A. NING ZHOU AND ERICK HUNG PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA INTRODUCTIONS PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA OBJECTIVES ▸ Discuss frameworks for understanding professional identity tensions in the age of social media. ▸ Define professional policies, best practices, and principles relate to social media use. ▸ Discuss professional boundary issues relevant to social media use. ▸ Reflect on one’s online presence, describe privacy features, and adjust privacy settings on Facebook and Twitter. PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA WORKSHOP AGENDA ▸ Frameworks for social media use and professional identity ▸ AMA and UCSF guidelines and best practices ▸ Boundary issues ▸ Audit your online presence and adjust your privacy settings PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Professional Personal Public Social Media TEXT TEXT PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA DEFINITIONS Social networking site (SNS) “…web-based services that allow individuals to (1) construct a public or semi- public profile within a bounded system, (2) articulate a list of other users with whom they share a connection. and (3) view and traverse their list of connections and those made by others within the system.” (Boyd, 2007) TEXT PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA INCREASING IMPORTANCE OF SOCIAL MEDIA 13% 33% 67% 87% Personal Use Professional Use Ryne, 2012 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA DIGITAL NATIVES VS. DIGITAL IMMIGRANTS Ginrory, 2012 and Chretien, 2011 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA ONLINE DISINHIBITION EFFECT ▸ While online, some people self-disclose or act out more frequently or intensely than they would in person ▸ Anonymity ▸ Invisibility ▸ Asynchronicity ▸ Minimization of authority Suler, 2004 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA SMALL WORLD ETHICS Lannin and Scott, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PROFESSIONALISM: ONE-MINUTE PAPER ▸ What is professionalism? ▸ Why do we uphold it? ▸ How do we uphold it? PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PROFESSIONAL IDENTITY FORMATION Cruess, 2015 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA GUIDELINES AND POLICIES ▸ AMA Policy on Professionalism and Social Media Use ▸ UCSF Social Media Policies for Personal Accounts PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA UCSF POLICY AMA POLICY 1. Respect confidentiality 1. Patient privacy/confidentiality 2. You speak for yourself, but 2. Use privacy settings your actions reflect those of 3. Maintain appropriate UCSF boundaries 3. Live by the law 4. Separate personal and 4. UCSF is subject to laws professional online content regarding political speech 5. Report unprofessional content 5. Understand HIPAA and CMIA 6. Online behavior may affect 6. Act as if you were at work reputation and have consequences 7. Perception is reality PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA UCSF BEST PRACTICES AMA BEST PRACTICES 1. The internet is a public 1. Take responsibility and use (and permanent) space judgement 2. Think before you post 2. Be honest about who you are 3. Protect patient privacy 4. Respect work commitments 3. Be respectful 5. Identity yourself 4. Think it through 6. Use a disclaimer 5. Listen 7. Respect copyright and fair use laws 6. Add value to the discussion 8. Protect proprietary information 9. See expert guidance 7. Avoid arguments PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA VIGNETTE #1 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA RESPECTFUL COMMUNICATION ONLINE ▸ An active debate has sprung up in a residency class. A black female resident submitted the following post on Facebook: “I am so upset that I did not get the research award today from the Clinical and Translational Science Institute! I worked my butt off. This is another example of white privilege working against me!” Some of her classmates feel that this post is disrespectful. PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA RESPECTFUL COMMUNICATION ONLINE ▸ Has the resident followed the UCSF best practice guidelines on social media communication? ▸ Does the resident have a right to express her opinion? ▸ What feedback might we give to the resident? ▸ How could we facilitate a constructive discussion in the residency cohort? PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA VIGNETTE #2 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PROFESSIONAL COMMUNICATION FROM PERSONAL ACCOUNTS ▸ A urology resident recently began posting her medical opinions on Twitter. The same day that the United States Preventative Services Task Force came out with a recommendation against routine Prostate-Specific Antigen (PSA) screening in healthy men for prostate cancer, she posted the following tweet. “Speaking of prostate cancer screening, I would like to tell the Task Force where they can stick their new guidelines. They are completely blind to the individual needs of our patients!” The tweet has now gone viral and has been read by many of her patients, colleagues, fellow researchers, and friends. PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PROFESSIONAL COMMUNICATION FROM PERSONAL ACCOUNTS ▸ Has the resident followed the UCSF best practice guidelines on social media communication? ▸ Does the resident have a right to express her opinion? ▸ What feedback might we give to the resident? PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA VIGNETTE #3 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PERSONAL BEHAVIORS ONLINE ▸ A Department Chair informs her fellowship program director that a fellow has been tagged in a Facebook post outside of a restaurant following the annual Department holiday party. The fellow is with other fellows in the photograph and has what appears to be a joint in his hand. The Department Chair feels this is unprofessional and wants the program director to discipline the fellow. PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PERSONAL BEHAVIORS ONLINE ▸ Do you consider this unprofessional? ▸ Why would the Department Chair be concerned about this post? ▸ How should the program director engage the fellow in a productive conversation? PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA SORTING EXERCISE YOU ARE A MEMBER OF THE STATE MEDICAL BOARD! WOULD YOU TAKE DISCIPLINARY ACTION? PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Greysen, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Greysen, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Greysen, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Greysen, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Greysen, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Greysen, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Greysen, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Greysen, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Greysen, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA Greysen, 2012 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA STRICTLY FORBIDDEN VS. STRONGLY DISCOURAGED ▸ Strictly forbidden ▸ Violating patient confidentiality ▸ Reporting privacy academic information ▸ Neglecting official work commitment when interacting online ▸ Strongly discouraged ▸ Use of vulgar language ▸ Implying disrespect ▸ Presentation of alcohol misuse, substance use, sexual promiscuity ▸ Posting unflattering material on another individual’s website Greysen, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA BOUNDARIES PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA BOUNDARIES ▸ Definition ▸ The “edge” of appropriate professional behavior ▸ Boundary Issue Types ▸ Boundary Crossing ▸ Boundary Violation PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA PRINCIPLES TO CONSIDER IN BOUNDARY VIOLATIONS ▸ Ethical principles ▸ Self-disclosure ▸ Multiple relationships Lannin, 2013 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA BOUNDARIES ▸ Boundaries with colleagues ▸ Boundaries with patients PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA BOUNDARIES WITH COLLEAGUES TEXT PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA FACEBOOK FRIENDS WITH COLLEAGUES ▸ Study of clerkship directors in internal medicine in June 2010 ▸ 53% received a “friend request” from a current student ▸ 63% received a “friend request” from a current resident ▸ 19% accepted the student request ▸ 48% accepted the resident request ▸ Becoming friends with a former student, resident, or colleague was perceived as more appropriate Chretien, 2011 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA VIGNETTE #4 PROFESSIONAL IDENTITY TENSIONS IN THE AGE OF SOCIAL MEDIA FRIENDING WITH STUDENTS AND FACULTY ▸ Michelle is a PGY-2 resident in Surgery. She is very close to her faculty career advisor who is not in an academic supervisory role for her. She sends her career advisor on Facebook a friend request. ▸ John is a 4th-year medical student who receives a Facebook friend request from a PGY-2 resident. He had worked closely with the resident on his core clerkship one year ago. John feels pressure to