What Do Med Students Think About the Dangers of Facebook?

A lot his been written on this blog about medical professionalism and online social networks such as Facebook. There’s a lack of policies on Internet use for many med schools. In short, on social networking sites patients may learn information about their doctors or medical students that compromises the professional relationship. Threats to patient confidentiality is another danger of Facebook and other social networking sites.

But how do these medical students see these worries? What is their perspective on online professionalism, how do they define unprofessional content and how do they think med schools should handle these issues?

In six focus groups of pre and clinical med students ( George Washington University) open ended questions were asked on general online habits, nature of students’ postings, what would constitute inappropriate posted material, and thoughts about institutional guidelines.

Med students did use web 2.0, preclinical med students intensively as opposed to the clinical med students ( year 3 and 4) they used social networking sites less often. The vast majority of students used facebook and could easily be found by name as well as institution. Med students mostly use social networking sites for social updates and distraction. They often posted about novel experiences in med school.

Their opinion on what was inappropriate to post online differed between students. Especially on the subject of references to alcohol, speaking poorly about staff, their med school and specific class mates, posting pictures showing intoxication or sexual suggestive behavior. They all expressed that respect for patient confidentiality laws online was critical.

Most students acknowledged that their online “footprint” might not reflect who they actually were, they noted the distinction between their professional and social identities.

Only some felt that professional standards for medical professionals were held to a higher standard.

They were concerned about the impact of online content on social networking sites and their career on occasions such as interviewing for a med school, starting clinical years and applying for residency and jobs. Many of them have taken precautions like limiting public availability of postings on social networking sites.

Facebook ambivalence

On the one hand, Facebook is perceived as a vital social hub that is “so valuable to stay in touch with people.” Many students expressed that they felt they had to use Facebook since all their friends were on it. Yet, they also saw it as an increasingly risky “forum that can get you into trouble.”

The med students didn’t know of any formal guidelines. They felt these guidelines weren’t necessary, they felt recommendations were welcome but don’t control. They were afraid that these guidelines would be too controlling. They were against any kind of formal monitoring of their online activity.

Students seemed to view their online behaviors through a lens of personal risk—how they defined what was inappropriate depended on their comfort/discomfort with this risk.

Their suggestion was to incorporate online professionalism into existing curricula. Which seems to me the right solution instead of guidelines and rules and regulations. What do you think?

Chretien, K., Goldman, E., Beckman, L., & Kind, T. (2010). Itʼs Your Own Risk: Medical Studentsʼ Perspectives on Online Professionalism Academic Medicine, 85 DOI: 10.1097/ACM.0b013e3181ed4778