Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia.
Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia.
JMIR Med Educ. 2024 Feb 27;10:e50156. doi: 10.2196/50156.
Previous studies have predominantly measured e-professionalism through perceptions or attitudes, yet there exists no validated measure specifically targeting the actual behaviors of health care professionals (HCPs) in this realm. This study addresses this gap by constructing a normative framework, drawing from 3 primary sources to define e-professional behavior across 6 domains. Four domains pertain to the dangers of social networking sites (SNSs), encompassing confidentiality, privacy, patient interaction, and equitable resource allocation. Meanwhile, 2 domains focus on the opportunities of SNSs, namely, the proactive dissemination of public health information and maintaining scientific integrity.
This study aims to develop and validate 2 new measures assessing the e-professional behavior of doctors of medicine (MDs) and doctors of dental medicine (DMDs), focusing on both the dangers and opportunities associated with SNSs.
The study used a purposive sample of MDs and DMDs in Croatia who were users of at least one SNS. Data collection took place in 2021 through an online survey. Validation of both indexes used a formative approach, which involved a 5-step methodology: content specification, indicators definition with instructions for item coding and index construction, indicators collinearity check using the variance inflation factor (VIF), external validity test using multiple indicators multiple causes (MIMIC) model, and external validity test by checking the relationships of the indexes with the scale of attitude toward SNSs using Pearson correlation coefficients.
A total of 753 responses were included in the analysis. The first e-professionalism index, assessing the dangers associated with SNSs, comprises 14 items. During the indicators collinearity check, all indicators displayed acceptable VIF values below 2.5. The MIMIC model showed good fit (χ=9.4, P=.742; χ/df=0.723; root-mean-square error of approximation<.001; goodness-of-fit index=0.998; comparative fit index=1.000). The external validity of the index is supported by a statistically significant negative correlation with the scale measuring attitudes toward SNSs (r=-0.225, P<.001). Following the removal of 1 item, the second e-professionalism index, focusing on the opportunities associated with SNSs, comprises 5 items. During the indicators collinearity check, all indicators exhibited acceptable VIF values below 2.5. Additionally, the MIMIC model demonstrated a good fit (χ=2.5, P=.718; χ/df=0.637; root-mean-square error of approximation<0.001; goodness-of-fit index=0.999; comparative fit index=1.000). The external validity of the index is supported by a statistically significant positive correlation with the scale of attitude toward SNSs (r=0.338; P<.001).
Following the validation process, the instrument designed for gauging the e-professional behavior of MDs and DMDs consists of 19 items, which contribute to the formation of 2 distinct indexes: the e-professionalism index, focusing on the dangers associated with SNSs, comprising 14 items, and the e-professionalism index, highlighting the opportunities offered by SNSs, consisting of 5 items. These indexes serve as valid measures of the e-professional behavior of MDs and DMDs, with the potential for further refinement to encompass emerging forms of unprofessional behavior that may arise over time.
之前的研究主要通过感知或态度来衡量电子专业精神，但在这一领域，针对医疗保健专业人员（HCP）实际行为的验证性衡量方法尚不存在。本研究通过构建一个规范性框架来解决这一差距，该框架源自三个主要来源，旨在定义六个领域中电子专业行为。其中四个领域涉及社交网络（SNS）的危险，包括保密性、隐私、患者互动和公平资源分配。同时，两个领域侧重于 SNS 的机会，即主动传播公共卫生信息和维护科学完整性。
本研究旨在开发和验证两项新的衡量医生（MD）和牙医（DMD）电子专业行为的措施，重点关注与 SNS 相关的危险和机会。
本研究使用克罗地亚至少使用一种 SNS 的 MD 和 DMD 的有目的样本。数据收集于 2021 年通过在线调查进行。两个指数的验证都采用了形成性方法，包括五个步骤：内容规范、指标定义，包括项目编码和指数构建的说明、使用方差膨胀因子（VIF）检查指标共线性、使用多指标多原因（MIMIC）模型进行外部有效性测试、使用 Pearson 相关系数检查指数与社交网络态度量表之间的关系以检查外部有效性。
共有 753 份回复被纳入分析。第一个电子专业精神指数评估与 SNS 相关的危险，包含 14 个项目。在指标共线性检查中，所有指标的方差膨胀因子值均低于 2.5，表现出可接受的值。MIMIC 模型显示出良好的拟合度（χ=9.4，P=.742；χ/df=0.723；均方根误差小于 0.001；拟合优度指数=0.998；比较拟合指数=1.000）。指数的外部有效性得到了支持，与衡量对 SNS 态度的量表呈统计学上显著的负相关（r=-0.225，P<.001）。在删除一个项目后，第二个电子专业精神指数，侧重于与 SNS 相关的机会，包含 5 个项目。在指标共线性检查中，所有指标的方差膨胀因子值均低于 2.5，表现出可接受的值。此外，MIMIC 模型显示出良好的拟合度（χ=2.5，P=.718；χ/df=0.637；均方根误差小于 0.001；拟合优度指数=0.999；比较拟合指数=1.000）。指数的外部有效性得到了支持，与衡量对 SNS 态度的量表呈统计学上显著的正相关（r=0.338；P<.001）。
经过验证过程，为衡量 MD 和 DMD 的电子专业行为而设计的工具包含 19 个项目，这些项目构成了两个不同的指数：重点关注与 SNS 相关的危险的电子专业精神指数，包含 14 个项目，以及强调 SNS 提供的机会的电子专业精神指数，包含 5 个项目。这些指数可作为 MD 和 DMD 电子专业行为的有效衡量标准，并且可以进一步完善，以涵盖随着时间的推移可能出现的新兴非专业行为。
