Cited by 82Social Media in Health EducationInnovations in Medical EducationImpact of Technology on Adolescents

Who’s misbehaving? Perceptions of unprofessional social media use by medical students and faculty

Open access
Kitsis, Elizabeth A., Milan, Felise B., Cohen, Hillel W., Myers, Daniel, Herron, Patrick, McEvoy, Mimi, Weingarten, Jacqueline, Grayson, Martha S.·2016·BMC Medical Education

Abstract

BACKGROUND: Social media use by physicians offers potential benefits but may also be associated with professionalism problems. The objectives of this study were: 1) to examine and compare characteristics of social media use by medical students and faculty; 2) to explore the scope of self- and peer-posting of unprofessional online content; and 3) to determine what actions were taken when unprofessional content was viewed. METHODS: An anonymous, web-based survey was sent to medical students and faculty in October, 2013 at the Albert Einstein College of Medicine in Bronx, New York. RESULTS: Three-quarters of medical students reported using social media "very frequently" (several times a day), whereas less than one-third of faculty did so (p < .001). Medical students reported using privacy settings more often than faculty (96.5 % v. 78.1 %, p < .001). Most medical students (94.2 %) and faculty (94.1 %) reported "never" or "occasionally" monitoring their online presence (p = 0.94). Medical students reported self-posting of profanity, depiction of intoxication, and sexually suggestive material more often than faculty (p < .001). Medical students and faculty both reported peer-posting of unprofessional content significantly more often than self-posting. There was no association between year of medical school and posting of unprofessional content. CONCLUSION: Medical students reported spending more time using social media and posting unprofessional content more often than did faculty.

AI snapshot

Written from the paper’s full text.

TL;DR

Medical students at one institution reported more frequent social media use and more self-posting of unprofessional content than faculty, though both groups reported seeing peers post unprofessional content more often than posting it themselves. Students also used privacy settings more often but rarely monitored their online presence, and posting did not decrease across medical school years.

Key findings

  • Medical students reported heavier social media use than faculty: 34.1% of students used social media six or more hours per week versus 9.0% of faculty (p < .001), and 15.9% of students reported “do not use” or “less than one hour” versus 60.1% of faculty (p < .001).
  • More students than faculty used privacy settings (96.5% vs. 78.1%, p < .001), but most in both groups reported “never” or “occasionally” monitoring their online presence (94.2% vs. 94.1%, p = 0.94).
  • Medical students reported self-posting profanity, depiction of intoxication, and sexually suggestive material more often than faculty (p < .001); both students and faculty reported peer-posting of unprofessional content significantly more often than self-posting (p < .001).
  • There was no association between year of medical school and posting of unprofessional content; students were more likely than faculty to take action if they found objectionable online information, with 13.7% of students versus 44.1% of faculty reporting no action (p < .001).

Methods

  • Anonymous, web-based SurveyMonkey survey sent in October 2013 to all medical students and faculty at Albert Einstein College of Medicine; the 32-item core instrument was based on existing literature and focus groups, modified for each population, and piloted.
  • Respondents included 496/781 medical students (63.5%) and 614/2713 faculty (22.6%); the survey asked about social media platform use, privacy settings, monitoring, self- and peer-posting of unprofessional content, and actions taken.
  • Analyses used frequencies, chi-square or Fisher’s exact tests, and Spearman correlations for Likert scales; proportions were dichotomized into positive versus non-positive responses, with two-tailed alpha = 0.05 and SPSS Version 20.

Limitations

  • The paper states responder bias may be present, especially in the faculty sample; lower self-report than peer-report of unprofessional postings could be due to social desirability bias; the faculty response rate was 23%, relatively low but not atypical for web-based physician surveys.
  • The paper states the study was conducted at a single institution, so generalizability is unknown, and because it was survey-based it reflects respondents’ perceptions rather than actual online behaviors.
  • Evident from the text: the design is cross-sectional and self-reported, with no independent verification of social media content or behavior, and denominators varied slightly because some respondents did not answer every question.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12909-016-0572-x

Cites

25 of 25 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 10 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    89.0 % of medical students ranked public perceptions of unprofessional behavior by colleagues as a somewhat or very important concern about social media use, compared with 66.5 % of faculty (p < .001).

