Professional Documents
Culture Documents
Profess Use of Social Media
Profess Use of Social Media
Profess Use of Social Media
⁎
Department of Pediatric Surgery, University of Nebraska Medical Center, Omaha, Nebraska; †Department
of Surgery, University of Utah, Salt Lake City, Utah; ‡Division of Acute Care Surgery, Johns Hopkins University
School of Medicine, Baltimore, Maryland; §Department of Surgery, Program for Liver, Pancreas, and Foregut
Tumors, Penn State College of Medicine, Hershey, Pennsylvania; ║Division of Cardiothoracic Surgery,
University of Utah, Salt Lake City, Utah; and ¶Department of Surgery, David Geffen School of Medicine at
UCLA, UCLA Health Burbank Breast Care, Burbank, California
OBJECTIVE: Among surgeons, professional use of social CONCLUSIONS: Most of surgeons responding to our
media (SM) is varied, and attitudes are ambiguous. We survey used some form of SM for professional purposes.
sought to characterize surgeons' professional use and per- Perceived barriers include lack of value, time constraints,
ceptions of SM. and personal and patient privacy concerns. Generational
differences in surgeon attitudes suggest usage of SM among
DESIGN: Surgical faculty and trainees received institutional
surgeons will expand over time. ( J Surg Ed ]:]]]-]]]. J
C 2017
review board-approved e-mail surveys assessing SM usage
Association of Program Directors in Surgery. Published by
and attitudes. Regression analyses identified predictors of
Elsevier Inc. All rights reserved.)
SM attitudes and preference for professional contact.
KEY WORDS: social media, professional development,
SETTING: Surveys were administered to surgical faculty,
generational trends, surgical education, patient privacy
fellows, and residents at 4 academic medical centers between
January and April 2016. COMPETENCIES: Medical Knowledge, Professionalism
PARTICIPANTS: Of 1037 surgeons, clinical fellows, and
residents e-mailed, 208 (20%) responded, including 132
faculty and 76 trainees. INTRODUCTION
RESULTS: Among 208 respondents, 46 (22%) indicated In spite of the near-ubiquitous nature of social media (SM)
they preferred some form of SM as their preferred network- in modern life,1 use of these tools among surgeons in
ing and communication modality. A total of 145 (70%) professional environments is poorly characterized. Previ-
indicated they believe SM benefits professional develop- ously documented barriers to SM adoption by physicians
ment. The position of clinical resident predicted preference include a lack of available time and a lack of perceived value,
to maintain professional contact via SM (p ¼ 0.03). Age as well as concerns about personal and patient privacy.2,3 In
o55 predicted positive attitude (p ¼ 0.02) and rank of addition to the practical barriers to adoption of SM in the
associate professor predicted negative attitude toward SM professional realm, a generation gap exists, with millennials
(p ¼ 0.03). Lack of time as well as personal and patient using SM for contact and information far more frequently
privacy concerns were cited most commonly as reasons for than members of generation X and baby boomers.4,5 Digital
not using SM. natives seem to be more comfortable working in the virtual
space provided by SM, although they are no less likely to
commit personal or patient privacy violations.6
With the exception of a recent study profiling the use of
Correspondence: Inquiries to Deanna J. Attai, MD, FACS, Department of Surgery,
David Geffen School of Medicine at UCLA, UCLA Health Burbank Breast Care, 191 SM by oncology physicians and trainees,2 little is reported
S. Buena Vista, #415, Burbank, CA 91505; E-mail address: dattai@mednet.ucla.edu regarding the use of SM by physicians for professional
Journal of Surgical Education & 2017 Association of Program Directors in Surgery. Published by 1931-7204/$30.00 1
Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jsurg.2017.09.008
purposes within a particular specialty. Our study was Most of respondents (80%) indicated they were aware of
designed to assess usage of and attitudes about SM by at least 1 online journal club, private case discussion, or
surgical faculty and trainees at 4 academic centers. other surgical forum, whereas 42 respondents (20%)
indicated they were not aware of any. A total of 128
respondents (62%) indicated they have been prompted to
METHODS read a journal article from another individual's posting on a
SM site. Only 25 respondents (12%) indicated they have
An electronic survey using SurveyMonkey was designed to
collaborated professionally with a colleague known to them
query participants′ attitudes, interest, and involvement with
only from SM. Excluding e-mail, 83 respondents (40%)
common SM outlets in professional practice (Appendix A).
