Between Likes and Ethics: Benefits and Challenges of Social Media Use in Medical Practice in a Pre- and...

Social media use among medical students is nearly universal, yet it often occurs without adequate ethical-legal literacy, particularly considering the update introduced by Resolution No. 2,336/2023 of the Brazilian Federal Council of Medicine (Conselho Federal de Medicina, CFM). This study assessed medical students' knowledge and perceptions of the benefits, risks, and ethical limits of social media use before and after an educational intervention based on practical scenarios grounded in that resolution.

This was a quasi-experimental study with a paired pre- and post-test design. An electronic questionnaire containing 15 practical scenarios rated on a five-point Likert scale (13 forming the ethical adequacy score and two assessing institutional/curricular perceptions) was administered to students from the first through the twelfth semester. After excluding colliding pairing codes, 101 valid matched pairs were analyzed. Unethical responses were reverse-scored to build an ethical adequacy score, compared using the Wilcoxon signed-rank test (primary analysis, given a deviation from normality) and a paired Student's t-test (sensitivity analysis).

The overall ethical adequacy score rose from a mean of 3.40 (standard deviation (SD) 0.40) to 3.95 (SD 0.42) after the workshop (P < 0.001, Cohen's d = 1.37, 95% confidence interval (CI) 0.47-0.63), with the largest gains observed in scenarios addressing therapeutic guidance via direct message, advertising sensationalism, and exposure of surgical procedures. Two items describing already-permitted conduct (regulatory flexibilities and the use of social media as a communication channel during an epidemic) showed a significant score decrease, indicating a post-intervention overconservatism effect. No significant differences in score change were found between subgroups defined by training stage, gender, or daily screen time.

Scenario-based interventions are effective in raising ethical adequacy in the short term, but they require monitoring for interpretive side effects and should be complemented by continuous curricular training.