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Cyberbullying in Academic Medicine

A Framework for Managing Social Media Attacks

Cain, Jeff, EdD, MS; Linos, Eleni, MD, MPH, DrPH; Chretien, Katherine C., MD

doi: 10.1097/ACM.0000000000002649
Invited Commentaries
Free

Criticism, scathing comments, and harassment are becoming more common elements of social media discourse. Recent coordinated public attacks directed at higher education faculty illustrate these troubling trends. In several cases, these attacks have been politically motivated by participants who disagree with a faculty member’s statements regarding sensitive subjects. Whereas most high-profile cases have included faculty teaching at the undergraduate level who use social media to promote scholarly discussion, medical school faculty may also be at risk, especially if their scholarly pursuits pertain to politically charged issues (e.g., race and diversity, firearms, vaccinations, the health of transgender populations). In today’s digital environment of cellphone recordings, forwarded e-mails, and open-access manuscripts, any faculty member who discusses or engages in scholarship of politically sensitive issues on- or offline may be at risk. In this Invited Commentary, the authors discuss the multifaceted problem of cyberbullying of medical school faculty and provide recommendations to faculty and administrators about how to mitigate and manage these situations.

J. Cain is associate professor, Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky; ORCID: http://orcid.org/0000-0002-0018-0588.

E. Linos is associate professor, Department of Dermatology, University of California, San Francisco, San Francisco, California.

K.C. Chretien is professor of medicine and associate dean for student affairs, George Washington University School of Medicine and Health Sciences, Washington, DC.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Jeff Cain, University of Kentucky College of Pharmacy, 114M Lee T. Todd, Jr. Building, 789 S. Limestone St., Lexington, KY 40536-0596; telephone: (859) 257-4429; e-mail: jeff.cain@uky.edu; Twitter: @DrJeffCain.

As the amount of online communication in today’s society increases, so do cases of cyberbullying and online harassment. Pew Internet Research reports that 41% of Americans have personally experienced online harassment and 18% have been subject to severe forms of it.1 Recent reports in the popular press also indicate that faculty are increasingly becoming high-profile targets of cyberbullying.2 In these instances, the story is familiar and repeats itself. A faculty member posts something online that someone dislikes, and that post is shared with social media influencers, who in turn respond with outrage and call for retribution. The faculty member and institution are then forced to deal with the onslaught of social media backlash, demands, and threats.3 The “Internet outrage machine,” an apt label for the multitude of vocal social media users eager to share their opinions, can be engaged in a manner of minutes, and faculty and administrators should be prepared for it.4 Contemporary digitally driven public discourse and a highly contentious cultural and political environment have resulted in the recent proliferation of these viral and sometimes concerted social media attacks on university faculty.

Issues related to online professionalism have been discussed extensively and remain relevant for all medical faculty.5,6 However, the new phenomenon of vitriolic attacks directed at academic faculty via social media can occur with or without an e-professionalism transgression. As the dean of the University of Ottawa Faculty of Medicine warned in a memo to faculty engaging in political commentary using their personal social media accounts, the medical field “isn’t without its controversial issues.”7 Vaccinations, firearm safety, diversity, the health of transgender people, physician-assisted deaths, international events, and abortion are examples of politically charged topics that could be in line with many medical faculty members’ research or teaching areas. Faculty who use social media for scholarly discussions can become targets merely because of the nature of their jobs. Recent high-profile examples of faculty undergoing social media assault are well chronicled and include cases of posts pertaining to climate change, race, and several other politically relevant topics.8 Medical faculty have also been targeted for their public health stances related to alcohol and artificial food colors.9

The purpose of this Invited Commentary is not to enumerate and dissect specific cases but, rather, to describe and promote discussion of the emerging, multifaceted problem of public social media attacks on faculty members. Although cyberbullying of faculty by students or colleagues has been discussed in the literature,10,11 social media attacks on faculty from the public are a new phenomenon. A literature search revealed that peer-reviewed publications regarding this topic are sparse, with the popular press leading the coverage of this emerging digital communication issue. In this essay, we expand discussion of the complexities associated with the problem, provide an academic medicine perspective, and conclude with recommendations for health professions faculty and administrators to consider with regard to preventing and/or responding to such attacks.

