Social Media Use in Nursing Education

Social Media Use in Nursing
Education
Terri L. Schmitt, PhD, RN, FNP-BC
Susan S. Sims-Giddens, EdD, RN
Richard G. Booth, MScN, RN
Abstract
As

technological

advances

continue

to

expand

connectivity

and

communication, the number of patients and nurses engaging in social
media

increases.

Nurses

play

a

significant

role

in

identification,

interpretation, and transmission of knowledge and information within
healthcare. Social media is a platform that can assist nursing faculty in
helping students to gain greater understanding of and/or skills in
professional communication; health policy; patient privacy and ethics; and
writing competencies. Although there are barriers to integration of social
media within nursing education, there are quality resources available to
assist faculty to integrate social media as a viable pedagogical method.
This article discusses the background and significance of social media
tools as pedagogy, and provides a brief review of literature. To assist
nurse educators who may be using or considering social media tools, the
article offers selected examples of sound and pedagogically functional
use in course and program applications; consideration of privacy concerns
and advantages and disadvantages; and tips for success.
Citation: Schmitt, T., Sims-Giddens, S., Booth, R., (September 30, 2012)
"Social Media Use in Nursing Education" OJIN: The Online Journal of Issues
in Nursing Vol. 17, No. 3, Manuscript 2.
DOI: 10.3912/OJIN.Vol17No03Man02
Key words: Social media, nursing education, curriculum, informatics,
TIGER initiative

Social media is more than an emerging technology platform or
cultural trend, but a method of communication that is changing the way
individuals and organizations throughout the world transmit and receive
information. Social media is a platform that can assist nursing faculty to
help

students

gain

greater

understanding

of

communication,

professionalism, healthcare policy, and ethics. Merriam-Webster dictionary
(2012) defines social media as a “form of electronic communication (as
Web sites for social networking and microblogging) through which users
create

online

communities

to

share

information,

ideas,

personal

messages, and other content” (para. 1). Social media is more than an
emerging technology platform or cultural trend, but a method of
communication that is changing the way individuals and organizations
throughout the world transmit and receive information. The meaning and
value of social media continue to be debated among business leaders,
computer science scholars, educators, and users.
The key purpose of social media is engagement of others
through electronic means, most often supported through internet sites or
software. These are called social networking sites and involve people who
‘follow’ or are ‘friends’ with each other, meaning that people linked to a
person can see his or her information and updates. Within these sites
people also share their lists of followers and interact to exchange
information, knowledge, opinions, and other forms of communication
(Boyd & Ellison, 2007).

Technological advances continue to fuel the

development of social media as a mechanism for knowledge and
information exchange within local, national, and global communities.
...nurse educators are beginning to explore sound methods of
application of social media into nursing curricula.

Nurses serve as

significant

systems,

knowledge

brokers

within

healthcare

among

healthcare disciplines, and with patients, families, and communities
(Robert Wood Johnson Foundation [RWJF], 2010; Schmitt & Lilly, in press);

therefore, nurse educators are beginning to explore sound methods of
application of social media into nursing curricula. The rapid growth of
technology has kept nursing and other healthcare disciplines scrambling
to keep pace. In the United States, the Technology Informatics Guiding
Educational Reform (TIGER) competencies; TIGER educational initiative;
American Nurses Association (ANA) social media toolkit; and nursing
informatics toolkit developed by the National League for Nursing (NLN)
assist educators in developing nursing informatics courses that include
sound social media content such as blogging or engagement through a
medium such as Facebook® (ANA, 2011; Hebda & Calderone, 2010; The
TIGER Initiative, n.d.; NLN, n.d.). Similarly in Canada, the Registered
Nurses Association of Ontario (RNAO) (2012) recently released a faculty
eHealth toolkit to help educators to embed informatics content within
undergraduate education. Other resources both within and outside of
nursing continue to be developed to aid nursing faculty to prepare nursing
students for future demands (Center for Disease Control, 2011; Webicina,
2012).
Roughly 80% of both Americans and Canadians currently use the
Internet, and between 70 to 80% of these users seek health information
data through this medium (Pew Research Center, 2011; Statistics Canada,
2010, 2010b). Equally impressive, the number of healthcare facilities that
make use of social media grew 210% between 2009 and 2011 (Bennett,
2011). Of the millennial generation (those who will come to adulthood
during this millennium), 75% use some form of social media. This
generation views integration and use of technology into their lives as a
defining characteristic of their generation (Pew Research Center, 2010).
Social media is not only a means of sharing social information, but also
used to find employment; create a professional voice in topic areas or on
professional issues; project and research collaboration; and disseminate
and gather of professional information (RWJF, 2010; Schmitt & Lilly, in
press).
...risks of policy or privacy violation, time, cost, and lack of
familiarity with technology continue as barriers for nursing faculty in

