UBC Undergraduate Research

Synthesis project : utilizing social media for new grad transition McSkimming, Catherine; Luengas, Isabel; Nguyen, Trang Jan 23, 2013

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Runninghead: Utilizing Social Media for New Grad Transition                                                              1         Synthesis Project:  Utilizing Social Media for New Grad Transition  Catherine McSkimming Isabel Luengas Trang Nguyen  January 23, 2013 University of British Columbia        Runninghead: Utilizing Social Media for New Grad Transition                                                              2   Introduction:  The transition of a nursing graduate into a professional role as a registered nurse can be a challenging experience. The initial year for a new grad is often described as a frustrating, stressful and overwhelming experience (Newhouse & Hoffman, 2007). In North America, 33-61% of new graduate leave their job or change careers within their first year of nursing, implying that  more support needs to be available to them (Duchsher, 2009). It takes a minimum of 12-18 months following graduation for new graduates to feel confident and comfortable in their new nursing role because working environments are becoming more hectic and nursing competencies are expanding (Newhouse & Hoffman, 2007). Currently, new graduates are eligible to write the licence exam immediately after graduation and become completely certified registered nurses (Dyess &Sherman, 2009). Studies have found that although graduates may meet the legal and professional conditions to practice, many of them still lack the clinical techniques and judgment sufficient to implement safe and competent care ((Dyess & Sherman, 2009). This becomes a greater issue with the increased demand for nurses and an aging nursing workforce. The average age for RNs in Canada is 44 years old (Graham & Duffield, 2010). With this factor in combination with the high turnover rate, the support for new nurses becomes an even greater challenge. In addition, the increasing patient acuity, shortages of staff, and the emergence of new technologies make the transition for new graduates even more difficult, as it raises expectations for greater skills and autonomy (Dyess & Sherman, 2009). Even seasoned nurses are finding these new environments difficult, resulting in increased burnouts and decreased job satisfaction. Unfortunately, due to increasing clinical demands and increased cost containment, there is Runninghead: Utilizing Social Media for New Grad Transition                                                              3  limited time for effective orientation of new nurses and a greater push for new grads to take on cases beyond their competencies (Dyess & Sherman, 2009). Currently Vancouver Coastal Health, Fraser Health and Providence Health all provide new grad programs to nursing graduates who meet specific qualifications. For example, Vancouver Coastal Health offers a 4 series workshop, which covers topics such ?transitioning from a student to the RN role? and ?leadership at the bedside? (VCH, 2013). To be qualified for this program, new graduates must have graduated within the past 12 months and have less than 500 hours of clinical experience (VCH, 2013). Providence Health, in comparison, in addition to educational workshops, provides two weeks of orientation, which include classroom sessions, unit education and guided bedside shifts (Providence Health Care, 2012). These programs aim to encourage confidence, provide support and help new graduates transition into their clinical settings. Although these programs are very beneficial for new graduates and their transition into professional roles, the availability of these programs can be limited. Presently, social media tools such as youtube, facebook and moodle have been utilized in nursing schools to help assist students in their learning. Perhaps these tools can be utilized within hospitals to assist and provide further support to new graduates in their transition to the clinical setting as professional nurses. Background:  Social media is defined as ?a group of Internet-based applications that build on the ideological and technical foundations of Web 2.0, and that allow the creation and exchange of User Generated Content,? (Kaplan & Haenlein, 2010) and in recent years, it has become a vastly popular outlet for sharing information and connecting with others.  The universality of the internet?s presence among the nation is demonstrated in the World Bank collection of Runninghead: Utilizing Social Media for New Grad Transition                                                              4  development indicators, which estimated that over 82% of Canadians had access to the internet in 2011 (World Bank,  2012). As a reflection of its widespread prevalence, the population of internet users who actively utilized social media reached 78% in 2008 and is continually growing (Kaplan & Haenlein, 2010).  Part of the internet?s draw comes from it?s emergence as a new platform for people to create social networks that encompass ?any interpersonal, non-hierarchical connection between individuals, business units, or organizations along which knowledge flows? (Barczyck & Duncan, 2011). Social media has transformed our concept of social networking. In the past, social networking was defined by face-to-face interactions such as a business luncheons, conferences, or office-sponsored parties, while nowadays the idea has been expanded to include online communication through websites such as Facebook, Google+, YouTube, or LinkedIn. Other popular social media platforms include blogs and web forums such as Tumblr, Moodle, and allnurses.com, which provide a space where users can ask each other questions, share stories, and exchange information. As of September 2012, Facebook, the number one social networking website on the internet, reported over 1.01 billion people utilizing the site each month (Associated Press, 2012). On a global scale, this emphasizes not only the popularity of utilizing internet applications, but also the demand for online communication.   By harnessing the power of social networking in a professional context, healthcare organizations can utilize social media to create a powerful, sustainable, and cost effective professional development tool. The nursing students in the University of British Columbia?s 2012-2013 cohort have already worked towards establishing a method of sharing information and connecting with peers by creating a Facebook group dedicated to personal and professional Runninghead: Utilizing Social Media for New Grad Transition                                                              5  development as nurses. In the UBC cohort page, the number of group members exceeds the nursing cohort?s actual size, illustrating the demand for this type of outlet amongst new nurses.   