Koontz, N. A.Tomblinson, C. M.Shatzkes, D. R.Glastonbury, C. M.Phillips, C. D.Dean, K.Strauss, S.Agarwal, M.Robson, C. D.Wiggins, R. H.2024-04-242024-04-242022-12Koontz, N. A., Tomblinson, C. M., Shatzkes, D. R., Glastonbury, C. M., Phillips, C. D., Dean, K., Strauss, S., Agarwal, M., Robson, C. D., & Wiggins, R. H. (2022). A Gamified Social Media-Based Head and Neck Radiology Education Initiative of the American Society of Head and Neck Radiology: Viewership and Engagement Trends at 3 Years. AJNR. American Journal of Neuroradiology, 43(12), 1784–1791. https://doi.org/10.3174/ajnr.A7711https://hdl.handle.net/1805/40213BACKGROUND AND PURPOSE: Social media has made inroads in medical education. We report the creation and 3-year (2018–2021) longitudinal assessment of the American Society of Head and Neck Radiology Case of the Week (#ASHNRCOTW), assessing viewership, engagement, and impact of the coronavirus disease 2019 (COVID-19) pandemic on this Twitter-based education initiative. MATERIALS AND METHODS: Unknown cases were tweeted from the American Society of Head and Neck Radiology account weekly. Tweet impressions (number of times seen), engagements (number of interactions), and new followers were tabulated. A social media marketing platform identified worldwide distribution of Twitter followers. Summary and t test statistics were performed. RESULTS: #ASHNRCOTW was highly visible with 2,082,280 impressions and 203,137 engagements. There were significantly greater mean case impressions (9917 versus 6346), mean case engagements (1305 versus 474), case engagement rates (13.06% versus 7.76%), mean answer impressions (8760 versus 5556), mean answer engagements (908 versus 436), answer engagement rates (10.38% versus 7.87%), mean total (case + answer) impressions (18,677 versus 11,912), mean total engagements (2214 versus 910), and total engagement rates (11.79% versus 7.69%) for cases published after the pandemic started (all P values < .001). There was a significant increase in monthly new followers after starting #ASHNRCOTW (mean, 134 versus 6; P < .001) and significantly increased monthly new followers after the pandemic started compared with prepandemic (mean, 178 versus 101; P = .003). The American Society of Head and Neck Radiology has 7564 Twitter followers throughout 130 countries (66% outside the United States). CONCLUSIONS: Social media affords substantial visibility, engagement, and global outreach for radiology education. #ASHNRCOTW viewership and engagement increased significantly during the COVID-19 pandemic.en-USPublisher PolicySocial mediaedical education#ASHNRCOTWTwittereducation initiativeArticle