Better understanding the ethical and social issues associated with social media uses in physiotherapy: A critical interpretive synthesis.

INTRODUCTION: Social media uses by physiotherapists are proliferating (e.g. interprofessional collaboration, publicity, information dissemination). While offering opportunities for health democratization, these practices raise ethical and social issues such as cyberincivility and digital literacy-related inequalities, necessitating deeper ethical and social reflection in physiotherapy. Critical literature reviews are useful to develop an evidence-informed theoretical framework to inform ethical reflections. METHODS: This review employed critical interpretive synthesis to examine ethical and social issues in physiotherapists' social media uses, searching Medline, Embase, CINAHL, and Web of Science (2000-2025), yielding relevant studies via PRISMA-guided screening. Inductive data extraction and analysis were used to generate synthetic constructs through iterative critique, integrating evidence from empirical and non-empirical studies on this topic. RESULTS: Out of 4547 studies, 28 included studies reveal eight key ethical and social issues in physiotherapists social media uses: privacy concerns and confidentiality, conflict of interest and transparency, cyberincivility and professional misconduct, risks of blurred boundaries between professional and personal spheres, power imbalance during digital interactions with vulnerable populations, risks of uncontrollable and overloaded digital information dissemination, disinformation and misinformation in professional online communication, and risks of jeopardizing intellectual property rights. The resulting conceptual framework prompts reflection on developing digital professionalism in physiotherapy centred on cybercivility and accountability. Fostering digital professionalism requires training professionals and students with digital literacy as a core competency and developing and disseminating clear guidelines. CONCLUSION: This review proposes deeper ethical reflections on social media uses in physiotherapy. It emphasizes the need for empirical research to address gaps, enhance reflexivity, and advance digital professionalism.