Guidelines not enough: Medical students and social media use

“Exposure to guidelines on professional online conduct had no effect on posting behavior.”
For those who believe medical students can be taught the appropriate professional use of social media and follow guidance from well-prepared guidelines, the above must be one of the more chilling statements seen in the published literature this year.
The statement comes from a recently published survey of social media use by 880 Australian medical students published in the Medical Journal of Australia which documented posting of unprofessional conduct by 34.7% of respondents.
The study by Dr. Christopher Barlow and colleagues reported on results of a 35-question voluntary online survey conducted among medical students among 21 Australian medical schools in 2013.
In this cohort social media use was found to be almost universal with 99.4% of respondents reporting using Facebook and 96.6% using YouTube. This social media use was also fairly savvy it appears, with 71% of those using Facebook utilizing higher level privacy settings.
In addition, the majority of respondents said they were aware of social media guidelines produced by either a professional body or a university. Slightly more than a third of respondents said they had received instruction about online professionalism.
Despite all of this, 306 students reported posting unprofessional content ranging from, most commonly evidence of intoxication (34.2%) to posting of patient information (14 cases or 1.6%).
Obviously these results are concerning.
Despite findings that students were aware of their professional obligations and guidelines for appropriate social media use, more than a third still reported posting inappropriately.
As the authors say, it is clear that reducing unprofessional use of social media “will require more than providing guidelines.”
They went on to state that medical educators need to consider approaches that go beyond providing guidelines “and students should be regularly prompted to reflect on their activities, to evaluate their online behaviors, and to temper them if appropriate.”
The study goes to show that while there may be medical students fully versed in the social media world and their inherent professional responsibilities, many still need proper guidance still lacking from most medical schools globally.


1 thought on “Guidelines not enough: Medical students and social media use

  1. Thanks, Pat, for sharing the Barlow study here. The results are hardly surprising, really, given that we have an entire generation schooled in the popular practice of routinely posting their drunken party photos online. Every detail of everyday life, no matter how inane or moronic, deserves to be shared. So how can these narcissistic brainiacs resist this long-established urge to share when they get accepted into med school and start encountering REALLY cool stuff to impress their followers with?

    I’m reminded of the Stony Brook University Medical Center in Long Island a few years ago announcing that it was developing a “revised ethics policy” after a medical student posted a photo on Facebook of his classmate posing with a thumbs up next to a dead body in the hospitl. (That’s hilarious, kids… )

    But according to the Barlow study’s discouraging conclusions, such ethical guidelines may not work at all. My concern, of course, is that these med students grow up to be the docs taking care of us one day. Consider the ER physician Dr. Alexandra Thran as an example: she was fired from her Rhode Island hospital, fined, and sanctioned by the state medical board for posting personal information about one of her trauma patients on Facebook. Although she did not specifically include the patient’s name, she did violate the patient’s privacy rights by writing enough that others in the community could easily identify the patient, according to the state board filing.

    How many med students (arguably far less mature and experienced than the 48 year old Dr. Thran) possess the level of subtlety and sensitivity required to identify why what she did was wrong? And for your readers who might be tempted to dismiss the severity of the problem in the Australian study (after all, just 14 cases of posting patient information doesn’t seem like much!), I’d remind them that this number should be zero.


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