Professional accountability in social media

The concept of e-professionalism or e-accountability can be defined as, ‘the attitudes and behaviours reflecting traditional professional paradigms that are manifested through digital media’ (Cain & Romanelli, 2009:1). Despite professional guidance and organisational policy being in place for several years, literature outlines issues associated with e-professionalism. For the public, this sends an inconsistent message and can lead to loss of confidence in nurses/the profession. For nursing students, evidence suggests the need for further guidance and input from educators, though the nursing profession has not reached explicit consensus about what ‘unprofessional’ behaviour is (e.g. why are pictures of drinking alcohol deemed as unprofessional when it is legal and acceptable to be doing this in the physical world?) While one nurse will assess a particular behaviour to be unprofessional, another will see it as simply unacceptable; hence, the outcome and consequences of reported and observed ‘incidents’ on social media vary significantly.

The A2A (Awareness to Action) decision making tool has been developed as part of a 42-month ethnographic study that conducted semi-structured interviews, focus groups [with nurses and nursing students] and online observations of publicly accessible professional groups. The study found that:

  1. There is an awareness of e-professionalism and accountability on social media but social, political and personal events impact on the perception and subsequent actions of nurses. For example, swearing and bullying is deemed as unprofessional, but when responding to posts about NHS reforms this was ‘accepted’ by the wider nursing community.
  2. Nurse perceptions and understanding of behaviours that require ‘action’ to be taken is inconsistent (e.g. what one nurse would discipline, another might just view as unacceptable, not unprofessional and thus, take no action).
  3. Nurses perceived self-efficacy (awareness) is inconsistent with ‘actual’ observed behaviours (i.e. what individuals think they do and share is not what they actually do).
  4. The above findings result in confusion, inconsistency and reluctance to report incidents:

– that are actually unprofessional and require further investigation

– professional penalties against acceptable or unacceptable [rather than unprofessional] behaviours (e.g. photos of drinking alcohol being shared with friends)

– the removal of online posts, investigations and/or disciplinary action for behaviours that are actually professional; serving a genuine purpose within the parameters of the NMC code (2015; 2016).

When discussing what actions would be challenged in physical practice, and why such actions would not be challenged in Facebook there were three main reasons identified: a lack of clarity, context and confirmability.

 

School of Health, Wellbeing and Social Care

For over 30 years, we have been delivering supported and open distance learning in the field of health and social care, and developing highly-respected materials for multi-disciplinary and multi-professional use. Today, we are one of the largest and most innovative providers of educational opportunities and learning solutions in this sector.

We offer a wide range of practice-related courses and awards, from single modules for professional development to qualifying and post-qualifying routes, and from vocational training to undergraduate and research degrees.

The School is characterised by a vigorous intellectual life fostered through shared research interests, collaborative teaching, flexible study arrangements and a strong external focus. We currently have 100 members of academic staff, 28 academic related staff and 14 postgraduate students. Our work is organised into three areas – Health and social careSocial Work, and Nursing:

  • We work in partnership with employers to provide learning programmes that meet their changing needs. Over 50% of our students are sponsored by employers – mainly in the NHS, Social Services and the voluntary sector.
  • As the UK’s largest provider of part-time social work training, we support a large student population of about 12,000 who study a diverse range of open modules and awards in the field of wellbeing, health and social care that are relevant to practice and work.
  • We also offer a unique work-based pre-registration nursing programme which delivers a flexible qualifying route for staff working in healthcare practice in a caring role across the UK, together with a range of modules and awards for professional development.

Our teaching materials are underpinned by the excellence of our research as well as by high quality scholarship in the area of teaching and learning – focusing on the delivery of an excellent student experience. We are deeply committed to the principles and practice of equality and diversity and to the pursuit of social justice.

We have a strong track record in applied health and social care research. We are in receipt of funding from Research Councils (ESRC and AHRC), the National Institute for Health Research, and a wide range of trusts, charities and commercial organisations.

