Guidelines on Use of Electronic Communication and Social Media

Background:

This document is intended to provide MPT students with an awareness of, and guidelines for professional and responsible use of social media and electronic communication devices within academic settings (e.g. classroom, lab, small group) and while engaged in clinical practice courses.

The use of electronic media is integrated into our culture, a regular part of everyday life worldwide. The tools have a widespread use in both clinical and academic environments as a mechanism to efficiently communicate with other health professionals and patients, for knowledge sharing, and educational purposes.  We also acknowledge the difficulties, and risks, in differentiating the boundaries between the professional lives and private lives of individuals.

For the purpose of these guidelines, electronic communication and social media encompasses interaction between: instructors and students, students and patients, students and other health professionals, and between students.  It includes, but is not limited to, the use of such tools as:

a) Mobile electronic communication devices for sending and receiving messages or information: cell phone, iPhone (smart phone), Blackberry, Smart Pens, etc. These may have various applications and features including photography.

b) Use of Social media i.e. web-based forums where users interact on line and share information:  e.g. Facebook, Twitter, YouTube, Instagram, Wikipedia, Google+, LinkedIn, etc. including emails, blogs, file transfers &/or discussion groups.

Maintaining professional boundaries is an important aspect of professionalism.  However, how to function professionally within an evolving environment of electronic communication and social media can be confusing, unclear and vague when interaction is so readily available, and rules of engagement are not well defined.   One can unintentionally violate their professional Code of Ethics or breach established Standards of Practice.  Indeed, there are examples of health facilities, health sciences education programs and licensing boards dealing with such breaches of ethics involving use of electronic communication &/or social media.  These breaches are considered very serious, often manifesting as a breach in confidentiality (which easily happens with electronic media) and may carry sanctions.

While the principle of confidentiality is well defined and legally enshrined with regard to privacy of personal health information, concerns also exist with interaction between students and instructors in academic and clinical settings.

Guiding principles for this topic can be gleaned from various overarching legal and ethical documents that define professional expectations, with which School of Rehabilitation Science students are expected to comply.   This includes the School of Rehabilitation Science Professional Behaviours and Expectations (Professionalism), CPA Code of Ethics and Rules of Conduct, the Health Information Protection Act (HIPA), the University of Saskatchewan Social Media Guidelines, and the U of S Academic Integrity and Student Misconduct Regulations, with special note of the Saskatchewan Academic Health Sciences Network Provincial Clinical Placement Agreement, especially Schedule N: Mobile Device Usage.

In addition, the Saskatchewan College of Physical Therapists Regulatory Bylaws, Code of Ethics and Rules of Conduct state: Physical Therapists shall conduct themselves in such a manner as to merit the respect of the society for the profession and its members.   The Saskatchewan College of Physical Therapists also has Position Statements and Standards of Practice on: ‘Risk Behaviors – Client Care’, ‘Personal Information and Privacy’, ‘Record Keeping’, ‘Medical Records (Electronic Computer Records)’.   It is expected that Physical Therapists and Physical Therapy students, maintain ethical standards in both personal and professional lives.

Other health science education programs across Canada, the Canadian Medical Association and the Ontario College of Teachers, to name a few, have developed guidelines, which have also been referenced in formulating these guidelines.

Guidelines for responsible use of communicating through connected electronic systems, including the use of Social Media sites:

1. When communicating electronically, conduct yourself as you would in a face-to-face environment – i.e. with a professional demeanor, and with careful attention to proper etiquette and language.
2. Before engaging in online communication or posting photos, ask yourself if it would reflect poorly on you or on the profession of Physical Therapy.  If so, refrain from doing so.  This includes accessing or distributing objectionable or illegal material.
3. Never criticize health care professionals, patients / clients (even if unnamed), clinical and/or academic instructors or classmates in online forums. If you find yourself in need to do this, there are formal avenues available to address your concerns, e.g. meet with your Faculty Advisor.
4. Consider that all information sent or posted electronically can remain permanent and that it may be accessible to the public even after it is deleted – no security system is perfect.  Also, keep in mind it is always possible to find the author of information posted in electronic interactions and forums.
5. Ensure that all privacy settings in your account (s) are set at a high level.
6. Manage your personal information by monitoring content related to your own person - ask others to remove undesirable content relating to you, and request that your name be “tagged” only with your permission.
7. Alert professional colleagues of inappropriate content on social media sites relating to them.
8. Err on the side of caution with respect to relationships: 

i) Do not initiate invitations to be online “friends” with patients / clients, their families, your professors, or clinical instructor(s).
ii) It is best to refrain from accepting “friend” requests from patients / clients, their families, your professors or clinical instructor(s), or engaging in any other online communication in which a non-professional relationship develops.

