Lifting the negative cloud of social media use within medical education

The number of anatomy educators using popular social media platforms such as YouTube (Jaffar, 2012), Facebook (Jaffar, 2014), and Twitter (Hennessy et al., 2016) to support their students has increased over recent years. Journals and conferences related to medical education are showing support for the scholarship of such work as it becomes more apparent that social media is ingrained in how today’s students communicate and source information (Barry et al., 2016). During the recent joint summer meeting of The Anatomical Society and British Association of Clinical Anatomists (held at Brighton Sussex Medical School, Brighton, UK on July 19–21, 2016), two further examples of academic social media platforms were described, one using Facebook (Pickering and Bickerdike, 2016) and one using Twitter (Gunn et al., 2016). Similar to the findings by Cheston et al. (2013) and George et al. (2013), in each of the reports listed in the previous paragraph, student feedback from academic social media platforms was considerably positive. In each case, students felt that the platform was useful for supporting their anatomy learning. Other benefits that students frequently reported were: facilitating communication with tutors, promoting discussion and engagement with the subject (Jaffar, 2014; Hennessy et al., 2016), and decreasing student anxieties (Hennessy et al., 2016; Pickering and Bickerdike, 2016). Although educators rarely make the use of these platforms compulsory, the favorable percentage uptake demonstrated by students [86% of cohort reported by Jaffar (2012); 23% by George et al. (2013); 89% by Jaffar (2014); 91% by Hennessy et al. (2016); 48% by Pickering and Bickerdike (2016), and 31% by Gunn et al. (2016)] suggests that they are interested and willing to engage with academic social media platforms. However, I have noticed one emerging trend from these reports—that only a minority of students actively make contributions to the platforms, instead the majority of students decide to simply visit and view the contributions made by others (Hennessy et al., 2016; Pickering and Bickerdike, 2016). What is the reason for this? Originally, I had accepted this as normal behavior since White and Le Cornu (2011) described internet users as either “residents” or “visitors” and concluded that visitors (observers) predominate over a small number of noisy residents (contributors) and like one student explained to me during a previous focus group: “You’re always going to get those people who have no problem with asking questions and that would be the minority. it’s the same in lectures, it’s always the same ones that ask the questions. ” But I have come to realize that there is another major factor limiting, as one student explained in a more recent focus group: “We’ve all got this inherent fear of sticking our neck on the line for the fear that you’ll just end up coming out worse than you would otherwise. The whole process of getting into medical school. is a massive competition so you don’t want to be seen to be stupid or. like you don’t know something. ” Pickering and Bickerdike (2016) supported this finding and reported that males are significantly less likely to ask a question on social media platforms in case they are perceived to lack knowledge. I recently learned that during their orientation week at medical school, students receive a very negative message about social media from curriculum leaders as they raised the issue of professionalism. One student recalled being warned as follows: “your social media account. we’re not monitoring it but if you say something or do something strange or criminal, it’s going to come back and bite you. nothing is invisible. ” Another student described the underlying feeling and belief amongst medical students that the “GMC [General Medical Council] are everywhere” monitoring and recording any unruly behavior on social media or otherwise which could damage their record and influence their career progression. Langenfeld et al. (2016) reported that such practice does take place in areas of the United States with 18% of surgical program directors visiting social media profiles of medical students and 45% visiting profiles of surgical residents, often resulting in candidates being lowered in rank or formally disciplined based on their social media behavior. Although one could argue that this is an invasion of privacy, most of the program directors did not concur, instead believing that medical professionals should be held accountable for their online behavior (Langenfeld et al., 2016) regardless of the intended audience. This seems a good argument since online social media content is open to the public, unless appropriate privacy settings are in place. By virtue of this fact, Langenfeld et al. (2014) observed that 26% of surgical resident exhibited unprofessional or potentially unprofessional behavior on Facebook, therefore it is not only medical students who are at risk of unprofessionalism online. *Correspondence to: Miss Catherine Hennessy, Brighton and Sussex Medical School, University of Sussex, Medical School Building, Falmer, BN1 9PX, United Kingdom. E-mail: c.hennessy@bsms.ac. uk