Unprofessional behaviour on social media by medical students

A Reassessment of the Impact and Significance of Social Media to Pathology

CONTEXT

Social media (SM) use in pathology and medicine today is widespread, receives active advocacy, and is said to bring a host of benefits. In latter days, the harmful effects of SM have received attention, but they have yet been followed by greater encouragement of professionalized SM usage. SM use in medicine has seen adoption in parallel to its general ascendancy, even though the platforms are products with purposes misaligned with the practice of medicine.

OBJECTIVE

To (1) characterize premises and forces that propel professional SM platform adoption and use, and (2) examine wide-ranging literature, both medical and nonmedical, that substantiates the premises and to find counteracting perspectives and evidence.

DATA SOURCES

Review of the literature using relevant keyword searches in PubMed, Google Scholar, Dimensions, and Web of Science for articles that study/describe professional SM use in pathology and medicine. Additionally, we examined business, technology, and social sciences literature and high-quality gray literature (newspapers, books, blogs) that addressed questions in relation to the topic of professional SM adoption.

CONCLUSIONS

We identified 6 major premises as motivators of professional SM use and highlight significant counteracting factors. We conclude that the harms of professionalized SM use have not been fully considered in the medical literature and that a change in direction and the creation of new communication platforms would be beneficial.

The Reel Health Care Professionals of Instagram: A Systematic Review

Social media and health research have covered the benefits for the public and patients as users. Specifically, this has focused on searching for health information, connecting with others experiencing similar health issues, and communicating with their health professionals. Recently, there has been a shift in research to focus on health care professionals as users as they participate in professional development, improve communication with patients, and contribute to health research and service. However, such research has predominantly focused on text-based platforms, namely Facebook and Twitter. The scope of this article is a systematic review of publications on health care professionals' use of the image-based platform Instagram, according to the preferred reporting items for systematic reviews and meta-analyses guidelines. This study, drawing from 51 articles, shows how health care professionals use Instagram, and reveals that these professionals utilize the platform to address health concerns that may not necessarily align with their specific expertise. Images were the common format of posts created by health care professionals, with six content types identified: (a) educational, (b) promotional, (c) patient experience, (d) personal, (e) emotion based, and (f) other. Three measures of post engagement were used by researchers, including (a) likes and comments, (b) use of hashtags, and (c) number of followers. This study also identified the dangers of misleading users, including (a) lack of credentials reported, (b) edited images, (c) quality of content, and (d) patient and client confidentiality issues. In conclusion, insights into the advantages of health care professionals' use of Instagram and ways in which they can maximize its use to reach and engage with their target audience are provided.

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.

Impact of Social Media on Choosing Skin Care and Cosmetic Products Among Females in Saudi Arabia

BACKGROUND

Social media is a network that allows information to be shared globally with millions of users. It is becoming evident that social media plays quite a prominent role these days in skincare. Social media surely has come to benefit millions of its users around the globe, but the downside of social media is that it has the potential to put users at risk while they follow popular trends.

AIM

This study aims to assess the impact of social media on choosing skincare and cosmetic products in Saudi Arabia with the most used social media platforms.

METHODS

A questionnaire-based cross-sectional study was conducted targeting adult female residents across Saudi Arabia. Data were collected from the participants who met our criteria via electronic data collection Google forms did not show any nominative information that was distributed through social media platforms. The questionnaire covered participants' demographic data, social media use, source of information, and degree of trust with the influence of social media on using cosmetics. The eligible females were asked to fill out the study questionnaire received till no more new answers were obtained.

RESULTS

A total of 1,174 females fulfilling the inclusion criteria completed the study questionnaire. Participants' ages ranged from 18 to more than 40 years with a mean age of 22.5 %C2%B1 13.9 years old. Exact of 655 (55.8%) were single, and 463 (39.4%) were married. The most used social media platforms included Snapchat (39.4%), TikTok (26.7%), and Instagram (19.6%). A total of 881 (75%) of the study females reported they use social media for more than an hour a day. Exact 51% of the study females became familiar with skin care products from social media platforms. Also, 91.3% of the study female's confidence in information related to cosmetic and skin care products was affected by visual presentation.

CONCLUSION

In conclusion, the study showed that most of the study participants used social media for many hours daily mainly Snapchat, TikTok, and Instagram. Also, social media was the main source of information regarding skin care products mainly dermatologists on social media.

Exploration of Cyberethics in Health Professions Education: A Scoping Review

As digital technologies rapidly integrate into Health Professions Education (HPE), understanding cyberethics is increasingly crucial. This scoping review explores the pedagogy of cyberethics in HPE, highlighting a significant gap in explicit definitions and conceptualizations. Additionally, the absence of specific theoretical frameworks in most documents raises concerns about research progression. Only four articles introduce educational interventions in cyberethics, indicating a promising avenue for future research. While comprehensive search methods are employed, limitations, including language biases, exist. Future investigations should broaden the discourse to encompass ethical implications of emerging technologies within HPE. Cultivating comprehensive, culturally sensitive, and inclusive guidelines is vital for ethical digital practices in the health care community.

Characteristics and patients' portrayals of Norwegian social media memes. A mixed methods analysis

Background

Despite reports on troublesome contents created and shared online by healthcare professionals, a systematic inquiry of this potential problem has been missing. Our objective was to characterize the content of healthcare-associated social media memes in terms of common themes and how patients were portrayed.

