Opinions of Students from a Brazilian Medical School Regarding Online Professionalism
Open accessAbstract
Introduction Unprofessional online behavior by medical students or physicians may damage individual careers, and the reputation of institutions and the medical profession. What is considered unprofessional online behavior, however, is not clearly defined and may vary in different cultures.Objectives To determine the frequency with which students from a Brazilian Medical School come across ten given examples of unprofessional online behavior by medical students or physicians, and gather the opinions of participants regarding the appropriateness of these behaviors.Methods A cross-sectional survey of 350 students from the Medical School of Bahia, Brazil. Only those who had a profile in social media were included in the final analyses.Results 336/350 (96.0%) medical students kept a profile in social media. Only 13.5% reported having discussions about online professionalism during ethics classes. They reported witnessing the investigated examples of unprofessional online behavior with varying frequencies, ranging from 13.7% for "violation of patient's privacy" to 85.4% for "photos depicting consumption of alcoholic beverages". Most participants felt neutral about posting "pictures in bathing suits", whereas the vast majority rated "violation of patient's privacy" as totally inappropriate. When presented with a case vignette illustrating violation of patients' privacy (publication of pictures of hospitalized children or neonates in social media), however, most participants felt neutral about it. Participants considered all investigated examples of unprofessional online behavior more inappropriate if carried out by doctors rather than by students.Conclusions Medical students are witnessing a high frequency of unprofessional online behavior by their peers and physicians. Most investigated behaviors were considered inappropriate, especially if carried out by physicians. Participants were not able to recognize the publication of pictures of hospitalized children or neonates in social media as cases of violation of patients' privacy. Further studies are needed to determine if an academic curriculum that fosters online professionalism will change this scenario.
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Potential damage to professional image has been depicted by students as concerns about repercussions of their posts on career development or future employment, since employers are checking social media profiles of candidates.
“Potential damage to the professional image has been depicted by students as concerns about repercussions of their posts on career development or future employment, since employers are checking SM profiles of candidates [43, 45, 51, 56, 57, 59, 66, 68, 70].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [59]
The Results and Discussion (page unavailable) report that Brazilian medical students were concerned about the effects of social-media posts on their careers and potential employers’ opinions. The Introduction says posts may be accessible to future employers, but the paper does not establish that employers check candidates’ profiles. (LLM, conf=0.85)
Experimental — accuracy not yet measuredLoosening accountability is a danger to e-professionalism from two points of view: eroding public trust by providing poor quality of information on social media and damaging the professional image.
“According to some studies in this review, loosening accountability can be seen as a danger to e-professionalism from two points of view: eroding public trust by providing poor quality of information on SM [39,106,117] and damaging to the professional image [43, 45, 51, 56, 57, 59, 64, 66, 68, 70, 73, 102, 106, 112].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [59]
The Introduction (page unavailable) says unprofessional social-media posts may harm careers and the image of institutions and the medical profession; the Results also report students’ concern about such repercussions. The paper does not link poor-quality information on social media to erosion of public trust, so it supports the professional-image part but not that other attributed danger. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA wide range of opinions have been observed concerning friending a patient, ranging from one-third of medical students in Brazil finding this unacceptable to 92% of senior medical students in New Zealand.
““Friending a patient” is generally not acceptable nor endorsed; a wide range of opinions have been observed concerning this issue, ranging from one-third for medical students in Brazil [59] that find this unacceptable to 92% for senior medical students in New Zealand [70].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [59]
The Results and Table 1 (page not provided) report that 112 of 334 Brazilian medical students (33.5%) answered “No” when asked whether they would like to befriend patients on social media after graduation. This supports the one-third figure, but declining a future friendship is not the same as judging friending a patient unacceptable. The cited Brazilian paper does not supply the New Zealand figure, which the sentence attributes to a separate citation. (LLM, conf=0.88)
Experimental — accuracy not yet measuredNumerous studies document blurred boundaries between patients and health care professionals, and between students and faculty.
“Numerous studies document blurred boundaries between patient and HCPs, and between students and faculty [40, 43, 47, 59, 64, 65, 68, 70, 73, 75, 78, 82, 85, 98, 100, 105, 107, 114, 117].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [59]
The Results and Discussion report social-media posts violating patient privacy, including pictures of hospitalized children, which supports the patient–health care professional aspect of the claim. The Introduction notes that posts can be seen by educators, but the paper does not document blurred boundaries between students and faculty. No page numbers are available in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredAmong Brazilian medical students, frequencies of self-reported unprofessional behavior ranged from 13.7% for violation of patient's privacy to 85.4% for photos depicting consumption of alcoholic beverages.
“Among Brazilian medical students, frequencies ranged from 13.7% for “violation of patient’s privacy” to 85.4 % for “photos depicting consumption of alcoholic beverages” [59].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [59]
The Results and Table 3 give the stated range, from 13.7% for violation of patient privacy to 85.4% for photos depicting alcohol consumption. These are students’ reports of having witnessed posts by medical students or physicians, not frequencies of behavior the respondents reported engaging in themselves. Page numbers are not available in the supplied copy. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Students depict potential damage to professional image as a concern about repercussions of their posts on career development or future employment because employers check social media profiles of candidates.
