Introduction
The rapid diffusion of social network sites such as Facebook have presented a wealth of challenge and opportunity for the nursing profession. A large majority of nurses have adopted Facebook but may not understand the implications and unintended consequences of the information shared in a personal or innocent way.
No research has yet critically analysed or explained [in depth] the underlying factors that influence and determine the relationships between professional accountability and social media. Or if there is actually a 'problem' with social media, and if there is how we can address it?
Aim
Explain the relationship between professionalism and online behaviours in social media, and produce a framework to guide decision making relating to e-professionalism.
Methods
Critical realist (CR) ethnography employing online observation of three online groups, 30 public profiles and professional group discussion topics, focus groups (academic and practising nursing staff n=8) and semi-structured interviews with student nurses over two geographical sites (n=16). CR retroductive analysis (developed as part of this project) was employed to identify: relationships, models, theories and framework(s) in the data. Theories were ‘tested’ using the models and consequently used to confirm the most likely explanations in response to the project aim.
Results
Three relationships were identified a) how we define professional accountability, b) how we use and behave on Facebook and c) how we determine what is professional and acceptable in the online environment. Six diagrammatic models were generated to explain [within the data] the interaction of different components (e.g. people, places, structures) and possible causal mechanisms of these relationships: 1) the concept of professional accountability 2) patterns of use 3) behaviours and activities 4) physical versus online reality 5) unacceptable, acceptable, professional or unprofessional behaviours 6) perceived knowledge and awareness versus actual behaviours. Three theories informed the development of the final, evidence based Awareness to Action (A2A) framework: socialisation & social capital, diffusion of innovations and experiential learning theory.
Conclusion
Lack of physical context and presence in the online environment causes dissonance between perceived and actual behaviours, and confidence versus competence in the online environment. Emotional, political and mass media triggers changes to behaviours and perceptions about what is deemed to be unprofessional. There are also inconsistencies in what professionals believe to be professional and acceptable, what action [if any] should be taken and in what circumstances.
The A2A tool enables professionals to make consistent and evidence based decisions about online behaviours