Professionalism in a digital and mobile world: A way forward for nursing

Reclaiming the concept of professionalism in the digital context: a principle-based concept analysis

BACKGROUND

There has been an alarming surge in the usage of social networking sites (SNSs) by healthcare professionals (HCPs) without adherence to the principles of professionalism. The widespread use of SNSs in medical practices has been coupled with reports of breaches of professional behaviors. Despite the benefits of SNSs, skepticism prevails about a clearly defined role for SNSs within medicine based upon the core principles of professionalism. Thus, there is a need to understand the manifestations of professionalism in the digital context, classically known as e-professionalism. This study systematically examines HCPs' perceptions of e-professionalism to advance a thorough understanding of e-professionalism.

METHODS

This concept analysis was performed using the principle-based approach of Penrod and Hupcey. In January 2023, we searched the databases of PubMed and ISI Web of Science for English-language articles specific to 'e-professionalism' in the medical field. The final selected research corpus of 63 articles was analyzed in this study.

RESULTS

A comprehensive analysis of the selected articles highlighted that e-professionalism is an epistemologically mature and distinct concept by a standard definition. However, inconsistencies in conceptual meanings were reported due to varied interpretations despite digital literacy. The pragmatic utility showed a lack of sound methodological and philosophical paradigms. Perhaps the rapid technological advancements and manifestations have hampered linguistic maturity. However, logically, e-professionalism is perceived as an extension of conventional professionalism but with a focus on a distinct framework with a set of attributes to be digitally relevant.

CONCLUSION

This study identifies a scarcity of research about the collective perspective of essential stakeholders, underpinning the need to further explore e-professionalism due to its emerging complex nature within the digital context. There is also a recognition that a framework is essential to guide future HCPs to yield a profound understanding and to provide remediation strategies in the rapidly advancing medical field in digital realm.

Nurses' media competency: A concept analysis

OBJECTIVES

To analyze and define the concept of nurses' media competency.

DESIGN

Concept analysis.

DATA SOURCES

We conducted a literature search in PubMed, CINAHL, PsycInfo, and RISS International, as well as a hand-search, for relevant articles published between January 1990 and April 2023. A total of 57 articles related to nurses' media competency, published in English or Korean, were included in this study.

REVIEW METHODS

We used Walker and Avant's method of concept analysis to identify the defining attributes, antecedents, and consequences of the concept.

RESULTS

The seven defining attributes of nurses' media competency were networking with members of the media, selecting the appropriate media platform, considering that the target audience is the public, creating one's own media products, delivering intended messages through the media, monitoring and responding to the media, and maintaining professional dignity. Antecedents of the concept included cultivation of desirable nursing professionalism, critical evaluation of policies and issues, recognition of media influence, establishment of education and guidelines for media use, and having facilities and availability of technologies for media use. Consequences of the concept were improved influence of individual nurses, enhanced public awareness of the nursing profession, stronger networks and collaboration among professionals, and contributions to the promotion of public health.

CONCLUSIONS

This concept analysis presents a theoretical definition of nurses' media competency that can provide guidance on how to educate nurses to develop media competency and how to measure nurses' media competency.

Clinical nurses' work procrastination and smartphone addiction: a potential profile study

Background

In the medical field, effective time management by clinical nurses is crucial for enhancing the quality of patient care. However, in recent years, with increasing work pressure for clinical nurses, procrastination has become a prevalent issue. Many nurses use smartphones as a way to alleviate stress and manage emotions, but excessive smartphone use could exacerbate procrastination, thereby jeopardizing patient safety and healthcare quality. Therefore, understanding the current state of work procrastination among clinical nurses, its heterogeneity, and exploring the impact of smartphone addiction and demographic factors on different aspects of nurse procrastination hold significant importance for improving patient care quality.

Objective

This study aims to explore the current state of work procrastination among clinical nurses and identify potential profile categories. It further analyzes the impact of mobile phone addiction and demographic factors on work procrastination among clinical nurses.

Methods

Convenience sampling was employed to recruit participants from three tertiary hospitals in central China from October to November 2023. Surveys measuring nurses' work procrastination and smartphone addiction were distributed and collected through online platforms. A total of 1,536 nurses participated in this study. Mplus 8.3 statistical software was used for latent profile analysis of clinical nurses' work procrastination, and SPSS 26.0 software was utilized for chi-square tests, rank-sum tests, and multi-classification logistic regression analyses.

