Teaching difficult concepts is a challenge for instructors and determining which concepts that need review is a challenge for students. The goal of this pilot study was to use Twitter as a platform to for students to identify the difficult concepts so that their instructor could create videos for students to review while on their five-week nursing clinical placements. Twitter has successfully been used to hold small group discussions in small classes (<20 students) (Halpin, 2016; Halpin and Lockwood, 2019; Lellis-Santos and Halpin, 2018) and this is our first effort to scale up this design for a large class setting. The ONPS2648 Therapeutics for Nursing class of 369 students meet for the first two weeks of the term and then are on clinical placements for five weeks before returning to the classroom. To ensure they review the material and stay engaged in course content they were assigned via email an alphanumeric randomly generated (Random.org) Twitter username and provided with an instruction video on how to use Twitter. The class was divided into groups of 8-12 students and each group was assigned their own Twitter hashtag e.g. #ONPS2648GRP1. At the first class meeting, only 40% of enrolled students attended and of those 40% signed up for Twitter. Students tweeted the difficult concept from the cardiovascular lecture the first week and the antimicrobial lecture the second week. Each week a Python script was used to collect the tweets automatically via the Twitter API. Tweets were parsed using the Python Natural Language Toolkit (NLTK) to extract and count the terms most relevant to the current week’s content. These data were then used to generate a wordcloud and the most common concepts were the focus of the of the review videos. The participation level in signing up for Twitter exceeded our expectations, however, engagement with the Twitter platform was below that which was expected. The reasons for this needs to be explored but this does highlight a key challenge in engagement with digital media platforms in large classroom settings. Funding provided by the American Physiological Society Teaching Career Enhancement Award.