Assessment instruments for e-professionalism in healthcare: a systematic review

E-professionalism represents the foundation guiding the conduct of health professionals on social media. Assessing e-professionalism allows the identification of gaps in professional education and supports institutions in adapting to technological changes. Gathering evidence on the quality of available instruments may promote reliable and consistent measurement of this construct. To evaluate the evidence of validity of instruments used to assess e-professionalism among students and healthcare professionals. A systematic review was conducted in accordance with the systematic review manual of the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). The protocol was registered in PROSPERO (ID CRD42023454825). The search was carried out in July 2025 in the PubMed/MEDLINE, EMBASE, Web of Science, ERIC, and Scopus databases. Articles reporting e-professionalism instruments with evidence of validity were included, targeting professionals and/or students in Nursing, Pharmacy, Medicine, and Dentistry, with no restrictions regarding language or year of publication. The quality of the instruments was analyzed using COSMIN criteria. The search identified 4,616 studies, with 28 included, published between 2009 and 2025. The instruments were predominantly directed toward students (n = 20; 71.4%). Overall, the instruments contained an average of 26 items and three subscales. Only one of the studies established cutoff points for interpreting the results. Regarding psychometric properties, only four of the nine recommended by COSMIN were investigated, with emphasis on content validity (n = 24; 85.7%), internal consistency (n = 8; 28.5%), and structural validity (n = 7; 25%). This review highlights the need for greater conceptual consensus regarding e-professionalism and its domains, as well as the development of instruments with robust validity for both students and health professionals. The lack of reliable tools limits comparisons and evaluations, reinforcing the importance of research that integrates theoretical definition with psychometric validation to accurately reflect the construct.