JMIR Publications

ABSTRACT

Background:

While previous studies measured e-professionalism as the perception of e-professionalism or attitude towards e-professionalism, there is no validated measure of e-professional behaviors for healthcare professionals. To create this kind of measures, this study developed normative framework based on three fundamental sources defining e-professional behavior through six domains, four relating to the dangers of social networking sites (SNSs): confidentiality, privacy, contact with patients, and fair distribution of resources, while two relating to the opportunities of SNSs: proactive publication of information of public health interest and scientific objectivity.

Objective:

The objective of this study was the development and validation of two new measures of the e-professional behavior of medical doctors (MDs) and doctors of dental medicine (DMDs) that measure the dangers and the opportunities aspects of SNSs.

Methods:

Data from MDs and DMDs in Croatia (n=753) who use at least one SNS were collected in a convenience sample in 2021 using an online survey. A formative approach was applied for the validation of both indexes using a five-step methodology: content specification, indicators definition with instructions for item coding and index construction, indicators collinearity check using the variance inflation factor (VIF), external validity test using multiple indicators multiple causes (MIMIC) model, and external validity test by checking the relationships of the indexes with the scale of attitude towards SNSs using Pearson correlation coefficients.

Results:

The first e-professionalism index, which measures the danger aspect of SNSs, consists of 14 items. The indicators collinearity check showed acceptable VIF values on all indicators below the value of 2.5. The MIMIC model showed good fit (χ213=9.4, P=.742; χ2/df=0.723; RMSEA<.001; GFI=0.998; CFI=1.000). The external validity of the index is supported by the statistically significant negative correlation with the scale of attitude towards SNSs (r=-0.225, P<.001). The second e-professionalism index, which measures the opportunity aspect of SNSs, consists of five items, after removing one item. The indicators collinearity check showed acceptable VIF values on all indicators below the value of 2.5. The MIMIC model showed good fit (χ24=2.5, P=.718; χ2/df=0.637; RMSEA<0.001; GFI=0.999; CFI=1.000). The external validity of the index is supported by the statistically significant positive correlation with the scale of attitude towards SNSs (r=0.338; P<.001).

Conclusions:

After the validation process, the instrument for measuring the e-professional behavior of MDs and DMDs has 19 items that are used to form two indexes: the index of e-professionalism – the danger aspect of SNSs (14 items), and the index of e-professionalism – opportunity aspect of SNSs (five items). These indexes represent valid measures of the e-professional behavior of MDs and DMDs, with the potential for further development to include new forms of unprofessional behavior that may appear over time.