Materials and methods

This study applied a mixed methods approach to characterize the contents of Instagram memes from popular medicine- or nursing-associated accounts in Norway. In total, 2,269 posts from 18 Instagram accounts were included and coded for thematic contents. In addition, we conducted a comprehensive thematic analysis of 30 selected posts directly related to patients.

Results

A fifth of all posts (21%) were related to patients, including 139 posts (6%) related to vulnerable patients. Work was, however, the most common theme overall (59%). Nursing-associated accounts posted more patient-related contents than medicine-associated accounts (p < 0.01), but the difference may be partly explained by the former focusing on work life rather than student life. Patient-related posts often thematized (1) trust and breach of trust, (2) difficulties and discomfort at work, and (3) comical aspects of everyday life as a healthcare professional.

Discussion

We found that a considerable number of Instagram posts from healthcare-associated accounts included patients and that these posts were diverse in terms of contents and offensiveness. Awareness that professional values also apply online is important for both healthcare students and healthcare providers. Social media memes can act as an educational resource to facilitate discussions about (e-)professionalism, the challenges and coping of everyday life, and ethical conflicts arising in healthcare settings.

Online Health (Mis)Information: The Role of Medical Students

The public perceive social media as a convenient source of health information. Some physicians might use this to enhance their visibility and market value. In this study, we aimed to assess medical students' awareness of regulations for dispersion of health-related information on social media and physicians' online self-promotional activities. A cross-sectional study was conducted among undergraduate medical students from the 3 largest administrative regions of Saudi Arabia: Central, Western, and Eastern regions. Data was collected between February-July 2020 via online distribution of a self-administered questionnaire. Results showed that: (a) a total of 730 medical students participated; (b) about half of respondents were unsure or unaware of guidelines of both, online posting of medical information and physicians' online self-promotional activities (343/47% and 385/52.7%, respectively); (c) 610 (83.6%) students supported that healthcare providers report accounts sharing unreliable health information. Physicians' online promotional activities, and posting about successful cases, might shift physicians' focus from patient care to becoming more popular online. Care should be taken not to breach essential professional and ethical principles, such as protecting the confidentiality and privacy of patients. Raising awareness among patients and physicians, current and future ones, of the regulations governing these online health related interactions is imperative.

Defining Potentially Unprofessional Behavior on Social Media for Health Care Professionals: Mixed Methods Study

BACKGROUND

Social media presence among health care professionals is ubiquitous and largely beneficial for their personal and professional lives. New standards are forming in the context of e-professionalism, which are loosening the predefined older and offline terms. With these benefits also come dangers, with exposure to evaluation on all levels from peers, superiors, and the public, as witnessed in the #medbikini movement.

OBJECTIVE

The objectives of this study were to develop an improved coding scheme (SMePROF coding scheme) for the assessment of unprofessional behavior on Facebook of medical or dental students and faculty, compare reliability between coding schemes used in previous research and SMePROF coding scheme, compare gender-based differences for the assessment of the professional content on Facebook, validate the SMePROF coding scheme, and assess the level of and to characterize web-based professionalism on publicly available Facebook profiles of medical or dental students and faculty.

METHODS

A search was performed via a new Facebook account using a systematic probabilistic sample of students and faculty in the University of Zagreb School of Medicine and School of Dental Medicine. Each profile was subsequently assessed with regard to professionalism based on previously published criteria and compared using the SMePROF coding scheme developed for this study.

RESULTS

Intercoder reliability increased when the SMePROF coding scheme was used for the comparison of gender-based coding results. Results showed an increase in the gender-based agreement of the final codes for the category professionalism, from 85% in the first phase to 96.2% in the second phase. Final results of the second phase showed that there was almost no difference between female and male coders for coding potentially unprofessional content for students (7/240, 2.9% vs 5/203, 2.5%) or for coding unprofessional content for students (11/240, 4.6% vs 11/203, 5.4%). Comparison of definitive results between the first and second phases indicated an understanding of web-based professionalism, with unprofessional content being very low, both for students (9/222, 4.1% vs 12/206, 5.8%) and faculty (1/25, 4% vs 0/23, 0%). For assessment of the potentially unprofessional content, we observed a 4-fold decrease, using the SMePROF rubric, for students (26/222, 11.7% to 6/206, 2.9%) and a 5-fold decrease for faculty (6/25, 24% to 1/23, 4%).

CONCLUSIONS

SMePROF coding scheme for assessing professionalism of health-care professionals on Facebook is a validated and more objective instrument. This research emphasizes the role that context plays in the perception of unprofessional and potentially unprofessional content and provides insight into the existence of different sets of rules for web-based and offline interaction that marks behavior as unprofessional. The level of e-professionalism on Facebook profiles of medical or dental students and faculty available for public viewing has shown a high level of understanding of e-professionalism.

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.

Social media in undergraduate medical education: A systematic review

INTRODUCTION

There are over 3.81 billion worldwide active social media (SoMe) users. SoMe are ubiquitous in medical education, with roles across undergraduate programmes, including professionalism, blended learning, well being and mentoring. Previous systematic reviews took place before recent explosions in SoMe popularity and revealed a paucity of high-quality empirical studies assessing its effectiveness in medical education. This review aimed to synthesise evidence regarding SoMe interventions in undergraduate medical education, to identify features associated with positive and negative outcomes.

