Table 3.
Studies Regarding SoMe Influence on Professional Development.
| Studies Regarding SoMe Influence on Professional Development | ||||
|---|---|---|---|---|
| Study Authors and Date | Aim(s) | Participants | Evaluation Method(s) | Major Findings |
| Adilman et al (2016)34 | Assess SoMe use among oncologists as increased use will enhance physician communication, education, and mentorship | n = 207 consisting of 51% medical oncologists, 29% trainees, 6% radiation oncologists, 6% medical students, 6% other | • Survey to measure SoMe use to identify gaps between age-defined physician generations | 72% use SoMe. SoMe use highest at 93% in 25-34 yrs old. SoMe use lowest at 39% in 45-54 yrs old. |
| Barker et al (2012)35 | Determine SoMe practices of anesthesiology PDs | n = 66 anesthesiology PDs | • Survey regarding SoMe use practices by PDs and its influence on anesthesiology trainees | 30.3 % of program hospitals had SoMe policies. 81.8% denied reprimanding trainee for inappropriate SoMe use. 66.7% denied providing SoMe use education. 54.5% monitor SoMe habits of trainees if alerted of problem. 12.1% report frequent use of internet for screening resident applicant. 57.6% report never using internet to screen applicants. |
| Ben-Yakov et al (2015)36 | Determine ethical perspective and practices of using internet to search for patients | n = 530, including emergency physicians, residents, and medical students | • Survey to assess frequency of searching patient on internet | 12.1% used Google to search for patients, 1.9% used Facebook. 13% disclosed their actions to patient. 24.5% reported searching for patients on Facebook as “very unethical” |
| Black et al (2010)37 | Measure and compare use frequency and content on Facebook profiles of 2 cohorts of medical students and residents (2007 and 2009) | n = 1,023 consisting of 372 Facebook profiles of medical students and residents in 2007, and 651 in 2009 | • Evaluate Facebook profiles for privacy settings, personal information, affiliated social groups, and photographic content | 39.8% of residents and 69.5% of medical students maintained their Facebook accounts. 2009 cohort was less likely to post unprofessional content compared with 2007 cohort. 33% of public profiles depicted alcohol use, 12.6% had unprofessional “wall” postings including obscenities, racist remarks, and descriptions of unprofessional behavior. |
| Chandawarkar et al (2018)5 | Characterize trends and content of plastic surgery residency-associated Instagram accounts | n = 67 integrated plastic surgery programs | • Identify number of integrated plastic surgery programs with Instagram accounts, number of posts, follower count • Post content analysis |
21% of integrated plastic surgery programs have active Instagram accounts, with a total of 806 posts, 4,466 followers, 3.97% posts included intraoperative photos, one (0.12%) showed a patient image. |
| Colvin et al (2018)38 | Implement a pilot curriculum to address professionalism, social, and communication competencies in surgical residency | n = 16 surgical interns | • Pre- and postintervention surveys regarding perceived need for PSC training | Preintervention survey revealed 86% agreeing to additional PSC training, this increased to 94% postintervention. |
| Cook et al (2013)39 | Examine professionalism practices and policies, utilization of new resources, and professionalism concerns with SoMe use in pediatric training programs | n = 122 pediatric program PDs | • Survey regarding professionalism practices, including structure of curricula, methods of trainee assessment, use of nationally available resources, and SoMe policies | 70% provide instruction to trainees about professionalism on SoMe. 73% were unaware of the AMA policy on “Professionalism in the Use of Social Media.” 30% report prohibiting trainee from graduating or sitting for an exam secondary to ethical or professional misconduct. |
| Dawkins et al (2017)40 | Explore SoMe professionalism competency and frequency of exposure to postings that violate SoMe professionalism guidelines among pediatric residents | n = 1,628 pediatric residents | • Survey with vignettes that challenge published SoMe guidelines to test competency • Assess frequency of viewing similar postings • Assess knowledge of institutional SoMe policies, and experience with education on SoMe professionalism |
73.29% correctly determined the 5 vignettes as unprofessional. 53.93% endorsed frequently viewing posts that violated professionalism standards, including derogatory remarks about patients. 40% unaware of SoMe policy, and 12.5% reported no such policy exists. 22.85% have never received structured SoMe training. |
| Desai et al (2014)41 | Investigate novel use of private bidirectional direct messages via Twitter to provide resident feedback and evaluations | n = 13 emergency medicine residents | • Pre- and postintervention surveys regarding opinions on pre- and postintervention feedback and evaluation methods • Measurement of tweets and completed formal evaluations via Twitter |
13 residents received 8 formal evaluations. 220 tweets were provided by 7 faculty members. Postintervention survey demonstrated increased feedback volume and detail of evaluations via Twitter |
| Diller et al (2018)42 | Analyze Twitter use of EM residency programs and assess conformance of recommendations by CORD of emergency medicine | n = 88 EM programs | • Survey to determine CORD compliance • Assess program Twitter use motives |
