A Slippery Slope

Facilitating nursing education poses both similar challenges as well as obvious differences to those of you who educate in primary, middle and high school.  Besides the understandable differences such as  maturity level, age, curriculum, and legislation, there are more serious and consequential elements that must be considered. The content which often considers health teaching and concerns, frequently revolves around personal and confidential data, as well as praxis which incorporate best- practice and an ever changing  and evolving skill and knowledge base.

Being mindful of the above mentioned points, I believe opening  nursing and health related online course spaces to the world pose both benefits and risks/drawbacks.

Nursing students exposed to open course forums could benefit from the exposure and access to expert, diverse and advancing health knowledge, treatments and research. The polarizing discussions formulated in open forums could easily be facilitated through the exposure to  varied and diverse perceptions, experiences and the sharing of unique knowledge. Furthermore and just as importantly, this sharing could potentially have significant effects  not only on nursing knowledge, but ultimately positive patient outcomes.  Open forums in health education could also result in unforeseen and unique teachable moments that may not occur in typical closed discussion rooms. The experiences shared from various diverse populations and demographics can only enhance and widen the lens in which healthcare workers assess, diagnose and treat medical conditions and illnesses.

Professionalism and its associated behaviors, content that is discussed at length within nursing education programs, could also be incorporated within open online forum discussions and assist students in communicating in professional and competent manners. Often in closed forums, where students often become comfortable with their peers, professional language, effective conflict resolution and medical information and jargon is often communicated at a level that is consistent with the cohort of students. Engaging in an open forum would encourage nursing students to post and respond to comments in respectful, professional and at a level appropriate to those they are conversing, be it a layperson or expert.

Drawbacks to open online forums in relation to nursing education also exist. Consciously or not, students may inadvertently discuss private and confidential patient information. Not only would this pose issues with their educational institution but with their future regulatory body.  Educational institutions, such as the Saskatchewan Polytechnic, and Regulatory bodies, such as the Saskatchewan Association of Licensed Practical Nurses(SALPN) and the Saskatchewan Registered Nurses Association (SRNA), have strict standards and guidelines when it comes to patient confidentiality and professional boundaries in the use and sharing via electronic and social media. Discipline investigations and processes would incur if confidentiality standards and guidelines were breached.

The rules and regulations regarding open sources and media are strictly monitored and enforced by healthcare institutions and regulatory bodies. A recent incident regarding a Prince Albert nurse who posted about her grandfather’s health care experience on Facebook was found guilty of professional misconduct. Regardless of the fact that the accused nurse argued that her post was made on a her personal Facebook page and was made from the perspective of a family member, not a nurse, the SRNA felt that as a nurse, professional behaviors must be maintained both at work and in the private lives of nurses.

Another drawback to nursing students participating in open online forums would be to the potential exposure to information and knowledge that does not meet or exercise best practice standards and knowledge. Students could potentially be exposed to practitioners who don’t practice to best- practice standards,unregistered healthcare workers, laypeople or those who misrepresent themselves. The potential for  misrepresentation, false or inaccurate  knowledge and anonymity pose risks in relation to nursing student knowledge and raise issues regarding patient safety and care.

If open online forums were an option for nursing students, I believe that safeguards would have to be in place. Moderators would have to be secured to ensure content was vetted for accuracy and patient confidentially was maintained. Although these securities would pose enormous consumption of time and exhausting responsibility and obligation, the benefits in relation to student learning and exposure to vast amounts of knowledge and research would be tremendous.


About Twana2017

Wife, mother, nurse, teacher, life-long learner and kid at heart!
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8 Responses to A Slippery Slope

  1. Thanks for your interesting post Twana. I can certainly see how confidentiality risks could pose problems in open online discussions. It is possible to imagine how someone might inadvertently share private information. I think the potential for crossover between person and professional lives is great. I am aware of how in the role of teacher, we must be aware of our presence out in public view. Also, the idea that nursing students who are looking for new information and guidance might be led astray is an interesting one. Of course there are all sorts of ‘professionals’ who are will to share ‘their’ way of doing things. Lots to think about.


  2. I couldn’t agree more that this is a very slippery slope when it comes to nursing education. While reading your post all I could think about was that nurse from PA that you mentioned in your blog. I believe that nurses, teachers and professionals alike need to remain professional on and off the job. I have found this nurses case particularly interesting for many reasons and it has made me ask myself, where is a ‘safe’ place for nurses to discusses ones concerns about the health care system that will make a “real” impact on change within our health care system? I can agree that Facebook is not the place. Would an open online forum where nurses can discuss issues in a more ‘positive’ way help inflict strategies and suggestions for change. This would give access to the “powers that be” to take this information and suggestions forward in a more meaningful way.

    Getting back to nursing education and open forums….as you have said, I also agree that open forums could have it’s benefits and drawbacks. If something like this was to be implemented, it would have to come with much consideration, have strict guidelines and ongoing monitoring.
    Do we have the time, resources and man power to make something like this work?


    • Twana2017 says:

      i don’t know Melinda… I think if nurses were to have a place to openly discuss knowledge, issues etc it would have to have strict rules and be moderated. I really cant see an open forum working without being policed…


  3. adamkrammer says:

    I really enjoyed your post this week! It was very interesting reading about the professional part of your post and how we need to watch everything that we are posting whether that be a comment on someones blog or simply the information that is being provided over the internet. It was also interesting how you placed this in a nursing student perspective, and typically I see it from a middle years perspective. Well done!


  4. Great post Twana! I think you raise a lot of important points related to online forums, particularly the confidentiality aspect. We have all heard stories of things getting put online and then consequences for professionals. It actually always makes me nervous to say maybe negative aspects of my career or criticize elements of it, online, because of possible repercussions. The risk wouldn’t be as great in closed forums. Thanks for sharing!


    • Twana2017 says:

      Thanks for your comments Liz. I think open forums have a time and place and I think being to speak freely is important as well. I believe if one frames their comments in a respectful manner and is open to feedback open forums can be a great place for learning and gaining greater perspectives.


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