ADHD & YOU: an educational website for those with and in contact with those with ADHD

A summary of a project from one of our own HWSC academics, Gemma Ryan

ADHD & You project summary

An evaluation of an educational website on ADHD for parents, carers and education staff.  (2012-2014)

This website was improved by its owners Shire, and is now available at http://www.adhdandyou.co.uk/

 

What was the purpose of this study?

‘ADHD & You’ is a website developed by Shire AG Ltd. and is aimed at providing information and advice to parents, carers, teachers of children and young people with ADHD, people with a diagnosis of ADHD and healthcare professionals.

We evaluated this website to see if it was useful to parents, carers and education staff who have care of, or who come into contact with a child or young person with a diagnosis of [or suspected] ADHD.

 

What did we want to know?

We wanted to know whether the website was informative and how usable it was.  We also wanted to know if it helped to improve knowledge of ADHD.

 

What did we do?

We recruited participants through community paediatric outpatient clinics and other services.

They were asked to:

  • Read a participant information sheet
  • Ask any questions about the study
  • Sign an informed consent form
  • Give us some information about themselves e.g. ethnicity, age, age of child/young person, diagnostic status of child/young person
  • Complete a true-false quiz/questionnaire
  • Access the website freely for one month as they wished
  • Complete the same true-false quiz/questionnaire after one month
  • Provided feedback on the frequency of use (if used) and opinions of the website e.g. what was good/needed improvement

 

What did we find?

Who participated?

172 participants were involved in the parents/carers part of the project.

We could not contact 14 people for the follow up quiz.

91 of the 172 participants accessed the website and provided feedback.

Most people accessed the website once or twice (33%) and those who did not access the website stated that they ‘lacked the time’ to do so.

 

The average age of participants was 41 years.  These people were parents or carers of children whose average age was 10 years.

 

76% of our participants were mothers of children with ADHD, 15% were fathers and the rest were ‘other’ e.g. grandparent, sister, aunt.

 

94% of our participants declared themselves as White-British.

 

Of the 172 participants, 40 (24%) had suspected ADHD, 21 (13%) were diagnosed less than 6 months ago and 107 (64%) had been diagnosed for 6 months or more.

 

How did people use the website?

41% of participants did not access the website at all.  59% accessed the website at least once.

 

Those people whose child had a confirmed diagnosis of ADHD were more likely to have accessed the website, as were parents of younger children.

 

Who used the website?

Most people (74%) used the website to browse for information.

 

How useful was the website?

86% of people found the website relevant and 91% said that they would use the website again.

 

When we tested participants knowledge of ADHD with the true-false quiz this showed that the website did help to increase knowledge of ADHD.

 

Most people were positive about the website and liked the downloadable files e.g. reward charts and also the real life story video.

 

Advised improvements included:

  • Age specific resources and information
  • Addition of a discussion forum or group
  • More detail of the science behind ADHD
  • Search function to search for specific themes or questions

 

Participants felt that they were happy to be directed to reliable educational websites by their healthcare professional.

 

How have we shared these findings?

  • Through a report to our funders and organisations involved in the project
  • Through an article in a journal (in process)
  • Through this summary

 

If you want to know more:

Contact the co-investigator Gemma Ryan on g.s.ryan@open.ac.uk

 

Acknowledgements

We would like to thank all of our participants.

Thank you for Shire AG International for providing the grant funding for this project.   Leicestershire Partnership NHS Trust acted as sponsor for this study and provided NHS approvals and research governance processes.

The Families, Young People and Children’s Services Research Team were essential to the success of this project; Gail Melvin, Lynne Hartwell, Tom Pringle, Ruth Beardsley, Julie Rybicki. The Principal Investigators acknowledge the support of the National Institute of Health Research Clinical Research Network (NIHR CRN).

Thank you to Sussex Community NHS Trust and Coventry & Warwickshire Partnership NHS Trust for their contribution and recruitment to this project.

 

Trial registration

Registered on National Institute for Health Research portfolio, United Kingdom Clinical Research Network ID 13980 http://public.ukcrn.org.uk/Search/StudyDetail.aspx?StudyID=13980

 

This project was completed in partnership with Leicestershire Partnership NHS Trust (sponsor & lead site) & University of Derby (Gemma Ryan)