# Social justice and social media: How medical schools display critical consciousness online

## TL;DR

This study examines how Canadian medical schools use social media to promote social justice and equity, finding that while they often celebrate marginalized groups, they rarely engage in critical self-reflection about their role in systemic inequities.

## Contribution

The study introduces a novel application of critical consciousness theory to analyze social media content from medical schools, revealing gaps in institutional self-reflection on equity issues.

## Key findings

- Only 16.12% of tweets from Canadian medical schools displayed critical consciousness.
- Empowerment of marginalized populations was the most common theme, while intersectionality was rarely addressed.
- Language used in tweets focused on celebrating equity-deserving groups but avoided acknowledging institutional roles in perpetuating inequities.

## Abstract

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.

In our study, we explored how Canadian medical schools use the social media platform X (formerly Twitter) to share messages of social justice and equity. Social media offers these institutions a powerful tool to raise awareness of systemic inequities and foster dialogue. By analyzing over 3,400 tweets from official accounts, we found that while many posts highlighted the achievements of marginalized groups and celebrated diversity, fewer delved into critical self-reflection about the schools’ own roles in perpetuating inequities. This emphasis on celebration over introspection reveals a missed opportunity. Social media can serve as more than just a platform for awareness; it can foster meaningful dialogue about systemic change. By acknowledging their positions of power and addressing internal challenges transparently, medical schools can build trust with the public and the communities they aim to serve. Our findings underscore the importance of moving beyond surface-level advocacy. Embracing deeper, reflective engagement online could strengthen the social accountability of medical institutions, ultimately advancing the broader goal of equitable healthcare.