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Using social media for continuous professional
Healthcare practice pertaining to nursing is constantly
changing as a result of new knowledge, research, government policies and regulatory code of practice; therefore, it
is vital that nurses maintain currency with practice guidelines, research and skills. Social media is relatively new and
its full potential in terms of educational benefits is yet to be
realised. In this editorial we discuss how Twitter and other
forms of social media can be used for continuous professional development (CPD) in the nursing profession and
explore the different ways that nurses can use Twitter to
keep up to date with practice.
Twitter is an online social networking service that allows
users to send a message known as a tweet using 140 characters to each other or their followers i.e. those in a person’s
network. Unlike Facebook, Twitter has no privacy settings
and tweets can be seen by anyone, but you have to be an
account holder to be able to reply to a tweet signing up for a
Twitter account is free. A review of people on Twitter shows
that there are a growing number of health professionals
using Twitter for professional conversation and pass along
value. In 2010, it was estimated that there were 19,100
nurses on Twitter (Baumann 2010), in 2014, there were,
3800 health communities, 6 6 Million Healthcare Twitter
Profiles and 10,000 Provider Profiles (MD, RN etc.) (Symplur 2014). Moorley & Chinn 2014, examined creating an
online nursing community using Twitter hashtags, they highlighted that the nurses who used and belonged to their nursing community (@WeNurses) reported benefits such as
feeling part of a wider community and shared identity, gaining support in an online world, sharing of information,
ideas, debate and challenges.
Understanding CPD & PREP
One way to maintain up to date practice and knowledge is
through continuous professional development. Continuous
professional development is an activity that can use both
formal and informal approaches that lead to gain in professional knowledge, skills attitudes and behaviour (Heron
© 2014 John Wiley & Sons Ltd
& Hammond 2001). In the UK the body that governs and
regulates Nurses and Midwives is the Nursing and Midwifery Council (NMC). In view of revalidation of nursing
and midwifery registration, the NMC has produced a set
of guidelines for post registration education and practice
(Prep). There are two types of Prep: (i) the Prep (practice)
standard; and (ii) the Prep (continuing professional development) standard. The practice standard states that an
individual must have worked as a nurse or midwife during
the previous 3 years for a minimum of 450 hours, or have
successfully undertaken an approved return to practice
course within the last 3 years. The continuous practice
development standard, states that nurses or midwives must
have undertaken and recorded continuing professional
development (CPD) over the 3 years prior to the renewal
of their registration. All nurses and midwives have been
required to comply with this standard since April 1995.
Since April 2000, all nurses and midwives must declare on
their notification of practice (NoP) form that they have
met this requirement when renewing their registration
(NMC 2011). The Prep handbook produced by the NMC
states that Prep can help to provide a high standard of
practice and care, assist practitioners to keep up to date
with new developments in practice; create an area for
thinking and reflecting for yourself and by doing all of
these demonstrate that you are keeping up to date and
developing your practice.
Continuous professional development may use formal
approaches to learning such as training sessions, classroom
events (e.g. lectures) or education workshops. Informal
learning may take the form of face to face conversations
with colleagues or verbal feedback on actions or performance. As a result of the World Wide Web these
approaches to knowledge sharing and transmission can
extend to online environments. One such environment is
social media using the platform Twitter. Twitter can be
used as a learning resource; there are metrics that show
healthcare conversations on Twitter. Symplur a provider of
Health Care Social Media Analytics revealed there were
410 Million Healthcare Tweets. Some of these tweets were
linked directly to discussions, conferences or learning
resources pertaining to health. The Prep handbook (2011
pg8) states ‘The learning activity which you undertake to
meet this standard must be relevant to your practice. However, there is no such thing as approved Prep (CPD) learning activity.’
Some of the communities that are listed online that hold
healthcare discussions include WeNurses, Evidence Based
Nursing Journal Chat, WeMidwives, PDN hour (Postal
Natal Depression) Nursing Times and the Royal College of
Nursing. These communities hold structured discussions on
predefined topics which are often published on their webpage. The discussions have an aim and are structured in
such a way that they share knowledge and information on
practice or policy relevant to each community. This may be
seen as a learning activity and therefore in our opinion can
contribute to Prep CPD.
WeNurses an example of Twitter discussions as
Prep CPD
WeNurses is a nursing community on Twitter which was
launched in July 2012 and currently has over 18,000 followers mainly nurses or those associated with nursing or
health care. On Twitter their discussions can be located by
using #WeNurses. The symbol # is used to bind the conversations that take place so all those involved can see what is
being said the symbol also makes it easy to organise and
find information. WeNurses hold weekly pre-determined
chats that are suggested by their followers. WeNurses is
one community that nurses can use for continuous professional development, their chats are archived on their webpage and they also use Facebook as an additional platform
with information pertaining to health and nursing. They
also attend national and international conferences and provide information that nurses can use to further research and
develop practice. WeNurses uses authors of nursing texts
and engages organisations such as the Nursing and Midwifery Council in discussions; this gives authenticity to the
events that can be used as CPD/Prep. WeNurses reminds
their followers about responsible use of social media for
nurses and midwives and directs them to where they can
find such information on their webpage. This community is
one example that nurses can use to demonstrate as part of
continuous professional development, as they provide relevant activities that can enhance nursing practice and knowledge for personal and professional development. In the flow
chart below are some steps that can be followed to use
social media for CPD.
