Trainees on Technological Terrain: a Video Vignette-Based Tool to Teach E-Professionalism
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MEDIA COLUMN
Trainees on Technological Terrain: a Video Vignette-Based Tool to Teach E-Professionalism Isheeta Zalpuri 1
&
Mirjana Domakonda 2 & Marika Wrzosek 3 & Sandra DeJong 4
Received: 8 April 2020 / Accepted: 25 September 2020 # Academic Psychiatry 2020
As the digital revolution has unfolded, and smartphones and social networks have begun to permeate and expand the boundaries of medical practice, lapses in online professionalism and decorum have surfaced. In 2010, more than half of the US medical school deans reported breaches of professionalism related to online conduct [1], and 92% of responding American state medical boards (44 out of 48) reported having received at least one report of online professionalism violations, ranging from inappropriate online communication with patients to the use of Internet for inappropriate practice, including misrepresentation of credentials online [2]. In response to these professionalism breaches and the resulting sanctions, medical organizations published several reports and developed professional guidelines, standards, and consensus statements regarding responsible physician use of social media and the Internet [4] (Table 1). However, in an effort to promote and preserve open communication, access to care, and innovation, government agencies have been reluctant to over-regulate online content, placing the onus on physicians to “self-regulate” and comply with “voluntary codes of conduct” [5]. Indeed, this expectation for selfmonitoring and peer-based reporting of online unprofessional behavior is embedded in some professionalism guidelines (American Medical Association (AMA) American College of Physicians, and Federation of State Medical Boards (FSMB); Table 1). Psychiatric trainees and experienced, well-established psychiatrists lie at the precipice of a generational crossroads in the mobile era. Psychiatric trainees are predominantly “digital * Isheeta Zalpuri [email protected] 1
Stanford University School of Medicine, Palo Alto, CA, USA
2
Hartford Hospital/Institute of Living, Hartford, CT, USA
3
Medical College of Wisconsin, Milwaukee, WI, USA
4
Cambridge Health Alliance, Boston, MA, USA
natives,” adept at utilizing and manipulating new technologies, while many seasoned psychiatrists are considered “digital immigrants,” forced to adapt to the digital revolution midway through their career [6]. In this generational divide, the learner may be more technologically savvy, while the teacher’s experience and expertise deem them more competent to recognize professionalism breaches. Inexperience in either realm could inadvertently have a negative impact on patient care and compromise physicians’ personal and professional reputations. Licensing authorities in many jurisdictions can discipline physicians for unprofessional behavior, taking actions that range from a letter of reprimand to revocation of their medical license [7]. Despite the sensitive nature of their profession, psychiatrists cannot realistically be expected to abstain from social media use or re
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