Optometric Education

The Journal of the Association of Schools and Colleges of Optometry

Optometric Education: Volume 41 Number 3 (Summer 2016)


Social Media: Opportunities and Challenges

Aurora Denial, OD, FAAO

Aurora Denial, OD, FAAO

Aurora Denial, OD, FAAO

The internet has created the opportunity for social media to thrive. Participating in social media forums, known collectively as “Web 2.0,” allows communication and information-sharing with large groups of people instantaneously. Social media can fall into one of six primary categories:1

  • Social networks: sites that allow users to connect and share with people who have similar interests and backgrounds. Example: Facebook.
  • Bookmarking sites: sites that allow users to save and organize links to any number of online resources and websites. Example: Stumble Upon.
  • Social news: sites that allow users to post news links and other items to outside articles. Example: Reddit.
  • Media sharing: sites that allow users to share different types of media, such as pictures and video. Example: YouTube.
  • Microblogging: sites that allow users to submit short written entries, which can include links to products and service sites as well as links to other social media sites. Example: Twitter.
  • Blog comments and forums: sites that let users engage in conversations by posting and responding to community messages.

How Social Media is Being Used in Health Care and Education

The use of social media in health care and education has climbed in recent years,2 leading to numerous opportunities and challenges. In hospital settings, social media can be used to alert patients to wait times, update patient status, deliver public health messages, recruit for research and communicate with staff. Healthcare providers also use social media to disseminate information, answer questions and communicate with patients. Several studies indicate that 70-90% of students in healthcare professions use social media.3 This is not a surprising finding because most of the current students in healthcare professions are in the Millennial generation, born after 1982. Millennials are accustomed to staying connected with the outside world using handheld, wireless devices and are considered “digital natives.”4

In the education environment, the opportunities intrinsic to social media are plentiful. Some of the potential opportunities include collaboration and connectivity among users, access to clinical experts, access to information from a number of different sources, and the ability to disseminate information. The development of content within social media, such as learning to concisely communicate through Twitter, can also be a valuable skill. In healthcare professions, storytelling or relaying clinical experiences are common and allow students the opportunity to reflect and share. When storytelling occurs on social media, feedback is immediate, camaraderie can provide emotional support, and input from others can enrich a learning experience. However, relaying clinical experiences via social media can also present significant challenges. Complying with the Health Insurance Portability and Accountability Act (HIPAA), maintaining professionalism, and respecting patient privacy and confidentiality are common challenges.

The following example represents a posting on social media by a medical student. “I had my first patient death, a man who served his country in combat. … I will never forget the last conversation I had with him, about his wife of 50 years. They met when they were just kids and had such a great life together, raising three daughters. … The wife never saw this coming, she looked so shaken and scared.”5 Although this example does not violate HIPAA, it raises the question of whether it respects the patient’s privacy. The patient may have felt comfortable sharing these personal details with his doctor, but the patient and/or family members may not have intended the information to be shared on Facebook.5 Several professional medical organizations have attempted to address these types of challenges. In 2013, the American College of Physicians published a position paper that states “Consideration should be given to how patients and the public would perceive the material …”6 Therefore, clinicians and healthcare students should ask themselves before posting: Would my patient or his or her family want me to post about them on Facebook?5

In addition to the challenges related to storytelling, inappropriate postings on social media can negatively impact careers or the public’s perception of a healthcare profession. Chretien et al. found that 47 out of 78 medical schools reported incidents of students posting unprofessional online content.7 The content included profanity, pictures of intoxication, and sexually suggestive material. At a recent medical education conference in Boston, medical school faculty relayed a case where a student posted on social media: I cannot believe how wasted I was this morning. I needed to be at the hospital early so that I could participate in a renal transplant. A reply to the post: Are you my daughter’s doctor? 8 Clearly this post has numerous implications including the potential to damage the public trust in the profession.

Facing the Challenges

The American Medical Association (AMA) has added the following to its Code of Ethics. “Physicians must recognize that actions online and content posted may negatively affect their reputation among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession.”9 Social media is an incredible tool. Optometric educators should reflect on the formal training offered to students regarding the use of social media in the educational and professional settings. Are we doing enough to prepare our students to be responsible users of social media? Are they able to take advantage of the many opportunities and effectively deal with the challenges?


  1. SEOPressor Connect. [cited 2016 June 2] Available from: https://seopressor.com/social-media-marketing/types-of-social-media/.
  2. Brenner J, Smith A. Pew Research Center. Washington, D.C. [Cited 2013 Aug. 5] Available from: https://www.pewinternet.org/2013/08/05/72-of-online-adults-are-social-networking-site-users/.
  3. von Muhlen M, Ohno-Machado L. Reviewing social media use by clinicians. J Am Med Inform Assoc. 2012;19(5):777-81.
  4. Presnky M. Digital natives, digital immigrants part 1. On the Horizon. 2001; 9(5):1-6.
  5. Wells DM. Lehavot Keren, Isaac ML. Sounding off on social media: the ethics of patient storytelling in the modern era. Academic Medicine. 2015;90(8):1015-1019.
  6. Farnan JM, Sulmasy LS, Worster BK, et al. Online medical professionalism: patient and public relationships: policy statement from the American College of Physicians and the Federation of State Medical Boards. Ann Intern Med. 2013;158(8):620-627.
  7. Chretien KC, Greysen SR, Chretien JP, Kind T. Online posting of unprofessional content by medical students. JAMA. 2009;302(12):1309-15.
  8. Denial A. Conference attendee, Principles of Medial Education: Maximizing Your Teaching Skills, Boston, MA. April 13-15, 2016.
  9. American Medical Association. Professionalism in the use of social media, Opinion 9.124. [Cited 2016 June 2]. Available from: https://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion9124.page?.
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Dr. Denial, Editor of Optometric Education, is a Professor and Chair of the Department of Primary Care at the New England College of Optometry and a Clinical Instructor at a community health center in Boston.