When using Twitter for Prep it is important to ensure
that the discussion is relevant to your practice once this has
been confirmed there are a few steps that can be taken to
enhance the learning opportunity. The individual should
clearly document the time used on learning:
Be prepared to share and learn, it is most likely you
are joining in a discussion because it relates to your
particular nursing interest. Most discussions would
have a brief on the topic; this may be in the form of a
blog or a short piece on the discussion aims and objectives, some hosts may ask you to look at a video or listen to a podcast before the discussion. It is worth
visiting the webpage for joining instructions; there may
also be other information here such as archived chats it
is advisable to look through these as they may provide
further opportunity for learning. Tip Ensure you document the content, the relevance and the time you have
spent researching.
During the discussion, you can either get involved by
contributing to the discussion or just watch and listen
to what others say. It is worth favourite – ing (a Twitter action that saves a particular tweet in a “Favourite”
stream so you are able to refer to it at a later date)
some of the tweets that resonate with you to refer to
later. Tip Take a note on comments and people that
got you thinking, making notes is good as some online
content may move or disappear quite quickly.
After the discussion, you will find that some hosts may
create a transcript that will allow you to go over what
was said at your own pace, this is a good time to
reflect on what you may have missed as an online discussion can become quite busy and you may have
missed some parts of the chat. Tip By reviewing the
discussion, you may identify nurses that you think you
would like to continue the discussion with or maybe
you share similar or different views, both are reasons
to follow each other on Twitter.
It is clearly stated in the NMC PREP handbook that
you need to document your learning “You must document, in your profile, your relevant learning activity
and the way in which it has informed and influenced
your practice. Although there is no approved format
for the profile and you can meet the Prep (CPD) standard in many different ways” p8. It’s a good idea to
write your own summary of the discussion to facilitate
reflection on what you have learnt. Tip You may want
to blog or video blog about you reflection or simply
add it to your portfolio.
Some points to consider in your reflection
Why did you think this discussion would be relevant to
you, what did you hope to gain by participating?
© 2014 John Wiley & Sons Ltd
Finally, include why you found the discussion valuable
and relevant to your practice.
If you take this approach, the time spent reviewing the
discussion may be more than the original length of the discussion. This approach will help you to explore and document all the value you gained from being part of the
Twitter discussion.
You don’t have to take part in live Twitter discussions to
use them for CPD as most Twitter discussions provide transcripts after the event for people who have missed it.
Archived discussions are a great resource and can be used
in the almost the same way as live discussions, the only difference being that you would be unable to add your own
comments to the debate.
Other forms of social media and Prep
Twitter discussions are valuable; however, it is important to
understand that Twitter is not the only form of social media
that could be used for CPD. Platforms such as Facebook,
YouTube, and blogs can also provide learning opportunities.
Many nurses use Facebook to connect and to share information and discuss ideas pertaining to health and nursing. A
good example of this is Learning Disability Nurse Facebook
page which is a vibrant community of Learning Disability
Nurses who share a plethora of information about their speciality. As with Twitter the discussions that take place in forums like these are valuable learning activities which can be
documented and reflected upon. Facebook unlike Twitter
may operate a closed group and you may have to be a member before being able to view any information published.
What twists and turns did the discussion take, how did
opinions from different participants vary?
Try to summarise the discussion in your own words or
provide a link to the official transcript and summary.
Note any ideas you found interesting that you would
use to discuss with colleagues later, or evaluate the
way you perform a specific nursing task.
© 2014 John Wiley & Sons Ltd
There are 100 hours of YouTube videos being uploaded
every minute (YouTube 2014
press/en-GB/statistics.html) the use of videos to aid CPD is
becoming increasingly easier. TedMed is an excellent
example of the use of videos for learning. It is also worthwhile exploring more low-tech examples for example
wound care specialist Julie Vuolo (YouTube name julieherts) has produced a very informative series of videos
around wound care. In this way, nurses using videos for
Prep can produce a critical appraisal of the videos and
techniques learnt and how applicable it is to their area of
Blogs are open access personal web pages on which an individual records opinions, thoughts, ideas and reflections and
then shares this with an audience. Blogs are not peer
reviewed, therefore, caution must be applied. However,
blogs do encourage open and transparent discussion and
debate through the comments section, and can be seen as a
form of peer review. Blogs can be used to gain different
insights from a variety of perspectives including the patient
perspective, the student nurse/mentor relationship and
learning can take place and reflected upon.