METHODS

Authors searched 31 key terms through seven databases, in addition to references, citation and hand searching, between 16 June and 16 July 2020. Studies describing SoMe interventions and research on exposure to existing SoMe were included. Title, abstract and full paper screening were undertaken independently by two reviewers. Included papers were assessed for methodological quality using the Medical Education Research Study Quality Instrument (MERSQI) and/or the Standards for Reporting Qualitative Research (SRQR) instrument. Extracted data were synthesised using narrative synthesis.

RESULTS

112 studies from 26 countries met inclusion criteria. Methodological quality of included studies had not significantly improved since 2013. Engagement and satisfaction with SoMe platforms in medical education are described. Students felt SoMe flattened hierarchies and improved communication with educators. SoMe use was associated with improvement in objective knowledge assessment scores and self-reported clinical and professional performance, however evidence for long term knowledge retention was limited. SoMe use was occasionally linked to adverse impacts upon mental and physical health. Professionalism was heavily investigated and considered important, though generally negative correlations between SoMe use and medical professionalism may exist.

CONCLUSIONS

Social media is enjoyable for students who may improve short term knowledge retention and can aid communication between learners and educators. However, higher-quality study is required to identify longer-term impact upon knowledge and skills, provide clarification on professionalism standards and protect against harms.

A Preliminary Study on Uncovering Medical Students' Unprofessional Behaviors from YouTube Videos

Creation of guidelines and education on digital professionalism have been sluggish despite the ever-increasing use of social media by digitally native medical students, who are at risk of blurring the line between their professional and personal lives online. A qualitative thematic analysis was applied on 79 videos extracted from 70,154 YouTube videos uploaded by Korean medical students between March and April 2020. We found 20% contained at least one concerning behavior themed under 'failure to engage,' 'disrespectful behaviors,' or 'poor self-awareness.' Professional lapses identified were classified into seriousness levels. Mostly were "controversial' or 'concerning' but some 'highly concerning' contents were also found. This is the first study on digital professionalism behavior on medical students' YouTube videos. The potential negative impact on the medical profession of the easily accessible public online videos cannot be ignored and thus we suggest the need for them to be taken more seriously.

'Doctors can't be doctors all of the time': a qualitative study of how general practitioners and medical students negotiate public-professional and private-personal realms using social media

OBJECTIVE

The objective of this study is to explore the experiences and perspectives of general practitioners' and medical students' use of, and behaviour on, social media and to understand how they negotiate threats to professional and personal life on social media.

DESIGN

A two-phase qualitative design was used, consisting of semistructured interviews and follow-up vignettes, where participants were asked to respond to vignettes that involved varying degrees of unprofessional behaviour. Data were analysed using template analysis.

SETTING AND PARTICIPANTS

Participants were general practitioner tutors and third year medical students who had just completed placement on the University of Limerick longitudinal integrated clerkship. Five students and three general practitioners affiliated with the medical school were invited to participate in one-to-one interviews.

RESULTS

Three overarching themes, each containing subthemes were reported. 'Staying in contact and up to date' outlines how social media platforms provide useful resources and illustrates the potential risks of social media. 'Online persona' considers how social media has contributed to changing the nature of interpersonal relationships. 'Towards standards and safety' raises the matter of how to protect patients, doctors and the medical profession.

CONCLUSION

Guidance is required for students and medical practitioners on how to establish reasonable boundaries between their personal and professional presence on social media and in their private life so that poorly judged use of social media does not negatively affect career prospects and professional efficacy.

Development and validation of scale for measuring attitudes towards e-professionalism among medical and dental students: SMePROF-S scale

BACKGROUND

Social media permeated everyday life and consequently it brought some changes to behaviour of health professionals. New form of professionalism emerged called e-professionalism depicting professional behaviour while using social media. There are a number of studies conducted in the past several years measuring behaviour of different populations of health professionals on social media and social media sites. Many studies have investigated aspects of e-professionalism of medical or dental students as future health professionals, but there are no validated instruments made for assessing attitude towards e-professionalism of those two populations. Objective of this paper is to validate a newly developed scale for measuring attitudes towards e-professionalism among medical and dental students.

METHODS

The original 32-item scale was developed and administered to 411 medical students (RR 69%), and 287 dental students (RR 49.7%). Exploratory factor analysis was used to investigate the existence of underlying factors. Principal component analysis was used as an extraction method with oblimin as selected oblique rotation method. Cronbach's alpha was used to assess reliability.

RESULTS

Total of 698 student answers entered analysis. The final scale had 24 items that formed seven factors named: ethical aspects, dangers of social media, excluding physicians, freedom of choice, importance of professionalism, physicians in the digital age, negative consequences. Cronbach's alpha indicating scale reliability was .72. Reliability conducted on each factor ranged from .570 to .877.

CONCLUSIONS

The scale measures seven factors of attitude towards e-professionalism and exhibits satisfactory reliability. Based on insights from validation, some possible improvements are suggested.

Perception of social media behaviour among medical students, residents and medical specialists

INTRODUCTION

Behaviour is visible in real-life events, but also on social media. While some national medical organizations have published social media guidelines, the number of studies on professional social media use in medical education is limited. This study aims to explore social media use among medical students, residents and medical specialists.

