About Michelle Lin, MD

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco

When Research Meets Social Media Expertise: Lessons from the PECARN-ALiEM Partnership

PECARN - ALiEM partnership twitter X
From Pipe Dream to Proven Strategy: How a 4-year partnership between PECARN and ALiEM created a replicable framework for evidence-based research dissemination

Sometimes the best collaborations begin with simple questions. Following Dr. Nathan Kuppermann’s grand rounds presentation in 2018, I had the opportunity to discuss an idea with him as PECARN’s Steering Committee Chair: might there be untapped potential in using social media platforms like Twitter to amplify PECARN’s research impact? Five years later, that initial conversation has grown into a reality with a systematic approach and measurable outcomes.

Social media is not just about fads and marketing. In fact, it represents the foreseeable future for information dissemination, even in scientific research, because it meets learners and providers where they already are. Rather than hoping clinicians would stumble upon publications in traditional journals, we should actively bring the research to the platforms they frequently check.

Why Organizational Social Media Requires Strategic Planning

Organizational social media for research dissemination can’t just “do social media.” This endeavor requires fundamentally different approaches than personal academic accounts. While individual faculty might share insights casually or build personal brands, research organizations need systematic frameworks that ensure consistency, maintain academic rigor, and deliver measurable impact.

The critical distinction: institutional social media isn’t about intuition or viral content—it demands rigorous planning, dedicated resources, and iterative optimization based on analytics. Just as we wouldn’t launch a research study without proper methodology and oversight, we shouldn’t approach organizational research dissemination without strategic frameworks and quality control systems.

The Partnership Model: When Research Meets Social Media Expertise

Our approach began with recognizing a fundamental truth: most research organizations lack the specialized expertise needed for effective social media presence. Rather than building these capabilities from scratch, PECARN partnered with ALiEM, leveraging our existing social media infrastructure and experience. What started as an experimental collaboration became a four-year case study, which we recently published in JMIR Formative Research [1]. We share our processes, outcomes, and lessons learned to provide a replicable framework and roadmap for other research organizations considering similar initiatives on Twitter/X (or alternative social media platforms).

The Foundation: Building Sustainable Infrastructure

Organizational Inputs:

  • Research Organization (PECARN) – content expertise and credibility
  • Social Media Experts (ALiEM) – Twitter/X platform knowledge and audience understanding
  • Funding & Leadership Support – executive champions and resource allocation
  • Technical Infrastructure – analytics tools, scheduling platforms, communication systems

The 5-Person Dream Team:

  • Content Writers (2): Physician-researchers who understand both clinical context and platform constraints
  • Peer Reviewers (2): Quality control experts ensuring academic rigor
  • Account Monitors (2): Daily engagement specialists building community
  • Analytics Manager (1): Data scientist tracking performance and optimization
  • Graphic Designer (1): Visual content specialist (added after 2 years based on data)

We created 2-person teams for key roles to ensure sustainability and backup coverage. Faculty have competing priorities, and redundancy ensures consistent output despite scheduling challenges.

pecarn ALiEM twitter X partnership research dissemination architect

What the Numbers Taught Us

The key to our success wasn’t guesswork—it was rigorous analytics tracking and iterative evidence-based improvement. Over the 4 years (2020-23), 569 tweets were published, 99 PECARN journal publications were featured, and we grew an audience of over 2,000 followers.

Tweet-Level Analytics: The Strategy Elements That Actually Work

Through multiple linear regression analysis, we identified 3 characteristics with statistically significant impact on both impressions and engagement:

  1. Polls (β = 0.278): Our most impactful discovery was that interactive polls became our strongest engagement driver. we used polls to introduce clinical scenarios related to featured research, allowing audiences to test their knowledge before revealing study findings.
  2. Graphics (β = 0.195): Professional graphics significantly boosted engagement, leading us to add a dedicated graphic designer to the team after 2 years. This wasn’t cosmetic—it was a data-driven personnel decision.
  3. URL Links (β = 0.173): Links to full articles didn’t just drive traffic; they contributed to increased Altmetric Attention Scores, providing measurable academic impact beyond social media metrics.

Surprisingly, emojis showed a negative correlation with engagement in our academic audience. We hypothesize that these emojis may have not resonated with our academic and healthcare professions audience— a reminder that strategies must be tailored to the desired audience.

research dissemination architect pecarn ALiEM twitter X

Lessons Learned for Building Research Dissemination Architecture

1. Analytics Are Non-Negotiable

Don’t guess about what works. Track impressions, engagement, click-through rates, and downstream academic metrics. What gets measured gets optimized.

