Collaboration and social media – time to move from rhetoric to evidence

Different seas, same boats? Column

by Dr. Peter Murray, Senior Editor


Murray, P. (2013). Collaboration and social media – time to move from rhetoric to evidence.  Online Journal of Nursing Informatics (OJNI), 17 (1), Available at  http://ojni.org/issues/?p=2384


murrayWith the increasing ubiquity of smart portable devices (smartphones, tablets, etc), fast and ‘always on’ Internet access, and everyday use by mainstream media outlets of social media for communication and interaction, one would think that we were entering a golden age of communication and collaboration. Depending on the scientific or other paradigm that underpins your way of looking at the world, and of what you accept as ‘evidence’, you may have a more or less positive view as to whether we are still seeing more ‘hype than hope’ in how the use of social media impact health, healthcare, nursing, and wider civil society, or whether we are progressing to use that has real impact and facilitates change.

In this series of columns, I have addressed the potential for the use of social media for connecting nurses in different parts of the world, sharing their varied, but often common, experiences, and – hopefully – supporting each other and contributing to the development of nursing and healthcare practice and education. However, after using and evangelising the use of Web 2.0 and social media for more than 8 years now, including the  past two years of writing this column, perhaps I am reaching the slough of despond; or am through the “peak of inflated expectations” and into the “trough of disillusionment” in Gartner’s hype cycle (Goldner, 2012).  As Eggers & McGonigle (2012) noted in their recent OJNI editorial on the subject, as usage of social media becomes more widespread and mainstream, a range of issues remain of which nurses must be professionally aware. Currently, I wonder, given all the hype, whether we are seeing significant benefit, behaviour change, or health impacts from social media use – and whether we are seeing the kinds of connections and exchanges that we would like to see developed. Where is the evidence? Perhaps, as  Steele (2011) suggests, while “social media and social networking support a truly global forum of communication”, they are simply building on pre-existing connections between individuals, and within already existing communities.

Over the past 8 years or so, as the use of the terms ‘Web 2.0′ and social media have gained mainstream and widespread use, most of the scientific literature, grey literature, and just plain journalism and discussion, have tended to be around their potential uses and benefits – much of it over-hyped in the early days, and probably still so today. Some of the early papers, though, still bear re-reading (such as Boulos et al’s 2006 paper) and make useful points of reference to see how far we have come – or not.

The received wisdom used to be that the term ‘Web 2.0′ was attributed to Tim O’Reilly, and was essentially coined around 2004 when he launched his series of Web 2.0 conferences (O’Reilly, 2005) – indeed, I have cited that myself in several papers and conference presentations.  Now, the term is thought to have originated in the late 1990s, but only really took off in the mainstream from 2004 onwards (Wikipedia, 2013); similar origins are suggested for the term ‘social media’, thought to have been first used in the mid 1990s and then popularised a decade later. Even today, differing views abound as to whether Web 2.0 is substantively different from prior web technologies. That there are differences has been challenged by no less an authority than the inventor of the World Wide Web , Sir Tim Berners-Lee, who views the term as essentially jargon, due to his original vision of the Web as being “a collaborative medium, a place where we [could] all meet and read and write”. The discussions around origins may seem rather esoteric to the majority – and perhaps they are. The more important discussions nowadays are, or should be, around what impact social media are having on the ways in which nurses interact, exchange information, share with and learn from their colleagues; and whether we are seeing real effects on helping to connect with, and provide benefit for, our colleagues in isolated and/or resource-poor parts of the world (which includes many rural and deprived city areas of parts of what are otherwise seen as resource-rich countries).

We are seeing more and more health-related use of social media; increasing numbers of hospitals, professional organisations, and individual nurses and health professionals are using social media. A useful list of US hospitals using YouTube, Twitter, LinkedIn and other tools is available (http://network.socialmedia.mayoclinic.org/hcsml-grid/) and similar lists have been developed in a number of other countries. Many nursing and informatics organisations now use a variety of social media tools, although, in general, their levels of use are not as great as one would expect. I remember back in the early to mid 1990s, many nursing informatics pioneers were early adopters of and pioneers in developing resources on the early World Wide Web, and of using discussion lists and other such tools as were becoming widely available. However, the nursing informatics organisations themselves were not as quick to adopt their use. It seems this pattern is being repeated again in terms of social media. Perhaps some of you will vehemently disagree, and wish to show me examples to prove me wrong. I would like to be proved wrong, but my own looking around to find evidence while I write this column is not bringing up too many examples.

A number of peer reviewed publications are beginning to show evidence for the impact on health of using a variety of social media tools. Gold et al. (2012), for example, writing in JMIR show how an Australian sexual health promotion intervention used social networking sites to target at-risk groups. They showed the need for interaction, but that using social media for health promotion interventions is “easier said than done”. Many presentations at recent conferences focusing on Web 2.0 and social media in health, such as the Medicine 2.0 series (http://www.medicine20congress.com/) have presented studies that are beginning to show some evidence. However, my own view is that a significant proportion of these studies are not really looking at social media, but simply at continuations of older technologies and discussion media that just happen to have a slightly newer interface. I am not convinced that discussion forums, per se, are “2.0”. However flawed some of the recent work may be, it is important that we begin to explore tools and techniques, adapting older ones and creating newer ones. Things change so fast, we cannot rely on long-term ‘gold standard’ studies and will need to look to other robust methods and more agile approaches to research, including a recursive and interactive approach to using the social media tools as research inputs, research methods, and dissemination tools.

As I close this column, I have a strong feeling of deja vu, that I have said many of these things before, and I risk starting to sound like a stuck record (for the younger readers who don’t know what a ‘record’ is, look it up; it is an ancient hardware approach to delivering music files). However, I think the issues remain valid, and I look forward to us together making progress in addressing them, and working to improve health globally and locally through the use of current and new technologies.



Boulos, M. N. K, Maramba, I., & Wheeler, S. (2006). Wikis, blogs and podcasts: A new generation of  web-based tools for virtual collaborative clinical practice and education. BMC Medical Education, 6,41. doi:10.1186/1472-6920-6-41 Retrieved from http://www.biomedcentral.com/1472-6920/6/41

Eggers, R. & McGonigle, D. (2012). Are nurses challenging social media? Online Journal of Nursing Informatics (OJNI), 16(3). Retrieved from http://ojni.org/issues/?p=2030

Gold, J., Pedrana, A. E., Stoove, M. A., Chang, S., Howard, S., Asselin, J.,…Hellard, M. E. (2012). Developing health promotion interventions on social networking sites: Recommendations from The FaceSpace Project. Journal of Medical Internet Research,14(1), e30. Retrieved from http://www.jmir.org/2012/1/e30/

Goldner, S. (2012, Sept. 11). A hype cycle view of social media. Don’t worry: The ‘stage of enlightenment’ is coming for social media. Retrieved from http://adage.com/article/digitalnext/a-hype-cycle-view-social-media/237124/

O’Reilly, T. (2005, Sept. 30). What is web 2.0? Design patterns and business models for the next generation of software. Retrieved from http://oreilly.com/web2/archive/what-is-web-20.html

Steele, R. (2011). Social media, mobile devices and sensors: Categorizing new techniques for health communication. The 5th International Conference on Sensing Technology, Palmerston North, New Zealand, 2011.

Wikipedia. (2013, Jan. 10). Web 2.0. Wikipedia entry, last updated 10 January, 2013. Retrieved from http://en.wikipedia.org/wiki/Web_2.0


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