METHODS

An anonymous, online survey was sent to 3844 medical students at two Dutch medical schools, 828 residents and 426 medical specialists. Quantitative, descriptive data analysis regarding demographic data, yes/no questions and Likert scale questions were performed using SPSS. Qualitative data analysis was performed iteratively, independently by two researchers applying the principles of constant comparison, open and axial coding until consensus was reached.

RESULTS

Overall response rate was 24.8%. Facebook was most popular among medical students and residents; LinkedIn was most popular among medical specialists. Personal pictures and/or information about themselves on social media that were perceived as unprofessional were reported by 31.3% of students, 19.7% of residents and 4.1% of medical specialists. Information and pictures related to alcohol abuse, partying, clinical work or of a sexually suggestive character were considered inappropriate. Addressing colleagues about their unprofessional posts was perceived to be mainly dependent on the nature and hierarchy of the interprofessional relation.

DISCUSSION

There is a widespread perception that the presence of unprofessional information on social media among the participants and their colleagues is a common occurrence. Medical educators should create awareness of the risks of unprofessional (online) behaviour among healthcare professionals, as well as the necessity and ways of addressing colleagues in case of such lapses.

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").

Pharmacy and medical students' attitudes and perspectives on social media usage and e-professionalism in United Arab Emirates

BACKGROUND

It is imperative to establish how students view and present themselves on social media and to assess level of awareness regarding the implications of their social media presence, e-professionalism, and accountability. The study objectives were to: 1) Determine the social media usage levels among medical and pharmacy students in the United Arab Emirates (UAE); 2) Characterize the students' views and perceptions, including their awareness of e-professionalism; and 3) Compare the responses in behavior between the two groups.

METHODOLOGY

A cross-sectional study was performed on 575 undergraduate students from two study disciplines, pharmacy (n = 325) and medicine (n = 250). Minor revisions were made to previously validated assessment tools and pilot tested. The study sample included students from five different universities across the country.

RESULTS

In comparison to medical students, pharmacy students were observed to use social media more for learning purposes (χ² = 6.8, P < .05). However, medical students' opinions reflected more strongly on the context of accountability and e-professionalism (χ² = 15.8, P < .05). A considerable proportion (89%) of students felt it was discriminatory for prospective employers to use their social media profile information for investigative purposes while hiring. One-third of respondents reported sharing information that they would not want their employers to view, and 67.1% reported the same for information relevant to patients.

CONCLUSION

The research findings converge to address the need for educators and administrators in the UAE to develop guidelines concerning its safe use and proactively integrate e-professionalism into their respective curriculum.

The relationship between Facebook behaviour and e-professionalism: A questionnaire-based cross-sectional study among Greek dental students

INTRODUCTION

The social media attitude of health science students might affect patients' opinion about the health profession and have negative impact on e-professionalism. The aim of this study is to investigate the behaviour of Greek dental students on Facebook, focusing on potentially unprofessional posts and the online student-patient relationship.

MATERIALS AND METHODS

Five hundred and twelve dental students in Greece answered an anonymous, 23-item questionnaire including multiple-choice questions about various topics, including Facebook profile settings and content shared by dental students, student-patient relationship via Facebook; and students' perception about the impact of their online behaviour.

RESULTS

93.2% of responders had a Facebook profile and 80.5% admitted that their online attitude might affect patients' opinion about dental profession. However, 71.7% posted pictures from holidays, 41.5% from nightclubs, and 26.2% photographs wearing swimwear/underwear, while 12.8% expressed online political party predilection. One quarter of students in clinical years were Facebook friends with patients and 58% and 30% of them had online discussion about topics related or not to dentistry, respectively, while 6.8% of dental students had posted defamatory comments about the dental school, faculty members or academic staff on Facebook.

DISCUSSION

In accordance with studies in other countries, most Greek dental students had a Facebook profile and, although the majority realised the impact of Facebook behaviour on e-professionalism, a considerable percentage posted unprofessional content.

CONCLUSION

Dental students might fall into pitfalls when it comes to e-professionalism. As social media are becoming an integral part of life, there is need to include e-professionalism in dental education curriculum.

Digital and Social Media in Anatomy Education

The use of images in various forms (drawing, photography, digital applications) has always been intrinsically associated with anatomy; however, the way in which anatomy educators and students create, access, view and interact with images has changed dramatically over the last 20 years. The method that anatomy educators use to engage with students and the wider public and how students engage with each other and faculty has also changed since the turn of the century, largely due to the emergence of social media. These two facets, the move towards digital images and the use of social media, are now intricately interlinked because social media enable anatomy educators to share digital learning resources easily and instantly to a global audience. This new trend of using social media to share digital images has created some ethical dilemmas that anatomy educators are researching and seeking guidance on to ensure that they are representing the potential conflicting needs and/or requirements of different stakeholders, including donors, donor families, students, the public, regulators and anatomy educators themselves. Meeting the various needs of stakeholders is complex; however, this chapter suggests an ethical approach for how digital images and social media can continue to be part of anatomy education.

