Yilmaz Eray, D'Mello Keegan, Kirpalani Amrit
Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
London Health Sciences Centre Research Institute, London, Ontario, Canada.
PLOS Digit Health. 2025 Aug 7;4(8):e0000981. doi: 10.1371/journal.pdig.0000981. eCollection 2025 Aug.
Academic medical institutions have a pivotal role in addressing the inequalities faced by marginalized populations, especially by promoting values of social justice on online platforms that not only reach the medical sphere, but also the broader public. Central to this transformative agenda is the framework of critical consciousness (CC), which compels individuals to develop an acute awareness of societal inequalities and power dynamics and act as agents of change against inequalities across society. To investigate if and how medical schools use X (formerly Twitter) to display CC, tweets from March 22 - June 22, 2023 from all available Canadian medical school Twitter accounts were obtained and deductively coded. First, a content analysis was performed to collate and categorize tweets related to CC, followed by a critical discourse analysis with a CC framework to examine the role of language in conveying messages about equity and medical education. Of the 3442 tweets reviewed, 554 displayed CC (16.12%). The content analysis revealed that Empowerment of Marginalized Populations was the most prominent display of CC amongst tweets (n = 286), whereas there was a paucity of messaging around Intersectionality (n = 20). The critical discourse analysis revealed that language was purposefully used to positively spotlight equity-deserving individuals (e.g., "celebrate" and "recognize") with minimal dialogue framing institutions as agents of systemic power differentials. Medical schools ultimately advocate for positive change by sharing awareness-raising content that celebrate marginalized communities. However, the step beyond surface-level awareness-raising content towards critical self-reflection that acknowledged institutions' roles in perpetuating inequities was largely limited; this represents a missed opportunity to leverage the power of social media and engage in meaningful dialogue online to build trust between the healthcare sector and the public.
学术医疗机构在解决边缘化人群所面临的不平等问题方面发挥着关键作用，特别是通过在不仅覆盖医学领域，而且涵盖更广泛公众的在线平台上促进社会正义价值观。这一变革性议程的核心是批判意识（CC）框架，它促使个人对社会不平等和权力动态形成敏锐的认识，并作为反对全社会不平等的变革推动者采取行动。为了调查医学院是否以及如何使用X（前身为推特）来展示批判意识，获取了2023年3月22日至6月22日来自所有可用的加拿大医学院推特账户的推文，并进行了演绎编码。首先，进行了内容分析，以整理和分类与批判意识相关的推文，随后采用批判话语分析和批判意识框架来研究语言在传达关于公平和医学教育信息方面的作用。在审查的3442条推文中，554条展示了批判意识（16.12%）。内容分析显示，在推文中，赋予边缘化人群权力是批判意识最突出的表现（n = 286），而关于交叉性的信息则很少（n = 20）。批判话语分析表明，语言被有意用于正面突出应得公平对待的个人（如“颂扬”和“认可”），而将机构作为系统性权力差异的推动者进行的对话极少。医学院最终通过分享提高认识的内容来倡导积极变革，这些内容颂扬边缘化社区。然而，从表面的提高认识内容迈向承认机构在延续不平等方面作用的批判性自我反思的步伐在很大程度上是有限的；这代表了一个错失的机会，未能利用社交媒体的力量并在网上进行有意义的对话，以在医疗保健部门和公众之间建立信任。