58% of respondents had a program-level Twitter account. 61% were not compliant with CORD recommendations and were managed by residents versus faculty. Twitter was frequently used for educational and promotional purposes. |
| Farber et al (2017)43 | Assess Twitter use by academic urology programs | n = 38 academic urology residency programs | • Assess volume of tweets, followers, following, account age, and activity details • Repeat assessment in 6 months |
30% of urology residencies have Twitter accounts. Among the 5 most active accounts, median number of tweets, followers, following, and age of account was 58, 154, 107.5, and 20 mo, respectively. At 6-mo reassessment, there was average 161% increase in tweets and 148% increase in follower count. Twitter presence and U.S. News and world report ranking appear to be unrelated (p = 0.51) |
| George et al (2014)44 | Measure medical students’ insight regarding the magnitude their Facebook postings may have on residency admissions process | n = 2,109 medical students | • Survey to determine medical student opinions on residency admissions committees using Facebook to screen applicants for unprofessionalism | 63.5% believed unprofessional Facebook photos should not be grounds for automatic rejection. 33.7% believed photos should have no bearing on application and are irrelevant. 2.8% believed pictures should be grounds for automatic rejection. Over 50% of residency programs report inappropriate Facebook posting could adversely affect admission |
| Ginory et al (2012)45 | Determine need for SoMe training about digital professionalism during residency | n = 182 psychiatry residents | • Survey regarding Facebook use along with professionalism concerns | 12.3% respondents have Facebook account publicly available for viewing. 9.7% have received friend requests from a current patient—none accepted. 3.9% received friend requests from a former patient—one was accepted. 18.7% have searched for their patient’s SoMe profile. 2.7% report having discussed the use of SoMe with their training programs |
| Irfan et al (2018)46 | Assess utility of SoMe among family medicine residents and physicians in Saudi Arabia | n = 132 including 92 family medicine residents and 40 physicians | • Survey to determine SoMe use frequency, platform preference, and perceived benefits | 38% physicians reported professional SoMe use versus 21% of residents. Youtube was most frequently accessed at 68.2%. Generally, females use SoMe for education and professional development, whereas males use it more frequently for personal purposes |
| Jain et al (2018)47 | Assess Canadian-educated, graduating urology residents’ practices of and attitudes toward personal and professional SoMe use | n = 100 final-year residents in urology training programs | • Survey to measure personal and professional SoMe use • Determine awareness of existing professional guidelines for SoMe use |
92% report SoMe use, of which 73% endorse personal SoMe use. 12% reported frequent professional SoMe. 59% objected to direct patient interaction online. 76% supported using SoMe to provide patients with static information, 65% supported using SoMe to collaborate with colleagues. 2%–8% had read guidelines and legislation for physician online use |
| Jent et al (2011)48 | Assess insight on SoMe and professionalism between faculty and trainees | n = 109 including 29 faculty members (pediatricians, psychologist, social workers), and 80 residents and medical students | • Survey regarding SoMe use and opinions on fictional SoMe vignettes | 93.8% trainees and students report SoMe use versus 72.4% of faculty. 17.5% of trainees and students and 11% of faculty reported searching patient’s SoMe. No significant differences in responses to vignettes between trainees, students, and faculty |
| Khandelwal et al (2015)49 | Successfully create a flipped classroom workshop to simulate settings focused on application of challenging professionalism principles, including SoMe use | n = 37 residents representing 19 different medical and surgical disciplines | • Pre and postintervention surveys evaluating various aspects regarding professionalism including competency and comfort. | Preintervention survey: 58.2% of trainees incorrectly believed physicians should “be available whenever their patients need them”. Postintervention trainees felt more comfortable defining professionalism, describing social contract between physicians and society, and applying principles of professionalism |
| Klee et al (2015)50 | Investigate SoMe use of younger physicians versus their predecessors, and evaluate whether or not training regarding appropriate SoMe use is adequate | n = 253 including 61 family medicine residents, and 192 family medicine physicians | • Survey to evaluate SoMe use and correlate this with age and level of medical experience | 90% of residents, 77% of junior physicians, and 70% of senior physicians reported having SoMe accounts. 66% of residents and 50% of practicing physicians believed it was unethical to be SoMe friends with patients. 26% junior physicians and 10% of residents or senior physicians report having had SoMe training. The majority agreed SoMe use should be addressed in medical school and residency |
