Table 3.

Summary of Evidence Regarding the Influence of Social Media on Resident Professionalism, Based on a 2015 Literature Review^a

Author, Year	Study details	Intervention	Results	MERSQI^b	COREQ^c
Ben-Yakov, 2015³⁰	- Quantitative - Cross-sectional - Single institution in Canada from Nov 2010 through June 2011 - N = 530 emergency physician residents, medical students in the ED rotation, and ED staff physicians - Social media platform used: Facebook and Google	Survey to explore attitudes about searching the Web for patient information	- 74% had a Facebook account - 19.2% had a Twitter account - 12.1% used Google to search for patients and 1.9% used Facebook to search for patients Of these individuals only 13% disclosed their action to their patients - 24.5% considered searching for patients on Facebook “very unethical”	10	N/A
Cook, 2013³¹	- Quantitative - Cross-sectional - Members of the Association of Pediatric Program Directors in the United States from May through August 2012 - N = 122 members - Social media platform used: Multiple social media sites, but predominantly Facebook	Survey about ethics and professionalism practices	- 92.2% stated that they studied professionalism and ethics through their program’s curriculum - 66.4% provided instruction to trainees about professional behavior on social media - 66.4% where unaware of the AMA policy on “Professionalism in the Use of Social Media”	8.5	N/A
Ginory, 2012³²	- Quantitative - Cross-sectional - Members of American Psychiatric Association listserv from February through March 2011 - N = 182 psychiatry residents - Social media platform used: Facebook	Survey regarding Facebook use	- 18.7% said they looked up patients' profiles - 9.7% reported having received a friend request from a current patient, 0 accepted the request - The majority said they had no guidance regarding professional use of social media Websites	9	N/A
Jent, 2011³³	- Quantitative - Case series - Single institution in the United States in pediatric department - N = 29 faculty members (pediatricians, a psychologist, and social workers) - N = 80 trainees (residents and medical students) - Social media platform used: Multiple social media sites	Survey about social media use and thoughts regarding seven fictional social media profiles	- Greater social media use by trainees than faculty (93.8% vs 72.4%) - Trainees and faculty alike generally believed that looking at social media about people they know or work with is not an invasion of privacy - Only trainees (17.5%) reported conducting searches on patients on the Internet and social media sites - No significant differences existed between faculty members’ and trainees’ responses to the vignettes	8	N/A
Landman, 2010³⁴	- Qualitative - Cohort study - Single institution in the United States during November 2009 - N = 88 general surgery residents - N = 127 general surgery faculty - Social media platform used: Facebook	Evaluation of online profiles of general surgery residents and faculty members	- General surgery residents (64%) and faculty members (22%) had Facebook profiles. Of these, 50% were public. Of those 50%, 31% had work-related postings - discussed formulation of guidelines at departmental and individual level based on findings	N/A	26
Langenfeld, 2014³⁵	- Qualitative - Cohort study - Residents in the Mid-West (United States) through American College Surgeons Website - N = 319 general surgery residents with Facebook profiles - Social media platform used: Facebook	Reviewed Facebook profiles to assess whether they were in alignment with professionalism guidelines	- 73.7% profiles did not contain unprofessional content - 14.1% of profiles contained potentially unprofessional content (alcohol in hand, etc); - 12.2% of profiles contained clearly unprofessional content (HIPAA violation; binge drinking; sexually suggestive material)	N/A	23
Moubarak, 2011³⁶	- Quantitative - Cross-sectional - Single institution in France in October 2009 - N = 160 residents - N = 42 fellows - Social media platform used: Facebook	Survey about Facebook and its impact on the doctor-patient relationship	- 85% would automatically decline patient friend request - 48% thought doctor-patient relationship would be altered if the patient discovered that their doctor had a Facebook account	8.5	N/A
Ponce, 2013³⁷	- Qualitative - Cohort study - Single institution in the United States during 2010 - N = 153 orthopedic surgery residents - Social media platform used: Facebook	Reviewed Facebook profiles and rated them based on professionalism	- mean professionalism score of 2.82 (3 = no professionalism issues; 2 = questionable content) - 16% of profiles contained unprofessional content - no significant difference in professionalism scores of those who matched versus those who did not match	N/A	25
Schulman, 2013³⁸	- Quantitative - Cross-sectional - Multi-institutional; in the United States, in 2009 - N = 46 medical school application reviewers - N = 511 residency admission reviewers - N = 43 reviewers of both medical school and residency applicants - Social media platform used: Multiple social media sites	Survey to assess familiarity with, usage of, and attitudes towards social media Websites of admissions offices at U.S. medical schools and residency programs	- 15% of medical schools or residency programs maintain social media profiles - 64% of reviewers searched individual profiles on social media Websites. - 53% of respondents felt that unprofessional information on applicants' social media Websites could compromise their admission	8	N/A
Thompson, 2011³⁹	- Qualitative - Cross-sectional - Single institution in the United States, in 2007 and 2009 - N = 372 medical student and resident profiles in 2007 - N = 651 in 2009 - Social media platform used: Facebook	Reviewed Facebook profiles to assess for possible privacy violations and adherence to professional norms	- 12 noted instances of potential patient violations (posting photos)—1 in 2007 and 11 in 2009 - Medical students were more likely to have these violations than residents (11 vs 1)	N/A	22

Abbreviations: ED indicates emergency department; AMA, American Medical Association; HIPAA, Health Insurance Portability and Accountabilit Act.

Two authors (P.L. and M.S.) scored each article independently for both the MERSQI and COREQ instruments. They reconciled any differences through discussion.

The MERSQI or Medical Education Research Study Quality Instrumentis a validated instrument which assesses the quality of quantitative medical education research. Scores may range from 6 to 18; higher scores represent higher quality.

The COREQ or Consolidated Criteria for Reporting Qualitative Studies (COREQ) is a checklist that consists of 32 criteria, developed to promote explicit and comprehensive reporting of qualitative studies. Scores may range from 0 to 32; higher scores represent higher quality.