“Potential damage to professional image has been depicted by students as a concern about repercussions of their posts, on career development, or on future employment since employers are checking SM profiles of candidates [43, 45, 51, 56, 57, 59, 66, 68, 70].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [59]
The Results report that students were concerned about the effects of social-media posts on their careers and on potential employers’ views; the Discussion gives the corresponding figures as 85.7% and 92.7%. The Introduction says posts may be accessible to future employers, but the paper does not establish that employers check candidates’ profiles. (LLM, conf=0.85)
Experimental — accuracy not yet measuredLoosening accountability is a danger to e-professionalism from two points of view: eroding public trust by providing poor quality information on social media and damage to professional image.
“According to some studies in this review, loosening accountability can be seen as a danger on e-professionalism from two points of view, eroding public trust by providing poor quality of information on SM [39,106,117] and damage to professional image [43, 45, 51, 56, 57, 59, 64, 66, 68, 70, 73, 102, 106, 112].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [59]
The Introduction and Results (pages not provided) support the risk of damage to professional image: unprofessional social-media posts may harm the image of the profession and institutions, and students reported concern about those repercussions. The paper does not link poor-quality information on social media to erosion of public trust; searches for those terms found no supporting passage. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA wide range of opinions exists on the acceptability of online interaction with patients, ranging from one-third of medical students in Brazil finding it unacceptable to 92% of senior medical students in New Zealand.
“Although online interaction with a patient is generally not acceptable nor endorsed, a wide range of opinions have been observed concerning this issue, ranging from one-third for medical students in Brazil [59] that find this unacceptable to 92% for senior medical students in New Zealand [70].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [59]
Table 1 (reproduced in the Discussion; page unavailable) reports that 112 of 334 Brazilian medical students (33.5%) answered “No” when asked whether they would like to befriend patients on social media after graduation. That supports the one-third figure, but the question was narrower than whether online interaction with patients generally is unacceptable. The New Zealand figure is attributed to a separate citation and is not assessed here. (LLM, conf=0.86)
Experimental — accuracy not yet measuredBoundaries are blurred between patients and health care professionals, and between students and faculty.
“Boundaries are blurred between patients and HCPs, and between students and faculty [40, 43, 47, 59, 64, 65, 68, 70, 73, 75, 78, 82, 85, 98, 100, 105, 107, 114, 117].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [59]
The Introduction (page unavailable) says students and physicians post personal, academic, and professional material that can be seen by patients and educators, supporting the concern that online activity crosses professional contexts. It does not say that patient–professional or student–faculty boundaries are blurred; the latter relationship is not examined as a boundary issue. (LLM, conf=0.70)
Experimental — accuracy not yet measuredSurveys that captured students' self-report of posted unprofessional behavior reported witnessing the investigated examples with varying frequencies.
“Surveys that captured students’ self-report of posted unprofessional behavior (eg, evidence of being intoxicated, illegal drug use, posting patient information, sharing clinical images inappropriately, and depictions of an illegal act) reported witnessing the investigated examples with varying frequencies [32,42,43,55,59,62,64,73,114,118].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [59]
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Cites
Online Posting of Unprofessional Content by Medical Students
Chretien, K. C. (2009) · JAMA · doi:10.1001/jama.2009.1387 · Cited by 448 · see citing works
The Intersection of Online Social Networking with Medical Professionalism
Thompson, L. A., Dawson, K., Ferdig, R., Black, E. W., Boyer, J., Coutts, J., & Black, N. P. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0538-8 · Cited by 425 · see citing works
Farnan, J. M., Snyder Sulmasy, L., Worster, B. K., Chaudhry, H. J., Rhyne, J. A., Arora, V. M., for the American College of Physicians Ethics, P. A. H. R. C., the American College of Physicians Council of Associates, & the Federation of State Medical Boards Special Committee on Ethics and Professionalism* (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-158-8-201304160-00100 · Cited by 420 · see citing works
Cost-Effectiveness of Distributing Naloxone to Heroin Users for Lay Overdose Reversal
Coffin, P. O., & Sullivan, S. D. (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-158-1-201301010-00003 · Cited by 347 · see citing works
Online professionalism and the mirror of social media.
