Differences between doctors of medicine and dental medicine in the perception of professionalism on social networking sites: the development of the e-professionalism assessment compatibility index (ePACI)

Reclaiming the concept of professionalism in the digital context: a principle-based concept analysis

BACKGROUND

There has been an alarming surge in the usage of social networking sites (SNSs) by healthcare professionals (HCPs) without adherence to the principles of professionalism. The widespread use of SNSs in medical practices has been coupled with reports of breaches of professional behaviors. Despite the benefits of SNSs, skepticism prevails about a clearly defined role for SNSs within medicine based upon the core principles of professionalism. Thus, there is a need to understand the manifestations of professionalism in the digital context, classically known as e-professionalism. This study systematically examines HCPs' perceptions of e-professionalism to advance a thorough understanding of e-professionalism.

METHODS

This concept analysis was performed using the principle-based approach of Penrod and Hupcey. In January 2023, we searched the databases of PubMed and ISI Web of Science for English-language articles specific to 'e-professionalism' in the medical field. The final selected research corpus of 63 articles was analyzed in this study.

RESULTS

A comprehensive analysis of the selected articles highlighted that e-professionalism is an epistemologically mature and distinct concept by a standard definition. However, inconsistencies in conceptual meanings were reported due to varied interpretations despite digital literacy. The pragmatic utility showed a lack of sound methodological and philosophical paradigms. Perhaps the rapid technological advancements and manifestations have hampered linguistic maturity. However, logically, e-professionalism is perceived as an extension of conventional professionalism but with a focus on a distinct framework with a set of attributes to be digitally relevant.

CONCLUSION

This study identifies a scarcity of research about the collective perspective of essential stakeholders, underpinning the need to further explore e-professionalism due to its emerging complex nature within the digital context. There is also a recognition that a framework is essential to guide future HCPs to yield a profound understanding and to provide remediation strategies in the rapidly advancing medical field in digital realm.

Differences between Doctors of Dental Medicine and Doctors of Medicine Awareness of Their Online Image and Perception Concerns: a Quantitative Cross-Sectional Study

Background

Healthcare professionals (HCPs), including doctors of dental medicine (DMDs) and doctors of medicine (MDs), use social networking sites (SNSs) for personal and professional purposes. This study aims to: (i) explore DMDs and MDs awareness of their online presence, (ii) examine how frequently and for what reasons DMDs and MDs monitor their online images, (iii) determine the prevalence of finding inaccurate, incomplete, or unprofessional information about themselves, examine that experience, and investigate actions performed regarding unprofessional or embarrassing posted material, (iv) assess concerns about their own SNSs usage and the content they post.

Methods

A cross-sectional study was conducted among DMDs and MDs in Croatia using a questionnaire.

Results

Out of 1,013 participants, 753 were active SNS users. Facebook (91.6%) and Instagram (63.1%) were the predominant SNSs used. DMDs exhibited a significantly higher inclination to utilize SNSs for professional purposes than MDs. Both groups reported a high level of proficiency in using Facebook (M=3.2, SD=0.827) and Instagram (M=2.44, SD=1.162). Approximately 55.4% of the participants repored monitoring their online presence, typically once a year or less frequently. DMDs emphasized the completeness of posted information more than MDs (U=25,623.0, p=0.001). Their highest level of concern pertained to confidentiality breaches and inaccurate medical and dental information. There are similar results for MDs and DMDs for finding erroneous information posted on SNSs.

Conclusions

This study offers insights into HCPs' online presence, and their concerns regarding SNS usage. It underscores the significance of e-professionalism, and provides recommendations for maintaining a positive online presence while mitigating potential risks.

Exploring changes in the perception of e-professionalism among medical and dental students: a quantitative cross-sectional study

AIM

To compare e-professionalism perceptions between medical and dental students, focusing on their awareness and understanding of guidelines for developing e-professionalism.

METHODS

A cross-sectional quantitative study was conducted at the University of Zagreb School of Medicine (UZSM) and School of Dental Medicine (UZSDM) in 2022/2023. Data were gathered through a questionnaire designed specifically for the survey.