    “89.0 % of medical students ranked public perceptions of unprofessional behavior by colleagues as a somewhat or very important concern about social media use, compared with 66.5 % of faculty (p < .001).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Similar proportions of medical students (91.1 %) and faculty (83.5 %) rated posting inaccurate medical information for patients as somewhat or very important concerns.

    “Similar proportions of medical students (91.1 %) and faculty (83.5 %) rated posting inaccurate medical information for patients as somewhat or very important concerns.”
    Quote in the paperNot a substantial claim
  • Findingown data

    15.9 % of medical student respondents reported frequency of social media use as "do not use" or "less than one hour" compared with 60.1 % of faculty respondents (p < .001).

    “15.9 % of medical student respondents reported frequency of social media use as “do not use” or “less than one hour” compared with 60.1 % of faculty respondents (p < .001).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Medical students and faculty both reported peer-posting of unprofessional content significantly more often than self-posting.

    “Medical students and faculty both reported peer-posting of unprofessional content significantly more often than self-posting.”
    • Also stated in: § Posting of unprofessional online content · plain
      “Viewing unprofessional content online posted by classmates or colleagues was reported more frequently by medical students and faculty than posting of such content themselves (p < .001).”
    Quote in the paperSubstantial claim
  • Findingown data

    More medical student than faculty respondents reported their online presence as "absent" (24.0 % vs 8.1 %, p < .001).

    “Medical student respondents reported that they found their online presence to be “unprofessional” (21.8 %) or “absent” (24.0 %) more often than faculty respondents (5.5 % and 8.1 %, respectively (both p < .001)).”
    Quote in the paperNot a substantial claim
  • May combine two claims. 8
  • Classified as probably not a substantial claim. 6
  • May combine two claims.

    Findingown data

    Almost all medical students (92.4 %) and the majority of faculty (83.4 %) rated violations of patient confidentiality as somewhat or very important concerns about social media use (p < .001).

    “Almost all medical students (92.4 %) and the majority of faculty (83.4 %) rated violations of patient confidentiality as somewhat or very important concerns about social media use (p < .001).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Most medical students (94.2 %) and faculty (94.1 %) reported "never" or "occasionally" monitoring their online presence (p = 0.94).

    “Most medical students (94.2 %) and faculty (94.1 %) reported “never” or “occasionally” monitoring their online presence (p = 0.94).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Three-quarters of medical students reported using social media "very frequently" (several times a day), whereas less than one-third of faculty did so (p < .001).

    “Three-quarters of medical students reported using social media “very frequently” (several times a day), whereas less than one-third of faculty did so (p < .001).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The faculty response rate of 23 % was relatively low, but not atypical of web-based physician surveys.

    “The faculty response rate of 23 % was relatively low, but not atypical of web-based physician surveys [26].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Kaplowitz MD, Hadlock TD, Levine R. A comparison of web and mail survey response rates. Public Opin Q. 2004;68(1):94–101. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Responder bias may be present, especially in the faculty sample.

    “Responder bias may be present, especially in the faculty sample.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    Medical students reported spending more time using social media and posting unprofessional content more often than did faculty.

    “Medical students reported spending more time using social media and posting unprofessional content more often than did faculty.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The greater use of privacy settings on social networking platforms by medical students compared with faculty may be due to a lack of awareness of the importance of privacy settings among faculty or a lack of knowledge about how to use them.

    “The greater use of privacy settings on social networking platforms by medical students compared with faculty may be due to a lack of awareness of the importance of privacy settings among faculty or a lack of knowledge about how to use them.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    Medical students self-post and notice peers' unprofessional posts more often than do faculty.

    “and that medical students self-post and notice peers’ unprofessional posts more often than do faculty.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The current survey results are consistent with population studies showing that younger people use social media more often than older adults.

    “The results of the current survey are consistent with population studies showing that younger people use social media more often than older adults [12]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Fox S, Rainie L. The web at 25 in the U.S. Available at: http://www.pewinternet.org/2014/02/27/the-web-at-25-in-the-u-s/ , Accessed March 17,2014.

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    A 2009 study found that 13 % of deans of student affairs reported incidents of violations of confidentiality by medical students.