Exploration of Cybercivility in Nursing Education Using Cross-Country Comparisons

Many nursing students have experienced negative social behaviors and incivility in cyberspace. We aimed to explore knowledge, experience, and acceptability of cyberincivility, as well as the perceived benefits of cybercivility education among nursing students in the United States of America (USA), Hong Kong (HK), and South Korea (K). We used a cross-sectional study design. The Academic Cyberincivility Assessment Questionnaire was administered to participants, and data were collected from 336 nursing students from a university in each country (USA (n = 90), HK (n = 115), and K (n = 131)). Cyberincivility was perceived as a problem by 76.8% of respondents. More than 50% of respondents had experienced cyberincivility, were knowledgeable about it, and found it unacceptable. Longer hours spent on social networking services and perception of cyberincivility were positively associated with the variables, but negatively associated with perceived benefits of learning. Cross-country differences in items and level of variables were identified (p < 0.01). The HK respondents demonstrated lower knowledge, compared to USA and K respondents. Frequency of cyberincivility experience and perceived learning benefit were lower for students in the USA than in HK and K. Acceptability of cyberincivility was significantly lower in respondents from K. Developing educational programs on general and sociocultural patterns of online communication could be useful in promoting cybercivility globally.

Assessment of dentists' behaviour on the use of patients' images

BACKGROUND

Photographs and radiographs are indispensable resources for dental education, research and dissemination of clinical cases in scientific journals. The objective of this study was to evaluate the behaviour of dentists on the use of patients' images.

MATERIAL AND METHODS

Fifty-two dentists were interviewed using a semi-structured script containing open-ended questions on the use of patients' images. The answers were analysed using a qualitative-quantitative method of the discourse of the collective subject, and the distribution of the absolute and relative frequency of the answers was presented according to the central ideas obtained from the discourses.

RESULTS

The following central ideas on the use of patients' images were identified: (a) purpose: didactic and/or academic; (b) informed consent: verbal or absent when the patient cannot be identified; (c) discussion groups on social media contribute to learning; (d) most dentists would not appreciate and sue the author if they had their own photographs/imaging examinations posted on social media; 5. most dentists received some information on ethical regulations during dental school and state that images can be used with patient authorisation, without identification and for didactic/academic purposes.

CONCLUSION

Dentists consider the use of patients' images for didactic and scientific purposes beneficial, request informed consent to share mainly images that reveal the identity and would not appreciate if their personal images were shared without consent.

Global Impact of Social Media on Women in Surgery

The professional use of social media is increasingly prevalent today, particularly in medicine and surgery. Several recent movements have highlighted the strengths of this forum for networking and mentorship for females in surgery who otherwise may lack mentors locally. We sought to describe modern uses for and strengths of social media for women in surgery globally via a systematic review of the literature. Multiple efforts and avenues have promoted gender equality in surgery, while also uniting female surgeons in a collaborative virtual network of colleagues. In particular, movements on Twitter, such as #ILookLikeASurgeon and #NYerORCoverChallenge, as well as other collaborative virtual fora have brought visibility to female surgeons, while drawing the young population of students and trainees toward surgical careers. Social media provides a unique opportunity for female trainees and established surgeons alike to network and establish mentorship relationships, which may aid in fostering interest in surgery and closing the gender gap in our field.

Medical students' opinions on professional behaviours: The Professionalism of Medical Students' (PoMS) study

Introduction: The Professionalism of Medical Students (PoMS) study aimed to develop a comprehensive understanding of Australian and New Zealand (Aus/NZ) medical students' opinions and experience with professionalism dilemmas.Methods: A confidential, online survey for medical students was developed and distributed to all Aus/NZ medical schools. Students submitted de-identified demographic information, gave opinions on the acceptability of a range of student behaviours for professionally challenging situations, and whether they had encountered similar situations.Results: 3171 medical students participated from all 21 Aus/NZ medical schools (16% of the total student population). Medical students reported encountering many of the professionally challenging situations and had varying opinions on what was acceptable behaviour for the scenarios. In general, students' opinions were not influenced by the seniority, gender or the type of health professional involved in the scenario. Participant demographic factors appeared to have significant effects on professional opinions - particularly male gender and being a student in the latter stages of the course.Discussion: Medical students' professional opinions are a complex area. The PoMS data provides a reference point for students, their educators and other health professionals in identifying current student professional behaviour norms, determining the effects of demographic factors on their decision making, and where important gaps exist in medical students' approaches to professionalism.

Social media use and ethics violations: Nurses' responses to hypothetical cases

AIM

This study aimed to evaluate nurses' ability to evaluate ethical violations to hypothetical case studies involving social media use.

BACKGROUND

Inappropriate use of social media necessitates health institutes, academic institutes, nurses and educators to consider occupational ethical principles while creating a  policy and guide on the usage of social media.

METHOD

The data were collected confidentially from the nurses working at a university hospital in Turkey, using the Personal Information Form and the Ethic Case Form. The study was carried out using descriptive and inferential analysis.

FINDINGS

Analysis of the data showed that the majority of the nurses had received training in ethics, used WhatsApp social media application most often, spent less than an hour a day on social media platforms and used social media to follow daily posts. Analyses of the ethical case evaluations showed that nurses' level of education and ethics training status was influential on their Case 1 evaluations and the length of time they had worked was effective in Case 2 evaluations. When Case 3 evaluations of nurses were analysed according to ethics training, statistically significant differences were found. The analyses of the Case 4 and Case 5 evaluations showed that no statistically significant differences were found according to nurses' descriptive characteristics.

