To friend or not to friend: the use of social media in clinical oncology

Perceptions of professional social media interaction with patients and faculty members - a comparative survey among dental students from Malaysia and Finland

BACKGROUND

Professional and personal boundaries are blurred with the wide application of social media (SM) in the health professions line of work. Little is known about practice of extending friend requests to patients and faculty members among dental students, which encompass a part of E-professionalism. The aim of this study is to assess the factors associated with the perceptions and practices of interactions with patients and faculty on SM among dental students from Malaysia and Finland.

METHODS

Dental students from 4 institutions in Malaysia and Finland completed self-administered questionnaires on the practices and perceptions of SM use. The main variables assessed were the perceptions and practices of student-patient and student-faculty communication on SM, between the two countries. Students' country, age, gender, time spent on SM and perceived importance of communicating dental related aspects over SM were analysed as potential explanatory variables. Crosstabulation was used to estimate the distributions of the response variables by the background characteristics. Multivariate analyses were performed using a dichotomous logistic regression model to investigate relevant associations between the responses and the explanatory variables independent from other factors.

RESULTS

A total of 643 students completed the survey in March-April 2021. More Malaysian students agreed with "guiding patients online is a new responsibility for dentists in the digital age" compared to Finnish students (86.4% vs. 73.4%). Similarly, significantly more Malaysian students befriended patients (14.1% vs. 1%) and invited faculty to be friends on SM (73.6% vs. 11.8%). Expectedly, clinical year students befriended patients more than pre-clinical (13.8% vs. 6.8%). Significantly more students who felt 'communication of dental related issues over SM' were likely to extend friend requests to faculty rather than accept patient friend requests.

CONCLUSIONS

Social media regulations and socio-cultural practices contribute to dental students' attitudes and behaviour when befriending patients and faculty members on social media. Future dental curriculum should incorporate guidelines for professional communication on social media based on local and cultural needs. Students' should be encouraged to interact with their patients using professional identities on social media.

Social media use, professional behaviors online, and perceptions toward e-professionalism among dental students

OBJECTIVES

This study aimed to assess self-reported social media use, professional behaviors online, and perceptions on e-professionalism while using social media among dental students in two Southeast Asian universities.

METHODS

This cross-sectional study involved clinical dental students at University of Malaya (UM), Malaysia (n = 150) and Airlangga University (AU), Indonesia (n = 150). A questionnaire was distributed using Google Form via WhatsApp network. Data were analyzed using descriptive, Chi-square, and Wilcoxon rank-sum tests.

RESULTS

All students responded (n = 300) and reported as active social media users. Majority spent ≥ 1 h a day on social media and checked their social media > 6 times a day. Most commonly used social media accounts were Instagram (UM: 92.7%, AU: 95.3%) and Facebook (UM: 94.7%, AU: 59.3%). A small proportion of UM and AU students admitted to posting clinical photographs, patient records, and comments about patients on social media. UM students had significantly better scores in terms of their professionalism behaviors on maintaining the integrity of the profession compared to AU students (p < 0.001). Meanwhile AU students had better scores than UM students on behaviors related to upholding colleagues' professional image on social media (p = 0.421). Most students in UM and AU shared similar positive perceptions toward online professionalism behavior statements. Majority reported concerns over unprofessional posts online.

CONCLUSION

Self-reported behaviors online sometimes contradict with students' perceptions and concerns about being unprofessional online. There is a need for clearer educational guidelines on how to instill e-professionalism values and behaviors among dental students.

Physician leaders' cross-boundary use of social media: what are the implications in the current COVID-19 environment?

PURPOSE

The purpose of this study is to better understand social media (SM) factors that physician leaders need to consider, as they adapt their cross-boundary practices to engage with colleagues and patients. Firstly, this study explores why SM is being used by physicians to cross horizontal (physician to physician) and stakeholder (physician to patient) boundaries prior to COVID-19. Secondly, based on the studies reviewed, this study provides insights on the practical SM implications for physician leaders working in the COVID-19 environment to actively enhance their practices, reduce public confusion and improve patient care, thus informing health-care practices.

DESIGN/METHODOLOGY/APPROACH

A systematic literature review was used to conduct a structured transparent overview of peer reviewed articles that describe physicians' use of cross-boundary SM across several disciplines (e.g. health, information science). As a baseline assessment prior to COVID-19, the review synthesized 47 articles, identified and selected from six databases and Novanet. This study used NVivo 12 to thematical code the articles, leading to the emergence of four broad factors that influence SM use.

