Concept of Electronic or Online Discussion Groups In Nursing Education
Whats are Electronic Discussion Groups
The Internet provides many opportunities for patients and healthcare professionals to participate in electronic discussion groups with other people who share a common interest. In the case of health and healthcare education, common interests can focus on a specific health-care problem such as cancer, a life circumstance such as death of a spouse, a health interest such as nutrition, or a professional issue such as nursing research.
Although different types of electronic discussion groups are available, all share a common feature the ability to connect people asynchronously from various locations via computer. People like electronic discussion groups because they are easy to use and are available 24 hours a day.
Because electronic discussion involves faceless communication with strangers from all over the world, there is a sense of anonymity even when real names are used. With the growth of Facebook, blogs, and other forms of social media, electronic discussion groups are not as popular as they once were. However, electronic discussion groups a wide range of topics are still available- covering aw able and active.
Types of Electronic Discussion Groups for Nursing Education
Electronic discussion groups can be structured in different ways. Some are moderate, whereas others have little or no oversight. Some electronic discussion groups have thousands of subscribers, whereas others are very small closed groups created for specific purposes.
For the nurse, electronic discussion groups can serve several purposes. Such groups can be used as vehicles for teaching or as learning resources to share with patients and other health care professionals. The nurse who chooses to create an electronic discussion group can use it to reach large or small groups of healthcare consumers or healthcare professionals from within the immediate vicinity or worldwide.
For example, electronic discussion groups have been created and moderated by nurses to promote networking and information sharing among nurses within a certain specialty area. These groups are open to anyone who is interested and typically have memberships of several hundred people from countries around the world. In comparison, nurses in a hospital or clinic might choose to set up a small private electronic discussion group as a means to facilitate a journal club.
Whether the group is large or small, the asynchronous nature of electronic discussion groups makes it possible for people to communicate with one another despite different time zones and work schedules. Also, no matter whether the nurse chooses to create an electronic discussion group or uses one already in existence, this form of online communication provides for a creative way to learn and to teach.
Automated Mailing lists and Use In Nursing Education
Automated mailing lists are one of the most popular means of setting up an electronic discussion group. With an automated mailing list, people communicate with one another by sharing e-mail messages. The principle by which these groups work is simple. Individuals who have subscribed to the mailing list send their e-mail messages to a designated address, where a software program then copies the message and distributes it to all subscribers.
Therefore, when a message is sent to the group, everyone gets to see it. The most popular of the e-mail list management software programs is LISTSERV. Although LISTSERV refers to a commercial product, all automated mailing lists are sometimes incorrectly referred to as “Listservs.”
Although mailing lists are owned or managed by an individual, much of the work involved in running the list is automated by the software program used. Subscribers are given two e-mail addresses to use when interacting with the mailing list: one to use when posting messages to the entire group and another to use for administrative issues such as requests to stop mail for a specific period of time.
Both functions distributing messages and handling routine requests are automated and handled by the software program rather than by a person. Subscribers must use the correct address and precisely worded commands when attempting to interact with the list because the computer program cannot solve problems.
Upon enrolling in the mailing list, subscribers are sent directions and a list of properly worded commands that should be used when communicating with the software program. New subscribers are encouraged to save the instructions and refer to them as needed. Despite these precautions, new users frequently make mistakes. It is not uncommon to read messages from frustrated subscribers who cannot stop their mail because they are either posting to the wrong address or failing to use the correct command.
Automated mailing groups are wonderful tools for the nurse when used as a means for delivering education to large numbers of people or when shared with clients and colleagues as a learning resource. Mailing lists are easy to use once a user understands how the system works. Multiple free tutorials are available on the Web to help the novice subscriber.
With multiple automated mailing lists available, it is possible to find an online group to cover almost any issue. The quality of the messages is usually very high in both health-related and professional mailing lists. Nurses who choose to create a group rather than to participate in an established one can learn to manage a large or small electronic mailing list without too much difficulty.
Even so, it is helpful for list managers to have either the support of computer professionals in their institution or the knowledge and skill necessary to handle the routine computer issues that arise from time to time.Mailing lists can be used effectively as vehicles for education or information exchange with groups desiring these opportunities over time.