Results

The median total score for clinical nurses' work procrastination was 21.00 (17.00, 28.00), and three subgroups were identified: low procrastination (66.93%), medium-low procrastination (20.66%), and medium-high procrastination (12.41%). Additionally, logistic regression analysis revealed that smartphone addiction and department atmosphere were common influencing factors for medium-low and medium-high work procrastination. Hospitals with stricter management and nurses holding the position of head nurse were more likely to belong to the low work procrastination group. Nurses with higher incomes or those holding intermediate titles were more prone to medium-low work procrastination, while those experiencing career advancement difficulties were more likely to exhibit medium-high work procrastination (p < 0.05).

Conclusion

Clinical nurses' work procrastination is generally at a medium-to-low level, with three subgroups identified: low procrastination, medium-low procrastination, and medium-high procrastination. Additionally, clinical nurses in surgical departments or those with intermediate titles exhibit higher levels of procrastination. Factors such as smartphone addiction, higher monthly income, tense departmental atmosphere, and unsuccessful career advancement are more likely to lead to work procrastination. Conversely, nurses in hospitals with strict management or those holding the position of head nurse exhibit lower levels of work procrastination. Therefore, nursing managers should pay close attention to the work procrastination behaviors of clinical nurses, actively monitor predictive factors among different groups, and provide psychological counseling and relevant training based on individual nurse circumstances. Additionally, it is also essential to focus on and improve departmental atmosphere and nurse smartphone addiction to enhance clinical nurses' work efficiency and reduce work procrastination.

Principles of digital professionalism for the metaverse in healthcare

BACKGROUND

Experts are currently investigating the potential applications of the metaverse in healthcare. The metaverse, a groundbreaking concept that arose in the early 21st century through the fusion of virtual reality and augmented reality technologies, holds promise for transforming healthcare delivery. Alongside its implementation, the issue of digital professionalism in healthcare must be addressed. Digital professionalism refers to the knowledge and skills required by healthcare specialists to navigate digital technologies effectively and ethically. This study aims to identify the core principles of digital professionalism for the use of metaverse in healthcare.

METHOD

This study utilized a qualitative design and collected data through semi-structured online interviews with 20 medical information and health informatics specialists from various countries (USA, UK, Sweden, Netherlands, Poland, Romania, Italy, Iran). Data analysis was conducted using the open coding method, wherein concepts (codes) related to the themes of digital professionalism for the metaverse in healthcare were assigned to the data. The analysis was performed using the MAXQDA software (VER BI GmbH, Berlin, Germany).

RESULTS

The study revealed ten fundamental principles of digital professionalism for the metaverse in healthcare: Privacy and Security, Informed Consent, Trust and Integrity, Accessibility and Inclusion, Professional Boundaries, Evidence-Based Practice, Continuous Education and Training, Collaboration and Interoperability, Feedback and Improvement, and Regulatory Compliance.

CONCLUSION

As the metaverse continues to expand and integrate itself into various industries, including healthcare, it becomes vital to establish principles of digital professionalism to ensure ethical and responsible practices. Healthcare professionals can uphold these principles to maintain ethical standards, safeguard patient privacy, and deliver effective care within the metaverse.

Social acceleration, alienation, and resonance: Hartmut Rosa's writings applied to nursing

This article aims to present the life and work of German thinker Hartmut Rosa as a philosopher of interest for nursing. Although his theoretical framework remains fairly unknown in the nursing domain, its main key concepts open up a philosophical and sociological approach that can contribute to the understanding of a wide range of study phenomena related to nurses, nursing, and healthcare. The concepts of social acceleration, alienation, and resonance are useful to explore healthcare organizations' performance by bringing the time dimension of modernity to the center; to grasp nurses' experiences of caring for patients; and to understand nurses as agents endowed with the capacity to deploy their political agency to create alternative forms of relationship to themselves, to others, and the world, challenging the institutional order of healthcare organizations when it fails to resonate with their professional ethos. In this article, we propose Hartmut Rosa's theoretical framework as a new and inspiring phenomenological and critical lens that should be further explored to advance knowledge concerning phenomena that are found at the crossroads of the nursing domain and other fields of knowledge.

Exploring the Nursing Care Process for Patients with COVID-19: A Grounded Theory Study

Introduction:

A specific model and process of nursing care for patients with COVID-19 has yet to be developed. However, nurses are navigating how to care for patients and themselves in a novel and stressful work environment. A care process is needed that promotes effective nursing for patients’ health and well-being.

Objective:

This study aimed to explore the current nursing care process for patients with COVID-19.