9. Understand that posting information or discussing confidential details about patients / clients, colleagues, employees or workplace practices, even if unnamed or seemingly anecdotal, is a breach of confidentiality. 
10. When interacting in professionally-oriented social media, clearly identify yourself as a PT student
11. Be aware that online forums in which clinical advice is posted may be deemed a therapeutic relationship, and an unintended “duty of care” may be established, for which you may be held responsible.  
12. If you become aware of a patient’s personal information from online sites or other sources, this should not be entered into their patient records without their permission.
13. Do not exchange private emails (nor email addresses), text messages or photos with patients.
14. If you must communicate by email with patients / clients while on clinical placement, do not use your “usask” email address, or other personal email address.  Use an official clinic or Health Region address.    
15. On personal sites, do not portray yourself as formally representing the viewpoint of the School of Rehabilitation Science and/or the University of Saskatchewan.
16. If you are authorized to use electronic devices, including networked computers owned by clinical placement facilities (clinics, health regions), you are responsible for protecting the confidentiality and integrity of the information stored on such devices by following the Information Technology policies and procedures of the facility.  This includes, but is not limited to the following:

1. You are responsible for any activity carried out under the user account assigned to you while on placement.
2. You are prohibited from accessing or distributing illegal or objectionable material on facility devices during clinical placements. 
3. You must report unacceptable internet use immediately to your supervisor.
4. The clinical facility has the right to monitor all internet activity on its network and access the contents of all files stored on its systems and all messages transmitted through its information technology infrastructure.  If an external investigation occurs, you must comply fully with such investigation procedures.

Use of Portable Electronic Devices:

1. Be aware of, and ask about, individual workplace and department policy on Electronic Devices at each clinical site, and follow that policy while on placement.   Students are generally allowed to use their cellular phones or other portable devices for learning purposes only during the clinical placement.
2. Be aware that portable Electronic Devices can interfere with vital medical equipment operating in your vicinity.
3. Be aware that portable Electronic Devices may be a source of infection. Students using their own device are responsible for cleaning and disinfection.  If this is not possible, those devices should not be used.
4. Do not, at any time, use your electronic device to conduct personal matters during work hours, unless specifically arranged with your clinical instructor.  Use designated breaks to attend to personal matters and do so in a non-clinical area.
5. Do not allow your Electronic Device to interfere with patient care at any time.  This includes noises that alert you to incoming data.
6. Do not take patient photos, audio recording, or videos without the knowledge or expressed written consent of the patient /client and the supervisor.  Also, do not take photos in the clinical setting without permission of staff members in the photo. 
7. Do not take or keep/save/store any identifiable patient information or photos at the clinical facility on a personal electronic devices used outside of the clinical facility. Devices that are owned and stored in the facility may be acceptable for these purposes.
8. Any photo/ video or audio recordings taken during academic activities (lectures, labs, etc.) must have the permission of the instructor prior to any recording.  If other individuals are included in the recordings (e.g. other students) then these individuals must give permission. These recordings are only to be used for educational use of the student during the MPT program.  Students are not to post or share materials without the permission of the instructor.

Disciplinary Action:

1. Violations of these guidelines may result in disciplinary action as set out in the U of S Academic Integrity Handout and the Student Academic Misconduct Regulations. 
2. Disclosing confidential information breaches workplace privacy policies and may result in severe disciplinary consequences from the Health Region, the Saskatchewan College of Physical Therapists, and/or the School of Rehabilitation Science.
3. Inappropriate use of electronic media may result in criminal charges or other legal action according to applicable federal and provincial laws.

Sources

1. School of Rehabilitation Science, University of Saskatchewan MPT Policies.
2. Saskatchewan College of Physical Therapists Regulatory Bylaws.
3. Canadian Physiotherapy Association Code of Ethics
4. University of Saskatchewan Academic Misconduct
5. U of S, School of Rehabilitation Science, MPT Professional Behaviours and Expectations document.
6. The College of Physicians and Surgeons of British Columbia Resource Manual – Social Media and Online Networking Forums.
7. Professional Advisory – Use of Electronic Communication and Social Media.  (February 23, 2011); Ontario College of Teachers.
8. Saskatchewan Academic Health Sciences Network Clinical Placement Agreement, 2017
9. University of Saskatchewan Social Media Guidelines