What's on YOUR Facebook profile? Evaluation of an educational intervention to promote appropriate use of privacy settings by medical students on social networking sites.

BACKGROUND: The rise of social media has led to growing concerns about the potential implications of 'unprofessional' postings by physicians and medical students on individuals, institutions, and the medical profession. Relevant and effective guidelines have been difficult to develop and enforce, and there is a need for students and physicians to consider how their online activities may be perceived in the context of their professional roles. The purpose of this project was to examine the Internet presence of a graduating Canadian medical school class by scanning students' public profiles on the social media site Facebook, incorporate this information into an educational activity addressing professionalism and social media, and evaluate the impact of this activity on student behavior. METHODS: A systematic search for public Facebook profiles of each member of the class was conducted, and data were collected on the types of publicly visible material. These were presented as part of an educational session on social media and professionalism. One month later, the Facebook search was repeated. RESULTS: Of 152 students in the class, profiles were found for 121 (79.8%). The majority of students used appropriately restrictive privacy settings; however, a significant minority had publicly visible information, including comments, photographs, location, and status as a medical student. The educational innovation was well received with more than 90% of students agreeing that this topic was important and well addressed. A follow-up search found that many students had altered their privacy settings to make less information publicly available. CONCLUSIONS: A small but significant proportion of students share potentially unprofessional content on social media. An interactive educational intervention, which includes specific disclosure of how participants appear to others on social media, resulted in a significant change in student behavior.

Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age.

Bronchiolitis is the most common reason for admission to hospital in the first year of life. There is tremendous variation in the clinical management of this condition across Canada and around the world, including significant use of unnecessary tests and ineffective therapies. This statement pertains to generally healthy children ≤2 years of age with bronchiolitis. The diagnosis of bronchiolitis is based primarily on the history of illness and physical examination findings. Laboratory investigations are generally unhelpful. Bronchiolitis is a self-limiting disease, usually managed with supportive care at home. Groups at high risk for severe disease are described and guidelines for admission to hospital are presented. Evidence for the efficacy of various therapies is discussed and recommendations are made for management. Monitoring requirements and discharge readiness from hospital are also discussed.

La bronchiolite est la principale cause d'hospitalisation avant l'âge de un an. La prise en charge clinique de cette maladie varie considérablement selon les régions du Canada et du monde, y compris une grande utilisation de tests inutiles et de thérapies inefficaces. Le présent document de principes porte sur des enfants en santé de deux ans ou moins qui sont atteints d'une bronchiolite. Le diagnostic de bronchiolite repose d'abord sur l'anamnèse de la maladie et sur les résultats de l'examen physique. En général, les examens de laboratoire sont inutiles. La bronchiolite est une maladie spontanément résolutive, qui est généralement prise en charge par des soins de soutien à domicile. Par ailleurs, les groupes très vulnérables à une bronchiolite grave sont décrits, et les indications d'admission à l'hôpital sont présentées. Les données probantes sur l'efficacité des diverses thérapies et les recommandations de prise en charge sont exposées. La surveillance requise et le moment du congé de l'hôpital sont également abordés.

"I have the right to a private life": medical students' views about professionalism in a digital world.

BACKGROUND: Social media site use is ubiquitous, particularly Facebook. Postings on social media can have an impact on the perceived professionalism of students and practitioners. AIMS: In this study, we explored the attitudes and understanding of undergraduate medical students towards professionalism, with a specific focus on online behaviour. METHODS: A volunteer sample of students (n = 236) responded to an online survey about understanding of professionalism and perceptions of professionalism in online environments. Respondents were encouraged to provide free text examples and to elaborate on their responses through free text comments. Descriptive analyzes and emergent themes analysis were carried out. RESULTS: Respondents were nearly unanimous on most questions of professionalism in the workplace, while 43% felt that students should act professionally at all times (including free time). Sixty-four free text comments revealed three themes: "free time is private time";" professionalism is unrealistic as a way of life"; and "professionalism should be a way of life". CONCLUSIONS: Our findings indicate a disconnect between what students report of what they understand of professionalism, and what students feel is appropriate and inappropriate in both online and real life behaviour. Curriculum needs to target understanding of professionalism in online and real environments and communicate realistic expectations for students.

Patterns of interaction during rounds: implications for work-based learning.

OBJECTIVES In-patient rounds are a major educational and patient care-related activity in teaching hospitals. This exploratory study was conducted to gain better understanding of team interactions during rounds and to assess student and resident perceptions of the utility of this activity. METHODS Data were collected by a non-participant observer using a novel, personal digital assistant (PDA)-based data collection system. Medical students and residents completed surveys related to the utility of rounds for patient care, education and ward administration. Analyses included descriptive and correlational statistics and the use of social network analysis to describe and measure patterns of interaction. RESULTS Eighteen different rounds were observed. On average, rounds were 106 minutes long and included discussion of 22.1 patients. Three different patterns of verbal interaction were observed. In most cases, the attending physician was most talkative and many students and residents spoke infrequently. More time was devoted to patients discussed earlier in the round, regardless of diagnosis. Observed teaching was primarily factual and teacher-centred. Attending physician-dominated sessions were rated more highly for educational utility than those that were more interactive. CONCLUSIONS In-patient rounds are an example of an opportunity for powerful work-based learning. In this study, we used a novel method of observational data collection and analysis to examine this activity and found that it may not always live up to its educational potential. Rounds are time-consuming and are generally dominated by the attending physician. Individuals who are not directly involved in a case are often minimally involved. Participants felt that rounds were most useful for patient care and, contrary to expectations, students and residents viewed attending physician-dominated sessions as more educational. To improve the educational impact of rounds, the order of patient discussion should be planned to highlight specific teaching points, preceptors (teaching staff) should ensure that all team members are actively engaged in the process and learning should be made explicit.

Residents as teachers in Canadian paediatric training programs: A survey of program director and resident perspectives.

BACKGROUND: The importance of the teaching role of residents in medical education is increasingly being recognized. There are little data about how this role is perceived within training programs or how residents develop their teaching skills. The aims of the present study were to explore the perspectives of Canadian paediatric program directors and residents on the teaching role of residents, to determine how teaching skills are developed within these programs, and to identify specific areas that could be targeted to improve resident teaching skills and satisfaction. METHODS: Program directors and residents in Canadian paediatric residency programs were surveyed about the scope of teaching performed by residents, resident teaching ability and resources available for skill development. RESULTS: Responses were received from 11 of 13 program directors contacted. Nine programs agreed to have their residents surveyed, and 41% of residents in these programs responded. Directors and residents agreed that residents taught the most on general paediatric wards, and that medical students and residents were the most frequent recipients of resident teaching. While 72% of directors reported that instruction in teaching was provided, only 35% of residents indicated that they had received such training. Directors believed that residents needed improvement in providing feedback, while residents wanted help with teaching at the bedside, during rounds and in small groups. Teaching performance was included in rotational evaluations in most programs, but residents were often uncertain of expectations and assessment methods. CONCLUSION: There is a general consensus that residents play an important teaching role, especially on the inpatient wards. Residents' ability to fill this role could be enhanced by clearer communication of expectations, timely and constructive feedback, and targeted training activities with the opportunity to practice learned skills.