FINDINGS

A key reason noted in the literature for physicians use of SM to cross horizontal boundaries is to share knowledge. Regarding stakeholder boundaries, the most cited reasons are to improve patient's health and encourage behavioural changes. Insights garnered on the practical SM implications include the need for physicians to be stronger leaders in presenting trustworthy and consistent facts about health information to the public and fellow peers. As role models for the effective use of SM tools, physician leaders can mentor and coach their colleagues and counterparts.

RESEARCH LIMITATIONS/IMPLICATIONS

As this was a literature review, the authors did not collect primary data to further explore this rapidly changing and dynamic SM world. Next steps could include a survey to determine firstly, how physicians currently use SM in this COVID-19 environment, and secondly, how they could leverage it for their work. Findings from this survey will help us better understand the role of physician leaders as health-care influencers and how they could better create trust and inform the Canadian public in the health information that is being conveyed.

PRACTICAL IMPLICATIONS

Physician leaders can play a key role in positively influencing institutional support for ethical and safe SM use and engagement practices. Physicians need to participate in developing regulations and guidelines that are fundamentally to physician leader's SM use. Central to this research would be the need to understand how physicians cross-boundary practices have changed during and potentially post COVID-19. Physician leaders also need to monitor information sources for credibility and ensure that these sources are protected. As role models for the effective use of SM tools, physician leaders can mentor and coach their colleagues and counterparts in this area.

ORIGINALITY/VALUE

Although there have been studies of how physicians use SM, fewer studies explore why physician leaders' cross boundaries (horizontal and stakeholder) using SM. Important insights are gained in physician leaders practical use of SM. Key themes that emerged included: organizational and individual, information, professional and regulations and guideline factors. These factors strengthen physician leaders understanding of areas of foci to enhance their cross-boundary interactions. There is an urgency to study the complexity of SM and the effectiveness of regulations and guidelines for physicians, who are being required, at an accelerated rate, to strengthen and increase their cross-boundary practices.

Live European School of Oncology e-Sessions (e-ESO)

The European School of Oncology (ESO) embarked on an online educational project, starting with live sessions in 2008 (e-ESO). Our scholars and young oncologists identified the need to be offered independent high-level online education with contributions from experts around the world, free of charge and available at any moment. We report on various types of e-sessions, such as grand-rounds, highlights, debates, clinical cases and other sessions. Our audience has grown over the last decade, reaching 11,123 users who have viewed a total of 77,041 sessions since the beginning of 2008. Moreover, our activities on social media platforms have enhanced our visibility, reaching more physicians around the globe. Due to the recent events surrounding the COVID-19 pandemic, online education has proven to be of great value in offering long-distance teaching. We have analyzed the growth of our audience and its attendance over the last 12 years.

The Development of Social Media Guidelines for Psychologists and for Regulatory Use

The Association of State and Provincial Psychology Boards, the national organization representing psychology regulatory/licensing boards in Canada and the USA, recently developed social media guidelines that are being recommended for use by its member boards. The purposes of the guidelines were to provide guidance to psychology regulatory boards both countries in identifying and communicating what are considered appropriate and inappropriate uses of social media and to promote consistency and clarity about this across jurisdictions. The process involved reviewing the professional literature, relevant guidelines, standards, current laws, and regulations. The guidelines developed include guidelines about confidentiality, informed consent, risk management, competence, multiple relationships, professional conduct, security of information, personal use of social media, and regulatory board use of social media. Major challenges and limitations in accomplishing this task are identified and discussed.

To be or not to be in the social media arena? The perspective of healthcare providers working within adolescent and young adult oncology in Switzerland

Background Given that social media is quickly penetrating clinical practice, it is essential to explore how these technologies can be used to improve patient-centered care. This is particularly important for healthcare professionals caring for adolescents and young adults (AYA), amid whom the use of social media is nearly universal and whose medical and psychosocial needs are often underestimated by the pediatric or adult oncology settings in which they are treated. Objectives To examine the perspectives of various medical professionals on the emerging role of social media in AYA oncology. Methods Three focus groups were performed with Swiss healthcare professionals involved in the care of AYA patients with cancer. The focus groups were analyzed using thematic coding. Results Healthcare professionals caring for AYA cancer patients in Switzerland are reluctant to step into the social media sphere because they find it difficult to navigate professional boundaries in an unfamiliar space where different contexts collapse. Nurses and younger healthcare professionals who tend to have a more intimate relationship with AYA, often lack virtual mentorship to know how to maintain online professionalism. Adolescents and young adults cancer-related social media presence was unknown to our participants which resulted in missed occasions to inform, educate and care for this often underserved population of cancer patients. Conclusions More practical guidance is needed to help healthcare professionals with how to integrate social media into clinical practice. Setting up fruitful collaborations between medical institutions and existing AYA support groups online might be the best way forward.

