Background As we are witnessing the evolution of social media (SM) use worldwide among the general population, the popularity of SM has also been embraced by health care professionals (HCPs). In the context of SM evolution and exponential growth of users, this scoping review summarizes recent findings of the e-professionalism of HCPs. Objective The purpose of this scoping review is to characterize the recent original peer-reviewed research studies published between November 1, 2014, to December 31, 2020, on e-professionalism of HCPs; to assess the quality of the methodologies and approaches used; to explore the impact of SM on e-professionalism of HCPs; to recognize the benefits and dangers of SM; and to provide insights to guide future research in this area. Methods A search of the literature published from November 1, 2014, to December 31, 2020, was performed in January 2021 using 3 databases (PubMed, CINAHL, and Scopus). The searches were conducted using the following defined search terms: “professionalism” AND “social media” OR “social networks” OR “Internet” OR “Facebook” OR “Twitter” OR “Instagram” OR “TikTok.” The search strategy was limited to studies published in English. This scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Results Of the 1632 retrieved papers, a total of 88 studies were finally included in this review. Overall, the quality of the studies was satisfactory. Participants in the reviewed studies were from diverse health care professions. Medical health professionals were involved in about three-quarters of the studies. Three key benefits of SM on e-professionalism of HCPs were identified: (1) professional networking and collaboration, (2) professional education and training, and (3) patient education and health promotion. For the selected studies, there were five recognized dangers of SM on e-professionalism of HCPs: (1) loosening accountability, (2) compromising confidentiality, (3) blurred professional boundaries, (4) depiction of unprofessional behavior, and (5) legal issues and disciplinary consequences. This scoping review also recognizes recommendations for changes in educational curricula regarding e-professionalism as opportunities for improvement and barriers that influence HCPs use of SM in the context of e-professionalism. Conclusions Findings in the reviewed studies indicate the existence of both benefits and dangers of SM on e-professionalism of HCPs. Even though there are some barriers recognized, this review has highlighted existing recommendations for including e-professionalism in the educational curricula of HCPs. Based on all evidence provided, this review provided new insights and guides for future research on this area. There is a clear need for robust research to investigate new emerging SM platforms, the efficiency of guidelines and educational interventions, and the specifics of each profession regarding their SM potential and use.

Even in the era of the internet, printed media are still among the most frequently identified sources of mental health information. Many studies have shown that this information is frequently negative and contributes to stigmatization of people with mental illness. This international comparative study describes the content of media messages about mental health/illness in terms of stigma in three central European countries. The study sample comprised all articles pertaining to the topic of mental health/illness (N=450) identified during five week-long periods in 2007 chosen from the six most widely read newspapers and magazines in each country. Content analysis methods were used to achieve quantitative as well as qualitative objectives. More than half of all articles contained negative statements reflecting stigma towards persons with mental illness. Substance abuse disorders are the most frequent mental conditions covered in all three countries (22%) and psychotic disorders are the most stigmatized. Countries significantly differ in length of articles, the association of aggressive behavior with persons with mental illness, and in the use of a sensationalized style of writing. Coverage of mental health/illness issues differs to some extent across countries, but is generally of poor quality. Based on our findings, practical recommendations for journalists can be tailored specifically for each country.

Aim To describe and compare social media (SM) use and habits, and attitudes of medical and dental students toward e-professionalism and to determine their opinion on potentially unprofessional behavior and posts. Methods In this quantitative cross-sectional questionnaire study, students of the University of Zagreb School of Medicine and those of the School of Dental Medicine completed a survey-specific questionnaire on the use of SM, SM habits, and attitudes toward e-professionalism. Results Of the 714 collected questionnaires, we analyzed 698 (411 from medical and 287 from dental students). The most commonly used SM were Facebook (99%) and Instagram (80.7%). Unprofessional content was recognized by both groups. Medical students significantly more frequently considered the posts containing patient photos (61% vs 89.8%; P < 0.001), describing interaction with a patient not revealing any personal identifiable information (23% vs 41.8%; P < 0.001), and containing critical comments about faculty (53% vs 39.7%; P = 0.001) to be unprofessional. Dental medicine students were significantly more open to communication through SM (39.7% vs 16.3%; P < 0.001), more often reported that they would accept (41.5% vs 12.2%; P < 0.001), and had accepted (28.2% vs 5.6%; P < 0.001) friend requests/follows/tracks from patients, and sent friend requests/follows/tracks to their patients (5.2% vs 1.2%; P = 0.002). Conclusion Both groups were highly aware of e-professionalism. Dental students were more desensitized to visual representations of patients, and more prone to SM interactions with patients, which might expose them to the risk of unprofessional behavior.

