Perceptions of Unprofessional Social Media Behavior Among Emergency Medicine Physicians

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.

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.

The Use of Social Media by Female Physicians in an International Setting: A Mixed Methods Study of a Group WhatsApp Chat

Background: The past decade has witnessed an increase in informal and bottom up driven "she-for-she" efforts, often using social media, to promote the advancement of women in medicine. Yet, this area of research is nascent with limited information on the use of social media platforms by female physicians, especially in the international medical arena. The purpose of this study was to investigate the use of a social media platform by a diverse group of female physicians in an international setting. Materials and Methods: The study used a mixed methods approach, including quantitative descriptive statistics and qualitative thematic analysis of the content of posts of a women physicians WhatsApp group during a 1-year time period (June 1, 2018-May 31, 2019). Results: The group consisted of 122 members with 4897 posts during the 1-year time period. Nine themes were identified including requests for medical information, logistics, personal recommendations, promotion, celebration, community engagement, education, women's empowerment, and employment inquiries. Engagement was high with 72% of members posting during the last 30 days of analysis and 92% of questions posted receiving a response, often within minutes. There were no instances of unprofessional social media behavior. Conclusions: The social media platform was effective in enabling female physicians to expand networks, exchange ideas, share scientific information, celebrate accomplishments, and provide support to colleagues. Creating a social media forum for women physicians may be an effective tool to foster a network of support and community.

Social media usage and online professionalism among registered nurses: A cross-sectional survey

BACKGROUND

Owing to its convenience and easy accessibility, social media is increasingly popular among healthcare professionals and has become a useful tool in the healthcare industry. Doctors' social media use patterns and online professionalism have been thoroughly studied. Various unprofessional behaviors such as excessive self-disclosure, violations of patient privacy and improper social media posts, were observed. However, studies exploring nurses' social media use and online professionalism are lacking.

OBJECTIVES

The objective of this study was to understand the social media use and online professionalism of Chinese registered nurses.

DESIGN

A cross-sectional survey was adopted.

SETTINGS

Eight nursing conferences and one continuing-education program that took place in Sichuan, China.

PARTICIPANTS

Convenience sampling was applied to select nurses who had obtained their Chinese nursing certificates, who were aged 18 years and above, and who worked in clinical settings. The final sample consisted of 658 registered nurses.

METHODS

Data were collected through the on-site distribution of an anonymous researcher-designed questionnaire. The questionnaire consisted of 41 items that focused on demographic and professional information, social media use and online professionalism. Medians, averages and percentages were used to describe the social media use patterns and online professionalism of Chinese registered nurses.

RESULTS

All participants in this study were social media users and 84.5% of them believed that social media had positively influenced their clinical practice. WeChat was the most frequently used form of social media, which was used among 93.5% of the subjects. Common reasons for social media use included receiving messages from work, networking, receiving news and relaxing. Approximately 56% of the participants spent one to three hours on social media daily. Most of the participants had reposted medical knowledge on social media and had subscribed to at least one medical social media account. Additionally, 67.2% of the sample disclosed that they "often" communicate work-related information with colleagues via social media. Roughly 50% of the sample insisted that their facilities had social media guidelines. Registered nurses' professionalism was also assessed. Around half of the participants had received "friend request" from patients, while 63.5% of the sample acknowledged that there were no patients on their most frequently used social media platforms. About 7.6% of the respondents had "sometimes" posted identifiable patient information, which was much lower than the reported 32.5% rate of witnessing colleagues' disclosure of identifiable patient information. Fully 50.3% of the participants indicated that they had witnessed improper posts by colleagues.

Older and wiser? Changes in unprofessional content on urologists' social media after transition from residency to practice

OBJECTIVE

To characterize changes in the frequency and nature of unprofessional content on urologists' Facebook accounts during the transition from residency to practice.

METHODS

Facebook was queried with the names of all 2015 US urology graduates 1 year after completion of residency. We identified unprofessional and potentially objectionable content on the public Facebook accounts using a rubric based on professionalism guidelines by the American Urological Association, the American Medical Association and the Accreditation Council for Graduate Medical Education. Comparisons of unprofessional content were made with data from this cohort collected at the completion of residency. To assess how professional identities were reflected on social media, we determined which urologists self-identified as a urologist on Facebook and any changes in their unprofessional content.

RESULTS

Of 281 urologists, 198 (70%) had publicly identifiable Facebook accounts. Of these, 85 (43%) contained any unprofessional or potentially objectionable content, including 35 (18%) with explicitly unprofessional content. Examples included images of and references to intoxication, explicit profanity, and offensive comments about patients. Of the 201 Facebook accounts that had been publicly identifiable at the completion of residency, most profiles (182, 91%) had remained public; of the 19 that were no longer public, about half had previously contained unprofessional content. Similarly, of the 80 urologists without public profiles 1 year previously, most (64, 80%) had remained unidentifiable on Facebook; of the 16 accounts that had since become publicly identifiable, half had unprofessional content. Among the urologists on Facebook overall, 11 (6%) had posted new unprofessional or potentially objectionable content since entering practice. Comparing this cohort in practice vs at the completion of residency, there were no significant differences in how many urologists had public Facebook accounts (70% vs 71%) or whose accounts had concerning content (43% vs 40%). The presence of unprofessional content at the completion of residency strongly predicted having unprofessional content later in practice. More urologists overall self-identified as being a urologist on Facebook, and a larger proportion of these profiles also displayed unprofessional content (53% vs 47% 1 year previously).

CONCLUSION

Most urologists maintained public Facebook accounts after the transition to practice, and about half of these contained unprofessional or potentially objectionable content. Amidst their increasing self-identification as urologists on social media, the majority of practising urologists had posted concerning content, which could have an impact on their professional identities and public perceptions of the specialty.