CONCLUSION

The study determined that education level, ethical training status, the source of ethics training and the duration of their work in the profession were effective regarding the case evaluation of the nurses.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nursing policymakers, educators, administrators and clinicians need to cooperate in the development of ethical awareness and creation of solutions to violations, the preparation of guidelines for social media use.

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.

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.

Attitudes toward Social Media among Practicing Dentists and Dental Students in Clinical Years in Saudi Arabia

Background:

Recently, social media use has been rising among dental students and practitioners.

Objective:

The aim of this study was to investigate the usage, attitudes, and professionalism on social media among dental students and dentists in Saudi Arabia.

Methods:

This cross-sectional study investigated 779 dental students, interns, and dentists recruited from university hospitals and private clinics in three major cities (Jeddah, Riyadh, and Dammam), representing the eastern, central, and western regions of Saudi Arabia. Validated questionnaires were distributed to the participants asking about the use of social media for general purposes and professional purposes, attitudes on the social media, professionalism on social media, and the use of social media for marketing purposes. This study was ethically reviewed and approved by the Faculty of Dentistry Institutional Review Board, Umm Al-Qura University with application number (102-18).

Results:

Among the participants, the social media platforms most frequently used on a weekly basis are WhatsApp (m = 6.13 days/week, SD = 2.10), Snapchat (m = 5.33, SD = 2.65), and Instagram (m = 4.63, SD = 2.84). LinkedIn was the least frequently used platform. The most common professional uses were to watch clinical procedures (80.49%), find new information (79.59%), learn from peers (61.1%), and communicate with patients (5.76%). Only 47.75% followed their university or workplace professionalism guidelines, and 31.74% do not have any professionalism guidelines for using social media. There were 28.75% of participants who had considered posting information/photos about a patient without the patient’s permission, those who had criticized a dental colleague numbered 49.04%, and 59.69% had criticized a dental organization. However, only a few items had statistically significant differences between dental students and dentists.

Conclusion:

More stringent guidelines regarding proper conduct online should be implemented and included in the dental continuous education material.

Educating Future Health Care Professionals About Cybercivility: Needs Assessment Study

As misbehaviors online in higher education have been widely addressed in recent research, the discourse on cyberincivility has become a contemporary issue in health professions education. However, studies regarding cybercivility, particularly from an interprofessional education standpoint, are few. This study assessed the knowledge, experience, and perceptions about cyberincivility among students in 4 health care disciplines. Their preferred means of learning about cybercivility and the perceived benefits of such education are also discussed.

Uncovering cyberincivility among nurses and nursing students on Twitter: A data mining study

BACKGROUND

Although misuse of social networking sites, particularly Twitter, has occurred, little is known about the prevalence, content, and characteristics of uncivil tweets posted by nurses and nursing students.

OBJECTIVE

The aim of this study was to describe the characteristics of tweets posted by nurses and nursing students on Twitter with a focus on cyberincivility.

METHOD

A cross-sectional, data-mining study was held from February through April 2017. Using a data-mining tool, we extracted quantitative and qualitative data from a sample of 163 self-identified nurses and nursing students on Twitter. The analysis of 8934 tweets was performed by a combination of SAS 9.4 for descriptive and inferential statistics including logistic regression and NVivo 11 to derive descriptive patterns of unstructured textual data.

FINDINGS

We categorized 413 tweets (4.62%, n = 8934) as uncivil. Of these, 240 (58%) were related to nursing and the other 173 (42%) to personal life. Of the 163 unique users, 60 (36.8%) generated those 413 uncivil posts, tweeting inappropriately at least once over a period of six weeks. Most uncivil tweets contained profanity (n = 135, 32.7%), sexually explicit or suggestive material (n = 37, 9.0%), name-calling (n = 14, 3.4%), and discriminatory remarks against minorities (n = 9, 2.2%). Other uncivil content included product promotion, demeaning comments toward patients, aggression toward health professionals, and HIPAA violations.

CONCLUSION

Nurses and nursing students share uncivil tweets that could tarnish the image of the profession and violate codes of ethics. Individual, interpersonal, and institutional efforts should be made to foster a culture of cybercivility.

Predictors of confidence in anatomy knowledge for work as a junior doctor: a national survey of Australian medical students

BACKGROUND

Major changes to the teaching of anatomy associated with the integration of basic and clinical sciences in modern medical curricula have coincided with students reporting concern over achievement of learning outcomes in anatomy. Little guidance exists for medical educators designing anatomy courses that account for factors that positively influence medical student confidence in their own anatomy knowledge. We sought to determine what factors are associated with medical students' self-reported confidence in their anatomy knowledge in preparation for clinical practice.

METHODS

Cross-sectional national survey of Australian medical students distributed using social media. We performed univariate and multivariable ordinal regression to determine the factors in anatomy learning and teaching that influence medical student self-reported confidence to have sufficient anatomy knowledge by the time of graduation, for practice as a junior doctor.