| Koo et al (2018)37 | Characterize changes in the frequency and nature of unprofessional content on urologists’ Facebook accounts during a 1-y transition period from residency graduation to practice | n = 281 urologists, of which 198 had publicly identifiable Facebook accounts | • Screen publicly available posts for unprofessional or potentially objectionable content via a 65 category rubric based on published professionalism guidelines at completion of residency • Repeat screen 1-year postgraduation |
No significant improvements. 70% versus 71% 1-y later, had publicly available Facebook profiles. 43% versus 40% 1-y later, contained unprofessional or potentially objectionable content (i.e., apparent intoxication, profanity, and offensive comments about patients) |
| Koo et al (2017)51 | Characterize unprofessional content on public Facebook accounts of US urology residency graduates | n = 281 urologists, of which 201 had publicly identifiable Facebook accounts | • Screen publicly available posts for unprofessional or potentially objectionable content via a 65 category rubric based on published professionalism guidelines | 40% of Facebook profiles contained unprofessional or potentially objectionable content, including 13% portraying explicitly unprofessional behavior. 42% self-identified as a urologist on their Facebook profile |
| Landman et al (2010)52 | Examine SoMe use among surgical residents and faculty and continue the discourse about both the use of SoMe and the need for practical guidelines for surgical house staff and faculty | n = 215 including 88 residents, of which 25 have public profiles, and 127 faculty members, of which 17 have public profiles | • Screen publicly accessible Facebook accounts for inappropriate content | 64% of residents and 22% of faculty had Facebook profiles, of which 50% were publicly available. 31% of the publicly accessible Facebook profiles displayed work-related postings, of which 14% were patient-specific. |
| Langenfeld et al (2014)53 | Investigate Facebook profiles of general surgery residents in the Midwest (USA) for evidence of unprofessional conduct | n = 996 surgical residents, of which 32% had identifiable Facebook profiles | • Screen Facebook profiles for unprofessional content | 73.7% of residents had no unprofessional content. 14.1% had potentially unprofessional content. 12.2% had explicitly unprofessional content (i.e., Binge drinking, sexually suggestive photos, and HIPAA violations) |
| Lefebvre et al (2016)54 | Investigate existing perceptions and competencies regarding SoMe and professionalism among residents | n = 70 residents from 9 disciplines | • Survey testing competency regarding digital professionalism and SoMe use | 29% were familiar with current institutional policy on SoMe use, this was associated with a higher score by a mean of 2.2 correct responses to the survey. 67% reported instruction during medical school regarding appropriate SoMe use |
| Moubarak et al (2011)55 | Obtain insight on opinions of trainees at an academic institution in France regarding Facebook activity and its impact on the doctor–patient relationship | n = 202 consisting of 160 residents and 42 fellows in varied specialties | • Survey evaluating views on the doctor–patient relationship via hypothetical situations that could arise with Facebook | 85% would automatically decline patient friend request. 48% believed the doctor–patient relationship would be altered if the patient discovered their doctor had a Facebook account |
| Thompson et al (2011)56 | Document potential patient privacy violations on Facebook profiles of medical students and residents at a single institution in Gainesville, Fla. | n = 1,023 consisting of 372 Facebook profiles of medical students and residents in 2007, and 651 in 2009 | • Screen Facebook profiles for unprofessional content and assess publicly accessible information at two points in time (2007 and 2009) | 12 instances of potential patient privacy violations—1 in 2007, and 11 in 2009. Medical students were more likely to have these violations compared with residents (11 versus 1) |
| Thompson et al (2008)39 | Assess content on SoMe posted by medical students and residents at a single institution in Gainesville, Fla | n= 362 consisting of 322 medical students and 40 residents | • Screen Facebook profiles for unprofessional content and assess publicly accessible information | 64.3% of medical students and 12.8% of residents had Facebook accounts. 62.7% of profiles were public. 10 profiles were randomly selected for in-depth analysis—70% had photos with alcohol, of which 10%–50% portrayed excessive drinking. 30% had unprofessional content including drunkenness, overt sexuality, profanity, and patient privacy violations |
| Wagner et al (2018)57 | Characterize surgeons’ professional use and perceptions of SoMe across 4 academic institutions in the USA | n = 208 including 132 faculty and 76 trainees | • Survey regarding SoMe usage and attitudes. | 70% believe SoMe benefits professional development. Age <55 predicted positive attitude toward SoMe, whereas the rank of respondent as an associate professor predicted negative attitude toward SoMe. Lack of time and personal and patient privacy concerns were cited most commonly as the reasons for not using SoMe |
CORD, Council of Residency Directors; EM, emergency medicine; HIPAA, Health Insurance Portability and Accountability Act; PD, program directors; PSC, professionalism and social competencies; SoMe; Social Media.