To critically appraise the scientific literature on social media use in physiotherapy and to develop a theory to better understand ethical and social issues associated with its multiple uses.
We conducted a critical interpretive synthesis review to identify, describe and explore the extensive literature on the subject. We conducted an electronic search in Medline, Embase, CINHAL and Web of Science in February 2023 using MesH terms and keywords related to physiotherapy, Web 2.0 and ethical and social issues. Two independent reviewers performed study selection. All types of studies addressing ethical and social issues associated with uses of the Web 2.0 in physiotherapy written in English or French were included. Data extraction was performed by one reviewer and revised by a second. Quantitative and qualitative data were extracted, criticized and synthesized following the critical interpretive synthesis method of Dixon-Woods.
Twenty-four studies were reviewed: 16 (67%) opinion articles, viewpoints, or editorials, 7 (29%) empirical articles (four quantitative, two qualitative, and one case study), and 1 (4%) literature review. Nineteen (79%) articles focused on physiotherapists, and five (21%) on students in physiotherapy. Most articles (n=20, 83%) were from Anglo-Saxon countries. Seven (29%) articles provided social media usage recommendations, seven (29%) highlighted social media opportunities, seven (29%) explored Web 2.0 practices, and three (13%) discussed ethical considerations. Some risks, including the boundaries between personal and professional relationships, imbalanced relationships between actors, the complexity of online information, conflicts of interest, privacy concerns, and legal issues between countries (e.g., licensing) were raised in the included studies. Numerous misuses of social media in physiotherapy were also reported such as patient bashing. Twenty (83%) studies included mitigation of these risks and opportunities for appropriate use of social media. Developing and teaching digital professionalism was another solution to mitigate ethical risk.
Through inductive and interpretive processes, critical reflection and theory development, we offered new insights to improve understanding of the social media use in physiotherapy. Despite a variety of issues raised, they are addressed superficially in the literature, and the recommendations made are mostly based on opinions. Additional studies are needed to better understand the use of social media and its implications in physiotherapy.
With the increasing social media uses in physiotherapy, it is important to understand the associated risks and ethical issues in order to develop guidelines suited to these challenges. A thorough understanding of these concepts will enable better training and awareness for professionals and students, promoting ethical and safe practices on social media resulting in better patient protection.
Social media
ethics