Integrating Social Media in Modern Oncology Practice and Research

The widespread adoption and diffusion of social media provides oncology professionals with a unique and unprecedented opportunity to engage with the public. However, there remains a paucity of literature examining how clinicians and researchers can effectively use social media to complement modern oncology practice and research. In this review, we dissect the benefits and risks of professional social media use in oncology and offer several best practices for clinicians and researchers to achieve effective engagement. We also describe how to participate constructively in Twitter conversations at the time of medical or scientific conferences. Additionally, we demonstrate how to communicate appropriately and safely with patients and families online. Finally, we explore the exciting and nascent field of social media research and highlight the need to investigate its potential value in personalized cancer medicine.

Patients With Cancer and Social Media: Harness Benefits, Avoid Drawbacks

Social media (SM) platforms such as Facebook, Instagram, Twitter, and online cancer support groups are an emerging source of social support. However, oncology care professionals may be unfamiliar with how patients use SM related to their cancer diagnosis. SM can be potentially beneficial by providing an avenue for patient engagement and empowerment, increasing psychosocial and informational support, strengthening patient-physician relationships, and relaying opportunities for clinical and research study participation. Conversely, it can spread misinformation, overwhelm with information overload, violate privacy, and expose users to financial exploitation. The purpose of this article is to describe five potential benefits and five potential drawbacks patients may experience while using SM and to encourage oncologists to become aware of these, to guide patients in using SM to their benefit. This review also provides specific care practice behaviors that oncologists can apply during care delivery to guide patients' SM use, to help avoid the potential drawbacks and harness the potential benefits.

Proper use of social media by health operators in the pediatric oncohematological setting: Consensus statement from the Italian Pediatric Hematology and Oncology Association (AIEOP)

Social media are powerful means of communication that can also have an important role in the healthcare sector. They are sometimes seen with diffidence in the healthcare setting, partly because they risk blurring professional boundaries. This issue is particularly relevant to relations between caregivers and adolescent patients. The Italian Pediatric Hematology and Oncology Association created a multidisciplinary working group to develop some shared recommendations on this issue. After reviewing the literature, the working group prepared a consensus statement in an effort to suggest an analytical approach rather than restrictive rules.

Physicians, patients, and Facebook: Could you? Would you? Should you?

This article investigates the opinions of physicians and patients regarding the use of Facebook to communicate with one another about health-related issues. We analyzed 290 comments posted on online discussion boards and found that most (51.7%) were opposed to physicians being Facebook "friends" with patients and many (42%) were opposed to physicians having any kind of Facebook presence. Some believed that health care organizations should have a social media policy and provide social media training. We conclude with suggestions for how health care administrators can provide assistance to physicians and effectively manage their social media presence.

Evaluating the Social Media Performance of Hospitals in Spain: A Longitudinal and Comparative Study

BACKGROUND

Social media is changing the way in which citizens and health professionals communicate. Previous studies have assessed the use of Health 2.0 by hospitals, showing clear evidence of growth in recent years. In order to understand if this happens in Spain, it is necessary to assess the performance of health care institutions on the Internet social media using quantitative indicators.

OBJECTIVES

The study aimed to analyze how hospitals in Spain perform on the Internet and social media networks by determining quantitative indicators in 3 different dimensions: presence, use, and impact and assess these indicators on the 3 most commonly used social media - Facebook, Twitter, YouTube. Further, we aimed to find out if there was a difference between private and public hospitals in their use of the aforementioned social networks.

METHODS

The evolution of presence, use, and impact metrics is studied over the period 2011- 2015. The population studied accounts for all the hospitals listed in the National Hospitals Catalog (NHC). The percentage of hospitals having Facebook, Twitter, and YouTube profiles has been used to show the presence and evolution of hospitals on social media during this time. Usage was assessed by analyzing the content published on each social network. Impact evaluation was measured by analyzing the trend of subscribers for each social network. Statistical analysis was performed using a lognormal transformation and also using a nonparametric distribution, with the aim of comparing t student and Wilcoxon independence tests for the observed variables.

RESULTS

From the 787 hospitals identified, 69.9% (550/787) had an institutional webpage and 34.2% (269/787) had at least one profile in one of the social networks (Facebook, Twitter, and YouTube) in December 2015. Hospitals' Internet presence has increased by more than 450.0% (787/172) and social media presence has increased ten times since 2011. Twitter is the preferred social network for public hospitals, whereas private hospitals showed better performance on Facebook and YouTube. The two-sided Wilcoxon test and t student test at a CI of 95% show that the use of Twitter distribution is higher (P<.001) for private and public hospitals in Spain, whereas other variables show a nonsignificant different distribution.