indicated they have participated in online discussion forums
The institutional review boards of the University of California
about surgery; however, only 26 respondents (13%) indi-
Los Angeles, the University of Utah, Johns Hopkins
cated they have participated as a physician in online patient-
University, and Pennsylvania State University approved this
care discussion forums.
study. The survey was pilot tested on a convenience sample
Respondents perceived the overall effect of SM on pro-
before distribution to the study group. The survey invita-
fessional development as very beneficial (15.6%), somewhat
tion was distributed via e-mail between January and April
beneficial (54.0%), neutral or irrelevant (21%), somewhat
2016 to all surgical faculty, fellows, and residents at the 4
detrimental (4.5%), very detrimental (1.0%), or other (4.0%,
participating institutions. At each institution, the survey
including more complex descriptions). Among those who do
invitation was sent twice, 2 weeks apart. Participation was
not use SM for professional purposes, respondents most
voluntary and survey participants were not compensated.
commonly cited their preference for more traditional methods
Descriptive data were used to characterize respondent
of communication, education, and collaboration. A total of
demographics. Stepwise regression was performed for multi-
36% of respondents cited concerns for personal privacy, and
ple independent participant characteristics, and multiple
33% cited concerns for patient privacy, and 31% cited lack of
linear regression was performed for binary categories of
time as reasons for not using SM. Table 3 summarizes this
independent participant characteristics to identify predictors
and other reasons respondents cited against SM use for
of SM as a preferred means of professional contact, as well
professional purposes. Results of regression analyses are shown
as characterizing attitudes toward SM. In stepwise regression
in Tables 4 and 5. Stepwise regression analyses (Table 4)
analyses, independent variables included sex, age, practice
showed that clinical residents were independently more likely
setting, academic rank, and year of medical school gradu-
to prefer SM as a method of keeping in touch professionally.
ation. In multiple linear regression analyses, binary category
Sex, age, and practice setting were not independent predictors
thresholds included participant sex; age of 45 years; age of
of preferences or attitudes regarding SM in stepwise regression
55 years; years of medical school graduation before 1990,
analyses. Multiple linear regression (Table 5) demonstrated
1995, 2000, and 2005; academic vs community practice
that respondent age o55 years independently predicted
setting; and faculty vs trainee position.
positive opinion of SM. Sex, medical school graduation year,
and practice setting were not independent predictors of
RESULTS preferences or attitudes regarding SM in multiple linear
regression analyses.
Over the study period, 1037 e-mail surveys were sent to 645
faculty members, 330 residents, and 62 fellows. There were
208 respondents from all 4 institutions, including 132 DISCUSSION
faculty, 74 residents, and 2 fellows, for an overall survey
response rate of 20%. Most of surgical faculty, fellows, and residents responding to
Among the 208 respondents, 79 (38%) were females. Age our survey used some form of SM for professional purposes.
ranges and years of graduation from medical school are However, many stated that they preferred traditional means
shown in Table 1. Professional practice settings of respond- of communication, education, and collaboration and approx-
ents included 191 in academic practices (92%) and 17 in imately 1 in 8 were unfamiliar with the use of SM in the
community-based practices (8%). professional setting. A recent study by Langenfeld et al.7
Table 2 summarizes respondents' preferred means of noted that 68% of program directors in general surgery use
maintaining professional contact. Respondents were permit- Facebook, and that it is common practice among them to
ted to select more than 1 option. In total, 205 respondents amend rank order lists of applicants based uniquely on SM
indicated their preferred means of keeping in touch was an content. Given that members of our educational leadership
electronic medium (i.e., computer-based, excluding tele- include SM in their selection process for trainees, ensuring
phone calls), whereas 46 respondents indicated they pre- SM awareness and literacy among our ranks is imperative.
