Learning Cybercivility: A Qualitative Needs Assessment of Health Professions Students

Exploration of Cyberethics in Health Professions Education: A Scoping Review

As digital technologies rapidly integrate into Health Professions Education (HPE), understanding cyberethics is increasingly crucial. This scoping review explores the pedagogy of cyberethics in HPE, highlighting a significant gap in explicit definitions and conceptualizations. Additionally, the absence of specific theoretical frameworks in most documents raises concerns about research progression. Only four articles introduce educational interventions in cyberethics, indicating a promising avenue for future research. While comprehensive search methods are employed, limitations, including language biases, exist. Future investigations should broaden the discourse to encompass ethical implications of emerging technologies within HPE. Cultivating comprehensive, culturally sensitive, and inclusive guidelines is vital for ethical digital practices in the health care community.

UK midwives' perceptions and experiences of using Facebook to provide perinatal support: Results of an exploratory online survey

Seeking support from Facebook groups during pregnancy is now widespread and social media has been widely used by the United Kingdom National Health Service (NHS) maternity services to communicate with service users during the COVID-19 pandemic. Despite this, little is currently known about midwives' attitudes towards, and experiences of social media in practice. Research is needed to understand barriers and solutions to meeting mothers' expectations of online support and to improve services. This study explored midwife involvement in Facebook groups, exploring experiences and perceptions of its use to communicate with and support mothers. An online survey consisting of open and closed questions was completed by 719 midwives and student during August- September 2020. Quantitative questionnaire data was analysed descriptively using SPSS v26. Qualitative data gathered from free text responses was analysed using reflexive thematic analysis. Few participants were involved in providing Facebook support, and most of these were unpaid. There was a consensus on a range of benefits for mothers, but widespread concern that engaging with mothers online was a personal and professional risk, underpinned by a lack of support. Experience of being involved in midwife moderation increased belief in its benefits and reduced fear of engaging online, despite a lack of renumeration and resources. Midwives and students felt they were discouraged from offering Facebook support and sought further training, guidance and support. Although limited, experiences of providing Facebook group support are positive. Perceptions of risk and a lack of support are significant barriers to midwives' involvement in using Facebook groups to support mothers. Midwives seek support and training to safely and effectively engage with mothers using Facebook. Engaging with mothers via social media is embedded in UK national policy and NHS digital strategy, and progress is needed to fulfil these, to improve services and meet mothers' expectations. Midwives' experiences suggest extending opportunities to provide Facebook support would benefit midwives, services and families. Consultation to revise local policy to support midwives and students in line with strategic goals is recommended.

Conceptual and theoretical models for cybercivility in education in health professions: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to examine conceptual and theoretical models used to educate students in health professions about cybercivility.

INTRODUCTION

Civil behavior in cyberspace is an important element of online communications. However, this is challenging to define and teach due to subjectivity and personal bias as to what constitutes cybercivility and cyberincivility. Conceptual models or frameworks are often used to provide guidance when new knowledge and skills need to be integrated into existing professional practice. This study will provide evidence on the development and implementation of curriculum for cybercivility across healthcare professions and its potential benefits in improving interprofessional communication.

INCLUSION CRITERIA

The review will consider studies that include students of health professions exposed to cyberincivility. This scoping review will include experimental, quasi-experimental and descriptive observational study designs. Dissertations will be considered, but conference abstracts, posters, editorials, commentaries and opinion papers will be excluded. The search will be limited to studies published in English after 2007.

METHODS

The databases to be searched include PubMed (MEDLINE), CINAHL (via EBSCO), Education Resources Information Center (ERIC), Embase, PsycINFO (via EBSCO), Education Full Text (H.W. Wilson) and gray literature databases such as the ProQuest Dissertations and Theses Global database, OpenGrey, EThOS and PaperFirst. After screening of abstracts/titles for inclusion by two independent researchers, full-text studies will be screened and reasons for exclusion will be provided. Data will be extracted from the papers included in the review by two independent researchers using the data extraction instrument. NVivo 12 will be used to analyze and report the results.