adoption of new technology into curricula. In general, nurses are late
adopters

of

technology,

with

increasing

age

being

an

important

contributing factor to this delay (PRWeb, 2011). In 2012, the American
Association of Colleges of Nursing (AACN) noted that the average age of
nursing professors was over 60 years, associate professors over 57 years,
and assistant professors over 51 years. In addition, risks of policy or
privacy violation, time, cost, and lack of familiarity with technology
continue as barriers for nursing faculty in adoption of new technology into
curricula (National Council of State Boards of Nursing [NCSBN], 2011;
Schmitt & Lilly, 2012). Given the presence of social media into the lives of
so many North Americans and the barriers to adoption, the purpose of this
article is to review current applications of social media in nursing
education by providing examples of sound and pedagogically functional
use. Advantages and disadvantages of social media use will be discussed
as well as suggestions for curriculum integration and future research
potential.
Background and Significance

Changing Pedagogy
As technology is rapidly changing, so is pedagogy within nursing
education. Both the National League for Nursing Accrediting Commission
(NLNAC) and the AACN have revised curriculum standards, encouraging
nursing programs to incorporate not only nursing informatics, but
technology competencies as well (AACN, 2008; AACN, 2011; NLNAC,
2008). Similarly, the Canadian Association of Schools of Nursing (CASN)
and Canada Health Infoway (Infoway) are finalizing competencies for
undergraduate nursing education to ensure graduating nurses are
prepared to practice in technology-enabled clinical environments (CASN,
2011).
Social media offers mechanisms for collaboration, networking,
and learning not previously available to faculty or students. With the
Institute of Medicine’s critical report on the future of nursing, many nurses
will return to school for further education (IOM, 2011). Technology
becomes a medium through which educators can instruct and students

can learn. Through social media, students can learn outside of the
traditional

classroom,

creating

a

professional

voice,

expanding

technological abilities, and enhancing their ability to professionally and
clearly communicate despite barriers of time and distance. Social media
offers mechanisms for collaboration, networking, and learning not
previously available to faculty or students. Social networking sites such as
Twitter®, Facebook®, and LinkedIn®; blogs; and file sharing of scholarly
works through entities like Mendeley are the tools through which students
can learn and embrace these new opportunities.
Eighty-seven percent of students who attend a community
college or university own a laptop; 62% own an iPod; and 55% own a
smartphone, digital camera, or webcam (Dahlstrom, Grunwald,deBoor, &
Vockley, 2011). The primary tool used in academia is the laptop computer,
essential for word processing and accessing library websites and college
learning management systems. Students understand they have greater
access to resources through technology, and that technology assists them
to be successful and engages them in the learning process.
Student Populations
Like all classroom tools, social media as a pedagogy needs a
clear

purpose;

an

orientation;

technology

support;

a

timeframe

appropriate to the course; and flexibility on the part of faculty and
student.Current undergraduate and graduate nursing students are of
varied

backgrounds

and

age,

from

millennials

to

baby-boomers.

Millennials multi-task personal and academic interactions daily; 58%
check their Facebook® account 13 times per day; 11% of students post or
read a collective of 112 times per day (Dahlstrom, Grunwald, deBoor, &
Vockley, 2011). Although technologically savvy, many millennials lack
understanding of proper technology use for professional purposes.
Regardless, Dahlstrom et al. (2011) purport that students within the
Millennium generation will desire responsive and interactive faculty, and
potentially evaluate classes by the effectiveness and frequency of
meaningful technology integration. Many millennial and generation-X
students have lived with computers and the internet all of their lives, and

do not see it as an asset, but a mandatory part of their environment.
These students may feel they are more adept than faculty at using
technology and may not be impressed by faculty use (Oblinger, 2003).
Baby boomers are the fasting growing age group of persons
using social media tools, with over 51% using some form of social media
(Pew Research Center, 2011) and over 150% growth in use since 2009
(Brandon, 2011). The biggest factors for non-traditional student (often of
baby boomer age) withdrawal from education is family and home
demands and lack of supportive services (Enseman, Coxon, Anderson, &
Anae, 2006). Use of social media within the classroom can address some
of these barriers and be successful with this population.
In sum, social media is appropriate to a variety of student
populations. Like all classroom tools, social media as a pedagogy needs a
clear

purpose;

an

orientation;

technology

support;

a

timeframe

appropriate to the course; and flexibility on the part of faculty and
student.
Review of Literature