2. Quality Control Maintains Credibility

Our peer review process for each tweet provided academic rigor for accuracy and quality, treating social media content with the same methodological care we apply to research publications. This approach strengthened PECARN’s digital credibility and built trustworthiness with our professional audience who expect evidence-based content even in 280 characters.

3. Team Redundancy Ensures Sustainability

Faculty have complex schedules. Build systems that work despite individual availability challenges.

4. Visual Content Isn’t Optional

Professional graphics aren’t “nice to have”—they’re proven engagement drivers in the era of information overload. They are worth the investment.

New Academic Role: Research Dissemination Architect

What began as grassroots FOAM (Free Open Access Medical education) with individual bloggers and social media educators has evolved into something more substantial: the emergence of the “Research Dissemination Architect” as a legitimate, potentially funded position within academic institutions and research organizations.

This represents a fundamental shift in how we think about knowledge translation careers. We’re no longer talking about faculty “doing social media on the side”—we’re talking about dedicated professional positions with specific expertise, measurable outcomes, and institutional recognition. Our recent publication in JMIR Formative Research documents our journey in this evolution. The ALiEM-PECARN partnership wasn’t just about Twitter success; it was about demonstrating that research dissemination can be a systematic, professional discipline worthy of institutional investment and academic recognition.

Conclusion

The PECARN-ALiEM partnership demonstrates that academic rigor and social media success aren’t mutually exclusive—they’re synergistic when approached systematically. Through this collaboration, we’ve contributed to establishing systematic approaches to research dissemination as a pathway toward accelerated knowledge translation.

Research Dissemination Architects represent an emerging career pathway that bridges traditional academic expertise with digital communication skills. As medical education continues evolving toward digital-first approaches, faculty who develop competency in evidence-based social media are positioning themselves at the forefront of this evolution. The framework we’ve developed offers one approach to professional research dissemination. As more organizations experiment with similar roles, we’ll undoubtedly see diverse models emerge, each contributing to our collective understanding of effective academic digital scholarship.

We hope our experience can inform others exploring this space. Whether you adapt our specific approach or develop entirely different methods, the opportunity to advance how research reaches its intended audiences has never been greater.

Reference

  1. Hooley GC, Magana JN, Woods JM, et al. Research Dissemination Strategies in Pediatric Emergency Care Using a Professional Twitter (X) Account: A Mixed Methods Developmental Study of a Logic Model Framework. JMIR Form Res. 2025;9:e59481. Published 2025 Jun 24. doi:10.2196/59481. PMID 40554778

EM Match Advice 48: Transitioning from ERAS to ResidencyCAS – Platform Features and Essential Resources

ResidencyCAS - transitioning out of ERAS application

In this episode of EM Match Advice, Dr. Sara Krzyzaniak (Stanford University EM Program Director) speaks with Dr. Liza Smith (Clerkship Director/Associate Program Director at UMass Baystate and past Chair of the CORD Application Process Improvement Committee, and Dr. Tim Fallon (Associate Program Director at Maine Medical Center and the committee’s current Chair), about the historic transition from ERAS to ResidencyCAS for EM residency applications. This marks the first year that EM is using ResidencyCAS as an application service, moving away from the ERAS platform used in previous years. The discussion focuses on essential resources and new platform features that applicants need to understand for successful applications.

Podcast: Transitioning from ERAS to ResidencyCAS

 

Critical Updates for the 2025-2026 Application Cycle

  • Do NOT apply to EM programs through ERAS for 2025-2026 – All EM applications go through ResidencyCAS.
  • ALL EM combined programs also use ResidencyCAS: EM-IM, EM-Peds, EM-Anesthesia, EM-FM, etc. are all on ResidencyCAS, not ERAS
    • Exception: If applying to separate specialties (e.g., both EM and IM as separate applications), you’ll need both ResidencyCAS for EM and ERAS for other specialties

Major Application Changes

  • Geographic preferences redesigned: The traditional regional geographic preference ranking has been eliminated. The new approach focuses on listing specific city-state locations where you’d feel supported (such as a hometown), rather than broad regional preferences
  • Hobbies section returns: The hobbies section is being reintroduced to ResidencyCAS applications
  • Non-work experience section added: Applicants can now include experiences outside of traditional work or medical activities

Key Dates for 2025-2026 EM ResidencyCAS Applications

  • June 4, 2025: ResidencyCAS application opens for data entry and initial application work
  • August 25, 2025: First date to officially request transcripts (USMLE/COMLEX) and Dean’s letters (MSPE) from schools
  • September 24, 2025: Application submission deadline
  • October 1, 2025: Programs can begin reviewing applications

Caution: These dates are specific to ResidencyCAS for Emergency Medicine applications. Always verify dates directly with official sources as they may be subject to change.

