Table 4 Results of reliability analysis of 28 items (n = 500)

Self-anonymity

 1. I identify myself by name and profession on publicly accessible social media sites and networks

.471

.969

 2. I am cautious when posting my personal information on professional social media platforms

.731

.967

 3. I bear in mind that any post uploaded anonymously can, in many cases be traced back to its source or point of origin

.783

.967

Privacy settings

 4. I apply conservative/strict privacy settings and carefully select the intended audience on my personal social media profile

.794

.967

 5. I regularly review the privacy settings of my personal and professional social media profiles

.535

.968

 6. I keep in mind that the privacy settings are imperfect and any content posted online is public and widely accessible

.735

.967

 7. I bear in mind that once the information is posted online, it is difficult to remove it completely as users may distribute it further or comment on it

.808

.967

Maintaining boundaries

 8. I do not entertain my patient's queries about healthcare if they access me through my private/personal social media profile

.134

.971

 9. I avoid establishing online personal contacts with my patients like accepting friend requests

.690

.968

 10. I respect the privacy of my patients and do not search their social media profiles

.863

.967

Maintaining confidentiality

 11. I avoid posting masked/unidentifiable/anonymized images of my patients on social media sites when informed consent of patients could not be obtained

.684

.968

 12. I refrain from discussing my patient's complaints and treatment with colleagues on publicly accessible social media sites

.755

.967

 13. I keep in mind that an unnamed patient may be identifiable through minimal information even in a private online forum

.787

.967

Conflict of interest

 14. I specify that the opinions I express online are my own and do not reflect another employer, colleague, or institute

.846

.967

 15. I declare any financial or commercial conflict of interest when posting content online (health care organizations, pharmaceutical, and biomedical companies)

.496

.969

 16. I refrain from endorsing and promoting healthcare products and events on social media sites based on my personal experience

.723

.967

Accountability

 17. I keep in mind that the content I post online is subject to the same laws of copyright and defamation as written or verbal communication

.889

.966

 18. I acknowledge the original source while posting healthcare-related information and post evidence-based facts on my professional accounts

.884

.966

 19. I keep in view the legal implications (defamation, cyberbullying, privacy lawsuits, copyright breach) of my online posts regarding patient care and management

.868

.967

 20. I comply with social media guidelines for healthcare professionals while using social media platforms for professional use

.883

.966

 21. I keep in mind that any information I share online as a healthcare professional represents the medical profession at large and is trusted by the public

.901

.966

Respect for colleagues

 22. I treat my colleagues with respect and do not bully, harass, or post baseless comments about them on social media forums and blogs

.903

.966

 23. I keep in mind that my comments on my colleague’s content can negatively affect their reputation

.888

.966

 24. If I see unprofessional content posted by my colleague, I feel responsible to bring it to the attention of that person

.727

.967

Ethics

 25. I keep my relationship with patients strictly professional and do not exploit them for any personal or financial gains

.899

.966

 26. I recognize and resolve ethical issues (e.g., breach of privacy, confidentiality & trust, relationship abuse) encountered during online communication with patients

.880

.966

 27. I take care of patient safety and trust while giving medical advice during online interactions

.904

.966

 28. I respect the diversity (ethnicity & racial differences) of my patients and colleagues during online interaction

.906

.966