A number of nurse researchers and educators have published
accounts about the potential of social media. Examples of social media
reported within the nursing education literature have generally aligned
thematically into three categories: expository commentaries outlining
functionality or potential of social media; social media best practice
recommendations and discussions of privacy, legality, and ethics within
nursing education; and research studies exploring the efficacy or value of
social media modalities in education. Each of these perspectives will be
briefly explored.
Expository
Given

the

relative

newness

of

the

topic,

expository

commentaries outlining the functionality or potential of social media
appear frequently in nursing literature. Grassley and Bartoletti (2009)
discussed the use of blogs and wikis as part of nursing education,
encouraging the use of these tools to facilitate interactive learning and
engagement

with

learners.

Billings

(2009)

summarized

potential

functionalities of blogs and wikis in continuing nursing education, outlining
benefits within clinical settings to promote interprofessional collaboration,
facilitate peer support, and assist in project management.
Twitter® functionalities make it a versatile tool for continuing
nursing education... Twitter® and micro-blogging are highlighted as
innovative approaches to knowledge sharing and distribution (Bristol,
2010; Dreher, 2009; Skiba, 2007). Twitter® functionalities make it a
versatile tool for continuing nursing education, including the use of
hashtags within conference/workshop settings and as a framework to
organize class discussions (Bristol, 2010). Hashtags are words prefixed
with the “#” symbol that identify topics or groups within social media
sites (i.e., Twitter®). The more a hashtag is utilized and repeated by
others to denote a specific topic/event (e.g., #NI2012; #election2012),
the greater the level of ‘trending (visibility of a specific topic/event) can
occur (Hashtag, n.d.). For instance, the hashtag of #nc2010 was utilized
during a three day conference to assist in aggregating messages related
to the event, and build a conference-wide Twitter® discussion (Bristol,
2010). Twitter® used as a teaching tool was evaluated by Mistry (2011) in
asynchronous and synchronous class environments. Students were asked
to watch videos of clinical scenarios and then communicate via Tweeting
about the evolving patient condition. Student response was positive.
Tweeting allowed them to reflect, discuss, interact with classmates,
review, make decisions, and reinforce learning.
Facebook® and other social networking sites hold potential for
integration within education and research in safe and productive ways
(Amerson, 2011; Wink, 2011). Platforms such as podcasts and virtual
reality simulators (e.g., Second Life®) have also been discussed as
potential modalities from which to build further interactivity into education
and facilitate various learning styles (Ahern & Wink, 2010; Delaney,
Pennington, & Blankenship, 2010; Hansen, 2008; Maag, 2006; McCartney,
2006; Schmidt & Stewart, 2010; Skiba, 2005). For example, Schmidt and
Stewart (2010) used Second Life® in an online accelerated community
health nursing course to sensitize students to various public health issues.

Students were provided access to a developed Second Life® environment
in the form of a restaurant, and by using the virtual learning environment
were able to ‘inspect’ the premises for potential public health infractions.
Best Practices
A number of professional and regulatory bodies offer direction
through various documents related to appropriate use of social media
technology A number of recent publications focus on best practices and
legal/ethical considerations of social technology use. Fraser (2011)
outlined best practices related to social media usage by nurses (and
students), including various topics related to professionalism, knowledge
generation, and developing a functional online reputation. Haigh (2010)
presented a number of salient and relevant issues related to increased
use of social technologies within education, focusing upon topics such as
third-party material ownership and confidentiality/privacy online. A
number of professional and regulatory bodies offer direction through
various documents related to appropriate use of social media technology
(ANA, 2011; College of Nurses of Ontario, 2011; College of Registered
Nurses of British Columbia [CRNBC], 2012). The CRNBC (2012) have listed
nine recommendations for nurses who elect to use social media,
encompassing discussion of competence, image, confidentiality, privacy,
boundaries, expectations, integrity, policy, and accountability.
Research
Morley (2011) explored the use of wikis among 69 nursing
students, 45% of whom indicated that they perceived wikis to be valuable
for communication. Forbes and Hickey (2010) reported in a study of 170
nursing students, “students overwhelmingly perceived that podcasting
had a positive impact on their learning in the course (92.4%)” (p. 226).
Contrary to concerns that providing podcasts of lecture material would
decrease class attendance, only 11 students (15%) reported they had
opted to not attend class (at least once) because of the availability of the
podcast. A survey of 644 first-year and 413 graduating health science and
nursing students found that Facebook® was used by 77% of students,
18% used LinkedIn®, and only 7% used Twitter® (Giordano & Giordano,