As the Chronicle of Higher Education succinctly describes, in this era of partisan divide and social media discourse, faculty speech is monitored ever more closely, and any missteps are subject to amplification.2 Furthermore, cyberbullying is not limited only to those who engage in online speech. Cellphone video recordings and private e-mail messages that contain controversial comments can just as easily be shared via social media without consent.12,13 Even text from controversial matters in peer-reviewed manuscripts can be excerpted and broadcast via social media in formats that invite public attack.13

Sharing personal opinions and attitudes in online environments tends to exacerbate dissension over controversial topics. Research has shown that content evoking strong emotional responses such as anxiety or anger (especially toward an outgroup member) is more likely to have a strong online viral response.14,15 Furthermore, the Internet “public” does not necessarily distinguish between personal opinion and scholarly discourse. As Berry and Sobieraj16 explain, today’s popular media, regardless of political perspective, engage in a form of communication that often glosses over the complexities and nuances of political issues and favors mockery of the opposing side. Social media serves as a conduit to further fuel and harass the victims. One of the most disturbing problems is that these viral social media attacks do not have a goal of public debate but, rather, seek to destroy reputations or careers.17 Freedom of speech, academic freedom, institutional values, reputations, and accountability to the public are all factors that must be considered when responding to cases of social media attacks toward faculty.

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Complexity and Nuances of Online Speech for Health Professions Faculty

The concept that faculty speech is protected by academic freedom is more complex in today’s digital world than when it was originally conceived. Speech is no longer confined to small, distinct audiences in a classroom or conference hall but, instead, is readily available to a diverse, global audience. In addition, the dividing line between personal and professional speech is almost indistinguishable, and it is unreasonable to expect that a faculty member denote every single online statement as representing either personal or professional views.18 Regardless of whether academic freedom applies, individuals do not give up their First Amendment rights when they join the ranks of faculty. They maintain the legal right to voice opinions as regular citizens. However, even when protected by academic freedom, if a professor crosses the proverbial line and advocates violence or rejoices in the physical suffering of the “other side,” such statements may be difficult to defend to the public.19

Finally, the complexity of this issue lies in the particulars of each case. In some instances, the professor may invite negative attention through inflammatory comments,20 while in others the faculty member may be blindsided by attacks simply because his scholarly expertise lies in a controversial area.9

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Repercussions for Faculty and Administrators

Whether public criticism of a faculty member’s online speech is warranted or not, it can exert a number of negative effects on both the faculty member and his or her institution. Suppression of faculty speech is one of the biggest concerns, and many fear that faculty will increasingly withdraw from discussing controversial subjects for fear of reprisal.3 This undermines the very role of educators to develop critical thinking and confront difficult issues.

Second, once online content goes viral, the faculty member (and institution) loses control of the message and context. What may have been a simple misstep can be transformed into an egregious offense as critics can frame the message however they want and often misrepresent what the faculty member said or meant. As Friedersdorf17 describes, the mischaracterization occurs in a manner that maximizes the outrage and umbrage-taking from the critic’s readers.

Third, the faculty member may experience extreme emotional abuse in addition to threats to her own physical safety and/or that of her family.21 The relative anonymity afforded by Internet communications creates an environment conducive to extreme verbal abuse and enables many to post aggressive comments free from retribution.22 This public disparagement could potentially alter the faculty member’s commitment as an educator.

Fourth, the educational mission is compromised when teaching responsibilities have to be removed or reassigned because of threats. The faculty member might need to take administrative leave during the investigation, potentially leading to loss of learner trust. In extreme cases, entire campuses are closed because of threats.23

Finally, responding to social media attacks can consume a significant amount of institution time and resources. Department chairs, deans, and presidents may have to address the issues both privately and publicly and even become subject to further criticism and harassment as their response can fuel further attacks and condemnation. University attorneys, public relations personnel, faculty senates, and other governing bodies may also have to devote significant effort toward the legal, ethical, and public relations issues that arise.

Perhaps one of the more difficult, yet most important, tasks for administrators is to balance the rights of and respect for faculty with the need to subdue the public backlash from donors, legislators, learners and their families, and the general public. The complexity increases when faculty make very controversial statements that also fall within the bounds of academic freedom. In cases such as these, actions may proceed along two completely different channels. One channel, academic freedom, is governed primarily by faculty peers, while the other channel, the public relations aspect of quelling negative attention, belongs to administrators. The public relations response may or may not be overly supportive of the faculty member, which can cause further turmoil within the institution itself.

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Recommendations for Faculty and Administrators

Although there is no single solution to cyberbullying of faculty, there are some logical actions that may mitigate the issue. Table 1 outlines our recommendations to both faculty and administrators for the prevention and management of social media attacks directed at medical school faculty.

