Vooral onder jongeren is het gebruikelijk te communiceren en te publiceren op het internet, en dan met name via sites als YouTube, Facebook, Flickr en Twitter, kortweg ‘Web 2.0’. Daarbij worden de regels van het fatsoen en privacy nog wel eens uit het oog verloren – ook door medische studenten. Onderzoekers van de George Washington University in Washington DC maakten zich daarover zorgen, en vroegen de decanen van alle 130 medische opleidingen in de VS naar hun ervaringen met ‘onprofessioneel gedrag’ onder studenten ( JAMA 3009;302:1309–15).

Context
Web 2.0 applications, such as social networking sites, are creating new challenges for medical professionalism. The scope of this problem in undergraduate medical education is not well-defined.

Objective
To assess the experience of US medical schools with online posting of unprofessional content by students and existing medical school policies to address online posting.

Design, Setting, and Participants
An anonymous electronic survey was sent to deans of student affairs, their representatives, or counterparts from each institution in the Association of American Medical Colleges. Data were collected in March and April 2009.

Main Outcome Measures
Percentage of schools reporting incidents of students posting unprofessional content online, type of professionalism infraction, disciplinary actions taken, existence of institution policies, and plans for policy development.

Results
Sixty percent of US medical schools responded (78/130). Of these schools, 60% (47/78) reported incidents of students posting unprofessional online content. Violations of patient confidentiality were reported by 13% (6/46). Student use of profanity (52%; 22/42), frankly discriminatory language (48%; 19/40), depiction of intoxication (39%; 17/44), and sexually suggestive material (38%; 16/42) were commonly reported. Of 45 schools that reported an incident and responded to the question about disciplinary actions, 30 gave informal warning (67%) and 3 reported student dismissal (7%). Policies that cover student-posted online content were reported by 38% (28/73) of deans. Of schools without such policies, 11% (5/46) were actively developing new policies to cover online content. Deans reporting incidents were significantly more likely to report having such a policy (51% vs 18%; P = .006), believing these issues could be effectively addressed (91% vs 63%; P = .003), and having higher levels of concern (P = .02).

Conclusion
Many responding schools had incidents of unprofessional student online postings, but they may not have adequate policy in place.