2011). The results of the study demonstrated that many health
professional students currently utilize social media platforms during their
education, and this mode of communication may provide a “unique
opportunity in social networking…for universities if they are willing to
think creatively” (p. 80).
Examples of Social Media Use in Nursing Education

Blogging, Twitter®, Facebook®, and LinkedIn® are common and
logical places to begin social media integration into nursing curriculum.
The NLN highlights three core content areas for nursing informatics
courses: computer literacy, information literacy, and informatics (NLN,
n.d.). Other key areas of curricular emphasis through the use of social
media include professional communication; health policy; patient privacy
and ethics; and writing competencies. Several varied examples of social
media in nursing curricula follow to illustrate some typical applications.
Table 1 provides additional information about selected social media
software appropriate for educational use.

Table 1: Social Media Software for Classroom
Social media tool options are rapidly expanding. This table is not meant to
be inclusive, but is a review of sites discussed in this article for purposes of
nursing education.
PRESENTATION SOFTWARE
Prezi®
http://prezi.com

BRIEF DESCRIPTION
Free concept map type
software

can

be

used

of
for

presentations, mind mapping,
and

collaboration

on

SlideRocket®

assignments.*
Free presentation software that

www.sliderocket.com/

allows

for

creation

of

presentations kept and stored
on

the

internet,

freeing

up

storage space and expanding
availability. Upgraded version

has

greater

including

capabilities,

sound

recording,

SlideShare®

polls, and statistics tracking.*
SlideShare offers the ability to

www.slideshare.net/

upload two free presentations
to share over distance with
others and search capabilities
for other presentations based

Vimeo®

on topics or presenter.*
Similar
to
YouTube®

http://vimeo.com/

software allows the user to

this

create an account and upload
video presentations. There are
Voki®

free versions available.
Free site that allows

www.voki.com/

creation of simple voice-over

for

videos to cartoon animation.
Can

be

used

introductions

in

for

audio

an

online

course; creation of scenarios
and role-play by students; and
expansion

of

technology

knowledge and creativity.
SOCIAL NETWORKING SITES
Google Plus®

Social media tool. Can be used

https://plus.google.com/

to create specific groups for
collaboration

and

communication.

distanced
Google

Hangouts® is a feature within
Google Plus® that allows for
video chat with more than two
LinkedIn®

people.
Free
professional

www.linkedin.com/

which allows users to display
their

professional

network,
profile,

resume, curriculum vita, and
other

qualities

among

networked clients across the
world.

Groups,

discussion

boards, and messaging options
available.

Several

nursing

Twitter®

groups available. *
Free microblogging site used to

https://twitter.com/

connect in real time through
chats, or searched for current
topic trends and information

Twitter® management software

regarding health care.*
Free software to assist

in

Twitter® management. Current
topics

or

trends

can

be

searched and specific hashtags
followed.*
Hootsuite

–

http://hootsuite.com/
Tweetdeck

-

www.tweetdeck.com/
SITES FOR E-PORTFOLIO CREATION
Google Googlios®

Free site offers the ability to

https://sites.google.com/site/googlioproj

create a webpage or e-portfolio

ect/

and a variety of settings for
privacy of sharing developed

Wordpress®

content.
Free blogging site can be set up

http://wordpress.com

for public writing assignments,
e-portfolios,

and

blogging.

Pages can also be passwordprotected through publication
settings.
LITERATURE MANAGEMENT
SOFTWARE

Mendeley®

Free software assists users in

www.mendeley.com/

organizing reference material.
Download
search

the
the

software
website

or
for

academic research, literature,
and

collaboration.

downloaded
indexes,

software

scans,

and

The
also
sorts

documents.*
*(Schmitt & Lilly, 2012)
Informatics Courses
The design of one undergraduate informatics course incorporated the
three NLN nursing informatics core areas by using social media. To that
end, students in this course were required to:
1.

submit no paperwork in a Microsoft Word® document or physical
paper format

2.

create a blog in which they wrote professionally on certain topics;
create a sound webliography on a healthcare topic; and keep a
course journal

3.

create a Twitter® account with a specified number of legitimate
healthcare and nursing followers; a specific number of substantial
interactions with others; and attendance and participation in at least
one online nursing or healthcare chat within this platform

4.

use and explore other social media and Web 2.0 tools (e.g.,
SlideShare®, Slide Rocket®, Glogster®, Prezi®) to engage in
collaboration on group projects and presentations. (Schmitt and Lilly,
2011)
The purpose of using social media tools to facilitate such

integration was to emphasize professional communication; better improve
student comprehension and use of technology beyond electronic medical
records (EMR) and personal computer word processing programs; and
enhance student networking and collaboration with other nurses globally.

