New professionalism challenges in medical training: an exploration of social networking

Innovative online technology can enhance the practice of medicine, yet it also may be a forum for unprofessional behavior.

We surveyed program directors regarding their perceptions and experiences with residents' use of social networking sites (SNS).

In September 2011, we sent an online survey to program directors and associate program directors of pediatrics residency programs within the United States who are members of the Association of Pediatric Program Directors.

A total of 162 program directors or associate program directors (representing 50% of residency programs) responded to the survey. One-third of respondents are "very familiar" with SNS and 23% use them "daily or often." Most respondents (70%) rated "friending" peers as "completely appropriate," whereas only 1% of respondents rated "friending" current or past patients as "completely appropriate." More than one half of respondents believe inappropriate behavior on SNS is "somewhat" or "very" prevalent, and 91% are "somewhat" or "very" concerned that the prevalence of inappropriate behavior on SNS may increase. The most commonly reported problematic online activity was posting inappropriate comments about the workplace. Posting of inappropriate comments about self, patients, and staff also was observed. Residency programs commonly educate trainees about SNS during intern orientation (45%), or using written guidelines (29%) and ad hoc remediation (16%).

As educators teach trainees principles of online professionalism, appropriate use of SNS needs to be included in the training process. Curricular efforts may be hindered by some program directors' lack of familiarity with SNS.