Social media and professionalism: a retrospective content analysis of Fitness to Practise cases heard by the GDC concerning social media complaints

Social media use, professional behaviors online, and perceptions toward e-professionalism among dental students

OBJECTIVES

This study aimed to assess self-reported social media use, professional behaviors online, and perceptions on e-professionalism while using social media among dental students in two Southeast Asian universities.

METHODS

This cross-sectional study involved clinical dental students at University of Malaya (UM), Malaysia (n = 150) and Airlangga University (AU), Indonesia (n = 150). A questionnaire was distributed using Google Form via WhatsApp network. Data were analyzed using descriptive, Chi-square, and Wilcoxon rank-sum tests.

RESULTS

All students responded (n = 300) and reported as active social media users. Majority spent ≥ 1 h a day on social media and checked their social media > 6 times a day. Most commonly used social media accounts were Instagram (UM: 92.7%, AU: 95.3%) and Facebook (UM: 94.7%, AU: 59.3%). A small proportion of UM and AU students admitted to posting clinical photographs, patient records, and comments about patients on social media. UM students had significantly better scores in terms of their professionalism behaviors on maintaining the integrity of the profession compared to AU students (p < 0.001). Meanwhile AU students had better scores than UM students on behaviors related to upholding colleagues' professional image on social media (p = 0.421). Most students in UM and AU shared similar positive perceptions toward online professionalism behavior statements. Majority reported concerns over unprofessional posts online.

CONCLUSION

Self-reported behaviors online sometimes contradict with students' perceptions and concerns about being unprofessional online. There is a need for clearer educational guidelines on how to instill e-professionalism values and behaviors among dental students.

Digital Entrepreneurship via Sustainable Online Communication of Dentistry Profession, Oradea, Romania: A Longitudinal Analysis

Dentistry is an entrepreneurially oriented public interest profession that must maintain a balance between professional specificity and business sustainability. Communicating with patients is vital in a competitive system, and the dentist needs to use handy resources such as websites and social media. The aim of this research is (a) to examine whether websites and social networks are a digital entrepreneurship tool used in the dentistry profession in Oradea, a city in full economic development in Romania, to promote the profession nationally and internationally, (b) to compare the changes made using digital tools in the period between 2018–2021 for all licensed dentists in the mentioned city (between 430–450 people, depending on the stage of analysis) using the content analysis method and (c) to identify how the lockdown period imposed by the emergence of the COVID-19 pandemic influenced not only the sustainability of the medical services provided to the population but also the communication practices of the dental offices. The results of examining the dentist’s online presence reveal that there is an interest among practitioners to grow their business sustainably through a digital presence that is increasingly relevant to them and their clients, but the potential remains under-exploited.

Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review

BACKGROUND

As we are witnessing the evolution of social media (SM) use worldwide among the general population, the popularity of SM has also been embraced by health care professionals (HCPs). In the context of SM evolution and exponential growth of users, this scoping review summarizes recent findings of the e-professionalism of HCPs.

OBJECTIVE

The purpose of this scoping review is to characterize the recent original peer-reviewed research studies published between November 1, 2014, to December 31, 2020, on e-professionalism of HCPs; to assess the quality of the methodologies and approaches used; to explore the impact of SM on e-professionalism of HCPs; to recognize the benefits and dangers of SM; and to provide insights to guide future research in this area.

METHODS

A search of the literature published from November 1, 2014, to December 31, 2020, was performed in January 2021 using 3 databases (PubMed, CINAHL, and Scopus). The searches were conducted using the following defined search terms: "professionalism" AND "social media" OR "social networks" OR "Internet" OR "Facebook" OR "Twitter" OR "Instagram" OR "TikTok." The search strategy was limited to studies published in English. This scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines.