Revalidation will come into effect from December 2015
when it becomes the process where a nurse or midwife in
the UK demonstrate that they remain fit to practice at point
of registration renewal with the Nursing and Midwifery
Council. Part of the demonstration would involve meeting
the requirements of Prep and confirmation from a third
party. Confirmation from a third party involves someone
that is suitably placed to comment on the nurse or midwife’s practice based on the Code. There is a revised code
of practice, which is currently undergoing consultation;
there are 115 points to consider which fall under various
At point of revalidation, the nurse or midwife will need
to demonstrate that they:
Spontaneous twitter discussion
Not all Twitter discussions are scheduled. Sometimes a
professional conversation takes place in a spontaneous and
unorganized way and learning can take place as a result
of this. Capturing these discussions as proof of CPD can
be problematic but there are web tools available to assist
with this. Storify is an online tool that allows a user to
capture a conversation via a transcript and even allows
the user to make comments that link the conversation in
between Tweets. This helps to create a “story” type record
of the discussion. However, the use of Storify requires
some skills a low-tech alternative may be to simply take a
screen shot of the twitter discussion and use this as proof
of CPD.
Using blogs for reflection
Blogs have a reflective component, which means that not
only can the knowledge and information in them be used
for CPD but also a blog can act as a personal log of CPD.
Blogs pages are extremely versatile and free and easy to set
up. Blogger and WordPress are examples of two very popular blog sites. Blogging can be used as a tool to help
develop your nursing skills through reflecting and gaining
feedback from those that engage with your blog. Nurses are
encouraged to reflect on their practice and how it has an
impact on themselves and others therefore an advantage of
blogging is that it helps the individual to develop reflective
practice and structured thinking becoming more analytical
of the situations that surrounds them. Blogging is a digital
way to bring all your CPD into one place. Some examples
of reflective blogging include:
Continue to remain fit to practise by meeting the principles of the revised Code.
Have completed the required hours of practice and
learning activity through continuing professional development (CPD).
Have used feedback to review and improve the way
they work.
Have received confirmation from someone well placed
to comment on their continuing fitness to practise
(NMC 2014).
To make sure revalidation can meet the needs of an individual’s scope of practice or setting, the NMC is now consulting on revising CPD requirements and what are suitable
CPD activities and ways that nurses and midwives can
obtain confirmation of their continuing fitness to practise. It
is not clear if revalidation will lead to CPD becoming more
prescriptive, our instinct is that nurses and midwives will
continue to have scope but all those undergoing revalidation
will have to justify the use of social media as CPD to a third
There is a potential for nurses and midwives to capitalise on the value of social media to meet the requirements
of revalidation. Using a social media, digital space can
help to develop skills and knowledge in theory and practice for example engaging in Twitter discussions, writing
blogs and viewing videos. It is important that the Nursing and Midwifery Council provides clear guidance for
their registrants on the applicability of social media usage
to demonstrate revalidation. It is equally important that
nurses document and use social media responsibly to
enhance their continuous professional development. Most
importantly, the Nursing and Midwifery Council and
© 2014 John Wiley & Sons Ltd
Complete a 500 word (minimum) discussion that outlines 3 professional
benefits for using social media and 3 potential concerns with social
media. Your discussion must include two peer reviewed articles (citation
ADA style)
Consider the following:
• Who is able to view the information?
• What are the ethical considerations of social media?
• Consider what we have discussed in regards to ethics of practice and
• What are the costs associated with these platforms?
• How might information be reviewed or vetted?
• Who uses social media?
Some professional benefits of social media are sharing knowledge, benchmarking and
branding. Some social media potential concerns are the adverse reaction from people, insecurity
leading to cybercrimes and ignorance from target people.
Information from social media can be viewed by each, and every person provided they
have linked themselves to the various forms of social media, for example, Twitter, Facebook,
LinkedIn, Instagram and blog websites among others. This linking is through the creation of
accounts by providing relevant information required.
The ethical considerations of social media include privacy, truthful and accurate
information, professional boundaries and transparency. For example, Facebook makes it easier to
separate personal and professional identities by allowing different personal and business profiles
in the same account when one is opening a Facebook account. Other platforms such as Twitter
and Instagram, one has to open multiple accounts to separate personal and professional
information, thus making posing challenges to some users. Research shows that American
college of physicians and the federal or state medical boards recommend that personal and
professional information provided in the social media should be separate to avoid blurring
boundaries in their interaction with their patients as well as their colleagues. Still on professional
boundaries, in the health sector, the professionals should be very cautious and selective when
interacting with their patients in social media, they should evaluate their online patients as well
as follow the employer social media policies. Going contrary to these policies is the employers
should take unethical and immediate action. (Helm & Jones, 2016)
Costs associated with social media platforms like Twitter, Facebook, Instagram, and
blogs are relatively high especially for those who run social media campaigns. These include
costs monitoring any related keywords and then pushing these links to people on social media
that are talking on relevant topics, costs for ensuring consistency in feed updates and also costs
for selecting appropriate and target followers. There are also training stuff costs and those for
notifications of newly found promotions. Central costs associated with blogging are for blog
posts, monitoring of user comments and even charges of keyword search as software has to be
used. (Panahi, Watson & Partridge, 2014)
Information from social media platform can be reviewed by check …
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