Council on Medical Student Education in Pediatrics


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COMSEP 2010 Albuquerque Meeting


Terry Kind, MD, MPH, The George Washington University School of Medicine, Children's National Medical Center, Washington, DC; Ellen F. Goldman, EdD, Graduate School of Education and Human Development; Louis Beckman, BA; MD candidate, The George Washington University School of Medicine, The George Washington University, Washington, DC; Katherine C. Chretien, MD, The George Washington University School of Medicine, Veterans Affairs Medical Center, Washington, DC


Background: US medical school deans have reported incidents of medical students posting unprofessional online content, some warranting dismissal. Yet, medical students' views on posting online have not been well-explored. Objectives: To inform possible institutional professionalism policies, curricula, and guidelines, we explored medical student experiences with online posting. Methods:  Six 90-minute focus groups were conducted with medical students from a single institution in Nov 2009.  Preclinical and clinical students were in separate groups. Trained moderators conducted the groups using a pre-established guide. Focus groups were audiorecorded and transcribed verbatim. 2 authors independently analyzed transcripts using qualitative methods to develop themes. Themes were triangulated with moderator summaries. Results: 64 students participated. Average age was 23.7 years in preclinical and 27.1 in clinical focus groups. Students described their Web 2.0 use. Transcript analysis yielded themes in the following categories:   Professionalism: Except for HIPAA violations, interpretations differed regarding what was inappropriate for medical students to post online. Students struggled with online identity conflicts (professional vs personal; impact on self vs on institution/profession). Some felt medical professionals were held to a higher standard, but most felt standards should be same for all professionals.   Concerns: Many situations increase students' perception of risk of online activity, such as residency and job applications, becoming medical students, and starting clinical rotations. Many have taken precautionary behaviors online. Students revealed ambivalence towards Facebook perceiving it as both a vital social hub and an increasingly risky forum. They felt a lack of control online and held skepticism about privacy settings.  Guidelines: Their online behaviors were guided by commonsense.  There was little support for having institutional guidelines, although students wanted recommendations. They suggested raising awareness in the context of medical student orientation sessions and professionalism curricula, with peer honor councils involved in developing codes of conduct and determining consequences. Discussion: Many medical students are conflicted about their online behaviors. While most did not want guidelines, they suggest incorporating discussions of online professionalism into orientation sessions and existing professionalism curricula, with peer honor council involvement. These views should be taken into account as faculty/administrations plan next steps in addressing professionalism in the social media age.