Featured Resources

1. ResidencyCAS Official Website

  • What it is: Official platform and information hub for ResidencyCAS applications
  • Access: ResidencyCAS.com

2. EMRA Advising Guide (Updated 2024)

  • Key chapters: Updated Chapter 4 and Chapter 7 focus specifically on ResidencyCAS applications
  • Access: Updated EMRA Advising Guide – ResidencyCAS Chapters

3. Applicant Sandbox

4. CORD Homepage Resources

  • Content: Information about the collaboration and resources being shared with programs
  • Access: CORD Homepage – ResidencyCAS Information

Read and Listen to the Other EM Match Advice Episodes

Blog posts: https://www.aliem.com/em-match-advice-series/

 

By |2026-06-16T16:19:02-07:00May 26, 2025|EM Match Advice, Medical Student|

EM Match Advice 47: 2025 EM Match By The Numbers

EM Match Advice 2025 Match by the numbers

The Emergency Medicine (EM) Match process continues to evolve, with the specialty experiencing significant shifts in recent years. In this 47th installment of the EM Match Advice podcast series, Dr. Sara Krzyzaniak (Stanford EM PD) hosts the annual program director reflection on the Match with Dr. Abra Fant (Northwestern EM PD), who returns for her fourth consecutive year to share insights on the NRMP Match trends and data. 

Podcast Episode: EM Match by the Numbers

 

Tables: EM Match by the Numbers

EM Match Advice by the Numbers

 

EM Match by the Numbers by specialty

 

Key 2025 Match Statistics: A Clear Improvement

Significant Reduction in Unfilled Positions

The most notable trend in the 2025 EM match is the continued reduction in unfilled positions:

  • 65 (2%) unfilled positions in 2025, down from 135 (4%) unfilled positions in 2024
  • This continues the positive trend from the peak of 554 (18%) unfilled positions in 2023

Dr. Fant notes this represents a faster-than-expected recovery: “I think we all suspected we would recover as a specialty, but looking at other specialties that have gone through similar roller coasters, I think this recovery has been more rapid than potentially others anticipated.”

Program and Position Growth

The 2025 match showed stable program numbers with modest growth in positions:

  • 292 EM programs in 2025, unchanged from 2024
  • 3,068 total positions offered, up slightly from 3,026 in 2024
  • 3,753 total applicants to EM in 2025, up slightly from 3,574 in 2024

Applicant Demographics Remain Stable

The composition of the EM applicant pool remained relatively consistent year-over-year:

  • 1,514 US MD seniors (40% of applicants)
  • 1,231 DO seniors (33% of applicants)
  • The remaining 27% comprised IMGs and other applicant types

Fill Rates by Applicant Type

The distribution of positions filled by different applicant types remained stable:

  • 1,377 positions filled by US MD seniors (45% of filled positions)
  • 1,078 positions filled by DO seniors (35% of filled positions)
  • 446 positions filled by US IMGs (15% of filled positions)
  • The fill rate for EM positions was 98% overall

Factors Driving Success in the EM Match

Several key factors contribute to the improved Match results and program director priorities:

  1. Realistic interview and ranking practices
  2. Effective use of preference signals
  3. Better distribution of interviews 
  4. Geographic considerations
  5. Demonstrated interest in Emergency Medicine

Looking Ahead: Changes on the Horizon

Several significant changes are coming to EM education and the application process:

  • Proposed Resident Review Committee (RRC) program requirements: New RRC requirements were announced right around rank list certification day, which could significantly impact the upcoming match cycle.
  • Transition to ResidencyCAS system: The specialty is moving from ERAS to ResidencyCAS, representing substantial shift to an entirely new platform to manage applications, interviews, and communications.

Despite these upcoming changes, Dr. Fant remains optimistic: “Overall this is a really positive outlook for applicants to emergency medicine in the upcoming 2025-26 Match cycle.”

“EM is one of the best specialties. It has been for many years and we have overcome plenty of roadblocks. We hope that you will join our ranks.”