Pedagogical foundations of cybercivility in health professions education: a scoping review

BACKGROUND

Teaching cybercivility requires thoughtful attention to curriculum development and content delivery. Theories, models, and conceptual and theoretical frameworks (hereafter "tools") provide useful foundations for integrating new knowledge and skills into existing professional practice and education. We conducted this scoping review to identify tools used for teaching cybercivility in health professions education.

METHODS

Using Arksey and O'Malley's scoping review framework, we searched six biomedical and educational databases and three grey literature databases for articles available in English published between January 1, 2000 and March 31, 2020. Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), we screened and extracted relevant data, and reported the results of the search.

RESULTS

The search resulted in 2272 articles, with 8 articles included in this review after inclusion criteria were applied. Four articles (50%) were peer-reviewed journal papers while the other 4 (50%) were dissertations. Eleven unique tools were identified by this review: (1) Transpersonal Caring Theory, (2) Theory of Workplace Incivility, (3) Conceptualization of Incivility, (4) Media Ecology Theory, (5) Principlism, (6) Salmon's Five Stage Model of Online Learning, (7) Learner-Centered Educational Theory, (8) Gallant and Drinan's 4-Stage Model of Institutionalization of Academic Integrity, (9) Theory of Planned Behavior, (10) Communication Privacy Management Theory, and (11) Moral Development Theory. Based on the tools analyzed in our scoping review, we determined three features of cybercivility pedagogy to which the tools provided a guide: (1) behavioral manifestations, (2) academic integrity, and (3) digital professionalism.

CONCLUSIONS

The reviewed tools provide a pedagogical foundation and guidance for teaching various properties of cybercivility. Future studies should be expanded to include a broader literature body and non-English literature to provide the global perspective and global skills needed by a diverse population of learners.

Cyberincivility Experience of Korean Clinical Nurses in the Workplace: A Qualitative Content Analysis

Although clinical nurses use online platforms to acquire health-related information and communicate with other healthcare providers, there are increasing reports on their incivility exposure in cyberspace. However, an in-depth understanding of their cyberincivility experience is lacking. This study aimed to identify Korean clinical nurses’ perception and experience of cyberincivility. A qualitative study was conducted. Twenty clinical nurses from seven private and public hospitals in the Seoul metropolitan area were recruited using purposive sampling. Individual semi-structured interviews were conducted with the nurses from June to September 2019. Conventional content analysis was applied for the interview data analysis. Clinical nurses perceived cyberincivility as disrespectful and condemning behavior as users hide under the shield of anonymity to persecute others without fear of retribution. Four themes regarding participants’ cyberincivility experience emerged: unprofessional behavior, hierarchical communication, lack of respect and morality, and forming an inefficient work environment. The results of this study provide an understanding regarding clinical nurses’ experience of cyberincivility that goes beyond that of previous studies, which mainly focused on students. These results could increase awareness of cyberincivility among clinical nurses, and provide key information for the design of cybercivility educational programs and guidelines to curb cyberincivility, nurture professional online communication, and consequently improve quality of care.

Exploration of Cybercivility in Nursing Education Using Cross-Country Comparisons

Many nursing students have experienced negative social behaviors and incivility in cyberspace. We aimed to explore knowledge, experience, and acceptability of cyberincivility, as well as the perceived benefits of cybercivility education among nursing students in the United States of America (USA), Hong Kong (HK), and South Korea (K). We used a cross-sectional study design. The Academic Cyberincivility Assessment Questionnaire was administered to participants, and data were collected from 336 nursing students from a university in each country (USA (n = 90), HK (n = 115), and K (n = 131)). Cyberincivility was perceived as a problem by 76.8% of respondents. More than 50% of respondents had experienced cyberincivility, were knowledgeable about it, and found it unacceptable. Longer hours spent on social networking services and perception of cyberincivility were positively associated with the variables, but negatively associated with perceived benefits of learning. Cross-country differences in items and level of variables were identified (p < 0.01). The HK respondents demonstrated lower knowledge, compared to USA and K respondents. Frequency of cyberincivility experience and perceived learning benefit were lower for students in the USA than in HK and K. Acceptability of cyberincivility was significantly lower in respondents from K. Developing educational programs on general and sociocultural patterns of online communication could be useful in promoting cybercivility globally.