CONCLUSIONS

The Internet presence of Spanish hospitals is high; however, their presence on the 3 main social networks is still not as high compared to that of hospitals in the United States and Western Europe. Public hospitals are found to be more active on Twitter, whereas private hospitals show better performance on Facebook and YouTube. This study suggests that hospitals, both public and private, should devote more effort to and be more aware of social media, with a clear strategy as to how they can foment new relationships with patients and citizens.

ReCAP: Social Media Use Among Physicians and Trainees: Results of a National Medical Oncology Physician Survey

QUESTION ASKED:

To what extent, and for what purpose, do oncology physicians and physicians-in-training use Web-based social media?

SUMMARY ANSWER:

Despite the ability of social media to enhance collaboration and knowledge dissemination among health care providers, this cohort survey study identified an overall low use of social media among oncologists, and significant generational gaps and differences in patterns of use.

METHODS:

A nine-item survey was designed using a survey-generating Web site (SurveyMonkey) and was distributed securely via weekly e-mail messages to 680 oncology physicians and physicians-in-training from July 2013 through September 2013. All responses were received anonymously. Results were analyzed and are reported using descriptive statistics.

RESULTS:

Of 680 surveys sent, 207 were completed, for a response rate of 30.4%. Social media were used by 72% of our survey respondents (95% CI, 66% to 78%; Table 1 ). Results were cross tabulated by age, which revealed a significant difference in social media use by age group, with 89% of trainees, 93% of fellows, and 72% of early-career oncologists reporting social media use, compared with only 39% of mid-career oncologists (P < .05). Respondents reported using each social media platform for either personal or professional purposes, but rarely both. When respondents were questioned regarding barriers to social media use and their hesitations around joining a medically related social media site, the majority (59%) answered, “I don't have enough time.” [Table: see text]

BIAS, CONFOUNDING FACTOR(S), DRAWBACKS:

This study was conducted online, via e-mail. Therefore, respondents may represent a subpopulation of individuals who already prefer using Web-based technologies and may be more inclined to use social media, compared with individuals who do not use e-mail and were, by default, excluded from the study. We assumed, in designing this study, that the proportion of practicing oncology physicians who do not use e-mail is low. Although our sample size is small, it does represent one third of all registered medical oncologists in Canada. Finally, the high percentage of medical oncologist respondents and the concomitantly low fraction of respondents from other specialties may mean these results are more telling of social media habits in the aforementioned demographic rather than other oncology specialties.

REAL-LIFE IMPLICATIONS:

Our study revealed that oncology physicians and physicians-in-training who participate in Web-based social networking are largely within the younger age cohorts, whereas mid-career oncologists (age 45 to 54 years) are largely absent from the social media scene. Gaps in social networking use between younger physicians and trainees and older generations of physicians may result in critical gaps in communication, collaboration, and mentorship between these demographics. It is hoped that with further research into understanding patterns of use and limitations, medical professionals and trainees may increase their use of social media for networking, education, mentorship, and improved patient care.

Social Media and Oncology: The Past, Present, and Future of Electronic Communication Between Physician and Patient

The relationship between patient and physician is in flux with the advent of electronic media that are advancing and enhancing communication. We perform a retrospective, current, and forward-looking examination of the technologies by which information is exchanged within the healthcare community. The evolution from e-mail and listservs to blogs and the modern social networks is described, with emphasis on the advantages and pitfalls of each medium, especially in regard to maintaining the standards of privacy and professionalism to which doctors are held accountable. We support the use of contemporary platforms like Twitter and Facebook for physicians to establish themselves as trustworthy online sources of medical knowledge, and anticipate ongoing collaboration between researchers, patients, and their advocates in trial design and accrual.

Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer

Medical providers are trained to investigate, diagnose, and treat cancer. Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population. Early, systematic integration of palliative care into standard oncology practice represents a valuable, imperative approach to improving the overall cancer experience for adolescents and young adults (AYAs). The importance of competent, confident, and compassionate providers for AYAs warrants the development of effective educational strategies for teaching AYA palliative care. Just as palliative care should be integrated early in the disease trajectory of AYA patients, palliative care training should be integrated early in professional development of trainees. As the AYA age spectrum represents sequential transitions through developmental stages, trainees experience changes in their learning needs during their progression through sequential phases of training. This article reviews unique epidemiologic, developmental, and psychosocial factors that make the provision of palliative care especially challenging in AYAs. A conceptual framework is provided for AYA palliative care education. Critical instructional strategies including experiential learning, group didactic opportunity, shared learning among care disciplines, bereaved family members as educators, and online learning are reviewed. Educational issues for provider training are addressed from the perspective of the trainer, trainee, and AYA. Goals and objectives for an AYA palliative care cancer rotation are presented. Guidance is also provided on ways to support an AYA's quality of life as end of life nears.