ferred a SM outlet above all other means to keep in touch Almost 70% of respondents noted that SM use could
with professional contacts. have a “very” or “somewhat” beneficial effect on
TABLE 3. Proportions of Respondents Citing Reasons Against Using SM for Professional Purposes
Prefer more traditional methods of communication, education, and collaboration 48%
Concern about personal privacy 36%
Concern about patient privacy and HIPAA violations 33%
Lack of time 31%
Lack of perceived value 24%
Unsure how to use 13%
I do use SM for professional purposes 40%
HIPAA, Health Insurance Portability and Accountability Act.
question has been raised regarding whether professional SM nonacademic practices, were not discussed or assessed. Our
use should “count” toward academic faculty advancement, survey was performed in 2016, so our results may under-
and a prominent online blogger has noted that opinions estimate current SM use due to the exceptionally rapid
shared on SM may in fact be more important than the growth of SM activity. Finally, our survey did not use a
number of published articles, given that many articles are validated instrument because one is not available in this area.
never read or cited.32,33 In 2016, the Mayo Clinic
announced that it will take scholarly SM activity into
account when considering academic promotion.34 As pro-
CONCLUSIONS
fessors and associate professors are less likely to view
professional SM positively, it remains to be seen whether Most of academic surgical faculty and trainees who responded
current residents and assistant professors will succeed in to our survey use some form of SM for professional purposes
promotion based upon SM engagement and productivity. and consider SM participation potentially beneficial to pro-
Our study has several limitations. First, though our fessional development. Personal and patient privacy concerns
response rate is comparable to other e-mail survey studies, as well as uncertainty regarding potential uses remain barriers
it does reflect a low proportion of our intended participant to more widespread use. Clinical resident propensity to keep in
population. Respondents may have been subject to selection touch via SM and positive attitude regarding SM among
bias toward those with preconceived notions (either positive younger surgeons may reflect a generational trend in profes-
or negative) regarding SM. Furthermore, nearly all partic- sional collaborative behaviors and leads us to believe that SM
ipants in this study work at academic medical centers, which use will organically expand in the future. Many SM outlets
may tend toward more traditional communications infra- have demonstrated value to the surgical community. However,
structure or may have policies limiting faculty engagement additional research is necessary to determine how to optimally
on SM. We did not clearly define “professional use,” and our integrate the use of SM into the surgeon's daily workflow, to
survey did not inquire about personal SM use or how it may develop guidelines for assessing professional SM activity for
overlap with the professional activities of users. Potential academic advancement, and to clarify best practices for the
benefits to more isolated surgeons, particularly those in surgeon operating in the public online space.
8. Buckarma EH, Thiels CA, Gas BL, et al. Influence of 21. Reames BN, Sheetz KH, Englesbe MJ, et al. Evaluat-
social media on the dissemination of a traditional ing the use of Twitter to enhance the educational
surgical research article. J Surg Educ. 2017;74(1):79-83. experience of a medical school surgery clerkship. J Surg
Educ. 2016;73(1):73-78.
9. Ibrahim AM, Lillemoe KD, Klingensmith MD,
Dimick JB. Visual abstracts to disseminate research 22. Wang AT, Sandhu NP, Wittich CM, et al. Using
on social media: a prospective, case-control crossover social media to improve continuing medical education:
study. Ann Surg. 2017. http://dx.doi.org/10.1097/ a survey of course participants. Mayo Clin Proc.
SLA.0000000000002277. [Epub ahead of print]. 2012;87(12):1162-1170.
10. Roberts MJ, Perera M, Lawrentschuk N, et al. Global- 23. Rainie L. E-patients and their hunt for health informa-
ization of continuing professional development by tion. 2013. Retrieved from: http://www.pewinternet.
journal clubs via microblogging: a systematic review. org/2013/10/10/e-patients-and-their-hunt-for-health-
J Med Internet Res. 2015;17(4):e103. information/. Accessed 16.07.17.
11. Chan TM, Thoma B, Radecki R, et al. Ten steps for 24. Centers for Disease Control. Morbidity and mortality
setting up an online journal club. J Contin Educ Health weekly report (MMWR). 2015;64(49):1367. Retrieved
Prof. 2015;35(2):148-154. from: https://www.cdc.gov/mmwr/preview/mmwrhtml/
SUPPLEMENTARY MATERIAL
Supplementary data are available in the online version of
this article at http://dx.doi.org/10.1016/j.jsurg.2017.09.
008.