Is TikTok The Next Social Media Frontier for Medicine?

With 72% of the public participating in at least one social media platform, technology has become influential in allowing online communities to interact and share information surrounding similar problems, solutions, and insights. ¹ Social media platforms represent some of the most recent community‐oriented applications allowing Lave and Wegner’s original concept of “communities of practice” (CoP) to be expanded beyond the walls of an institution. ² , ³ These virtual communities allow for users to develop, retrieve, and explore content generated by others at their convenience irrespective of time or place. The wide range of available platforms facilitates the sharing and distribution of knowledge in a variety of formats. ⁴ The medical education CoP has harnessed the influence of social media to enhance relationships and to share, discuss, and debate a wide variety of interests and key issues with colleagues and experts from around the world. ⁵ , ⁶

The field of public health has successfully harnessed these CoP and the wide‐reaching abilities of social media to deliver information to the public, most recently apparent during the coronavirus disease of 2019 (COVID‐19) pandemic. ⁷ , ⁸ TikTok, a video‐based social media platform, has recently been described as a new potential platform to disseminate public health information amidst the COVID‐19 pandemic. ⁸ Due to the app’s wide‐reaching influence, with over 800 million users worldwide and an average use of 52 minutes a day, it is an ideal platform to disseminate information to a large group of people. ⁹ During the COVID‐19 pandemic, many news outlets discussed the use of TikTok by medical professionals to disseminate facts and dispel myths related to the disease. Many users of the app itself have also developed content to help clarify questions about the disease. These videos have reached millions of viewers and gained popularity, most notably a video receiving more than one million views on how to properly don and doff gloves. In fact, a manual search of the hashtag “coronavirus” on the TikTok app returns 90 billion views, demonstrating the extensive reach of this platform.

TikTok’s public health impact is seen beyond the COVID‐19 pandemic as well. A search performed within the TikTok application revealed the hashtags “medicine” and “doctor” received 1.4 billion and 6.7 billion views, respectively. Medical professionals, such as Dr. Rose Marie Leslie (@drleslie), have used the platform to share videos with the public on topics ranging from vaping‐associated lung injury and the importance of a primary care doctor to her video explaining symptoms of COVID‐19, which has been viewed 4.3 million times. Another anonymous account (@medicineexplained), dedicated to soliciting and answering common medical questions from the community, boasts 1.1 million followers with over 16 million likes. The same profile has less than 1,000 Instagram followers and 127 YouTube subscribers, representing an example where content and target audience can differ between TikTok and other social media tools.

This can have significant public health implications. With 41% of TikTok users between the ages of 16 and 24, this is the ideal platform to disseminate public health information pertaining to this age group (e.g., safe sex practices, substance abuse, and mental health issues). ⁹ Prominent organizations working to address adolescent health issues should consider going to the location of their target audience and using TikTok to deliver reliable information to this age group, which comprises almost half of the viewership. In addition, these organizations could employ the help of already influential social media figures to deliver and enhance their message. TikTok is already being used to answer common medical questions for the public but could be expanded to explain specialty‐specific procedures and educate potential patients to reduce confusion or concern about interacting with the medical system.

Beyond public health, TikTok also has particular relevance in medical education. Social media platforms, such as Twitter and Instagram, are already utilized in medical education through direct instruction of clinical concepts, disseminating evidence‐based medicine, and active sharing of educational blogs and podcasts. ⁵ , ¹⁰ , ¹¹ However, there is little organized data on the use of TikTok for this purpose. Educators are already working to use this platform as an innovative way to enhance medical education to both the public and other medical professionals. As of August 2, 2020, the hashtag “MedEd” has over 4.6 million views on TikTok. Content ranges from discussing anatomy lessons to breaking down concepts learned in medical school and demonstrating lifesaving procedures.