RESULTS

Of 1309 surveyed, 1101 (84%) responded, representing 6.5% of the Australian medical student population. Mean age was 23.9 years (SD 4.8 years), a majority were female (644, 58.5%), and students in all years of both undergraduate (52%, 575) and graduate entry courses (48%, 529) were represented. Items associated with increased self-reported confidence in anatomy knowledge included adequate assessment of anatomy (Odds Ratio 2.17 [95% CI 1.69-2.81]), integration of anatomy with other basic sciences (OR 1.97 [1.52-2.56]) and clinical teaching (OR 1.90 [1.46-2.48]), male gender (OR 1.89 [1.48-2.42]), anatomy education prior to medical school (OR 1.46 [1.14-1.87]) and exposure to dissection (OR 1.39 [1.08-1.78]). Medical students in their clinical years reported lower confidence in their anatomy knowledge (OR 0.6 [0.47-0.77], p < 0.0001). Age and career intention were not significant predictors of confidence.

CONCLUSIONS

Medical educators can enhance student confidence in their own anatomy knowledge by developing curricula that vertically integrating anatomy learning and teaching, integrate anatomy teaching with other basic sciences, and providing consistent assessment through both the pre-clinical and clinical stages of medical training. Anatomy education should also incorporate dissection as a teaching method, and students could benefit from completion of anatomy education prior to medical school. Consideration should also be given to further investigate the confidence of female students in their anatomy knowledge.

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

Introduction Since 2013, all General Dental Council (GDC) registrants' online activities have been regulated by the GDC's social media guidelines. Failure to comply with these guidelines results in a Fitness to Practise (FtP) complaint being investigated.Aims This study explores the prevalence of social media related FtP cases investigated by the GDC from 1 September 2013 to 21 June 2016.Method Documentary analysis of social media related FtP cases published on the GDC's website was undertaken. All cases that met the study's inclusion criteria were analysed using a quantitative content analysis framework.Findings It was found that 2.4% of FtP cases published on the GDC website during that period were related to breaches of the social media guidelines. All of the cases investigated were proven and upheld. Most of those named in the complaints were dental nurses and the most common type of complaint was inappropriate Facebook comments.Conclusions The low incidence rate should be interpreted with caution, being illustrative of the types of issues that might arise rather than the volume. The GDC will need to remain vigilant in this area and ensure that social media awareness training is an active part of CPD for all the dental team.

Smartphone Use and the Perception of Professionalism Among Medical Students and Surgical Faculty

OBJECTIVE

To understand the perception of professionalism surrounding smartphone use (wards/educational activities) among medical students and surgical faculty.

DESIGN

A prospective cohort study was conducted using an electronic survey and distributed to third- and fourth-year medical students, obstetrics/gynecology, and surgery faculty members. Five cases were randomly presented; participants were asked to review and rate the clinician's behavior on a 5-point Likert scale.

SETTING

The study was completed at The Johns Hopkins University School of Medicine, a tertiary care institution, in the departments of gyn/ob and surgery.

PARTICIPANTS

A total of 123 medical students (51% response rate) from the class of 2015/2016 along with 73 surgical faculty in the departments of gyn/ob and surgery completed the study. Of the surgical faculty, 48% were ob/gyn (54% response rate) and 52% were surgery (21% response rate). Of note, when quarrying the department of surgery all surgical faculty were included, however, only those with direct student interaction were asked to complete the survey leading to the lower response rate.

RESULTS

In 3 of 5 scenarios, students and faculty had significant differences in perception of professionalism (p<0.05). Faculty were more likely to find behaviors unprofessional compared to students. The acceptability of certain behaviors was significantly correlated in some case scenarios with how participants reported using their smartphones. Personal use of technology appears to influence the perception of acceptable behavior in certain scenarios.

Social Media among Medical Students and Personnel Here to Stay

Social media is no longer new, even in the professional medical world. It is an established and relatively public medium, and all users would do well to understand the risks associated with it. Medical personnel-whether medical student or staff physician-must familiarize themselves with it to ensure positive outcomes. As with other technologies, best practices will evolve with time, but existing and ongoing research can establish working use guidelines.

An assessment of professionalism on students' Facebook profiles

INTRODUCTION

With the advent of social media, healthcare professionals not only need to be conscious of professionalism in their face-to-face interactions but also in the electronic environment. The aim of this study was to assess the level of online professionalism on Facebook profiles available for public viewing of students from a dental school.

MATERIALS AND METHODS

A search was performed via a new Facebook account of all students in the University Dental School (dental hygiene, dental nursing, dental science and dental technology). Profiles were categorised as 'private' or 'public'. Demographic details and photographs/comments of unprofessional behaviour were recorded for each individual Facebook profile. Each profile was subsequently scored with regard to professionalism based on a previously published score.

RESULTS

There are a total of 287 students in the dental school. Of these, 62% (n = 177) had a Facebook account. Three per cent (n = 6) had a public account (fully accessible) whilst 97% (n = 171) had a private account (limited access); 36% (n = 63) of students mentioned the dental school/hospital on their profile; 34% (n = 60) had questionable content on their profile whilst 3% (n = 6) had definite violations of professionalism on their profile; and 25% (n = 44) had unprofessional photographs on their profile. Of those with unprofessional content, 52% (n = 23) of these had a documented affiliation with the dental school also visible on their profile.

CONCLUSION

There was a concerning level of unprofessional content visible on students' Facebook profiles. Students need to be fully aware of their professional responsibility in the setting of social media.