Because mailing lists facilitate group rather than individual communication, they work especially well for people who are interested in collaborative learning or learning from the experiences of others. Mailing lists designed for professional audiences are good examples. Multiple lists are available covering everything from nursing history to nursing research to specific areas of nursing practice.
Most of these automated mailing lists are quite active, and at any given time, several discussion topics can be addressed by the group. Members post questions, ask advice, and comment on current issues. Relationships between tween active members are established over time, and group members come to count on others in the group for their counsel.
For these same reasons, automated mailing lists have become popular as mechanisms for online support for health consumers (Coulson & Shaw, 2013; Mayo Clinic, 2015). With the increased use of computers by the general population, an increasing number of people have turned to their computers to access information and resources that can help them deal with their health issues.
As a result, the need has been identified for electronic discussion groups devoted to specific health problems and online support groups have been established (Medina, Filho, & Mesquita, 2013).
For example, the Association of Cancer Online Resources, Inc. (ACOR, 2017) has been a major player in the move to bring online support to healthcare consumers. This nonprofit organization, which is devoted to assisting people with cancer, has established more than 142 different online support groups since 1996, each devoted to a certain type of cancer or cancer-related problem.
Memberships in the various groups range from about 25 people in the smaller groups to almost 2,000 individuals in the larger groups.Other individuals and organizations have established similar online groups covering a wide range of healthcare issues. Sometimes these groups are started by individuals who have an interest in a special topic; others are started by professional or advocacy groups interested in providing service to a specific group of people.
In addition to the many public groups that have open enrollments, private groups can be established to meet the needs of a group of people associated with a certain healthcare provider or organization (Thompson, Parrott, & Nussbaum, 2011).
Online support groups are particularly relevant to the discussion of technology for education. Wright (2016) reviewed the literature on online support groups/communities to uncover predictors of participation, explore the application of relevant theoretical frameworks, and critique coping strategies and health outcomes for individuals with different health concerns.
Coulson and Shaw (2013) discussed the factors contributing to the success of online support groups. A review of the purposes and goals of several online support groups revealed education and information sharing as the reason for starting and maintaining a group.
The emphasis on information sharing in online support groups is not surprising. Many people join online support groups after they or their loved ones have been diagnosed with a serious illness. They come to the support group not only to receive reassurance and encouragement but also to gather as much information as possible so that they can begin to make necessary decisions about treatment.
By joining an online support group, they are turning to people who know what they are going through and who can give practical advice based on real-life experience. The desire to share the most current information is commonly what brings group members together, and a discussion of new treatments and other discoveries found in the literature is commonplace (Mou & Coulson, 2013; Silence & Bussey, 2017; Thompson et al., 2011 ).
Nurses may wish to teach their patients about the benefits of online support groups. If an appropriate group is not available, nurses can start an online support group of their own. On-line support groups may be especially helpful to people who find it difficult to leave home be- cause of illness or care responsibilities.
Patients who are unfamiliar with online communication should be reassured that there is no pressure for them to contribute to the discussion and that many people benefit just from reading the comments of others. Patients who are insecure about their ability to express: themselves in written format may find it helpful to initially compose their messages using a word processor so that they can take the time to think about what they want to say and use the spelling and grammar check function to edit their remarks.
Those who are unsure whether an online support group will meet their needs should be encouraged to give one a try. There are no costs involved other than the cost of being online, and users are under no obligation to continue their participation. Subscribers can withdraw from a group at any time. Online support groups have some disadvantages that should be shared with patients who are thinking about joining one.
Most people who have participated in a LISTSERV or other type of mailing list note that the volume of messages received each day can be problematic (Aranda, 2014). Some e-mail boxes are flooded with responses and the receipt of unwanted e-mails per day.
Experienced users learn to sort messages and delete the unnecessary or irrelevant ones quickly. Others find requesting that messages be sent in digest form (in which all messages received in a day are combined and sent in one mailing) helps control the volume of e-mails received. In any case, the daily volume of messages initially can be overwhelming and may present a problem for people with low literacy levels or for people for whom English is a second language.
Patients also should be made aware of the fact that most online groups do not have a professional facilitator. Instead, online groups are often run by someone who is interested in the health problem being discussed either because he or she has the condition or has a family member with the healthcare problem. Consequently, inaccurate information may be shared and problems with group dynamics may not be addressed.