Prior to engaging in these social media platforms all students
completed Health Insurance Portability and Accountability Act (HIPAA)
educational training and required reading in regard to privacy, ethics, and
professional communication. Students wrote about and presented through
these mediums on course content issues including nursing informatics,
meaningful use, the IOM report on the future of nursing, evaluation of
electronic health record systems, privacy, security, and patient use of the
Internet and technology as a health resource. This particular class was
further

revised

during

the

2011-2012

academic

year

by

nurse

informaticist Kezia Lilly to include student creation of electronic portfolios,
podcasts, Vokis®, multimedia presentations, and LinkedIn® profiles to
assist students with networking and applying for further education or
future employment. The following descriptions of e-portfolio, Twitter®,
and Wikipedia® assignments provide more specific details about how the
undergraduate and/or graduate level informatics courses incorporated
social media tools.
students are encouraged to provide a contact e-mail for
prospective viewers who may have interest in their work.
E-portfolios. One assignment often used to assist students in
professional communication and networking is the e-portfolio, which is
assigned to undergraduates in the informatics course and carried through
to their capstone course in the RN-to-BSN program. Students are
instructed on how to create an e-portfolio through Google, also known as a
Googlio®. A tutorial for beginning Googlio accounts is provided (Googlios,
n.d.) and several articles on e-portfolio reading are provided. Students are
instructed to load specific assignments; a professional resume and photo;
mission statement; and any other professional items that display
involvement, community work, and knowledge. Private information is
excluded, but students are encouraged to provide a contact e-mail for
prospective viewers who may have interest in their work. Students add to
this e-portfolio (e.g., major assignments, attendance at conferences)
throughout each course. Students are free to explore other mediums for
creation of their e-portfolio, such as Wordpress® and Blogger®. In our

experience, the creation of e-portfolios through Google® has been
particularly helpful and has allowed students to track evidence of their
RN-to-BSN program learning in one centralized area. The e-portfolios are
used by students after program completion as a way to easily display
professional nursing and specialty knowledge to employers.
Twitter®. Another required activity in the undergraduate
informatics course helps students to better understand why people
engage in social media; how people seek health information there; and
how social media can be used as a networking and information gathering
tool. Undergraduate students participate in a “Twitter®” assignment and
are required to do the following:


create a Twitter® account at the beginning of the course



learn how to use a secondary platform to manage the Twitter®
account such as Tweetdeck® or Hootsuite®



begin following at least 60 legitimate nursing and health care
Twitter® resources



have 40 legitimate followers in nursing and health care to their
account by the end of the course



engage in a set number of substantial of microblog updates which
must be related to current information in healthcare but follow all
privacy guidelines



demonstrate the use and understanding of hashtags



engage in at least one health care related ‘chat’ during the duration
of the course.
Assignments are graded based on a rubric and each student

shares their account with faculty and others in the course. Faculty also use
the course number as a hashtag and hold weekly class “chats” to discuss
current topics in nursing and course information or issues.
...students either generated a new article for Wikipedia® or
updated an existing article into a scholarly, lay-language, encyclopedia
entry. Wikipedia®. An activity within graduate informatics courses
required students to write Wikipedia® articles on topics related to health

and/or informatics (Booth, Stern, & Tkac, 2012). Students were requested
to search Wikipedia® for articles or subjects that were either poorly
written or missing from the encyclopedia. Working in small groups,
students presented and verbally defended the importance of their
proposed

Wikipedia®

topic/article

to

the

course

instructor.

Upon

ratification by the instructor, students either generated a new article for
Wikipedia® or updated an existing article into a scholarly, lay-language,
encyclopedia entry. Very quickly, a number of students found their
additions challenged by Wikipedia® editors or modified by other users of
Wikipedia®, teaching them the importance of accuracy and the peer
review process. In one case, students had to defend and justify the
uniqueness of their article, as it had been flagged for merger with another
topic of similar underpinning. The Wikipedia® criteria for a good article
[Available:
were

http://en.wikipedia.org/wiki/Wikipedia:Good_article_criteria]

operationalized

into

a

rubric

for

the

students,

and

their

updates/revisions were graded accordingly. ...students demonstrated
comprehension of privacy, health care policy issues, ethics, and an
improvement in both professional writing and engagement.

