Digital Smarts – A Common Sense Primer for Interns


I need your help.

Myself and pediatric resident Joey Spinner have been charged with creating a brief orientation on social media smarts for our incoming interns at Baylor College of Medicine/Texas Children’s Hospital.

But the challenge is this:  we’ve only got 30 minutes.

So we decided to flip the classroom by having our arriving interns listen in advance to a 20 minute recorded Keynote presentation with use of the 30 minutes in orientation to apply the concepts in discussion surrounding practical situations.  We’ll leave ’em with a one-sheet concept summary with references to online content produced by many of you reading this post.

We want to keep the recorded presentation focused and pithy.  This isn’t a comprehensive presentation.  This orientation is intended to introduce broad concepts and initiate discussion concerning professionalism, safety and mindfulness with social media.  Details will be covered as part of a broader longitudinal curriculum on digital professionalism that’s in preparation.

So the challenge lies in using the limited time to offer meaningful messaging.

Here’s what we have cooked up and where we need your input.  Bold subheadings below represent slides/key concepts.  There is a brief description of what’s discussed under each slide/point.  Picture it as fast moving voiceover on a visually appealing Keynote backdrop.

Digital Smarts – A Common Sense Primer for Interns

Opening slide and introduction to what we’ll talk about.  As hard as it may be, image me at this point trying to tell an amazingly funny joke to set the mood.

Technology is outpacing doctors and the system

Brief mention that technology is outpacing our ability to legislate its use.  As trainees and physicians we need to be individually responsible with our social tools.

You’re a doctor now

3 points summarizing some core challenges posed to a resident in our culture of transparency and ambient monitoring.  We’re trying to make the point that residents have a new level of responsibility that goes beyond that of a medical student.

  • You have a digital footprint.
  • Your patients will judge you based on what you do
  • You are ambassadors for your residency.

Here we segue into 9 focused points for interns

1.  Avoid patient-specific dialog in public places

Our patient’s business is no one else’s.  We’ll follow with a 4-step process of what to do when faced with direct clinical questions in public spaces.  We’ll add Wendy Sue Swanson’s point that ‘we’re way worse in the elevator than we are online.’  The point here is that the rules of privacy and professionalism haven’t changed, despite new media.

2.  PRIP

When residents discuss cases with each other or on physician only networks we challenge them to consider PRIP (This arose from a discussion I had with digital professionalism guru Neil Mehta following a group program I did with he and his students at the Cleveland Clinic)

  • Privacy – Have you removed patient identifiers?
  • Respect – Does your communication reflect respect for the patient under discussion?
  • Intent – What’s the intent of using the case or illustration?  Is it intended to amuse others at the patient’s expense or educate others.
  • Perception – How will the discussion be perceived?  If the patient were listening in or could read what you’ve written, how would they feel?

3.  They’re your patients, not your friends

A brief discussion surrounding boundaries and their limitations between personal and professional lives.

4.  What happens on Twitter stays on Twitter

Discussion of the permanency of social dialog and the digital footprint (of course with the qualifier that social participation needs to look at opportunity as well as risk).

5.  Remember your mother’s watching

Follows from the permanency discussion with the idea that those around us are looking at what we’re doing.  The point here isn’t that we should be so concerned with our mother’s opinion but that our communities and close contacts should serve as a valuable check on what we do and say.

6.  Anonymity is a myth

Here we offer the warning that anonymity isn’t a reliable strategy for reputation management.

7.  Be careful with pictures in the clinical setting

Brief discussion of how images and video media can capture protected info in the clinical setting.

8.  Remember that perception trumps reality

We’ll drive home the point that that how we look is sometimes more important to what we’re doing.  The example is public social dialog during clinical work hours even though you’re caught up on your charts.

9.  Exercise ‘medical mindfulness’

Be mindful of your phones, tools and tables when with patients and understand that they may not understand that you’re using that tablet to look up medication doses, not play Angry Birds.  This iPhone Attribution Error also supports the concept that perception trumps reality.

Remember to balance risk and opportunity

We’ll finish with the important reminder that despite the modest risks we face with social media, there are tremendous opportunities available to doctors.  We must always think about what we can accomplish professionally and for our patients.


So, this is an uber-brief, non-comprehensive presentation, created with the intent of launching interactive discussion surrounding some posed dilemmas in social media.  With that, what would you add or take away from what we have planned?  I think we have room to add a couple of more strong, broad concepts if you could come up with them.

Again, our residents will have more comprehensive training in digital literacy through our longitudinal curriculum that’s under construction.

We value your input and we need your help.  Please comment below for everyone to see or if you’re the silent type, email me in private: bsv AT bcm dot edu

Thanks to Associate Director of Housestaff Education at BCM, Teri Turner, for allowing us the latitude to begin this initiative.