title: Balancing Privacy and Professionalism: A Survey of General Surgery Program Directors on Social Media and Surgical Education.
abstract: OBJECTIVE
  Unprofessional behavior is common among surgical residents and faculty surgeons on Facebook. Usage of social media outlets such as Facebook and Twitter is growing at exponential rates, so it is imperative that surgery program directors (PDs) focus on professionalism within social media, and develop guidelines for their trainees and surgical colleagues. Our study focuses on the surgery PDs current approach to online professionalism within surgical education.
  
  
  METHODS
  An online survey of general surgery PDs was conducted in October 2015 through the Association for Program Directors in Surgery listserv. Baseline PD demographics, usage and approach to popular social media outlets, existing institutional policies, and formal curricula were assessed.
  
  
  RESULTS
  A total of 110 PDs responded to the survey (110/259, 42.5% response rate). Social media usage was high among PDs (Facebook 68% and Twitter 40%). PDs frequently viewed the social media profiles of students, residents, and faculty. Overall, 11% of PDs reported lowering the rank or completely removing a residency applicant from the rank order list because of online behavior, and 10% reported formal disciplinary action against a surgical resident because of online behavior. Overall, 68% of respondents agreed that online professionalism is important, and that residents should receive instruction on the safe use of social media. However, most programs did not have formal didactics or known institutional policies in place.
  
  
  CONCLUSIONS
  Use of social media is high among PDs, and they often view the online behavior of residency applicants, surgical residents, and faculty surgeons. Within surgical education, there needs to be an increased focus on institutional policies and standardized curricula to help educate physicians on social media and online professionalism.
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska. Electronic address: sean.langenfeld@unmc.edu.
authors.forename: Sean J
authors.initials: SJ
authors.lastname: Langenfeld
authors.affiliation: Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Vargo
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Schenarts
mesh_terms: D003219:Confidentiality / Q000941:ethics; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000941:ethics* / Q000379:methods; D005260:Female; D013502:General Surgery / Q000193:education* / Q000941:ethics; D006801:Humans; D007396:Internship and Residency / Q000941:ethics / Q000379:methods; D008297:Male; D020380:Needs Assessment; D008486:Physician Executives / Q000941:ethics*; D018907:Privacy; D028743:Professional Misconduct / Q000706:statistics & numerical data*; D061108:Social Media / Q000941:ethics / Q000706:statistics & numerical data*; D014589:Utah
keywords: Facebook; Interpersonal and Communication Skills; Practice-Based Learning and Improvement; Professionalism; Twitter; disciplinary action; privacy; professionalism; social media