Defining the Digital Self: A Qualitative Study to Explore the Digital Component of Professional Identity in the Health Professions.

BACKGROUND: Recent medical education literature pertaining to professional identity development fails to reflect the impact social media has on professional identity theory. Social media is transforming the field of medicine, as the web-based medium is now an avenue for professional development and socialization for medical students and residents. Research regarding identity development in social media has been primarily confined to electronic professionalism through best practice guidelines. However, this neglects other potential aspects pertinent to digital identity that have not yet been explored. OBJECTIVE: This study aims to define the properties and development of the digital self and its interactions with the current professional identity development theory. METHODS: A qualitative study was conducted using thematic analysis. A total of 17 participants who are social media education and knowledge translation experts were interviewed. The initial participants were from emergency medicine, and a snowball sampling method was used following their respective web-based semistructured interviews to enable global recruitment of other participants from interprofessional disciplines. The research team consisted of a diverse group of researchers including one current social media knowledge translation physician clinician educator, one postdoctoral researcher who is regularly engaged in social media knowledge translation, and 3 nonphysician research assistants who are not social media users. Half of the team conducted the initial coding and analysis, whereas the other 2 investigators audited the procedures followed. RESULTS: A total of 4 themes were identified that pertain to digital identity. In the first theme, origins of initial digital identity formation were found to be derived from perceived needs in professional roles (eg, as a medical student or resident). The second theme consisted of the cultivation of digital identity, in which digital identity was developed parallel to professional identity. The third theme that emerged was the management between the professional and personal components of digital identity. Participants initially preferred keeping these components completely separate; however, attempts to do so were inadequate while the integration of both components provided benefits. The fourth theme was the management of real-life identity and digital identity. Participants preferred real-life identity to be wholly represented on the web. Instances of misalignment resulted in identity conflict, compromising one of the identities. CONCLUSIONS: Social media introduces new features to professional identity in the digital world. The formation of digital identity, its development, and reconciliation with other identities were features captured in our analysis. The virtual component of professional identity must not be neglected but instead further explored, as educational institutions continue to give more importance to navigating professional identity development.

The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis.

STUDY OBJECTIVE: To evaluate the effectiveness of supplemental oxygen therapy and high-flow nasal cannula (HFNC) therapy in patients with obstructive sleep apnea (OSA) in different clinical settings to assess its application to surgical patients in the postoperative setting. DESIGN: A systematic search was conducted on MEDLINE and other databases from 1946 to December 16th, 2021. Title and abstract screening were conducted independently, and the lead investigators resolved conflicts. Meta-analyses were performed using a random-effects model and are presented as mean difference and standardized mean difference with 95% confidence intervals. These were calculated using RevMan 5.4. PATIENTS: 1395 and 228 OSA patients underwent oxygen therapy and HFNC therapy respectively. INTERVENTIONS: Oxygen therapy and HFNC therapy. MEASUREMENTS: Apnea-hypopnea index (AHI), oxyhemoglobin saturation (SpO2), cumulative time with SPO2 < 90% (CT90). MAIN RESULTS: Twenty-seven oxygen therapy studies were included in the review, with ten randomized controlled trials (RCT), seven randomized crossovers, seven non-randomized crossovers, and three prospective cohorts. Pooled analyses showed that oxygen therapy significantly reduced AHI by 31% and increased SpO2 by 5% versus baseline, and CPAP significantly reduced AHI by 84%, and increased SpO2 by 3% versus baseline. CPAP was 53% more effective in reducing AHI than oxygen therapy, but both treatments had similar effectiveness in increasing SpO2. Nine HFNC studies were included in the review, with five prospective cohorts, three randomized crossovers, and one RCT. Pooled analyses showed that HFNC therapy significantly reduced AHI by 36% but did not substantially increase SpO2. CONCLUSIONS: Oxygen therapy effectively reduces AHI and increases SpO2 in patients with OSA. CPAP is more effective in reducing AHI than oxygen therapy. HFNC therapy is effective in reducing AHI. Although both oxygen therapy and HFNC therapy effectively reduce AHI, more research is needed to draw conclusions on clinical outcomes.

Systems to support scholarly social media: a qualitative exploration of enablers and barriers to new scholarship in academic medicine.

INTRODUCTION: As academia begins to incorporate modern communication technologies into its scholarly structures, there are both enablers and barriers which foster academics' uptake of these innovations. Those who are early adopters of academic social media - whether it be for education, research-related networking, or knowledge translation - may therefore be best positioned to highlight both enablers and barriers within their work environments. METHODS: The authors conducted a constructivist grounded theory study to discern what prominent practitioners of academic social media (e.g. Twitter) have encountered in their careers. Participants were recruited via a snowball sampling technique and invited to participate in semi-structured interviews. Three investigators engaged in constant comparative analysis of incoming transcripts. To enhance rigour, we conducted an audit of the analysis and a participant member check. RESULTS: Seventeen emerging influencers in the field of academic social media were recruited. After axial coding, the 30 enablers and 21 barriers to academic social media use were mapped to three spheres of influence: personal, institutional, and virtual. The investigators propose a framework that organizes these enablers and barriers around a tipping point where sustainability becomes possible. CONCLUSIONS: Multiple enablers and barriers were described to influence social media users within academic medicine. By organizing these facets into a personal, institutional, and virtual framework along a spectrum, we can begin to understand the underlying structures that potentiate the academic ecosystems in which social media and similar innovations may flourish.

