Professional use of social media in medical education

PRESENTATION TO UOTTAWA UNDERGRADUATE MEDICAL EDUCATION PROGRAMSEPT. 7, 2016UOTTAWA

PAT RICH @PAT_HEALTH #UOSM16

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Lecture Objectives

Discuss the potential of social networking tools such as Facebook, Twitter, LinkedIn and Google+ in medical education.

Discuss the safe and professional behaviours regarding social networking usage.

Who I amPat Rich – Medical writer, editor and social media commentatorExperienced health care communicator with a keen interest and involvement in the use of social media tools in medicine and health care and believers in the value of these toolsWHO I AM NOTPhysicianAcademic

Medical students and social media – A perspective

When I was a child, I spoke as a child, I understood as a child, I thought as a child; but when I became a man, I put away childish things

1 Corinthians 13

What were once vices ...are now habits

MED 2.0: 2008-2013

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You are learning medicine in an era when social media, the Internet, digital care and mobile apps are becoming increasingly interconnected

Pat Rich, Sept. 7, 2016

What are social media?

Extension of every day interactionConversations & exchangeCommunities of shared interestTools for innovation Integrates technology

Social media, health care and medical students – a timely case study

Canadian Medical Association General Council meetingHalifax – Aug. 24-26, 2015Vancouver – Aug. 19-25, 2016

Case Study 1

#CMAGC2015 – Halifax

Tweets – 10,748 Participants – 1946

2016 - Vancouver Tweets – 15,306 Participants – 2177

Case Study 2 – Dr. Jen Gunter

Case Study 3 – OMA draft agreement

“In my now nearly 40 years as an Ontario physician I have never witnessed such passionate engagement with OMA affairs or the political process. (It) was directly fuelled by the use of social media and the enhanced connectivity between different regions and specialties.”

Dr. Alan Drummond (@alandrummond2)

A changing environment: Are you digitally literate enough to be a physician?

“Today’s medical professionals must be masters of different skills that are related to using digital devices or online solutions” and mastering those skills “is now a crucial skill set that all medical professionals require.”Dr. Bertalan Mesko

“The democratization of media has made every physician an independent publisher …physicians now have to learn to manage and maintain their identity in the public space,”

Dr. Bryan Vartabedian,

Why Care

“Whether physicians are active on social media or not, an understanding of social media and its potential implications on their professional lives is essential.”

Dr. Hartley Stern, CEO, Canadian Medical Protective Association

Why consider using social media

To stay informed As a learning tool in medical education Communicate (engage) with peers and patients Disseminate information Advocate for/against something To help get a job To deliver clinical care Because if you decide not to use social media, your decision

should be based on sound knowledge about what you are choosing not to use

The challenges

Impact to patients Liability Privacy Ethics Boundaries Time theft Reputation Compensation

Social media “policies” by academic medical centers or medical schools point out the “don’t do this, don’t do that”, but let’s also focus on what the trainees CAN do. Let’s consider how we can IMPROVE our current health care system and ultimately the care of patients with innovative uses of social media and social networking …

Dr. Alex Djuricich, Former Associate Dean for CME, University of Indiana School of Medicine

Social media at medical school

Students who don’t use social media in school “are missing out.”

Dr. Mike Leveridge, Queen’s University urologist

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”“Exposure to guidelines on professional online conduct had no effect on posting behavior.”

Medical Journal of Australia published study of social media use by 880 medical students

“… millennials whose use of social media is integrated into every other aspect of their life, are not happy with the educational status quo.”BMJ Senior Editor Tessa Richards

“Today’s learners have moved on. They are in a different environment than the instructors, the faculty, the people who are teaching themDr. Rob Rodgers, University of Kentucky

“… medical students are more interested in engaging other students rather than their faculty. The online space has become the lens through which we view our lives as future physicians,” ”Ajay Major, 4th year medical student University of Kentucky.

2016 Canadian studies have documented gap between learners and educators in understanding of and use of social networking sites in medical education

It’s not rocket science

I think there are too many people on the Web offering advice to you on how to use social media. Most of this advice is just regurgitated advice from people you may never have heard of before, …You really don’t need “How To” tips on blogging or Twitter. Oh, I’m confident that you’ll be told otherwise – but those folks, well-intentioned as they may be, don’t understand that you’re smarter than that. Rather than learn bad habits from the get-go, take advantage of your lack of experience. It’s okay to make mistakes that don’t cause harm and violate the privacy and dignity of others.