Background Social media presence among health care professionals is ubiquitous and largely beneficial for their personal and professional lives. New standards are forming in the context of e-professionalism, which are loosening the predefined older and offline terms. With these benefits also come dangers, with exposure to evaluation on all levels from peers, superiors, and the public, as witnessed in the #medbikini movement. Objective The objectives of this study were to develop an improved coding scheme (SMePROF coding scheme) for the assessment of unprofessional behavior on Facebook of medical or dental students and faculty, compare reliability between coding schemes used in previous research and SMePROF coding scheme, compare gender-based differences for the assessment of the professional content on Facebook, validate the SMePROF coding scheme, and assess the level of and to characterize web-based professionalism on publicly available Facebook profiles of medical or dental students and faculty. Methods A search was performed via a new Facebook account using a systematic probabilistic sample of students and faculty in the University of Zagreb School of Medicine and School of Dental Medicine. Each profile was subsequently assessed with regard to professionalism based on previously published criteria and compared using the SMePROF coding scheme developed for this study. Results Intercoder reliability increased when the SMePROF coding scheme was used for the comparison of gender-based coding results. Results showed an increase in the gender-based agreement of the final codes for the category professionalism, from 85% in the first phase to 96.2% in the second phase. Final results of the second phase showed that there was almost no difference between female and male coders for coding potentially unprofessional content for students (7/240, 2.9% vs 5/203, 2.5%) or for coding unprofessional content for students (11/240, 4.6% vs 11/203, 5.4%). Comparison of definitive results between the first and second phases indicated an understanding of web-based professionalism, with unprofessional content being very low, both for students (9/222, 4.1% vs 12/206, 5.8%) and faculty (1/25, 4% vs 0/23, 0%). For assessment of the potentially unprofessional content, we observed a 4-fold decrease, using the SMePROF rubric, for students (26/222, 11.7% to 6/206, 2.9%) and a 5-fold decrease for faculty (6/25, 24% to 1/23, 4%). Conclusions SMePROF coding scheme for assessing professionalism of health-care professionals on Facebook is a validated and more objective instrument. This research emphasizes the role that context plays in the perception of unprofessional and potentially unprofessional content and provides insight into the existence of different sets of rules for web-based and offline interaction that marks behavior as unprofessional. The level of e-professionalism on Facebook profiles of medical or dental students and faculty available for public viewing has shown a high level of understanding of e-professionalism.

Background Social media permeated everyday life and consequently it brought some changes to behaviour of health professionals. New form of professionalism emerged called e-professionalism depicting professional behaviour while using social media. There are a number of studies conducted in the past several years measuring behaviour of different populations of health professionals on social media and social media sites. Many studies have investigated aspects of e-professionalism of medical or dental students as future health professionals, but there are no validated instruments made for assessing attitude towards e-professionalism of those two populations. Objective of this paper is to validate a newly developed scale for measuring attitudes towards e-professionalism among medical and dental students. Methods The original 32-item scale was developed and administered to 411 medical students (RR 69%), and 287 dental students (RR 49.7%). Exploratory factor analysis was used to investigate the existence of underlying factors. Principal component analysis was used as an extraction method with oblimin as selected oblique rotation method. Cronbach’s alpha was used to assess reliability. Results Total of 698 student answers entered analysis. The final scale had 24 items that formed seven factors named: ethical aspects, dangers of social media, excluding physicians, freedom of choice, importance of professionalism, physicians in the digital age, negative consequences. Cronbach’s alpha indicating scale reliability was .72. Reliability conducted on each factor ranged from .570 to .877. Conclusions The scale measures seven factors of attitude towards e-professionalism and exhibits satisfactory reliability. Based on insights from validation, some possible improvements are suggested.

