Remaining on course, online: Reflections and recommendations on more effective psychiatrist participation in online chat forums in the context of social media dynamics.

Psychiatrists should carefully consider and curate their participation in online chat forums. Convivial discourse, including shared interests, knowledge, and skills are benefits. However, social media dynamics influence online roles and behaviour. There is a performative aspect to chat forums and social media, through depiction of a participant's persona, which can be understood through social avatar theory. Even on well-moderated chat forums, there remain the risks of subtle forms of negative social media roles and behaviour (e.g. cyberbullying, online abuse, and trolling). Furthermore, there are potential risks to professional identity and reputation from posting material as well as others commenting upon psychiatrists' posts. A single unprofessional post can have a devastating impact on reputation. There are also opportunity costs from the time, attentional and emotional costs of following a forum, which can also lead to harms from anxiety and depression due to excessive social media use. We provide practical recommendations on e-professionalism for more effective participation online.