Read and Listen to the Other EM Match Advice Episodes

Blog posts: https://www.aliem.com/em-match-advice-series/

 

By |2025-05-25T13:11:16-07:00Apr 24, 2025|EM Match Advice, Medical Student|

EM Match Advice 46 | Program Directors Share Match Season Insights

EM Match Advice 46 podcast match season

As interview season wraps up, medical students across the country are preparing their rank lists for the upcoming Match. EM Match Advice podcast host, Dr. Sara Krzyzaniak (Stanford EM Program Director) recently sat down with Dr. Melissa Parsons (University of Florida College of Medicine – Jacksonville EM Program Director), to discuss the match process from both program and applicant perspectives.

Podcast: Match Season Insights

Podcast Sound Engineer: Dr. Kaitlin Bowers 

What’s Happening on the Program Side?

Programs are busy finalizing their rank lists through comprehensive meetings with their teams. Many programs, including UF Jacksonville, are intentionally completing their rank lists before hosting second looks in February. This approach ensures that second look attendance doesn’t influence ranking decisions.

Do Letters of Intent Matter?

The impact of post-interview communication varies by program. While some program directors may give slight consideration to genuine letters of intent, there’s a consensus that “ranking you highly” letters carry little weight. Dr. Parsons notes that programs can verify the authenticity of “#1” declarations on Match Day, making honesty crucial in these communications.

Creating Your Rank List: What Really Matters

Focus on these key factors:

  • Mentorship opportunities
  • Program reputation and graduate outcomes
  • Geographic location
  • Support systems and work-life balance
  • Clinical training environment
  • Fellowship and career opportunities
  • Your gut feeling about the program

What to avoid:

  • Overvaluing others’ opinions on programs
  • Putting too much stock in online forums/spreadsheets
  • Making decisions based on minor perks or small salary differences

Strategic Advice for Applicants

  1. Make Your List Early: Write down your rankings and display them somewhere visible. Live with the list for a few weeks before certification.
  2. Consider Location: Think beyond the hospital – where do you want to live for the next 3-4 years?
  3. Be Thorough: While top and bottom choices might be clear, pay special attention to middle-ranked programs. Given recent Match unpredictability, thorough consideration of all ranked programs is crucial.
  4. Attend Second Looks Strategically: Use these opportunities to gather information for your decision-making, understanding that programs should have their lists finalized beforehand.

Important Dates

  • February 3, 2025: Rank list entry opens
  • March 5, 2025: Rank list certification deadline
  • March 21, 2025: Match Day

Final Thoughts

Remember that the Match algorithm favors applicant preferences. Focus on creating a rank list that reflects your true preferences rather than trying to predict where programs might rank you. Trust your instincts and prioritize what matters most to you in your training journey.

Read and Listen to the Other EM Match Advice Episodes

Blog posts: https://www.aliem.com/em-match-advice-series/

 

 

 

 

By |2025-01-25T12:55:15-08:00Jan 29, 2025|EM Match Advice, Podcasts|

EM Match Advice 44: Approaching your EM sub-internship clerkship – “Just gotta roll with it”

EM match advice approaching your sub-internship clerksihp

Dr. Sara Krzyzaniak (podcast host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Jessica Bod (Yale University Clerkship Director and 2024 CDEM Clerkship Director of the Year award winner) in this episode to discuss how one might approach their emergency medicine sub-internship. Dr. Bod shares her her wealth of experience and wisdom to provide not only general advice but also answers more detailed questions like:

  • What are some things NOT to do on a rotation?
  • How do I judge my own competitiveness in the residency application process?
  • What if I have decided late in the process that emergency medicine is the career fit for me?
  • What should I expect AFTER the rotation?

Podcast: Approaching your EM Sub-Internship Clerkship

 

Mentioned Links

Read and Listen to the Other EM Match Advice Episodes

Blog posts: https://www.aliem.com/em-match-advice-series/

 

 

 

 

By |2024-06-24T16:29:00-07:00Jun 25, 2024|EM Match Advice, Medical Student, Podcasts|

From Collision to Clarity: PECARN cervical spine injury prediction rule for injured children

PECARN cervical spine injury prediction tool featured image (adapted from Midjourney)

For years, adult literature has provided clear guidelines for cervical spine imaging through the NEXUS and Canadian C-spine Rule (CCR) tools. These have been invaluable in helping clinicians decide when to image the neck in trauma patients. Similarly, the Pediatric Emergency Care Applied Research Network (PECARN) has developed robust tools for assessing blunt head trauma in children. However, until now, there has been a gap in guidance for clinicians managing pediatric patients at risk for cervical spine injuries.