RESULTS

Of the 1632 retrieved papers, a total of 88 studies were finally included in this review. Overall, the quality of the studies was satisfactory. Participants in the reviewed studies were from diverse health care professions. Medical health professionals were involved in about three-quarters of the studies. Three key benefits of SM on e-professionalism of HCPs were identified: (1) professional networking and collaboration, (2) professional education and training, and (3) patient education and health promotion. For the selected studies, there were five recognized dangers of SM on e-professionalism of HCPs: (1) loosening accountability, (2) compromising confidentiality, (3) blurred professional boundaries, (4) depiction of unprofessional behavior, and (5) legal issues and disciplinary consequences. This scoping review also recognizes recommendations for changes in educational curricula regarding e-professionalism as opportunities for improvement and barriers that influence HCPs use of SM in the context of e-professionalism.

CONCLUSIONS

Findings in the reviewed studies indicate the existence of both benefits and dangers of SM on e-professionalism of HCPs. Even though there are some barriers recognized, this review has highlighted existing recommendations for including e-professionalism in the educational curricula of HCPs. Based on all evidence provided, this review provided new insights and guides for future research on this area. There is a clear need for robust research to investigate new emerging SM platforms, the efficiency of guidelines and educational interventions, and the specifics of each profession regarding their SM potential and use.

Preserving professional identities, behaviors, and values in digital professionalism using social networking sites; a systematic review

BACKGROUND

Despite a rapid rise of use of social media in medical disciplines, uncertainty prevails among healthcare professionals for providing medical content on social media. There are also growing concerns about unprofessional behaviors and blurring of professional identities that are undermining digital professionalism. This review tapped the literature to determine the impact of social media on medical professionalism and how can professional identities and values be maintained in digital era.

METHODS

We searched the databases of PubMed, ProQuest, ScienceDirect, Web of Science, and EBSCO host using (professionalism AND (professionalism OR (professional identity) OR (professional behaviors) OR (professional values) OR (professional ethics))) AND ((social media) AND ((social media) OR (social networking sites) OR Twitter OR Facebook)) AND (health professionals). The research questions were based on sample (health professionals), phenomenon of interest (digital professionalism), design, evaluation and research type. We screened initial yield of titles using pre-determined inclusion and exclusion criteria and selected a group of articles for qualitative analysis. We used the Biblioshiny® software package for the generation of popular concepts as clustered keywords.

RESULTS

Our search yielded 44 articles with four leading themes; marked rise in the use of social media by healthcare professionals and students, negative impact of social media on digital professionalism, blurring of medical professional values, behaviors, and identity in the digital era, and limited evidence for teaching and assessing digital professionalism. A high occurrence of violation of patient privacy, professional integrity and cyberbullying were identified. Our search revealed a paucity of existing guidelines and policies for digital professionalism that can safeguard healthcare professionals, students and patients.

CONCLUSIONS

Our systematic review reports a significant rise of unprofessional behaviors in social media among healthcare professionals. We could not identify the desired professional behaviors and values essential for digital identity formation. The boundaries between personal and professional practices are mystified in digital professionalism. These findings call for potential educational ramifications to resurrect professional virtues, behaviors and identities of healthcare professionals and students.

Digital professionalism on social media: A narrative review of the medical, nursing, and allied health education literature

BACKGROUND

Medical, nursing, and allied health students, and professionals are using online environments such as social media to communicate and share information. However, some have difficulty differentiating between their professional and personal roles and can behave inappropriately online. Better education and training may help prevent these issues from arising.

OBJECTIVE

Identify and synthesise literature on educating healthcare students and practitioners about digital professionalism on social media.

METHOD

Four databases i.e., CINAHL, ERIC, MEDLINE and PubMed were searched using relevant terms. Five hundred and twenty-two articles were found and screened. Data extraction and critical appraisal were conducted. Analysis followed Braun and Clarke's six phases of thematic analysis.

RESULTS

Eleven studies were included in the review. Digital professionalism was taught across medicine, nursing, and allied health education using a number of pedagogical approaches including traditional face-to-face teaching, as well as fully online, and blended methods. Its impact on learning centred on acquiring knowledge about communicating appropriately on social media which appeared to change how some students and practitioners behaved online, while improving confidence and information literacy. Developing and delivering education on digital professionalism tended to be affected by the amount of time faculty and trainers had to create curricula, organise and deliver teaching, and support students and clinicians. The design of the online platform seemed to be important as some had more functionality than others, allowing for greater interaction, which appeared to keep learners engaged.