Overall,

students commented that they were impressed with the rapidity with
which information was shared, critiqued, and modified on Wikipedia®.
Similarly, most students reflected that they felt attached to their newly
revised or created articles, leading a few to state they planned to follow
and update their pages beyond the duration of the course.
Through these activities, students demonstrated comprehension
of privacy, health care policy issues, ethics, and an improvement in both
professional

writing

and

engagement.

Integration

of

technology

throughout this course helped students demonstrate attainment of TIGER
competencies along with achieving better understanding of computer
science, library science, information management, and professional
conduct in online environments. Qualitative and quantitative responses
from students in course evaluations showed initial trepidation but ended
with enthusiasm for the many new skills and understandings they had
gained.

Graduate Nurse Educator Programs
To actively engage and prepare graduate nurse educator
students, we developed a graduate course, Technology for Healthcare
Education (Sims-Giddens, 2011). This course prepares future faculty to
assess the variety of generations and learning styles in classrooms and to
go beyond PowerPoint presentations. By exploring strategies to utilize
technology and digitally enhance course content, nurse educator graduate
students learn the significance and process of incorporating social media
(e.g., class social media sites), YouTube productions, and podcasts.
Graduate

students

are

encouraged

to

pilot

social

media

strategies in practicum courses. One graduate student incorporated a
private blog in place of a reflective journal so undergraduate nursing
students could share successful clinical experiences or procedures with
peers, as well as express any frustrations encountered. Another student
incorporated a class wiki for undergraduates to complete a group
assignment, providing them opportunity to learn the importance of
teamwork and group dynamics.
Before learning to use technology for a classroom application,
many graduate students used Facebook® to connect with friends and
family but had not explored other social networking sites nor considered
use of social media in graduate education. Brainstorming sessions allowed
students to identify new applications to actively engage undergraduates
in the classroom. Students became excited thinking of faculty research
and collaborative opportunities within and across nursing programs, as
well as across colleges and universities.
Using Social Media beyond Informatics Courses
A different approach was to embed the use of social media
technologies alongside traditional teaching methods in a senior-level
nursing theory course. The author screen-recorded and narrated animated
Prezi® slideshows of both clinical and professional situations. The videos
were then subsequently uploaded to the author’s personal Vimeo®
account

and

the

link

shared

through

the

university’s

learning

management system. Discussion of the video narrative and preparatory

readings for the class were completed online and further extended during
the face-to-face element of the class. Overall, students found the teaching
approach to be engaging. This approach allowed for a more complex
situation to be presented, given the audiovisual nature of the case
scenarios.
Another collaborative application was piloted between nursing
programs in America, Finland, and the Philippines. Faculty established a
private wiki and students in community health classes were invited to
participate

in

a

global

health

perspectives

assignment.

Students

introduced themselves by creating personal, narrated Power Point
presentations; wrote and shared essays about health promotion and
prevention and the relationship between health and the environment; and
developed Power Point presentations about health care delivery systems
and community health services in their countries. This exchange
encountered challenges, such as faculty time to develop the collaborative
group and how best to include and evaluate the assignments for a
particular course. The logistics of university calendars and time zone
delays presented scheduling problems. Benefits of the collaborative
assignment included student exposure to international cultures and health
care delivery systems, and trying new technology (Finnish students
narrated using Power Point for the first time). Student comments from this
exchange were very positive and encouraged faculty to continue the
collaborative effort. Faculty learned about educational and curricular
differences, and negotiated assignments and evaluation so the learning
experience would benefit students. This virtual collaborative was an
exciting adventure, one that will be discussed, refined, and repeated.
Considerations for Use of Social Media in Education

Teaching Privacy
The use of social media in the classroom assists in conveying
professional communication standards. Prior to use, students should
complete HIPAA education and be required to read the ANA Social
Networking Principles Toolkit (ANA, 2011). Students should also be
instructed to intentionally consider the following:



everything typed may be publicly accessed



who is the audience and who can see each posting



whether postings will add to or detract from the profession of
nursing and their professional reputation



the need to establish professional boundaries even between friends
and family



at all times to keep patient information private including their
assigned work unit and minor information (e.g., patient census or
their shift)



the need to keep privacy settings reviewed and updated

(Schmitt & Lilly, 2012). With careful use and preparation, social media
tools can provide exciting new strategies for students and teachers.
Advantages and Disadvantages
As illustrated in the examples above, social media venues offer
connectivity and a mechanism for teaching technology, communication
management,

information

management,

privacy,

ethics,

and

professionalism. Considering the following advantages and disadvantages
can be helpful to determine if, or how, social media tools might enhance
in a given nursing course or program.
Advantages:


New innovations in technology offer alternate mechanisms to
engage students with a variety of learning styles and help them
succeed.



