar researchers in a specific field \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Need to learn organization of website sections to facilitate navigation<br>• Regularly sends updates via email (more spam)<br>• Need to be aware of sharing and copyright restrictions when uploading full-text articles \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SlideShare \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Can log in using existing LinkedIn account<br>• Ability to share slide presentations (useful for clinician educators)<br>• Provides some free metrics, such as shares, favorites, views (including location), and downloads<br>• Can add a YouTube video \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Not peer-reviewed<br>• Need to be aware of sharing copyrighted content when posting publicly \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LinkedIn \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Can store and display an online CV<br>• Offers discussion groups (e.g., “Practice of Regional Anesthesia”)<br>• Can post blogs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• May generate a lot of additional email (e.g., “Please add me to your LinkedIn network”)<br>• Not limited to medicine so content may not always be relevant (alternatively may open up networking opportunities) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Doximity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Can store and display an online CV (profiles are automatically created using publicly available information)<br>• Same profile is used by U.S. News & World Report Doctor Finder search engine<br>• Offers discussion groups, HIPAA-compliant secure messaging and fax services \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Limited to clinicians in the United States \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Academia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Can display and organize an online CV<br>• Can create a personal website<br>• Can share articles and contact other researchers<br>• Provides some free analytics such as downloads and views of articles \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Not the easiest interface to navigate \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1662908.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Other free social media platforms applicable to academic physicians.</p>" ] ] 1 => array:6 [ "identificador" => "fig0005" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "mmc1.jpeg" "Alto" => 3332 "Ancho" => 2917 "Tamanyo" => 719371 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Social media survey distributed to attendees of the 2017 Spring annual meeting of the American Society of Regional Anesthesia and Pain Medicine.</p>" ] ] 2 => array:5 [ "identificador" => "fig0010" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "mmc2.jpeg" "Alto" => 3828 "Ancho" => 2917 "Tamanyo" => 756826 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0075" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Professional social networking in radiology: who is there and what are they doing?" 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