title: Opinions of students from a Brazilian medical school regarding online professionalism.
abstract: BACKGROUND
  Unprofessional online behavior by medical students or physicians may damage individual careers, and the reputation of institutions and the medical profession. What is considered unprofessional online behavior, however, is not clearly defined and may vary in different cultures.
  
  
  OBJECTIVE
  To determine the frequency with which students from a Brazilian Medical School come across ten given examples of unprofessional online behavior by medical students or physicians, and gather the opinions of participants regarding the appropriateness of these behaviors.
  
  
  METHODS
  A cross-sectional survey of 350 students from the Medical School of Bahia, Brazil. Only those who had a profile in social media were included in the final analyses.
  
  
  RESULTS
  336/350 (96.0%) medical students kept a profile in social media. Only 13.5% reported having discussions about online professionalism during ethics classes. They reported witnessing the investigated examples of unprofessional online behavior with varying frequencies, ranging from 13.7% for "violation of patient's privacy" to 85.4% for "photos depicting consumption of alcoholic beverages". Most participants felt neutral about posting "pictures in bathing suits", whereas the vast majority rated "violation of patient's privacy" as totally inappropriate. When presented with a case vignette illustrating violation of patients' privacy (publication of pictures of hospitalized children or neonates in social media), however, most participants felt neutral about it. Participants considered all investigated examples of unprofessional online behavior more inappropriate if carried out by doctors rather than by students.
  
  
  CONCLUSIONS
  Medical students are witnessing a high frequency of unprofessional online behavior by their peers and physicians. Most investigated behaviors were considered inappropriate, especially if carried out by physicians. Participants were not able to recognize the publication of pictures of hospitalized children or neonates in social media as cases of violation of patients' privacy. Further studies are needed to determine if an academic curriculum that fosters online professionalism will change this scenario.
authors.affiliation: Hospital Universitário Professor Edgard Santos (HUPES), Federal University of Bahia, Laboratório de Nefrologia, 6° andar, Rua João das Botas, s/n - Canela, 40110-160, Salvador, BA, Brasil, paulonrocha@ufba.br.
authors.forename: Paulo Novis
authors.initials: PN
authors.lastname: Rocha
authors.forename: Naara Alethéa Azael
authors.initials: NA
authors.lastname: de Castro
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004995:Ethics, Professional; D005260:Female; D006801:Humans; D008297:Male; D012577:Schools, Medical / Q000941:ethics / Q000592:standards*; D061108:Social Media / Q000941:ethics / Q000592:standards*; D013337:Students, Medical; D055815:Young Adult