The Editors Reply—We appreciate the thoughtful and valid critique of this study by Dr. Campbell and colleagues.

The low response rate of the survey was indeed the primary critique of this study during peer review. However, this critique was balanced by the novelty of the topic and relative lack of published data. Reviewers, therefore, suggested focusing the discussion of results on survey questions related to the ethics of online social network use (OSN). These questions are presumed to be less susceptible to bias than questions related to prevalence of OSN use.

The published manuscript reflects these suggestions and we believe is appropriately cautious about the clear and important limitations of this study. More rigorous surveys are clearly needed to quantify physician OSN use at the national level. But the paper by Bosslet and colleagues suggests interesting domains to include in future investigations.

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The Patient–Doctor Relationship and Online Social Networks: Results of a National Survey

The objective of this study was to evaluate the use of social media among healthcare workers in an attempt to identify how it affects the quality of patient care. An anonymous survey of 35 questions was conducted in South Texas, on 366 healthcare workers. Of the 97% of people who reported owning electronic devices, 87.9% indicated that they used social media. These healthcare workers indicated that they spent approximately 1 h on social media every day. The healthcare workers below the age of 40 were more involved in social media compared to those above 40 (p < 0.05). The use of social media among physicians and nurses was noted to be identical (88% for each group), and both groups encouraged their patients to research their clinical conditions on social media (p < 0.05). A higher number of physicians reported awareness of a social media policy in their hospital compared to nurses (p < 0.05). However, a large proportion of healthcare workers (40%) were unaware of their workplace policy, which could potentially cause a privacy breach of confidential medical information. Further studies are required to evaluate specific effects of these findings on the quality of patient care.

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Social media usage among health care providers

Free Open Access Medical education (FOAM) has taken the emergency medicine and critical care worlds by storm in the past decade. This article represents one perspective on the stages of transition for FOAM from its humble beginnings as a grassroots movement to the more recent multiauthor blogs that are described in the peer-reviewed literature. In this article, the authors describe the following four distinct waves of people within the movement, with each wave creating a new stage in the evolution of the FOAM community: Creation by the Founders, Adoption by the Enthusiasts, Structure and Formalization by the Structuralists, and Engagement and Activity by the End Users. The authors contextualize some of the phenomena that have been observed within this field and highlight challenges for the field moving forward.

A Short History of Free Open Access Medical Education. The Past, Present, and Future.

Objectives: To assess social media and search engines used to find health information in Saudi patients and their companions and to describe their perceptions, attitudes, and practices. Methods: A cross-sectional study was carried out on 374 patients and their companions at a tertiary care hospital in Riyadh, Saudi Arabia. The data were collected between January and March 2018 using a self-administrated questionnaire adopted from the literature and developed in Arabic. The questionnaire was validated and modified by the researchers to fulfill the purpose of this study. The questionnaire contains 4 sections (25 questions), divided into a demographic section and the 3 sections assessing perceptions, attitudes, and practices. Results: Eighty-five percent sought health information using social media; of whom 293 (78.3%) used WhatsApp, 237 (63.4%) used YouTube, and 46 (12.3%) used Facebook. Furthermore, 72% searched information for themselves and 52% for a family member. Approximately 28% of participants had used social media for medical consultations. The reliability of health information on social media was met for 51% of participants, and 81.4% claimed that the health information obtained was knowledgeable. However, only 29% share their personal health experience with the public on social media. Conclusion: Our findings suggest that the majority of the participants used social media platforms to find information related to their health conditions, while approximately one third received direct medical consultations online. Public awareness to use reputable sources for health information is needed. Saudi Med J 2019; Vol. 40 (12): 1294-1299 doi: 10.15537/smj.2019.12.24682 How to cite this article: Marar SD, Al-Madaney MM, Almousawi FH. Health information on social media. Perceptions, attitudes, and practices of patients and their companions. Saudi Med J 2019; 40: 1294-1299. doi: 10.15537/smj.2019.12.24682

https://smj.org.sa/content/smj/40/12/1294.full.pdf

Health information on social media. Perceptions, attitudes, and practices of patients and their companions.

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.

Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review

A growing number of physicians are using social media as a professional platform for health communication. The purpose of this study was to understand perspectives and experiences of these “early adopter” physician bloggers and social media users. This was an exploratory qualitative study involving in-depth semi-structured telephone interviews of physicians who were early adopters, defined as physicians who used social media to distribute health information. Participants were recruited through snowball sampling. Interview transcripts were manually analyzed for common themes by three separate investigators who came to common conclusions via the constant comparative method. Seventeen physicians participated in this study, including 35 % females, 76 % pediatricians and 76 % bloggers. Participants identified multiple perceived benefits and barriers to social media use by physicians; further, four major themes were identified. First, participants often saw themselves as rugged individualists who set their own rules for social media health communications. Second, participants expressed uncertainty about boundaries or strategies for social media use. Third, participants described using social media much like traditional media, as a one-way communication platform, rather than as an interactive forum. Finally, participants expressed disparate views regarding the time involved in participating in social media; some felt that time spent on social media was unproblematic to fit into their day while others felt that it was an impediment to patient care. Uncertainty remains regarding roles and responsibilities of physicians providing medical content within social media forums and few providers appeared to be using the platform to its full potential. Future studies may inform best practices to optimize social media health communication to benefit patients.

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Lauren Campbell

Papers

Social media use by physicians: a qualitative study of the new frontier of medicine