RESULTS

Of the 646 questionnaires collected, 626 were analyzed, with a response rate of 33.95% for UZSM and 37.83% for UZSDM. Most respondents (71.4%) were female, with a median age of 21. Medical students significantly more frequently considered it unprofessional to publish posts containing photos of patients/clients (96.5% vs 75.1%), endorsements of health products without conflict-of-interest disclosures (60.6% vs 33.0%), and posts describing patient interactions without revealing identifying information (51.7% vs 27.4%). In contrast, dental medicine students more frequently considered it unprofessional to publish posts with swearing or foul language (81.2% vs 67.4%), critical comments about lecturers (68.0% vs 46.9%), and criticisms of course material or the institution (52.3% vs 36.4%). Only 23.2% of students were aware of e-professionalism guidelines, with 37.9% of those familiar with their content.

CONCLUSION

While medical and dental students recognize the importance of e-professionalism, their perceptions have substantial differences. The need for promoting existing guidelines and integrating e-professionalism into curricula is evident. Continuous monitoring and research in this domain are essential to ensure future health care professionals maintain high standards of online professionalism.

Measuring e-Professional Behavior of Doctors of Medicine and Dental Medicine on Social Networking Sites: Indexes Construction With Formative Indicators

BACKGROUND

Previous studies have predominantly measured e-professionalism through perceptions or attitudes, yet there exists no validated measure specifically targeting the actual behaviors of health care professionals (HCPs) in this realm. This study addresses this gap by constructing a normative framework, drawing from 3 primary sources to define e-professional behavior across 6 domains. Four domains pertain to the dangers of social networking sites (SNSs), encompassing confidentiality, privacy, patient interaction, and equitable resource allocation. Meanwhile, 2 domains focus on the opportunities of SNSs, namely, the proactive dissemination of public health information and maintaining scientific integrity.

OBJECTIVE

This study aims to develop and validate 2 new measures assessing the e-professional behavior of doctors of medicine (MDs) and doctors of dental medicine (DMDs), focusing on both the dangers and opportunities associated with SNSs.

METHODS

The study used a purposive sample of MDs and DMDs in Croatia who were users of at least one SNS. Data collection took place in 2021 through an online survey. Validation of both indexes used a formative approach, which involved a 5-step methodology: content specification, indicators definition with instructions for item coding and index construction, indicators collinearity check using the variance inflation factor (VIF), external validity test using multiple indicators multiple causes (MIMIC) model, and external validity test by checking the relationships of the indexes with the scale of attitude toward SNSs using Pearson correlation coefficients.

RESULTS

A total of 753 responses were included in the analysis. The first e-professionalism index, assessing the dangers associated with SNSs, comprises 14 items. During the indicators collinearity check, all indicators displayed acceptable VIF values below 2.5. The MIMIC model showed good fit (χ213=9.4, P=.742; χ2/df=0.723; root-mean-square error of approximation<.001; goodness-of-fit index=0.998; comparative fit index=1.000). The external validity of the index is supported by a statistically significant negative correlation with the scale measuring attitudes toward SNSs (r=-0.225, P<.001). Following the removal of 1 item, the second e-professionalism index, focusing on the opportunities associated with SNSs, comprises 5 items. During the indicators collinearity check, all indicators exhibited acceptable VIF values below 2.5. Additionally, the MIMIC model demonstrated a good fit (χ24=2.5, P=.718; χ2/df=0.637; root-mean-square error of approximation<0.001; goodness-of-fit index=0.999; comparative fit index=1.000). The external validity of the index is supported by a statistically significant positive correlation with the scale of attitude toward SNSs (r=0.338; P<.001).

CONCLUSIONS

Following the validation process, the instrument designed for gauging the e-professional behavior of MDs and DMDs consists of 19 items, which contribute to the formation of 2 distinct indexes: the e-professionalism index, focusing on the dangers associated with SNSs, comprising 14 items, and the e-professionalism index, highlighting the opportunities offered by SNSs, consisting of 5 items. These indexes serve as valid measures of the e-professional behavior of MDs and DMDs, with the potential for further refinement to encompass emerging forms of unprofessional behavior that may arise over time.