Utilizing social media in the healthcare setting has several benefits for new nurses entering into the workplace. First, utilizing social media expands the users ability to access useful information. In nursing practice, we use many different modalities to provide education for our patients: verbal communication, handouts, demonstration, access to outside resources, and more. Creating an online initiative for new graduate RN?s facilitates learning by making education tools more easily accessible to the user.   An online group can also generate traffic with a substantial number of new graduates because ?unlike traditional [groups], bounded by space constraints, the number of participants in an online group can be unlimited? (White, 2001). Another benefit is that social media can be used as a tool to promote professional development. The creation of an online resource gives new graduates an outlet ?where learners can define their own needs for knowledge and skills and assign meanings to circumstances and contexts according to their own past experiences? (Hannafin & Land, 1997). This can provide new RN?s with a student-centered learning environment, which empowers them to meet their own goals. As a nursing student, it is quite common to hear the phrase, ?we don?t expect you to know everything,? and when it comes to practice, many new graduates are faced with unfamiliar situations that can leave them feeling insecure about their abilities and practice. With the inclusion of a forum, this new online resource could be used as a support system where new graduates can connect with other nurses for encouragement and validation; reassurance from peers and mentors is an invaluable resource that can offer new graduates a way to cope with emotional stress by giving them a way to identify with others and seek guidance when needed. Runninghead: Utilizing Social Media for New Grad Transition                                                              6   Methods: In order to collect information on nursing students and their usage of social media, we created an online survey to find out how they are currently using social media and how it is most beneficial to them. We used Surveymonkey, a free program designed to collect responses from a large audience. We distributed the link to the survey via facebook on the 2012-2013 UBC Nursing facebook page. The survey was also distributed to employed student nurses working for Vancouver Coastal Health by our project leader. One reminder was made mid way before survey completion. The survey consisted of 8 open and closed ended questions. We obtained 44 responses.  Results: Of the 44 responses, 31 were from UBC students. Four responses were from Langara College and the remaining responses were from various schools in the Lower Mainland and Fraser Valley. 88.6% of respondents reported that they use social media to assist them in nursing.  In order to find our what types of social media were used, we inquired about facebook, blogs, YouTube, Moodle, Twitter, web forums, and Google+. Facebook and YouTube were the most widely used, with 88.6% of respondents reporting that they use these social media outlets. Web forums were also widely used, with 47.7% of respondents indicating use of this social media. Moodle, Google +, and blogs were used by 20-31.8% of respondents. Twitter was the least used by respondents, with only 6.8% reporting they use this online resource.  93% of respondents reported that acquiring information was the reason they used social media. Other main reasons were for learning, asking questions, sharing information, and social Runninghead: Utilizing Social Media for New Grad Transition                                                              7  support. 43% of respondents indicated they used social media for entertainment and expressing thoughts and opinions.  No respondents reported they were ?very confident? to enter the workplace as a new RN.  31.8% were ?confident,? 38.6% were ?uneasy,? and 25% felt that they were ?neutral.? 4.5% of respondents reported that they were ?extremely uneasy.? Forty three out of forty four responders reported that they would use an online resource if their employer provided it. An open ended question inquired about describing what kind of online resources would be the most useful. Two major trends included resources related to ?learning? and ?social support.? Some people also noted some of their concerns regarding social media.  Most of the responders noted ?learning? in general as the type of resource that would be useful. Specifically, many responders noted that learning modules, tutorials, Q&A, evidence based practice, and case studies were valuable. The opportunity to ask questions through a forum was a trend. Many indicated that accessing clinical practice guidelines and policies was useful. Also, accessing current and accurate information was noted ie: drug guides, skills manuals, and UptoDate. One respondent expressed the wish to access intranet from home to use the valuable resources provided there. Several respondents showed interest in unit-specific resources, including scheduling, the way the unit was run, orientation, and workplace routine and processes. Other learning noted by a few respondents included videos, sharing information, review resources (pathophysiology and pharmacology), and continuing education. Moodle was specifically desired by two respondents. Another major trend was social support, both professional and personal. This included sharing information, asking others questions, and making connections. Other support modalities Runninghead: Utilizing Social Media for New Grad Transition                                                              8  in general were heavily emphasized. Some respondents desired a new grad page, opportunity for mentorship, and a social network for employees. One respondent thought that most learning was better if it was done in classroom rather than online. Two respondents indicated concern over the usage of facebook for work. One respondent also showed concern about how the online resource would be monitored and indicated that it would make them uneasy if a social support resource was administered by an employer. However, this respondent thought the concept had great potential if it was done appropriately. Discussion and Recommendations: Our survey provided us with some valuable information regarding the usage of social media and grad transition. Some limitations of our survey included that the survey was distributed through the nursing facebook page and 31 out of 44 (70%) of the survey respondents were UBC students. This biased the results in several ways. Firstly, those who use the facebook page are more likely to have interest in the usage of social media. Also, this limited the results to mainly UBC students. This survey was also convenience sampling to ESN students for VCH and UBC facebook users. The sample size was relatively small (N= 44).  