Online learning options continue to increase with over 6.1 million
U.S. college students currently taking some form of online course
work (Allen & Seaman, 2011). Social media offers a way to
overcome boundaries of distance and constraints of synchronous
classrooms, offering a tangible option for interacting with distance
students.



Incorporating

social

media

into

the

curriculum

may

foster

excitement and learning by faculty, management of information in a

way that can be recorded and researched, and creative group
project work (Sakraida, Spotanski, & Skiba, 2010).
Disadvantages/Barriers:


Nursing programs may not be providing enough technological
training to adequately meet student needs, desires, or the TIGER
competencies (McDowell & Xiping, 2007).



Barriers may restrict the use of or enthusiasm for incorporating
social media tools. Examples of barriers include lack of knowledge in
technology use; fear; cost; time; the rapid nature of technology
change;

multiple

demands

and

outside

distractions;

an

unwillingness by faculty or students to engage in social media use;
restrictive organizational policies; and reprimand or ostracism for
misuse or mistakes within social media (Schmitt & Lilly, in press).


Social media use poses a real risk to patient and student privacy,
with a larger reach and documentable evidence (NCSBN, 2011).
However, many infractions are not intentional and could be
overcome with clear education for both students and faculty prior to
use, creating practice environments where mistakes can safely be
made just as is done in physical clinical environments, and faculty
development of know-how and education mechanisms for sound use
of social media.

Tips for Social Media Use within Nursing Curricula

Know the institution and/or department social media policy. Several sound
resources exist to assist faculty in the use of social media (see Table 2). All
nursing faculty are encouraged to thoroughly examine these resources
when contemplating use of social media tools. Faculty engaging in online
education might also benefit from the yearly statistical report of the Sloan
Consortium
[Available: http://sloanconsortium.org/publications/survey/going_distance_
2011] about online learning within the United States. Other tips for
success include:


Know the institution and/or department social media policy. If a
social media policy does not exist, strongly consider developing one

through examination of published guidelines (e.g., ANA, NCSBN)
and/or other institutions.


Know the educational background of students entering a course.
Have students had a basic computer science course? Have they
had a program introduction course where policies or HIPAA
education occurs or does this need included? Ensure that students
have adequate opportunity for learning about privacy, policy, ethics,
and safety prior to introducing social media projects.



Choose no more than one or two types of social media to begin,
then expand into other areas once those areas are understood and
mastered by faculty and students.



Seek assistance from the university librarians, computer support
services, and other technology-savvy faculty.



Negotiate within faculty contracts or teaching loads to provide time
and/or compensation for making these changes in courses and the
curriculum.



Keep course outcomes, program outcomes, and accrediting body
standards as a priority and begin a project to meet specific
outcomes and standards.



Investigate systematic approaches and theoretical frameworks for
technology integration in curriculum.



Know your audience. Evaluate your student population’s perception
and attitude about technology, and their knowledge, preference,
and abilities. Be prepared to create tutorials or provide assistance in
areas where students may need more knowledge. Do not make
assumptions

about

a

group’s

technology

skills

based

on

a

demographic (e.g. being a millennial).


Pilot test your project with a small group of co-faculty or students
prior to implementation.



Be creative, have fun, think outside the box, and help students
connect with reputable organizations and nurses.



Allow students time to grow. Encourage netiquette (respectful online
behaviors) and forgiveness of others’ mistakes. Caution students to
not post when angry.



Provide students with privacy settings checklists for various
platforms.

Finally, provide examples of both incorrect and correct use of social
media, and encourage students to begin to think, discuss, and define what
professional communication in a healthcare context means in social media
platforms.
Table 2: Important Social Media and Technology Resources for
Nurse Educators
ANA’s
Social
Networking
Principles
Toolkit
www.nursingworld.org/socialnetworkingtoolkit
Canadian Association of Schools of Nursing’s publication on educating
for effective clinical use of information and communication www.casn.ca/en/Whats_new_at_CASN_108/items/104.html
CDC’s
Health
Communicator’s
Social
Media
Toolkit
www.cdc.gov/socialmedia/Tools/guidelines/pdf/SocialMediaToolkit_BM.p
df
The Chronicle of Higher Education: Various online resources and
articles about online learning and technology integration http://chronicle.com/section/Home/5
College of Registered Nurses of British Columbia statement on social
media
https://www.crnbc.ca/Standards/Confidentiality/Pages/SocialMedia.aspx
Pew Research Center American Life Project, Pew Internet: Health http://pewinternet.org/Commentary/2011/November/Pew-InternetHealth.aspx
Registered Nurses’ Association of Ontario Faculty eHealth Resource for
the Integration of eHealth into Undergraduate Nursing Curricula.
http://rnao.ca/ehealth/facultyresource
The Sloan Consortium: An organization focused on online educational
excellence - http://sloanconsortium.org/
The
Tiger
Initiative
Informatics
Agenda
http://tigersummit.com/Education_New.html
The Tiger Initiative Informatics competencies for every practicing nurse
- http://tigersummit.com/Competencies_New_B949.html
Conclusion