From: Physician Social Media: Has Advice About It Become a Crock? Yes @philbaumann, Jan. 1, 2013

Who is making the rules?• College of Physicians and Surgeons of Ontario

Guidelines

• Canadian Federation of Medical Students (CFMS) Guide to Medical Professionalism: Recommendations For Social Media

• Canadian Medical Association – Issues and Rules of Engagement

• Canadian Medical Protective Association

Key element of the rules

Apply same principles of professionalism that apply in personRespect patient confidentiality

“Student professionalism … can be strained by the use of social media due to its familiarity, ubiquity and impersonal nature.”

“Social media should be treated as a public forum akin to an op-ed in a newspaper or a lecture. Anything that would be inappropriate to share in these more traditional outlets should be considered inappropriate to share online.”CFMS Guide to Medical Professionalism: Recommendations for Social Media

“Don’t Lie, Don’t PryDon’t Cheat, Can’t DeleteDon’t Steal. Don’t Reveal”

Dr. Farris Timimi, medical director, Mayo Clinic Center for Social Media, April 5, 2012

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“[Medical students’] thoughts are posted, captured, and recorded for people more so than a decade ago,” she said. “At the same time, they’re trying to develop a professional identity without knowing for sure what constitutes professional behavior. We wanted to help students embrace the balance between professionalism and social media in a responsible way.”

Elizabeth Kitsis, MD, associate professor of clinical epidemiology, population health, and clinical medicine at Albert Einstein College of Medicine.Quoted in: AAMC Reporter, Dec. 2015

Case study: The Political Resident

Brandon is a resident who, since starting medical school, has kept a blog about his views on medicine, medical education, and health care politics. Recently, Brandon has blogged extensively about his extreme political views regarding the upcoming election. His residency director reads his blog and tells him that he must delete his posts and can no longer write new ones, as he is not only a hospital employee and a representative of the residency program, but also a professional who must represent himself accordingly

American College of Medical Schools Digital Literacy Toolkit

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Discussion

Is it reasonable for the residency program director to tell this resident that this non-medical blog should be removed? The residency director tells this resident to remove his blog. What would an appropriate response be? A. What a resident does on his own time is his business. B. He should have asked him to remove the offending posts and be careful in the

future. C. When you are a student and resident, you are ultimately under the guidance of your

dean and residency director.

Case study 2 – Looking up patients on Facebook

Susan is a psychiatrist who is treating a patient who is unwilling to reveal little or any personal information.

Susan believes a better understanding of the patient and his individual circumstances would aid her in providing more better treatment.

To do this, Susan decides to look the patient up on Facebook to see what – if anything has been written about him.

Case Study 2

Topic of widespread ongoing debate in the social media community

Would it be a different situation if Susan just thought the patient was vaguely recognizable and checked on Facebook to see if he was anybody famous?

“Do it if your conscience says there’s a good clinical reason for doing so.”

Case study 3 - Facebook

Maya is a fourth-year student completing an elective in a dermatology clinic. One young male patient expresses attraction to her and asks for her number, but she declines. She returns home from clinic to find that the patient has found her on Facebook and ‘friended’ her. What should Maya do? She expects to see the patient again in clinic for follow-up

Case study 3 – CFMS response

Maya should decline the request for connection from the patient with an explanation of her actions. In her explanation, Maya might explain that she has a personal policy to not accept such requests from active patients. It is seemingly never acceptable for a medical student to request a connection from an active patient of theirs... ‘Friend’ requests from former patients may be acceptable for personal accounts provided time has elapsed.

Using social media in medical school

Some suggestions Facebook presence for classmates etc. LinkedIn account to:

Build network for future career Follow discussion forums on medical education

Blog about your experiences Twitter account to:

Develop your list of people, journals and other accounts to follow

Watch (and engage) medical Twitter community (e.g. #hcldr)

Participate in Twitter Journal clubs

Questions?