INTRODUCTION: Alors que le milieu universitaire commence à intégrer les technologies de communication modernes dans ses structures d'enseignement, il existe à la fois des facteurs favorables et des obstacles à l'adoption de ces innovations par les chercheurs. Les premiers adoptants des réseaux sociaux scientifiques, que ce soit dans un cadre éducatif, de réseautage lié à la recherche ou d'application des connaissances, sont sans doute les mieux placés pour mettre en évidence aussi bien les facteurs favorables que les facteurs défavorables présents dans leur environnement de travail. MÉTHODES: Les auteurs ont mené une étude selon la théorisatoin ancrée qui s'inscrit dans un courant constructiviste afin de cibler les éléments de l'expérience d'importants utilisateurs des réseaux sociaux scientifiques (p. ex. Twitter). Les participants ont été recrutés par échantillonnage en boule de neige et invités à des entretiens semi-structurés. Trois chercheurs ont analysé les transcriptions reçues selon la méthode de la comparaison constante. Par souci de rigueur, nous avons procédé à une vérification de l'analyse et à un contrôle des participants. RÉSULTATS: Dix-sept influenceurs émergents dans le domaine des réseaux sociaux scientifiques ont été recrutés. Après un codage axial, les 30 catalyseurs et les 21 obstacles à l'utilisation des réseaux sociaux scientifiques ont été mis en correspondance avec trois sphères d'influence : personnelle, institutionnelle et virtuelle. Les chercheurs proposent un cadre qui organise ces catalyseurs et ces obstacles autour d'un point de basculement où la durabilité devient possible. CONCLUSIONS: De multiples facilitateurs et obstacles ont été décrits pour influencer les utilisateurs de réseaux sociaux dans le domaine de la médecine universitaire. La classification de ces facteurs sur une échelle par type de cadre (personnel, institutionnel et virtuel) laisse entrevoir les structures sous-jacentes des écosystèmes universitaires qui sont propices au développement des réseaux sociaux et des innovations de ce type.

Reframing organizations in the digital age: A qualitative study exploring institutional social media adoption involving emergency physicians and other researchers.

Background: Social media is changing the modern academic landscape; this study sought to explore how organizational structures support or inhibit the harnessing of social media use in academic contexts and knowledge translation. Methods: A qualitative study was conducted using framework analysis based on the Bolman and Deal's Four-Frame Model-structural, human resources, political and symbolic. The research team used the snowball sampling technique to recruit participants following the completion of each participant's semi-structured interview. A member check was completed to ensure rigour. Results: 16 social media educators and experts from several countries participated in the study. Study findings showed that within the Structural Frame, institution types were reported to have with diverse hierarchical structures, ranging from strict to malleable: hospital-based (strict), education institutional-based and online only groups (malleable). The Human Resources Frame revealed that most participants' social media organizations operated on unpaid volunteer staff. The training of these staff was primarily via role-modeling and mentorship. Regarding the Political Frame, social media helped participants accumulate scholarly currency and influence within their field of practice. Symbolic Frame showed a wide range of traditional to non-traditional organizational supports, which interacted with both intrinsic to extrinsic motivation. Conclusions: Bolman and Deal's Four-Frame Model framework may serve as an effective guideline for academic leaders who wish to strategically implement or enhance social media use into their organizations. The key insights that we have gained from our participants are how new emerging forms of scholarly pursuits can be more effectively enabled or hindered by the attributes of the organization within which these are occurring.

Good practices in harnessing social media for scholarly discourse, knowledge translation, and education.

INTRODUCTION: There still remains a gap between those who conduct science and those who engage in educating others about health sciences through various forms of social media. Few empirical studies have sought to define useful practices for engaging in social media for academic use in the health professions. Given the increasing importance of these platforms, we sought to define good practices and potential pitfalls with help of those respected for their work in this new field. METHODS: We conducted a qualitative study, guided by constructivist grounded theory principles, of 17 emerging experts in the field of academic social media. We engaged in a snowball sampling technique and conducted a series of semi-structured interviews. The analytic team consisted of a diverse group of researchers with a range of experience in social media. RESULTS: Understanding the strengths of various platforms was deemed to be of critical importance across all the participants. Key to building online engagement were the following: 1) Culture-building strategies; 2) Tailoring the message; 3) Responsiveness; and 4) Heeding rules of online engagement. Several points of caution were noted within our participants' interviews. These were grouped into caveat emptor and the need for critical appraisal, and common pitfalls when broadcasting one's self. DISCUSSION: Our participants were able to share a number of key practices that are central to developing and sharing educational content via social media. The findings from the study may guide future practitioners seeking to enter the space. These good practices support professionals for effective engagement and knowledge translation without being harmed.