As future applications of technology in nursing education continue to
expand, nurse educators must become early adopters and disseminators
of the feasibility, acceptability, and outcomes of technology integration.

One area of need is a larger body of sound research on student outcomes
and abilities with technology integration and social media use within
nursing curriculum. Social media is a viable option for conducting nursing
education and practice research, data gathering, or interventions (Bate &
Cannon, 2011; Crilly, Keefe, & Volpe, 2011; Galer-Uti, 2010).
As

nurse

educators

prepare

student

nurses

to

safely

administer

medications or perform health assessments, so must educators play an
active role in teaching students to engage in safe and professional
communication within a globally connected society. Social media offers a
mechanism for enhancing the education and expanding the knowledge
base

of

students

in

regard

to

privacy,

ethics,

health

policy,

professionalism, and communication. It may also assist nurses in building
an earlier professional identity and connection with the profession.
Barriers in the use of social media in nursing curricula continue to be
related to possible breaches in patient information and unprofessional
conduct by nursing students. These risks exist for professional nurses no
matter the medium of communication. As nurse educators prepare
student nurses to safely administer medications or perform health
assessments, so must educators play an active role in teaching students
to engage in safe and professional communication within a globally
connected society. Active engagement in social media may help nurses
identify false information; provide new sources of accurate information;
encourage preventive care; participate in discussions about how to
improve the future of the profession; find answers to key issues in nursing;
engage in interdisciplinary learning; and begin to disarm environments of
lateral violence by finding peers and platforms for positive influence. With
a

clear

purpose;

some

caution

and

education;

support

from

administration; resolution of barriers; and an idea of available platforms
that will meet outcomes, nurse educators can successfully integrate social
media into nursing curricula.
Authors
Terri L. Schmitt, PhD, RN, FNP-BC
E-mail: [email protected]

Dr. Terri Schmitt is an Assistant Professor in the Christine E. Lynn College
of Nursing at Florida Atlantic University. She has previously worked with
Southwest Baptist University and Chamberlain College of Nursing. She
received her diploma degree in nursing from St. John’s College of Nursing,
BSN from Missouri State University, MSN with an emphasis as a Family
Nurse Practitioner from Missouri State University, and her PhD in nursing
science from the University of Missouri, Kansas City. She runs the blog
nursestory.com and has previously facilitated online nursing discussions
through Twitter. Her research interests include adolescent female health,
body image, type I diabetes, social media, and student learning.
Susan S. Sims-Giddens, EdD, RN
E-mail: [email protected]
Dr. Sims-Giddens is an Associate Professor in the Department of Nursing,
Missouri State University. She received her BSN from West Texas A&M,
Canyon, Texas; MSN from the University of Texas El Paso, El Paso, Texas;
MEd in Bilingual Multicultural Education from Northern Arizona University,
Flagstaff, Arizona; and EdD in Educational Leadership from Northern
Arizona

University,

technology

in

Flagstaff,

healthcare

Arizona.

education;

Research
academic

interests

include

achievement

and

educational access for at-risk students; community engagement of
nursing students through service learning; student peer-mentoring;
nurses’ and nursing students’ attitudes and beliefs about poverty;
vulnerable population access to healthcare, Dr. Sims-Giddens teaches in
undergraduate generic BSN and BSN-Completion programs; a MSN Nurse
Educator program; and is the Program Director for the BSN-Completion
and Nurse Educator Programs.
Richard G. Booth, MScN, RN
E-mail: [email protected]
Richard Booth is a doctoral candidate and lecturer at Western University
(London, Canada), studying clinician learning and adoption of health
technology. He works clinically as a psychiatric-mental health nurse in the
adult psychosis program at St. Joseph’s Health Care London. Currently, he
teaches in the undergraduate program at the Arthur Labatt Family School

of Nursing at Western University, and holds an adjunct professor position
at the Institute of Health Policy, Management & Evaluation, University of
Toronto. His current research interests include nursing education, social
media, health informatics, and socio-technical perspectives.

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