JMIR Publications

ABSTRACT

Background:

Health professions students use social media to communicate with other health professionals, discuss career plans or coursework, and share results of research projects or new information. These platforms allow students to share thoughts and perceptions that are not disclosed in formal education settings. Twitter provides an excellent window through which health professions educators can observe students’ sociocultural and learning needs. Despite its merits, however, cyberincivility on Twitter among health professions students has been reported.

Objective:

The aim of this study was to describe characteristics and instances of cyberincivility posted on Twitter by self-identified health professions students. A further objective of the study was to analyze the prevalence of tweets perceived as inappropriate or potentially objectionable while describing patterns and differences in the instances of cyberincivility posted by those users.

Methods:

We used a cross-sectional Twitter data-mining method to collect quantitative and qualitative data from August 2019 through February 2020. The sample was taken from users who self-identified as health professions (e.g., medicine, nursing, dental, pharmacy, physician assistant, and physical therapy) students on their user description. Data management and analysis were performed with a combination of SAS 9.4 for descriptive and inferential statistics including logistic regression and NVivo 12 to derive descriptive patterns of textual data.

Results:

We analyzed the most recent 20 tweets of each account (N = 12,820). A total of 639 user accounts were analyzed for quantitative analysis, belonging to 280 medicine students (43.8%) and 329 nursing students (51.5%) in 22 countries: the USA (n = 287, 44.9%), the UK (n = 197, 30.8%), unknown countries (n = 104, 16.3%), and 19 other countries (n = 51, 8.0%). Of the 639 accounts, 193 (30.2%) were coded as having instances of cyberincivility. Of these, 61.7% (n = 119), 32.6% (n = 63), and 5.7% (n = 11) belonged to students in nursing, medicine, and other disciplines, respectively. Among 502 instances of cyberincivility identified from 641 qualitative analysis samples, the largest categories were profanity and product promotion. Several aggressive or biased comments toward other users, politicians, or certain groups of people were also found.

Conclusions:

Cyberincivility is a multifaceted phenomenon that must be considered in its complexity if health professions students are to embrace a culture of mutual respect and collaboration. Student perceptions and reports of their Twitter experiences offer insights into online behavior and the evolving role of cyberspace, and potentially problematic posts provide opportunities for teaching digital professionalism. Our study indicates that there is a continued need to provide students with guidance and training regarding the importance of maintaining a professional online persona. Designing evidence-based, intentional, multidisciplinary cybercivility instruction informed by social courtesy, professional ethics, and profound respect for others is recommended.