The use of video‐based platforms (e.g., Vimeo and YouTube) for medical education is not a new phenomenon. YouTube has previously been utilized to share clinical skills and topic‐based educational videos globally. ¹² With the average YouTube video being just over 11 minutes in length, it is ideal for more extensive topic discussions but may limit the ability for the learner to stay engaged. ¹³ In contrast, the video‐based social media platform TikTok is centered on videos limited to 60 seconds. As residency programs and national conferences incorporate more “rapid‐fire” style lectures, TikTok encourages active learning with shorter, condensed content delivery. ¹⁴ , ¹⁵ , ¹⁶ Similarly to when selecting appropriate content for a rapid‐fire–style lecture, certain topics appropriate for the 60 seconds allowed in a TikTok video must be chosen carefully. Examples of these topics include proper bagging technique (200,000 views) and how to properly don and doff personal protective equipment (1,000,000 views).

Additionally, the use of identification hashtags on TikTok allows users to post multiple videos in succession on the same topic resulting in a thread of related posts. This creates a series of “on‐demand” videos for users and an opportunity for spaced repetition learning. TikTok also provides a sense of community by allowing users to respond to videos and follow others with similar interests. Whereas traditional video‐based technologies might be better suited for more comprehensive videos discussing complex topics, TikTok allows for shorter, high‐yield content with a focus on rapid identification of key points and engaging presentations.

Finally, certain medical topics conducive to a 60‐second video can be adapted to this platform though the use of various educational methods. Just‐in‐time training is a method of education where the training occurs in close proximity to the clinical environment or encounter in a focused and concise manner. ¹⁷ This has shown educational benefit in a number of studies, although sessions typically range from 3 to 20 minutes in duration. ¹⁷ , ¹⁸ , ¹⁹ Alternatively, the idea of microlearning is to provide a series of short, 1‐ to 10‐minute educational activities designed to break down a topic into smaller portions and then accessed through the use of interactive multimedia. ²⁰ , ²¹ Microlearning educational interventions have demonstrated an improvement knowledge and confidence in performing procedures, retaining knowledge, studying, and engaging in collaborative learning. ²¹ The short, easy‐to‐view videos available on TikTok can take advantage of both of these methods of education. For example, learners could quickly review ultrasound techniques or procedural training immediately prior to performing the examination or procedure. By searching for a unique identification hashtag, this would provide an instantly available resource of high‐yield, short instructional videos on one topic to reinforce a learner’s knowledge about the desired topic.

Although text‐ or image‐based applications, such as Facebook, Twitter, and Instagram, also contain embedded videos, these applications are primarily centered around text or still images, thereby limiting the type and amount of information that can be shared. For example, each Twitter post, or “tweet,” can only contain 280 characters, severely limiting the content that can be delivered in each posting. Both Facebook and Instagram allow for a single user to link their own posts and videos together to watch in succession, but these are limited to content from that original user. TikTok users can view a stream of content, but the application also empowers people to comment and post response videos on a specific topic thereby allowing a more fluid discussion. Additionally, TikTok allows for these narratives to be augmented by images, text boxes, and music similar to Instagram. With the ability to publish short videos in succession, linked using an identification hashtag, TikTok provides the opportunity to present content with more detail than can be contained in a tweet but in a more succinct and engaging fashion than might be present in a YouTube video.

General limitations of using social media to spread medical information have been discussed previously and include issues with undisclosed conflicts of interest, unchecked spread of misinformation, difficulty identifying source credibility, and the need to filter through large amounts of noise and false information. ⁸ , ²² Challenges specific to TikTok include less space for accounts to list credentials and the absence of a system to verify reliable sources of information similar to the blue checkmark indicating the authenticity of an account on Twitter. These limitations place younger, more vulnerable patient populations at risk of being persuaded by social media influencers. ² Another challenge is that TikTok restricts videos to 60 seconds or less, limiting the depth of information conveyed in a given video. Additionally, other apps have been released with similar features to TikTok including Instagram Reels, Zynn, Triller, Byte, and Dubsmash in an attempt to gain a portion of the market share, possibly resulting in movement of individuals away from the initial platform and fragmenting the audience. ²³ , ²⁴ , ²⁵

Despite these potential limitations, TikTok offers significant benefits for public health and medical education. In an age where the use of social media is becoming more pervasive in our lives, the medical community should consider harnessing the unique characteristics of TikTok to deliver information to patients as well as for targeted training for medical education.

AEM Education and Training. 2021;5:1–4