Case Scenario: What would you do?

A 10-year-old boy presents to the emergency department (ED) after a high-speed motor vehicle collision. He complains of neck pain and is reluctant to move his head. The child’s mother is extremely worried, fearing the worst after witnessing the collision.

The Problem

Cervical spine injuries in children, while uncommon, can be devastating if not identified and treated promptly. Emergency physicians often face the challenge of deciding whether to proceed with imaging, given the potential risks associated with ionizing radiation from CT scans. The lack of clear guidelines specifically tailored for pediatric patients has historically led to either overuse of imaging, with its associated risks, or underuse, with the risk of missed injuries.

PECARN Cervical Spine Injury Prediction Rule

On June 4, 2024, Lancet published “PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.” This study proposes a new clinical prediction rule to guide imaging decisions for pediatric cervical spine injuries.

The study enrolled 22,430 children, aged 0–17 years, presenting with blunt trauma across 18 PECARN-affiliated ED in the US. About half were in the derivation and half in the validation cohort. The researchers derived and validated a clinical prediction rule using data from these children, which identified key risk factors for cervical spine injury, divided into high-risk and non-negligible (intermediate) risk factors.

High Risk (>12.1% risk of injury) -> Consider CT

  • Altered mental status (GCS 3-8 or AVPU = U)
  • Abnormal airway
  • Breathing
  • Circulation findings
  • Focal neurological deficits

Intermediate Risk (2.8% risk of injury) -> Consider X-Rays

  • Neck pain or midline neck tenderness
  • Mental status: GCS 9-14, AVPU = V or P, or other signs of altered mental status
  • Substantial head or torso injury

Definition on Cervical Spine Injury

  • Fractures or ligamentous injuries of the cervical spine
  • Cervical intraspinal hemorrhage
  • Cerebral artery injury
  • Cervical spinal cord injury, including
    • Changes in the cervical spinal cord on MRI
    • Cervical spinal cord injury without radiographic association
PECARN Cervical Spine Injury Prediction Tool

PECARN Cervical Spine Injury Prediction Tool (Download full sized PDF at PECARN site)

The prediction rule had strong test characteristics with 94.3% sensitivity and 99.9% negative predictive value, indicating that it can reliably identify children who do not need imaging, thus avoiding unnecessary radiation exposure. This evidence-based approach to pediatric trauma care would have reduced the number of CT scans by more than 50% without missing clinically relevant injuries.

Case Example Resolution

Using the PECARN cervical spine injury prediction rule, the attending physician evaluates the boy and finds that he does not exhibit any high-risk factors. However, because he reports neck pain and has midline neck tenderness on exam (intermediate risk), the rule recommends that the cervical spine can not be clinically cleared. It also suggests plain x-rays and not a CT scan. This differs from the adult population whereby CT scan imaging is often the first choice for diagnostic testing.

The x-rays reveal no evidence of cervical spine injury, and the boy is cleared with instructions for follow-up care. This approach not only alleviated the mother’s anxiety but also avoided unnecessary radiation exposure for the child.

Reference

Leonard JC, Harding M, Cook LJ, et al. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. 2024;8(7):482-490. doi:10.1016/S2352-4642(24)00104-4. PMID 38843852

By |2026-01-08T21:25:20-08:00Jun 10, 2024|Pediatrics, Radiology, Trauma|

Hot off the press: Bridge to EM curriculum (2nd edition) released

bridge to em emergency medicine 2nd edition

It has been 3 years since the 8-week, self-guided Bridge to Emergency Medicine (EM) curriculum was launched to help graduating medical students prepare for EM residency. The curriculum has been viewed over 43,000 times and we have awarded over 5,000 ALiEMU course certificates. It is now a part of many residency programs’ intern boot camp.

Launching the 2nd edition of Bridge to EM (2024)

We are thrilled to announce that we launching the second edition of the curriculum.

This was made possible thanks to our new co-editor, Dr. Andres Lopez, who revamped and updated the entire curriculum with Dr. Christina Shenvi to include more current articles, updated links, and new quiz questions. We also include a broader representation of foundational learning content such as the interpretation of diagnostic imaging as well as professional competency skills (e.g., communication, efficiency).

Check out the Bridge to EM home page and then head over to take the 9 free ALiEMU weekly quizzes.

By |2024-05-05T21:16:13-07:00May 6, 2024|ALiEMU, Medical Student|
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