Online social networks and the pre-registration student nurse: a focus on professional accountability




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De Montfort University


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Peer reviewed


Background & rationale: 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 student nurses have adopted Facebook but [as developing professionals] 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 explain how we can address it. Aim: Explain the context and relationships between professional accountability and Facebook for the pre-registration student nurse during their journey of professional socialisation. Methods: Critical realist ethnography employing focus groups (academic and practicing nursing staff n=8), semi-structured interviews with student nurses over two geographical sites (n=16) supported by online observation of three cohort groups, 30 public profiles and professional group discussion topics. Results: Six overarching models were explored, 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 and, 6) perceived knowledge and awareness versus actual behaviours. To explain the relationship between the pre-registration student nurse, Facebook and accountability three frameworks were developed. The first, Socialisation-Professional socialisation-Online socialisation (SPO) explains the journey of socialisation and the relationship between the online and physical world. Unacceptable-Acceptable-Professional-Unprofessional (UAPU) explains the complex nature of Facebook behaviours and how individuals understand the difference between the concept of unprofessional and simply unacceptable. The final framework ‘Awareness to Action’ takes the principles from the previous two frameworks and outlines a proactive tool to raise awareness of online profiles and, a reactive tool using ‘the 3Cs’ (clarity, context & confirmability) to make [professional] decisions about behaviours and incidents in the online environment. Conclusion: The relationships between the accountability, Facebook and the pre-registration student nurse are individual, complex and evolving (ICE). The very nature of socialisation means that this is based on individual background, experiences and values. Society and OSNs are complex environments which are changeable and, them and our relationship with them is continuously evolving. A2A and its ‘3Cs’ provides an assessment of self-efficacy, risk and decision-making tool to proactively [for nursing students] and reactively [for educators, employers and professional groups] manage self-awareness and behaviours in the online environment.





Research Institute