Methods:

The present qualitative study used a grounded theory approach. Participants included 23 nurses working in a hospital COVID-19 ward who were selected through purposive sampling. Semi-structured interviews were conducted with nurses, and data were simultaneously analyzed using MAXQDA software to code the data. Grounded theory with a storyline approach was used to categorize codes to elucidate themes from interviews and check for data saturation. This consists of several steps, including open coding, developing concepts in terms of their properties and dimensions, analyzing data for context, bringing the process into the analysis, and integrating categories.

Results:

Data analysis revealed seven main categories to describe nurses’ conceptions of the care process for COVID-19 patients: ‘patients’ complicated condition’, ‘severe nursing staff shortage’, ‘nursing professionalism’, ‘treatment team collaboration’, ‘work and environmental pressure’, ‘efficacy of care’ and ‘care deficit’. The category of ‘nursing professionalism’ was determined to be the core concept that nurses used to describe their care process.

Conclusion:

Though nurses think highly of their efficacy of care for patients with COVID-19, they face many challenges in their care process that lessen the care they are able to provide for patients and themselves. These include the complex health status of patients, shortage of staff, environmental stresses such as becoming infected, and lack of resources in the hospital. The results of the present study can be used for planning in various fields of nursing, including management, education and clinical training.

Digital professionalism on social media: The opinions of undergraduate nursing students

BACKGROUND

Social media are a suite of popular online technologies that enable people to share and co-create digital content. Evidence suggests some nursing students utilise social media inappropriately but there is limited literature on nursing students' opinions of professionalism in online environments. This study aimed to examine the opinions of nursing students in relation to digital professionalism on social media.

METHOD

A descriptive, cross-sectional study was conducted with undergraduate nursing students in the United Kingdom (n = 112). An existing self-reported questionnaire was adapted for data collection. This was distributed to adult nursing students enrolled across all four years of a Bachelor of Nursing programme. Data were analysed using descriptive statistics.

FINDINGS

Many nursing students were heavy social media users (n = 49, 44%), with Facebook, Instagram, and Snapchat being the most popular applications. Nursing students were also aware of the professional nursing regulator, the Nursing and Midwifery Council, guidelines on responsible social media use (n = 48, 43%). Nursing students' responses to various digitally professional scenarios revealed agreement that posts about alcohol or sexually explicit content, along with comments about colleagues or patients were inappropriate. However, there were mixed views around taking photographs at work, with some nursing students across all four years of the degree programme perceiving this to be satisfactory behaviour.

DISCUSSION

The opinions of nursing students towards digital professionalism on social media are somewhat aligned with professional standards, although students can hold varying views on the subject. More research on how nursing students employ social media is warranted to ensure their opinions match their actual practice in online environments. It is also recommended to educate nursing students about the professional values and behaviours required on social media and how best to communicate, interact, and share information on the various online platforms, to minimise personal and organisational risk.

Digital professionalism on social media: A narrative review of the medical, nursing, and allied health education literature

BACKGROUND

Medical, nursing, and allied health students, and professionals are using online environments such as social media to communicate and share information. However, some have difficulty differentiating between their professional and personal roles and can behave inappropriately online. Better education and training may help prevent these issues from arising.

OBJECTIVE

Identify and synthesise literature on educating healthcare students and practitioners about digital professionalism on social media.

METHOD

Four databases i.e., CINAHL, ERIC, MEDLINE and PubMed were searched using relevant terms. Five hundred and twenty-two articles were found and screened. Data extraction and critical appraisal were conducted. Analysis followed Braun and Clarke's six phases of thematic analysis.

RESULTS

Eleven studies were included in the review. Digital professionalism was taught across medicine, nursing, and allied health education using a number of pedagogical approaches including traditional face-to-face teaching, as well as fully online, and blended methods. Its impact on learning centred on acquiring knowledge about communicating appropriately on social media which appeared to change how some students and practitioners behaved online, while improving confidence and information literacy. Developing and delivering education on digital professionalism tended to be affected by the amount of time faculty and trainers had to create curricula, organise and deliver teaching, and support students and clinicians. The design of the online platform seemed to be important as some had more functionality than others, allowing for greater interaction, which appeared to keep learners engaged.

DISCUSSION AND CONCLUSION

This review provides the first synthesis of literature on educating the medical, nursing, and allied health professions on digital professionalism on social media. The results identify potential issues, knowledge gaps, and highlight implications for future educational interventions. Recommendations include setting clear boundaries and pedagogical instructions, understanding and applying privacy settings online, and utilising co-creation approaches with students and practitioners to improve the quality of health education.