Table 1

Table 1

First, the multifaceted issue of faculty becoming targets of cyberbullying entangles both faculty and administration. From an administrative standpoint, creating clear guidelines and informing faculty members of their rights and responsibilities regarding social media is the first step to preventing problems. The issues surrounding faculty online speech can be very confusing as separating personal opinion from professional statements often becomes difficult. The American Association of University Professors (AAUP) Committee A on Academic Freedom and Tenure advocates that professors should

have the freedom to address the larger community with regard to any matter of social, political, economic or other interest, without institutional discipline or restraint, save in response to fundamental violations of professional ethics or statements that suggest disciplinary incompetence.24

Furthermore, the AAUP in its report on academic freedom and electronic communications recommends

that each institution work with its faculty to develop policies governing the use of social media. Any such policy must recognize that social media can be used to make extramural utterances and thus their use is subject to Association-supported principles of academic freedom, which encompass extramural utterances.18

Not only should administrators adopt a stance protective of academic freedom via social media but they should also educate faculty accordingly. Every faculty member needs to know the bounds of his or her online speech, as well as its potential consequences. Faculty members should have a realistic expectation that online statements that could be considered controversial or politically charged are subject to attack, even if their job is protected by academic freedom. The First Amendment and academic freedom may protect one from government or institutional censorship, but there is no protection from public outrage and resultant complications generated through social media.

Second, because of the ever-increasing amount of public discourse occurring online, faculty and administrators should become well versed in social media communications, not only from a digital literacy standpoint but also from a public-dialogue-management perspective. This could be accomplished via faculty development opportunities like social media training workshops or “boot camps” focusing on skills building and online identity management. Medical schools have adopted digital professionalism curricula to help students navigate the social media world as physicians,25 and similar opportunities should be provided for faculty. Training could also make faculty aware of online participatory cultures and what is required for effective scholarly discourse.26 Learning how to promote civil debate and conversation that do not provoke rage is particularly important, as abrasive posts vilifying opponents are likely to evoke stronger emotional reactions that result in harsher and more viral responses.

Third, faculty should recognize that foregoing social media and avoiding difficult conversations may reduce risk, but it is not a complete solution. Comments made offline in classrooms or at conferences and excerpts from manuscripts can easily be captured digitally and disseminated to the online public, and are thus subject to the same forms of attack. This does not mean, however, that the faculty member should self-censor on important issues and withdraw completely from discourse of controversial topics in his field. There is a moral responsibility to use one’s expertise and position as an educator to advance thought and dialogue, but the difficulty lies in constructing those messages in a way that does not invite unwanted controversy. To reduce (but not necessarily eliminate) the chances of cyberbullying, when communicating online (and offline) it is advisable to use principles of civil discourse such as focusing on issues versus individuals, seeking points of common purpose, embodying open-mindedness, and treating others’ ideas with respect.27

Fourth, if a faculty member becomes embroiled in a social media maelstrom, swift action is required to minimize damage. Leaders of the institution may find themselves in rapidly escalating situations that require support for faculty speech, while simultaneously distancing themselves from that speech to appease online activists. Perhaps the most important action that an institution can take is to develop an a priori crisis plan that includes the public statements, legal actions, faculty relations, and campus safety that will be crucial for a quick and immediate response. This plan should address not only public relations management of media, donors, and public critics but also guidance for administrators on how to protect the academic and legal rights of the faculty member(s). A well-devised and comprehensive plan may help shorten the period of negative exposure and return the campus and faculty member to normal operations. Development of this plan will require input from a variety of constituents including deans, department chairs, faculty, legal counsel, public relations staff, and alumni/donor relations personnel.

Fifth, if a faculty member becomes the target of cyberbullying, she should inform university administration immediately, seek legal advice, and cease communications with the attacker. Law experts advise faculty to refrain from further engagement in social media conflict. Interacting with the critics can exacerbate the rage and also change the faculty member’s legal status from a private individual to a limited public figure, which reduces the available legal options.4

Sixth, the faculty member may need emotional support from peers, family members, colleagues, and supervisors.21 The aftereffects of social media attacks often linger for months as institutions and individuals sort through academic and/or legal proceedings. This can be an extremely exhausting period as one’s physical, mental, and financial well-being may be at stake.

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Conclusion

The speed of and anonymity provided by electronic communications have resulted in online public discourse that can be caustic, derogatory, and inflammatory. Reports of faculty members at the center of viral social media attacks are becoming increasingly common. The overall percentage of faculty who may experience this is low, but the stakes are high for the few who do. In some instances, faculty have put themselves at risk of attack by making online comments that violate basic principles of public decency, while others have been attacked merely for making statements within their realm of scholarship. The issues surrounding social media wars and subsequent responses to them are numerous and complex, necessitating further dialogue and understanding on the part of faculty and administrators. If, as medical faculty and health-related researchers, we hope to maintain our position and independence as thought leaders, we must learn how to prevent and manage these social media attacks, as well as continue to support our colleagues and mentees who are also at risk.

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© 2019 by the Association of American Medical Colleges