Lecture at orientation for 1st year uOttawa students - Sept. 7

1. Professional use of social media
in medical education
PRESENTATION TO UOTTAWA UNDERGRADUATE MEDICAL
EDUCATION PROGRAM
SEPT. 7, 2016
UOTTAWA
PAT RICH @PAT_HEALTH #UOSM16

2. 2
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.

3. Who I am
Pat Rich –
Medical writer, editor and social
media commentator
Experienced 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 tools
WHO I AM NOT
Physician
Academic

4. Medical students and social
media – A perspective
When I was a child, I spoke as
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

5. What were once vices
...are now habits
MED 2.0: 2008-2013

6. “
”
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

7. What are social media?
 Extension of every day interaction
 Conversations & exchange
 Communities of shared interest
 Tools for innovation
 Integrates technology

8. Social media, health care and medical
students – a timely case study
Canadian Medical
Association General
Council meeting
Halifax – Aug. 24-26, 2015
Vancouver – Aug. 19-25,
2016

9. Case Study 1
#CMAGC
2015 – Halifax
 Tweets – 10,748
 Participants – 1946
2016 - Vancouver
 Tweets – 15,306
 Participants – 2177

10. Case Study 2 – Dr. Jen Gunter

11. 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)

12. 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,

13. 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

14. 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

15. The challenges
 Impact to patients
 Liability
 Privacy
 Ethics
 Boundaries
 Time theft
 Reputation
 Compensation

16. 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

17. Social media at medical school
Students who don’t use
social media in school “are
missing out.”
Dr. Mike Leveridge, Queen’s
University urologist

18. “
”
“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

19. “… 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

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

21. “… 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.

22. 2016 Canadian studies have documented gap between
learners and educators in understanding of and use of
social networking sites in medical education

23. 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

24. 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

25. Key element of the rules
Apply same principles of professionalism that apply in person
Respect 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

26. “Don’t Lie, Don’t Pry
Don’t Cheat, Can’t
Delete
Don’t Steal. Don’t
Reveal”
Dr. Farris Timimi, medical director,
Mayo Clinic Center for Social Media,
April 5, 2012

28. “
”
“[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

29. 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

30. 30
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.

31. 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.

32. 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.”

33. 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

34. 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.

35. 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

36. Questions?