Nursing - a core element of rehabilitation

AIM

2020 was been acknowledged by the World Health Organization as the International Year of the Nurse and the Midwife. On this occasion, the Global Rehabilitation Alliance and the International Council of Nurse would like to conceptually reflect the role of nurses in rehabilitation.

BACKGROUND

Rehabilitation and nursing are strictly ingrained. Rehabilitation aims at improving, reaching and maintaining optimal functioning of persons with disability and persons with health conditions experiencing disability. Nursing is defined as use of clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life. Nursing has a crucial role in all phases of rehabilitation care (acute, post-acute and long-term rehabilitation). Nurses deliver rehabilitation in many settings, in nursing homes and community-based rehabilitation. The main principle is not to deliver care for the patient but deliver care with the patient. This includes explaining, demonstrating and practising with the goal to help the patient to (re-)gain independence.

DISCUSSION

Nurses play an important role in delivering rehabilitation and are involved in all aspects of the multidimensional rehabilitation process. One of the important points is that in most settings, nurses are the professionals with a prolonged relationship with patients and families, and may have the best insight into the patients' personal and contextual factors with regard to the rehabilitation process.

CONCLUSION AND IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

Strengthening nursing in rehabilitation is a vital factor to deliver high-quality rehabilitation and to achieve optimum outcomes. For this reason, we urge all relevant stakeholders at governmental and rehabilitation service provider levels to work towards these goals.

Development and Psychometric Properties of the Questionnaire for Assessing Educational Podcasts (QAEP)

The aim of this research was to develop and validate the Questionnaire for Assessing Educational Podcasts (QAEP), an instrument designed to gather students' views about four dimensions of educational podcasts: access and use, design and structure, content adequacy, and value as an aid to learning. In study 1 we gathered validity evidence based on test content by asking a panel of experts to rate the clarity and relevance of items. Study 2 examined the psychometric properties of the QAEP, including confirmatory factor analysis with cross-validation to test the factor structure of the questionnaire, as well as item and reliability analysis. The results from study 1 showed that the experts considered the items to be clearly worded and relevant in terms of their content. The results from study 2 showed a factor structure consistent with the underlying dimensions, as well as configural and metric invariance across groups. The item analysis and internal consistency for scores on each factor and for total scores were also satisfactory. The scores obtained on the QAEP provide teachers with direct student feedback and highlight those aspects that need to be enhanced in order to improve the teaching/learning process.

Integrating informatics into undergraduate nursing education: A case study using a spiral learning approach

A gap in informatics expertise amongst nursing students, practising staff and faculty has been noted globally, which reduces the potential for nurses to utilise technology to enhance patient care. National nursing education strategies and recommendations from professional associations have identified digital health as an area that needs investment. This case study describes how health informatics is being integrated into a Bachelor of Nursing programme in the United Kingdom. An international collaboration with a US-UK Fulbright Specialist Scholar enabled individual learning units corresponding to key health informatics competencies to be designed and incorporated into a pedagogic framework grounded in the spiral learning approach. This approach is proposed as one way to integrate informatics into nursing education, so students can become competent clinicians that are able to deliver technology enabled care in the health service.

Podcasting in nursing and midwifery education: An integrative review

Podcasting is used in higher education so various digital resources can be shared with students. This review aims to synthesise evidence on podcasting in nursing and midwifery education. PubMed, MEDLINE, CINAHL, Scopus and ERIC databases were searched using key terms. 242 articles were found and screened. Data extraction, quality assessment and data analysis, underpinned by a Social Media Learning Model, were conducted on relevant studies. Twenty-six studies were included in the review. Three themes emerged; 1) learning and other outcomes, 2) antecedents to learning, and 3) learning process. Students seemed to acquire new knowledge and skills by using podcasts and it also appeared to improve clinical confidence. The organisation of podcasting, digital literacy and e-Professionalism, the personal motivation of learners, and flexible access to the technology seemed to impact the delivery of this educational intervention. Mechanisms that appeared to affect the learning process were the speed of exchange, the type of social media user, the timeframe, quality of information, the functionality of podcasts and other learning activities. This review synthesised evidence on podcasting in nursing and midwifery education. The technology was seen as a positive learning tool but more robust research examining its efficacy in improving learning outcomes is needed.

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Podcasting is being used in nursing and midwifery education to support learning.

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Review findings suggest podcasting may improve learning outcomes.

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Newer generations of students seem to like technology enhanced learning resources.

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More robust studies are needed to determine the efficacy of this pedagogical tool.

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The Social Media Learning Model could help inform future teaching and learning.