    “A 2009 study found that 13 % of deans of student affairs reported incidents of violations of confidentiality by medical students [11].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11] Chretien KC, Greysen SR, Chretien J-P, Kind T. Online posting of unprofessional content by medical students. JAMA. 2009;302(12):1309–15. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Lower levels of self-report than peer-report of unprofessional postings could be due to social desirability bias.

    “Lower levels of self-report than peer-report of unprofessional postings could be due to social desirability bias.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    While students seemed more concerned than faculty about their professional images, their online behavior did not reflect this concern.

    “An interesting paradoxical observation from our study is that while students seemed more concerned than faculty about their professional images, their online behavior did not reflect this concern.”
    Quote in the paperSubstantial claim
12 of 12

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Age difference in the term older and wiser, meaning more cautious about posting unprofessional behavior online, was proven in studies comparing students' and faculties' online behavior.

    “Age difference in the term “older and wiser,” meaning more cautious about posting unprofessional behavior online, was proven in studies comparing students’ and faculties’ online behavior [114,118].”

    From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [118]

    The Results section (page not provided) reports that medical students self-posted unprofessional content more often than faculty. But the Discussion describes generational differences as a possible explanation requiring further research; it does not prove that age makes people more cautious about posting. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • The perception of unprofessional behavior varies among health care professionals, mostly associated with age of the participants.

    “Our previous findings demonstrate that the perception of unprofessional behavior varies among HCPs, mostly associated with age of the participants [86,109,114,118].”

    From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [118]

    The Conclusions say medical students and faculty may differ in their perceptions of social media professionalism. The Discussion proposes generational differences as a possible explanation but calls this speculation; it does not establish that age is the primary association. (LLM, conf=0.87)

    Experimental — accuracy not yet measured
  • A lack of free time or time constraint was often recognized as a barrier to health care professionals' use of social media in the context of e-professionalism, as well as a lack of knowledge or technical skills for use of social media.

    “A lack of free time or time constraint was often recognized as a barrier [39,69,74,79,91,93,96], as well as a lack of knowledge or technical skills for use of SM [33,39,76,79,93,118].”

    From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [118]

    The Results section, “Barriers to social media usage” (page unavailable), reports that 41.3% of medical students and 51.7% of faculty rated lack of knowledge as an obstacle to social media use. The passages found do not identify lack of free time or time constraints as a barrier, or specifically measure technical skills. (LLM, conf=0.85)

    Experimental — accuracy not yet measured
  • Studies showed privacy settings deployment from 71% to 97% among health care professionals.

    “Studies showed privacy settings deployment from 71% to 97% among HCPs [40,42,65,66,68,96,100,115,117,118].”
  • Several studies demonstrated a generation gap in social media use, where students are more likely than faculty to use social media.

    “Several studies demonstrated a “generation gap” in SM use, where students are more likely than faculty to use SM [114,115,117,118].”

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. McMahon JW. Professionalism in the use of social media. http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9124.page ? Accessed 3 February 2014.

Cited by

Sorted by citations

Authors
Kitsis, E. A., Milan, F. B., Cohen, H. W., Myers, D., Herron, P., McEvoy, M., Weingarten, J., & Grayson, M. S.
Affiliations
Albert Einstein College of Medicine (US)
Corresponding author
Kitsis, Elizabeth A.
Venue
BMC Medical Education
Published
2016-02-18
Volume
16
Issue
1
Pages
67-67
ISSN
1472-6920 (ISSN-L)
OpenAlex
W2273755143
Cited by
82
References
25
Citations by year
2026: 5 · 2025: 5 · 2024: 3 · 2023: 7 · 2022: 12 · 2021: 15 · 2020: 5 · 2019: 11 · 2018: 3 · 2017: 13 · 2016: 1 · 2012: 1
FWCI
12.32
Type
journal article
Language
en
Open access
Locations
  • BMC Medical Education (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Josiah Macy Jr. Foundation
  • Georgia Clinical and Translational Science Alliance (UL1TR001073)
  • National Institutes of Health (KL2TR001071, TL1TR001072, UL1TR001073)
  • National Center for Advancing Translational Sciences (TR001073)
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
social media use, medical professionalism, medical students, faculty, privacy settings, swearing
MeSH terms
Adult, Confidentiality, Faculty, Medical, Female, Humans, Male, New York, Surveys and Questionnaires, Students, Medical, Professional Misconduct, Young Adult, Social Media

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