# Enhancing Professionalism Online (Netiquette) in Medical Schools: A Systematic Scoping Review

## TL;DR

This study reviews existing guidelines for online professionalism in medical schools and identifies gaps and factors affecting netiquette to propose new recommendations.

## Contribution

The paper introduces a systematic scoping review framework for netiquette in medical education and highlights sociocultural influences.

## Key findings

- Current netiquette guidelines show variability and significant gaps.
- Sociocultural factors strongly influence breaches in online professionalism.
- Curricular and training adaptations are recommended to improve netiquette.

## Abstract

The relaxing of COVID-19 pandemic restrictions has not seen the return to previous in-person teaching formats. As blended training continues to be used, there is emphasis on the need to better appreciate the expectations, etiquette, and professional code of conduct (“netiquette”) surrounding online learning, especially in light of evidence that poor online professionalism compromises learning and clinical practice.

This review seeks to map regnant netiquette guidelines in medical schools that will inform and provide preliminary recommendations for a clinically relevant framework.

This study is a systematic scoping review (SSR).

Krishna's Systematic Evidence-Based Approach (SEBA)'s Constructivist ontological and Relativist epistemological lens was used to guide this SSR. The SEBA process involves 6 stages, including the Systematic Approach, Split Approach, Jigsaw Perspective, Funneling, Analysis of evidence-based and non-data-driven literature, and Synthesis of the SSR in SEBA.

In total, 7941 abstracts were reviewed, 198 full text articles were evaluated, and 83 articles were included. The analysis of the results revealed 4 key domains: (1) current guidelines, (2) manifestations, (3) contributing factors, and (4) implications. This SSR in SEBA highlights variability and gaps in current guidelines and reveals the impact of sociocultural factors on breaches in netiquette. Unsurprisingly, contextual and clinical considerations shape the contributory factors impacting lapses in netiquette and their implications.

Based on the data accrued, this article proposes basic guidelines on netiquette and measures to support their effective employment. This includes curricular adaptations, methods of teaching and enhancing engagement with the students and faculty training. Drawing on prevailing studies, it also recommends methods of assessing netiquette, online professionalism, and the learning environment. Suggestions are also made for future areas of study.