Medical Education has taken social media by storm. Twitter, Facebook, the Blogosphere…  Medical Educators have used these often misused and misinterpreted forms of social interaction to share resources and educate. However, social media is quickly merging our private and public personae. As educators, we must be savvy and up-to-date regarding our learners’ social media usage, since the worlds can often collide.

This week we present the case of Greg, a junior faculty member and attending emergency physician, who is experiencing a social media-mediated quandary.

The Concept

Inspired by the Harvard Business Review Cases and led by Dr. Teresa Chan (@TChanMD) and Dr. Brent Thoma (@BoringEM), the Medical Education In Cases (MEdIC) series puts difficult medical education cases under a microscope. On the fourth Friday of the month we will pose a challenging hypothetical dilemma, moderate a discussion on potential approaches, and recruit medical education experts to provide “Gold Standard” responses. Cases and responses will be made available for download in pdf format – feel free to use them!

If you’re a medical educator with a pedagogical problem, we want to get you a MEdIC. Send us your most difficult dilemmas (guidelines) and help the rest of us bring our teaching game to the next level.

The Case

Greg, a brand new EM attending, woke up from his nap after a long night shift and immediately was flooded with memories. It had been one of those nights where the patients never stopped coming. To make matters worse, he had been on with one of the junior EM residents, Tammi, who the program director had flagged to Greg as a ‘resident at risk.’

He had hoped to use the shift to build up her confidence, but near the end she got in a disagreement with one of the senior nurses. The nurse had held some questionable orders for Greg’s approval, and Tammi did not take it well when she found out. Greg had tried to debrief the event with her before she went home, but they did not get very far as she seemed to be on the verge of tears. He figured he would give her a call today to talk about it after she had slept and all of the dust had settled.

Greg walked to the fridge, thinking of all the ways he could re-frame the problem to Tammi.  He could role play the situation in reverse; he could have her reflect upon the words he had overheard… Hmmm.

But first… some Facebook time.

Typing in his password, he quickly scanned his wall to find some funny new memes, a few quasi-political rants from his college roommate, some cute pictures of his sister’s cats in costume… And then his face dropped.


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Greg was shocked. He knew that Tammi had been upset, but he hadn’t thought that she would react like that. The last thing he wanted to do was come down hard on her, but he had to say something. Before he spoke with her he decided to phone a friend for some advice.

Questions for Discussion

  1. As Greg’s friend, what advice might you give him?
  2. What are your own/local/hospital/state-wide/provincial/national policies for social media engagement?
  3. How would you approach this scenario if you were Tammi’s friend?
  4. What advice do you have for educators who encounter social media transgressions?
  5. Can you share your difficulties with confusion over the blurry border between virtual and real identities?

We look forward to hearing your thoughts over the week (Sept. 27 – Oct 4, 2013).

*UPDATED OCTOBER 4, 2013:  All the comments have been analyzed and incorporated into the curated community commentary that was released today (Oct. 4, 2013).   Please feel free to still add your words of wisdom to our comments, but the PDF compilation has been rendered as of this date.*

Next Week

Just like last time, we used the community responses to curate a commentary and published it with two expert responses. This month’s two medical education experts were well-versed on the topic of social media and professionalism:

Their response was published on October 4, 2013 along with the curated community response:

The case, the expert responses and the curated commentary can be found at this link (Click here)

Thanks to Dr. Brent Thoma (@BoringEM) for developing this second case. We will continue sharing writing/editing/recruiting duties for this series from here on out!

All characters in this case are fictitious. Any resemblance to real persons, living or dead, is purely coincidental.

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Teresa Chan, MD, MHPE
ALiEM Associate Editor
Emergency Physician, Hamilton
Associate Professor, McMaster University
Assistant Dean, Program for Faculty Development, McMaster University Ontario, Canada
Teresa Chan, MD, MHPE


ERDoc. #meded #FOAMed Own views expressed. Contributor to @ALiEMteam, @WeAreCanadiEM, ICE Blog, #FeminEM. @MedEdLIFE founder. Works @McMasterU & @HamHealthSci