Greysen, S. R., Kind, T., & Chretien, K. C. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1447-1 · Cited by 323 · see citing works
Reviewing social media use by clinicians: Table 1
von Muhlen, M., & Ohno-Machado, L. (2012) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2012-000990 · Cited by 319 · see citing works
(2009) · Issue Lab (Candid) · Cited by 269 · see citing works
Peluchette, J., & Karl, K. (2008) · CyberPsychology & Behavior · doi:10.1089/cpb.2007.9927 · Cited by 268 · see citing works
Content of Weblogs Written by Health Professionals
Lagu, T., Kaufman, E. J., Asch, D. A., & Armstrong, K. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0726-6 · Cited by 255 · see citing works
(2011) · JAMA · doi:10.1001/jama.2011.68 · Cited by 236 · see citing works
Greysen, S. R., Chretien, K. C., Kind, T., Young, A., & Gross, C. P. (2012) · JAMA · doi:10.1001/jama.2012.330 · Cited by 158 · see citing works
Shore, R., Halsey, J., Shah, K., Crigger, B.-J., & Douglas, S. P. (2011) · The Journal of Clinical Ethics · doi:10.1086/jce201122208 · Cited by 149 · see citing works
Protected health information on social networking sites: ethical and legal considerations
Thompson, L. A., Black, E., Duff, W. P., Paradise Black, N., Saliba, H., & Dawson, K. (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1590 · Cited by 114 · see citing works
Online professionalism and Facebook – Falling through the generation gap
Osman, A., Wardle, A., & Caesar, R. (2012) · Medical Teacher · doi:10.3109/0142159x.2012.668624 · Cited by 67 · see citing works
Online professionalism investigations by state medical boards: first, do no harm
Greysen, S. R., Johnson, D., Kind, T., Chretien, K. C., Gross, C. P., Young, A., & Chaudhry, H. J. (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-158-2-201301150-00008 · Cited by 46 · see citing works
From the Federation of State Medical Boards of the United States
Winn, J. R. (1992) · JAMA · doi:10.1001/jama.267.21.2857 · Cited by 44 · see citing works
Chrétien, J.-P. (2011) · JAMA · doi:10.1001/jama.2011.362 · Cited by 16 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- von Muhlen M, Ohno-Machado L. Reviewing Social Media Use by Clinicians. J Am Med Inform Assoc. 2012; 19:777-81.
Cited by
Sorted by citations
Vukušić Rukavina, T., Viskić, J., Machala Poplašen, L., Relić, D., Marelić, M., Jokic, D., & Sedak, K. (2021) · Journal of Medical Internet Research · doi:10.2196/25770 · Cited by 199 · see citing works
“Numerous studies document blurred boundaries between patient and HCPs, and between students and faculty [40, 43, 47, 59, 64, 65, 68, 70, 73, 75, 78, 82, 85, 98, 100, 105, 107, 114, 117].”
InfluentialAssessment of medical students’ attitudes on social media use in medicine: a cross-sectional study
Avcı, K., Çelikden, S. G., Eren, S., & Aydenizöz, D. (2015) · BMC Medical Education · doi:10.1186/s12909-015-0300-y · Cited by 132 · see citing works
Meira, T. M., Prestes, J., Gasparello, G. G., Antelo, O. M., Pithon, M. M., & Tanaka, O. M. (2021) · Progress in Orthodontics · doi:10.1186/s40510-021-00353-9 · Cited by 74 · see citing works
The Development and Impact of a Social Media and Professionalism Course for Medical Students
Gomes, A. W., Butera, G., Chretien, K. C., & Kind, T. (2017) · Teaching and Learning in Medicine · doi:10.1080/10401334.2016.1275971 · Cited by 53 · see citing works
Online professionalism: A synthetic review
Chretien, K. C., & Tuck, M. G. (2015) · International Review of Psychiatry · doi:10.3109/09540261.2015.1004305 · Cited by 49 · see citing works
Social Media in Health Science Education: An International Survey
O'Sullivan, E., Cutts, E., Kavikondala, S., Salcedo, A., D'Souza, K., Hernandez-Torre, M., Anderson, C., Tiwari, A., Ho, K., & Last, J. (2017) · JMIR Medical Education · doi:10.2196/mededu.6304 · Cited by 28 · see citing works
Karveleas, I., Kyriakouli, A., Koukou, M., Koufatzidou, M., Kalogirou, E., & Tosios, K. I. (2021) · European Journal of Dental Education · doi:10.1111/eje.12585 · Cited by 24 · see citing works
Almetwazi, M., Alahmari, G., Alnahdi, N., Aljamil, F., Aljawadi, M., & Alhossan, A. (2021) · Pharmacy Education · doi:10.46542/pe.2021.211.222229 · Cited by 3 · see citing works
Evaluating the appropriateness of Facebook posts – What do faculty and residents consider?
Loo, M. E., Wong, B., & Lee, Y. M. (2020) · The Asia Pacific Scholar · doi:10.29060/taps.2020-5-3/oa2226 · Cited by 2 · see citing works
- Authors
- Rocha, P. N., & de Castro, N. A. A.
- Affiliations
- Universidade Federal da Bahia (BR)
- Corresponding author
- Rocha, Paulo Novis
- ORCID
- Rocha, Paulo Novis
- Venue
- Journal of General Internal Medicine
- Published
- 2014-01-07
- Volume
- 29
- Issue
- 5
- Pages
- 758-64
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC4000336
- OpenAlex
- W1993414558
- Cited by
- 32
- References
- 17
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 2 · 2015: 3 · 2014: 2
- FWCI
- 4.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Social Media in Health Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- online professionalism, medical students, social media, patient privacy, medical ethics education, physician reputation, medical ethics curriculum, Brazilian medical students
- MeSH terms
- Adolescent, Adult, Brazil, Cross-Sectional Studies, Ethics, Professional, Female, Humans, Male, Schools, Medical, Students, Medical, Young Adult, Social Media
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