Understanding the benefits and risks of nursing students engaging with online social media

E-professionalism is defined as the competence and values expected of professionals when engaged in online communication, and is a rapidly expanding area of nursing practice. The use of online social media is popular among nursing students, some of whom have created online platforms for peer support and influence. There are significant benefits of using social media for nursing students, such as developing professional networks, engaging in the nursing community, accessing and providing support, and enhancing their knowledge. However, nursing students must be made aware of the potential risks in relation to how they share information and communicate online. These risks include misconduct investigations and could result in exclusion from their studies, resulting in them being unable to join the professional register. Nursing students and educators should be supported to use digital technologies in a way that capitalises on their benefits, while minimising their risks. This article aims to enhance nursing students' and nurses' understanding of e-professionalism so that they can use social media effectively for peer support and to enhance patient care.

Social media and professional boundaries in undergraduate nursing students

Social media use and professional boundaries are growing challenges for nurse educators. The current undergraduate nursing student population is a technology savvy generation that enjoys the constant stimulation and social connections created by social media. Professional standards in nursing are dictated by the ANA's Code of Ethics, and educators are responsible for instilling professional values into impressionable nursing students. Professional boundaries have become blurred with increased use of social media as students struggle to differentiate between personal and professional identities. Increased exposure to professional expectations along with clearly defined policies and procedures regarding social media use can foster the development of an ethical conscience in students that can be carried into future practice. The establishment of clear professional boundaries upon entry into nursing programs can support safe use of social media and promote a positive image for the future of the nursing profession.

Cyberincivility in the Massive Open Online Course Learning Environment: Data-Mining Study

BACKGROUND

Cyberincivility is a pervasive issue that demands upfront thinking and can negatively impact one's personal, professional, social, and educational well-being. Although massive open online courses (MOOCs) environments could be vulnerable to undesirable acts of incivility among students, no study has explored the phenomena of cyberincivility in this learning environment, particularly in a health-related course in which mostly current or eventual health professions students enroll.

OBJECTIVE

This study aimed to analyze the characteristics of text entries posted by students enrolled in a medicine and health care MOOC. The objectives were to (1) examine the prevalence of posts deemed disrespectful, insensitive or disruptive, and inconducive to learning; (2) describe the patterns and types of uncivil posts; and (3) highlight aspects that could be useful for MOOC designers and educators to build a culture of cybercivility in the MOOC environment.

METHODS

We obtained data from postings in the discussion forums from the MOOC Medical Neuroscience created by a large private university in the southeast region of the United States. After cleaning the dataset, 8705 posts were analyzed, which contained (1) 667 questions that received no responses; (2) 756 questions that received at least one answer; (3) 6921 responses that applied to 756 posts; and (4) 361 responses where the initiating post was unknown. An iterative process of coding, discussion, and revision was conducted to develop a series of a priori codes. Data management and analysis were performed with NVivo 12.

RESULTS

Overall, 19 a priori codes were retained from 25 initially developed, and 3 themes emerged from the data-Annoyance, Disruption, and Aggression. Of 8705 posts included in the analysis, 7333 (84.24%) were considered as the absence of uncivil posts and 1043 (11.98%) as the presence of uncivil posts, while 329 (3.78%) were uncodable. Of 1043 uncivil posts analyzed, 466 were coded to >1 a priori codes, which resulted in 1509 instances. Of those 1509 instances, 826 (54.74%) fell into "annoyance", 648 (42.94%) into "disruption", and 35 (2.32%) into "aggression". Of 466 posts that related to >1 a priori codes, 380 were attributed to 2 or 3 themes. Of those 380 posts, 352 (92.6%) overlapped both "annoyance" and "disruption," 13 (3.4%) overlapped both "disruption" and "aggression," and 9 (2.4%) overlapped "annoyance" and "aggression," while 6 (1.6%) intersected all 3 themes.

CONCLUSIONS

This study reports on the phenomena of cyberincivility in health-related MOOCs toward the education of future health care professionals. Despite the general view that discussion forums are a staple of the MOOC delivery system, students cite discussion forums as a source of frustration for their potential to contain uncivil posts. Therefore, MOOC developers and instructors should consider ways to maintain a civil discourse within discussion forums.