DISCUSSION AND CONCLUSION

This review provides the first synthesis of literature on educating the medical, nursing, and allied health professions on digital professionalism on social media. The results identify potential issues, knowledge gaps, and highlight implications for future educational interventions. Recommendations include setting clear boundaries and pedagogical instructions, understanding and applying privacy settings online, and utilising co-creation approaches with students and practitioners to improve the quality of health education.

Exploring the impact of digital professionalism awareness training on dental undergraduate students

INTRODUCTION

Since the publication of GDC guidance, there have been small, but rising numbers of Fitness to Practise (FtP) cases made against qualified dentists, relating to the use of social media. Prior to graduation, dental students currently receive training in the appropriate use of social media, but more work is needed to determine the most effective methods do this. The aim of this study is to explore the impact of the digital professionalism awareness training provided at one UK-based institution.

MATERIALS AND METHODS

In year 2, a "brown envelope" is compiled using an online publicly available Facebook profile search for every student. All year 2 to 5 dental undergraduate students at one UK dental school who had completed the "brown envelope" were invited to participate in focus groups to examine its impact on behaviour change. A qualitative framework analysis method was applied to the transcripts.

RESULTS

Eleven dental undergraduate students participated in two focus groups. All students had experienced the "brown envelope" intervention. Four main themes emerged, including: a clear expression of dental student autonomy and rejection of regulation; that online activity in dentistry is different to medicine; that the intervention is useful and changed online behaviour; and constructive suggestions for improving training.

CONCLUSION

The interactive "brown envelope" intervention for digital professionalism awareness training was well received and appeared to result in actionable behavioural change on student profiles (eg alterations in privacy settings or restricting access to their own "friends lists").

Hashtag, like or tweet: a qualitative study on the use of social media among dentists in London

Aim To explore dentists' perceptions and use of social media generally and in relation to their professional careers, together with its implications for professionalism.Methods Semi-structured interviews were conducted with dentists in their early, mid- and late careers working in a range of settings based in London. Participants were purposively sampled via gatekeeper organisations, supported by snowball sampling. Interviews were audio-recorded, transcribed verbatim and data were analysed using thematic analysis.Results Eighteen dentists working across a range of career stages and care settings were interviewed. Participants were aware of the risks and benefits of using social media and expressed ways of balancing them. A typology of social media user types in the dental profession emerged from the data, comprising avoiders, secondary users, occasional users, observers, seekers, active and cautious, limited, engaged users and deleters. Participants reported an awareness of the impact of maintaining professionalism when using social media.Conclusion Among the participant population sampled, the risks and benefits of general and professional social media were discussed and, in some cases, these overlapped. The findings suggest that dentists are aware of the risks and benefits and employ techniques to balance risk. There were a range of social media user types that varied by characteristics, use in learning and the influences that change their use. It was evident that social media plays an important role in communication between those dentists engaging with available platforms. This area requires further research into professionalism and social media in dentistry.

Conflicting demands that dentists and dental care professionals experience when using social media: a scoping review

Introduction There are many conflicting demands for dentists and dental care professionals (DCPs) when using social media, for example between using social media for marketing and as professional provider of information. To gain a fuller understanding of how dentists/DCPs should optimally use social media, these conflicting demands need to be explored. The aim of this scoping review was to map out the current state of the literature describing the conflicting demands encountered by dentists and DCPs when using social media and the approaches used to manage these conflicting demands.Methods A scoping review was carried out. PubMed and Web of Science Core Collection were searched using inclusion and exclusion criteria. Data was extracted from the identified articles and analysed.Results The review identified 39 articles for inclusion. Conflicting demands were related to marketing and education with little information about how these conflicting demands can be managed.Conclusions The published literature on dentists'/DCPs' use of social media highlights that there are conflicting demands and little advice on management strategies. To gain an understanding of these conflicting demands, further research is required, including looking at the patient perspective, to inform future practice.