Social media and professional identity: Pitfalls and potential

INTRODUCTION

Social media developments have completely changed how information is accessed and communicated. While great potential exists with these platforms, recent reports of online unprofessional behavior by doctors has threatened the medical professional identity; a matter of critical importance for clinicians and medical educators. This paper outlines a role for social media in facilitating support for clinicians and medical teachers; it will raise awareness of pitfalls and explain ethical and legal guidelines.

METHODS

An analysis of inappropriate behaviors and conflicting attitudes regarding what is acceptable in online posts, including the inter-generational contrast in online presence and perceptions of where the boundaries lie.

RESULTS AND DISCUSSION

Guidance documents are analyzed and potentially confusing and conflicting statements are identified and clarified. The authors believe that clinicians and medical students must follow ethical imperatives in both personal and professional spheres.

CONCLUSIONS

It is essential that medical educational and professional bodies encourage clinicians to support one another and share information online while providing clear legal and ethical advice on maintaining standards and avoiding common pitfalls. Education on the responsible use of social media and associated risk awareness should be a priority for medical school curricula.

Medical student use of Facebook to support preparation for anatomy assessments

The use of Facebook to support students is an emerging area of educational research. This study explored how a Facebook Page could support Year 2 medical (MBChB) students in preparation for summative anatomy assessments and alleviate test anxiety. Overall, Facebook analytics revealed that in total 49 (19.8% of entire cohort) students posted a comment in preparation for either the first (33 students) or second (34) summative anatomy assessments. 18 students commented in preparation for both. In total, 155 comments were posted, with 83 for the first and 72 for the second. Of the 83 comments, 45 related to checking anatomical information, 30 were requiring assessment information and 8 wanted general course information. For the second assessment this was 52, 14 and 6, respectively. Student perceptions on usage, and impact on learning and assessment preparation were obtained via a five-point Likert-style questionnaire, with 119 students confirming they accessed the Page. Generally, students believed the Page was an effective way to support their learning, and provided information which supported their preparation with increases in perceived confidence and reductions in anxiety. There was no difference between gender, except for males who appeared to be significantly less likely to ask a question as they may be perceived to lack knowledge (P < 0.05). This study suggests that Facebook can play an important role in supporting students in preparation for anatomy assessments. Anat Sci Educ 10: 205-214. © 2016 American Association of Anatomists.

Use of social media in education among medical students in Saudi Arabia

PURPOSE

Social media (SM), a virtual place where people can share, exchange, and communicate their ideas and knowledge, has become the new trend in communication and learning. This study aims to explore Saudi Arabian medical students' usage of SM and to discover the most common resources used in medical education. Furthermore, it aims to illustrate students' belief about the influence of SM on their learning.

METHODS

This cross-sectional study administered validated questionnaires to medical students from different universities in Saudi Arabia, via emails, Twitter, Facebook, and short message service. A non-probability sampling technique was utilized and a sample size of 381 students was arrived at, using 95% confidence interval and 5% margin of error, since the total number of medical students in Saudi Arabia is approximately 36,000. The total respondents were 657 students from 23 different Saudi Arabian medical schools (females: 60.5%, n=397; males: 39.5%, n=260).

RESULTS

The questionnaires of 21% of the students (n=139) were excluded from the analysis since they were incomplete. The most common website used by both genders was YouTube (42.3%, n=185); however, males preferred using Twitter and Wikis (p=0.001). With regard to utilizing SM for learning, 95.8% (n=419) of the students believed that it is beneficial. Females stated that SM helps them link basic and clinical science (p=0.003).

CONCLUSION

Medical schools need to improve the utilization of SM by their faculty and students by developing activities and encouraging the usage of SM in education.

A two phase study to revise the Australian Practice Standards for Specialist Critical Care Nurses

BACKGROUND

Observational work to develop the ACCCN Competency Standards was undertaken more than 20 years ago. Since then the landscape of critical care nursing as a specialty has changed and it is not known if the Competency Standards reflected contemporary practice.

OBJECTIVES

To revise the ACCCN Competency Standards for Specialist Critical Care Nurses to ensure they continue to meet the needs of critical care nurses and reflect current practice.

METHODS

A two-phased project was undertaken. In Phase I focus groups were held in all states. Thematic analysis was conducted using two techniques. The standards were revised based on the main themes. Phase II consisted of an eDelphi technique. A national panel of critical care nurses responded to three survey rounds using a 7 point likert-type scale to indicate their level of agreement with the revised standards. A 70% agreement level for each statement was determined a priori.

RESULTS

Phase I: 12 focus groups (79 participants) were conducted. Phase II: A panel of specialist critical care nurses (research, management, clinical practice and education) responded to round 1 (n=64), round 2 (n=56), and round 3 (n=40). Fifteen practice standards with elements and performance criteria were grouped into four domains (professional practice, provision and coordination of care, critical thinking and analysis, collaboration and leadership). The revised Practice Standards for Specialist Critical Care Nurses build upon and are additional to the Nursing & Midwifery Board of Australia National Competency Standards for Registered Nurses. The standards reflect contemporary critical care nurse practices using an expanded range of technologies to care for complex critically ill patients across the lifespan in diverse settings.

CONCLUSION

The national study has resulted in the 3rd edition of the Practice Standards for Specialist Critical Care Nurses. There was input from stakeholders and agreement that the revised standards capture contemporary Australian critical care nursing practice.