Health professionals in cyberspace: a systematic review of the literature

Abstract

BACKGROUND There is increasing interest in the use and potential impact of social media in the health professions. This is particularly with regard to how students, academics and clinicians use them socially and professionally, their relationship to professionalism and their role in professional training and development (1-3). Recognition of the risks posed by social networking for students engaged in professional courses has increased.

METHODS A systematic review of the literature was conducted. Relevant databases were searched for journal articles, policy documents, news reports and grey literature (such as professional body guidance (4) published between January 2004 and March 31st 2013. Search terms combined’ Professionalism’, ‘Social media’ ‘Social networking’, ‘Facebook’, ‘Twitter’ with ‘Doctors’, ‘Medical students’, ‘nurses’, ‘Nursing students’, ‘Interns’, ‘Medical residents’, ‘Medicine’, ‘Dentists’, ‘Paediatricians’, ‘Midwives’, ‘Radiologists’, ‘Osteopaths’ and ‘Pharmacists’. Hand searches were also performed. Search terms aimed to identify papers reporting and discussing all aspects of social media relating to professionalism but excluding those which used social media for teaching.

RESULTS The initial search generated 436 articles and 22 policy documents. A two-stage review process conducted by a team of researchers identified 167 articles which met the inclusion criteria. Empirical (n=44) studies focused most commonly on measurements of extent and frequency of social media use by students, academics and clinicians. Other areas reported included: social media use in selection and admission processes;, ‘Friend request’ policy of academics; privacy; and security issues related to clinical use. Studies were classified by health profession. Twenty five studies reported from the medical perspective ;nine studies were of pharmacists; four of psychologists; three examined nurse use; one reported dieticians’ use and three looked across health professions. Studies were primarily electronic surveys, conducted at single institutions, at a single time point. Several studies searched Facebook accounts, online profiles and blogs for personal information. One study reported the impact of an intervention on online behaviour while another explored student perspectives of e-professionalism utilising focus group methodology. Results from the review of conceptual articles retrieved will also be presented.

CONCLUSIONS Health professionals, students and academics frequently use social media and social networking for personal and professional reasons. Improved education regarding the dangers and implications of social media use for professionalism has been widely advocated but the effect of education/training interventions on behaviours has not been systematically researched.