Perceptions of e-professionalism among dental students: a UK dental school study

Introduction

The social media activity of some healthcare students has created doubt about their ability to uphold and defend the ethical principles of healthcare in their online behaviours. A lot of research has been conducted on the online behaviours of medical and allied health professional students, however, less has been undertaken on dental students.

Aims

The aim was to determine whether students were aware of the guidelines set by the General Dental Council (GDC) regarding social media and whether they believed they were being professional in their online activities.

Methods and materials

Eighty-eight dental students (46 from year 2; 42 from year 4) at one UK dental school completed a questionnaire study examining their attitude towards and perceptions of e-professionalism.

Results

The results show that most students were heavy users of social media with an awareness of social media guidelines set out by the GDC. However, student responses to various e-professionalism scenarios reveals disagreement on whether posts referring to alcohol and work colleagues were deemed unprofessional.

Conclusion

Student perceptions of and attitudes towards e-professionalism is complicated and contradictory. More research will need to be undertaken to explore how we can inculcate e-professional values and behaviours in dental professionalism teaching.

Topic Analysis of UK Fitness to Practise Cases: What Lessons Can Be Learnt?

Background: Fitness to practise (FtP) impairment (failure of a healthcare professional to demonstrate skills, knowledge, character and/or health required for their job) can compromise patient safety, the profession's reputation, and an individual's career. In the United Kingdom (UK), various healthcare professionals' FtP cases (documents about the panel hearing(s) and outcome(s) relating to the alleged FtP impairment) are publicly available, yet reviewing these to learn lessons may be time-consuming given the number of cases across the professions and amount of text in each. We aimed to demonstrate how machine learning facilitated the examination of such cases (at uni- and multi-professional level), involving UK dental, medical, nursing and pharmacy professionals. Methods: Cases dating from August 2017 to June 2019 were downloaded (577 dental, 481 medical, 2199 nursing and 63 pharmacy) and converted to text files. A topic analysis method (non-negative matrix factorization; machine learning) was employed for data analysis. Results: Identified topics were criminal offences; dishonesty (fraud and theft); drug possession/supply; English language; indemnity insurance; patient care (including incompetence) and personal behavior (aggression, sexual conduct and substance misuse). The most frequently identified topic for dental, medical and nursing professions was patient care whereas for pharmacy, it was criminal offences. Conclusions: While commonalities exist, each has different priorities which professional and educational organizations should strive to address.

How accessible are you? A hospital-wide audit of the accessibility and professionalism of Facebook profiles

Introduction Social media is an integral part of modern society and is increasingly being used by patients and clinical staff alike. The General Dental Council and most employers have social media guidelines to ensure employees use social media responsibly and do not bring their organisations into disrepute.Aims To establish the accessibility of Facebook profiles of the staff and students at Eastman Dental Hospital (EDH) and to assess compliance with the latest social media guidance from the General Dental Council as well as the employing trust and university.Design and setting A hospital-wide prospective audit conducted from January to March 2018 at Eastman Dental Hospital.Gold standard One-hundred percent compliance with: a) General Dental Council (GDC); b) University College London (UCL); and c) University College London Hospitals (UCLH) social media policies.Materials and methods The names of all clinical staff/students at EDH were searched for on Facebook using a dummy profile account, to simulate a member of the public. The profiles were assessed for the accessibility of personal information, affiliations to UCL/UCLH, personal views, social networking and conduct.Results A total of 219 out of 440 profiles (50%) were identified and were accessible to varying degrees. Many accessible profiles had a profile picture and personal information visible such as gender and location. No violations of patient confidentiality were seen. Overall, 6% (n = 14) and 2% (n = 4) of profiles displayed unprofessional behaviour and substance abuse, respectively.Discussion This audit highlighted Eastman Dental Hospital's compliance to local and national social media policies.Conclusion It was not possible to identify all staff/students through the Facebook search function. No serious professional misconduct was identified, however a small minority displayed unprofessional behaviour.