Interest was indicated the most in aspects of learning through modules, evidence based practice, clinical decision making, cheat sheets, and discussion forums. This makes sense given that none of the respondents were very confident in entering the workplace with nearly 39% of respondents reporting that they felt uneasy with the transition. We can infer that acquiring information and increasing clinical knowledge will likely lead to increased confidence and competence, which will lead to less stress, better job retention and satisfaction and better patient outcomes. Another major trend was the desire for a way to connect with other new nurses, Runninghead: Utilizing Social Media for New Grad Transition                                                              9  mentors, and employees through an online social support network. These two major findings are consistent with research that new nursing grads feel they need more clinical support and learning and that social support is an essential component to new grad transition. Establishing a discussion forum would likely be very valuable to address both these major trends. There was a strong interest in the usage of facebook. For reasons of privacy and confidentiality, sites such as facebook would not be viable tools for health authorities. However, we can take this valuable information to infer what kind and mode of support respondents desire. For example, facebook provides a way for users to post articles, images, links, share networking information, allows people to express thoughts and opinions, and gives a people a way to connect in general and offer support. A media outlet that would allow this would likely be a useful resource to new grads. Nearly 89% of respondents also noted that they used YouTube to assist them by watching demonstrations of practical nursing skills. There was also a strong indicator for modules. These findings indicate that respondents are visual learners and that seeing clinical demonstrations and skills through video is very valuable for learning. It would therefore be valuable if there were videos available to watch. The obvious benefits of social media are that most new grads are already using it effectively to assist them in their nursing career. 88.6% report that they use it to assist them in nursing. Likely, social media will become increasingly popular in the future. Since many people use social media, it would not be costly to train people to use it. For the most part, the vast majority of our respondents were open to using social media to assist them in nursing transition. Conclusion: In conclusion, we recognize the importance of hands on mentorship and we believe that social media would be valuable for supplementing new grad programs already provided in health Runninghead: Utilizing Social Media for New Grad Transition                                                              10  authorities. In the future, the establishment of a moodle site, which is presently being implemented at VGH, would likely be successful to assist new nurses because it offers social support and clinical information; two aspects of nursing that have been indicated as essential to successful nurse transition.                     Runninghead: Utilizing Social Media for New Grad Transition                                                              11   References:  Associated Press. (2012, October 23). Number of active users at facebook over the years.  Retrieved from http://finance.yahoo.com/news/number-active-users-facebook-over-years- 214600186--finance.html Barczyk, C., & Duncan, D. (2011). Social networking media as a tool for teaching business  administration courses. International Journal of Humanities and Social Science, 1(17),  267-275. Dyess, S. M., & Sherman, R. O. (2009). The First Year of Practice: New Graduate Nurses?.       Journal of Continuing Education in Nursing, 40(9), 403-410. Duchscher, J. E. B. (2009). Transition shock: the initial stage of role adaptation for newly. Journal of Adavanced Nursing, 65(5), 1103-1113. Graham, E. M., & Duffield, C. (2010).  An ageing nursing workforce. Australian Health Review, 34(1), 44-48.  Fraser Health.(2012). New Graduates. Retrieved January, 16, 2013, from  http://careers.fraserhealth.ca/great_careers/nurses/new_graduates/ Graham, E. M., & Duffield, C. (2010). An ageing nursing workforce. Australian Health Review,    34(1), 44-48.  Runninghead: Utilizing Social Media for New Grad Transition                                                              12  Hannafin, M. J., & Land, S. M. (1997). The foundations and assumptions of technology  enhanced student-centered learning environments. Instructional Science, 25(3), 167-202. Kaplan, A., & Haenlein, M. (2010). Users of the world, unite! the challenges and opportunities  of social media. Business Horizons, 53, 59-68. Newhouse, R. P., Hoffman, J. J., Suflita, J., & Hairston, D. P. (2007). Evaluating an Innovative  Program to improve New Nurses Graduate Socialization Into the Acute Healthcare  Setting. Nurs Admin Q, 31(1), 50-60. Providence Health Care. (2012). Students + Educational Opportunities. Retrieved January, 16,  2013, from http://www.providencehealthcare.org/careers/opportunities/stepsapply/students-educational-opportunities  Vancouver Coastal Health (VCH). (2013). New Graduates. Retrieved January, 16, 2013, from  http://careers.vch.ca/who_we_hire/nurses/new_graduates/ White, M. (2001). Receiving social support online: Implications for health education. Health  Education Resource, Oxford Journals, 16(6), 693-707. World Bank. (2012, October 31). Internet users (per 100 people). Retrieved from  http://data.worldbank.org/indicator/IT.NET.USER.P2?cid=GPD_44  


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