BackgroundA content analysis was used to describe the association between psychiatric disorders and aggression in the printed media in the Czech Republic and Slovakia.MethodsArticles were chosen from the most widely read daily newspapers and magazines in both countries during five one-week periods in 2007. A coding manual was developed and a content analysis was performed. Aggressive behavior was assessed by two separate categories - the role of the mentally ill person in the violent act (perpetrator/victim) and the type of aggressive act (homicide, suicide).ResultsA total of 375 articles were analyzed. Main findings: 1) The proportion of articles depicting psychiatric disorders together with either self- or other-directed aggressive behavior is 31.2%; 2) Homicide was most frequently mentioned in the context of psychotic disorders and schizophrenia, while affective disorders were most frequently associated with both completed suicides and homicides; 3) Eating disorders and anxiety disorders were seldom associated with any kind of aggressive behavior, including self-harm; 4) The vast majority of articles presented mentally ill people as perpetrators, and these articles were more often coded as stigmatizing. 5) Articles with aggressive behavior mentioned on the cover are roughly as frequent as those with aggressive behavior in the later sections of the media (36.7% vs. 30.7%).ConclusionsThe results are similar to the findings in countries with longer histories of consistent advocacy for improved depiction of mental illness in the media. However, we have shown that persons with mental illness are still over-portrayed as perpetrators of violent crimes, especially homicides.

PICMIN instrument allows comparison among countries and different studies over time.

Background Social networking sites (SNSs) have penetrated all aspects of health care professionals’ (HCPs’) professional and private lives. A new term, e-professionalism, has emerged, which describes the linking of traditional values with this new dynamic online environment for HCPs. The four aims of this study were: (1) to examine their SNS prevalence and usage habits, (2) to examine their perception of e-professionalism, (3) to develop an e-professionalism assessment compatibility index and (4) to investigate their tendencies and differences in values of the e-professionalism assessment compatibility index (ePACI). Methods A cross-sectional study was conducted among MDs and DMDs in Croatia via email using a questionnaire. The questionnaire was distributed to all MDs and DMDs who were members of their respective chambers. In addition to descriptive statistics, Chi-square or Fisher’s exact test when appropriate, t-test, ANOVA and Mann–Whitney U tests were used to determine differences between groups. A principal component analysis (PCA) with varimax rotation was used to investigate dimensionality. Results of the PCA were compared to the coding based on the Social Media e-Professionalism rubric in order to create the ePACI. Results Of the 1013 gathered responses, 753 were from valid SNS users and suitable for further analysis. Facebook (91.6%) and Instagram (63.1%) were the predominant SNSs used. Both groups have a good understanding of e-professionalism. The newly developed ePACI deviates slightly in the “conservative” direction in the cases of both, MDs (t506 = 19.033, p < 0.001) and DMDs (t245 = 12.991, p < 0.001). HCPs who are older (r = 0.308, p < 0.001), who have fewer SNS profiles (rs = −0.142, p < 0.001), and who access their profiles less frequently (r = −0.166, p < 0.001) have statistically significantly more conservative ePACI values. Conclusions MDs and DMDs in Croatia are frequent SNS users, with Facebook and Instagram being the main SNSs used. Both groups have a good understanding of e-professionalism. The newly developed ePACI deviates slightly towards the conservative side regarding perception of the e-professionalism content for both groups. The development of the ePACI, and its subsequent usage in further research, will have a direct influence in its validation, gathering comparable data, and be able to direct efforts in oversight, regulation and education.