EBM and Clinical Support Librarians@UCHC

A blog for medical students, faculty and librarians about their use of evidence based medicine, clinical literature, Web 2.0, sources and search strategies

News, Medical Students, Social Network Analysis: Digital Histories can’t be Deleted

The goals of this study were to describe reported incidents of medical students posting unprofessional content online at U.S. medical schools, describe current policies and views of medical school leaders regarding Web 2.0 use by medical students, and assess the relationship between unprofessional incidents and presence of policies.

Excerpt from an article published Sept 23/30, 2009 in JAMA (Vol. 302, No. 12: 1309-1315) written by Katherine Chretien, S. Ryan Greysen, Jean-Paul Chretien and Terry Kind


Medical Education is the theme of  this week’s issue of JAMA: Journal of the American Medical Association*.  Published in this issue is a seven-page article entitled “Online Posting of Unprofessional Behavior by Medical Students” written by four physicians affiliated with George Washington University and the Washington VA.

The questionnaire was sent out in March and April of 2009 to medical school deans or student affairs administrators at 130 allopathic schools of medicine accredited by the Association of American Medical Colleges.  The data was designed to be collected anonymously.  Staff from 78 medical schools chose to participate, with a return rate of 60%.

The questions in the survey focused on four principal areas: “School & respondent characteristics,  incidents of student-posted unprofessional online content, level of concern among student affairs deans or proxies and institutional policies and resources“.

About one-half of the deans or student affairs personnel who returned the survey reported that documented unprofessional behaviors by medical students were observed.

Following is a paragraph from the Commentary section of this article:

There are a number of actions that medical schools could take that might address some of the concerns raised by these findings. The formal professionalism curriculum should include a digital media component, which could include instruction on managing the “digital footprint,” such as electing privacy settings on social networking sites and performing periodic Web searches of oneself.  This is important given that residency program directors, future employers, and patients may access this information.

Excerpt from the above-referenced article published in JAMA (Vol. 302, No. 12: 1314).


The article will likely be read by many medical school administrators in the U.S. and abroad.  The literature is small but growing about what long-term effects one’s digital footprint (or captured misbehaviors) may have on a career in medicine. (As an example, two articles on this topic are linked here and here.) There were no social networking sites to capture a person’s online presence twenty years ago; the story is being told in the Now.

The JAMA article may serve as a wake-up call for those institutions of higher education who have yet to set up – or enforce existing – policies addressing online student profiles and conduct.

This week’s press coverage and subsequent discussions might also serve as a wake-up call to American medical students:   When is a good time to review your online profile? Answer: Quite likely, now.


Following are two related links.  First: click here for a collection of news stories or blog postings about this article, medical students and online behaviors compiled from Google.

Next: A different aspect of online identity and personal privacy issues was described by Carolyn Y. Johnson, who wrote an article published in The Boston Globe on Sept 20 2009.  Her report describes a 2007 research project conducted by two students at MIT enrolled in an ethics and law class.  Their software program, named Gaydar“, was used to import data from individual males’ Facebook pages, analyzing the relationships between stated  “interests”, “gender” and “groups of  friends” in order to make a statistical prediction about whether those men were gay.


.* JAMA is a subscription journal; if off-campus, use your proxy account number to connect in order to read full-text articles.



4 responses to “News, Medical Students, Social Network Analysis: Digital Histories can’t be Deleted

  1. anne marie cunningham September 25, 2009 at 4:13 AM

    I wasn’t clear about how the schools actually identified the offences. Do they systematically keep a track of their students’ online presence or respond to reports. If simply reports, as most likely, then it would be interesting to know how it comes to their attention and I’d also suspect that the extent of any problem could be much greater.

  2. creaky September 25, 2009 at 7:09 AM

    Thanks for your comment.

    After rereading the article, I do not see examples of “how” the schools tracked undesirable online behavior. It would be interesting to learn if medical students were tracking their classmates’ online content (and identifying undesirable materials there… in a way, they could be self-policing themselves).

    Here is an excerpt from the JAMA article that addresses your question peripherally (found on page 1314):

    “Limitations of this study include the possibility of responder bias. Those [schools] responding [to this survey] may have been more likely to have had incidents or higher levels of concern than non-respondents. However, the responding schools represent all school sizes and settings, and this survey includes most US medical schools. Despite non-response, these results indicate that a substantial proportion of schools experienced incidents”.

  3. anne marie cunningham September 25, 2009 at 7:18 AM

    Thanks. Yes, I had read the paper and couldn’t see anything about this. No-one is suggesting yet that medical schools should track students as far as I know.
    I wish that more of the discussion was around this area. If you are a student who sees unprofessional conduct in a colleague, what should you do? There is obviously a need for some sharing and learning there.

  4. Pingback: Tweetlinks, 9-25-09 [A Blog Around The Clock] « Technology Blogs

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