In a pre‑AI, pre‑COVID study (circa 2018) of a private Facebook group for robotic surgeons, the participants demonstrated how a niche surgical specialty leveraged the platform to share intra‑operative videos, seek immediate peer feedback, and engage in vicarious learning. Because operative video footage is inherently de‑identified, HIPAA concerns were minimal, allowing surgeons to post recordings and ask for advice on technique, troubleshooting, or patient‑specific nuances. Membership required verification, granting the group a legal status akin to an online "doctor's lounge" that limited liability for shared opinions. The discussion highlighted that the group’s integration into surgeons' daily social‑media habits drove high engagement, far surpassing what would be expected from a formal portal hosted by the American Surgical Association. While generic platforms like Facebook, YouTube, and Twitter offered accessibility and a constant presence, they lacked formal boundary‑setting and quality‑control mechanisms that institutional sites could provide. The speakers argued that informal social‑media communities and formal channels (conferences, peer‑reviewed journals) are complementary: the former preserves messier, real‑time practice details that are filtered out in polished conference presentations, and can rapidly iterate on published findings. The recent migration of many users to X (formerly Twitter) appears to have weakened the cohesion of this community, underscoring the importance of platform choice for sustaining tacit knowledge exchange among specialists.
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But, uh, a number of years ago, I mean, this predates AI certainly, I did a small study with some colleagues in surgery of a Facebook group for robotic surgeons. And it was this fascinating group because robotic surgery, certainly at the time, this was maybe 2018 or so, but still continues to be a fairly niche practice, right? You don't have tons and tons of robotic surgeons around. So you may be the only robotic surgeon in a 50-mile radius, certainly a robotic surgeon doing one particular type of procedure. So getting that informal knowledge, feedback, advice, mentoring can be quite challenging. But what these surgeons figured out pretty quickly is that as they're doing the robotic surgery, they use a camera for it, and that camera can record. And one of the beautiful things about doing surgery on the inside is most people's insides are HIPAA compliant, right? We're not, you know, like, I can't identify you by your spleen. Right. So it's a much lower barrier to then be able to say, hey, I'm gonna post this video of me doing my robotic surgery procedure on Facebook. And there's gonna be a community of a couple thousand robotic surgeons around the world who, because they're in different time zones, essentially are a 24-hour think tank to basically just throw the video up and say, hey, what do you guys think of the way that I approached it? Or I tried this new procedure that Dr. So-and-so recommended on here last month and it worked great. Look at how it went. Or, hey, this is what I was looking at. What would you have done here? And we found that it, it was actually quite active. I mean, people would comment pretty regularly. They would pass feedback along back and forth. Now it was a private group, so you had to be invited in to be a member. Presumably you had to provide some sort of proof that you were actually a robotic surgeon. And there have been some legal protections afforded to groups like that, that essentially they consider it an online version of the doctor's lounge. And just like what we were talking about with AI, asking your friend, what would you have done in this situation? Does not then make them liable or you any differently liable for the outcome of the surgery that you performed. And so again, even pre-COVID, pre- AI, we were seeing this sort of, I don't wanna say a backdoor use, but like this sort of unintended use of some of these large-scale social media platforms.
So community of practice basically based on Facebook for learning kind of, and this is, I'm gonna use this word intentionally to get you into it, but like this is vicarious learning through your peers.
Yeah.
Right.
Yeah. And I think there's a question of would that be better Would we all feel better and, and/or would it be better, which are two different questions, if that forum was hosted by the American Surgical Association, if it was some website that they logged into. What I can tell you for sure is it would get used a lot less if it was hosted by American Surgical Association instead of a group on Facebook. I think it's another login, it's another access. Who's logging on to American Surgical Association every day? Facebook, it pops up. I was a member of this group for a short time while we were studying it. It shows right up on your feed. There's nothing like going to like birthday party, new kid, spleen, colonoscopy, you know, uh, it makes for a very interesting scroll. But on the other hand, it's right when you scroll a very common thing. And as we know with research on communities of practice, the more accessible and central to your day-to-day interaction they are, the more you're going to use them. So again, yeah, I think that this question of do we do it on YouTube and Facebook and Twitter was a, a huge hub for a long time of academic knowledge sharing and vicarious learning as a, a big community of practice. It has ceased to be that since the move to X, but these sort of generic platforms I think have a real appeal, but what they lack is some of that kind of formal boundary setting and quality control perhaps that, that you would see if it was an institution-specific resource.
The group of robotic surgeons, I'm curious to know how the kind of Facebook group— I'm sure they had like formal conferences and papers and journals or stuff like that that they would also participate. And I'm curious how the kind of more informal Facebook thing compared with their kind of more formal organization as a group and what the impacts of each of those were on each other.
Yeah, we didn't study that directly, so I'm speculating here, but I would imagine based on what I've seen elsewhere, they're sort of complementary. Approaches, right? That, that informal interaction preserves a little bit of the messiness and the sort of immediacy that you wouldn't get by the time it's all cleaned up and made into nice slides at a conference, or certainly by the time it's through peer review and documented in that way. So I think they're symbiotic in that sense that somebody publishes a peer-reviewed randomized trial of a new procedure, and then you get a bunch of people trying it out and posting their results. To Facebook and maybe then refining it like, oh, okay. So they found if you approach from this side instead of that side, there's less scarring and less damage. Great. Well, I've been trying to approach from this side, but what do you do with a patient who has blank, you know, is overweight or underweight or has this preexisting condition? All those little kind of messy nuances of how do you actually do the thing? I think those get sorted out quite nicely on Facebook in the same way we might expect them to get sorted out face to face in a, a more traditional office environment, right, where there's that classic water cooler vicarious learning that's happening.