Although online support groups have been found to be beneficial for most individuals, it should be noted that some people report leaving groups because of the intensity of the discussion or because they felt that some participants were unkind to others. It has been suggested that the anonymity associated with the online format may result in some individuals feeling less inhibited, which results in people posting remarks that might not have been posted in a face-to-face environment (Hammond, 2015).
Although this chapter classifies online support groups within the category of automated mailing groups, it should be noted that online support groups take many forms. Many groups use the mailing list or LISTSERV format described here. Others use
Facebook as their platform for group information sharing. Still others maintain a website that provides many avenues for communication, including scheduled and unscheduled chats, bulletin boards, mailing lists. and electronic newsletters. Regardless of the format, online support groups provide a mechanism for meeting the teaching and learning needs of many different client populations.
Other Forms of Online Discussion In Nursing Education
Online discussion can take place through many other mechanisms. Although mailing lists and blogs are two of the more common approaches to online discussion, others are worthy of mention. When choosing a method for teaching or exchanging information online, it is important to consider all options and select the method that is most appropriate for the content to be delivered and the audience to be targeted.
Online forums, message boards, and bulletin boards are systems that provide a way for people to post messages for others to read and respond to. These systems are found on websites that allow users to post directly to the discussion board rather than indirectly via e-mail. Many people may find discussion boards easier to use.
Although most discussion board type forums require some system of registration, users can often select a user name of their choosing and e-mail addresses are not displayed. This added privacy is a boon to many people who are reluctant to share their names and e-mail addresses with strangers. Online forums, message boards, and bulletin boards for health consumers and healthcare professionals can be found on many health-related sites on the World Wide Web.
Online chats
Chats differ from e-mail and the other electronic communication modalities previously discussed in that they provide an opportunity for online conversation to take place in real time. Although chat conversations take the form of text rather than audio, a chat session shares many feature snares, several people from different locations participate in a conversation at the same time. Both also allow people to join or leave the session as needed.
Patients and healthcare professionals have many opportunities to engage in online chats related to health issues. A search of the World Wide Web can uncover a vast array of scheduled chats where a specific topic is being discussed at a given time as well as ongoing chats where people are invited to stop in at any time to ask questions or engage in conversation with people who happen to be in the chat room.
In addition to public chat rooms, many organizations sponsor chats for their own clients or staff to offer ongoing educational programs or information exchange among groups.When leading or facilitating a chat group, it is important in advance to plan for the interaction. The discussion in a chat room can move quickly, and it is very easy to get so involved in the process of chatting that the content to be covered gets lost or forgotten.
Also, without adequate control systems in place, chats can experience communication problems, such as multiple on-going conversations, lack of focus, and periods of silence.
Guidelines for Successful Online Discussion In Nursing Education
The following suggestions may help to organize a successful chat session:
E-mail or post the purpose of the chat session several days in advance. If appropriate, include an agenda, assignments to be completed ahead of time, or other resources that participants will need to prepare for the session.
Make a list of the discussion points to be covered during the session. The list should be well organized, easy to follow, and placed so that it can be easily seen during the chat. Chat sessions often move so quickly that there is little time for the facilitator to make sense of crumpled or scribbled notes.
Depending on the topic and the experience of the facilitator, it may be appropriate to limit the number of participants. The larger the group, the more difficult the challenge of running a smooth and productive online chat. Sign on to the chat session early and encourage participants to do so as well. You want to be able to handle unexpected problems before the session begins.
Watch the clock. Time in a busy chat session goes by quickly. If the chat was designed as a question-and-answer period, it may be helpful to ask people to e-mail important questions ahead of time so they are not forgotten.
Help the group to follow the conversation taking place. It is easy for chat discussions to become disjointed or off topic. When responding to a question, refer to the query and the person asking it. For example, “Karen asked about pain management. I think...” If the group is losing focus, bring the participants back to the agenda and the points being discussed.
Limit the amount of time spent discussing the detailed questions or concerns of one participant. If someone in the group needs individualized attention, suggest that he or she email or call you after the chat has ended. If appropriate, ask participants who have not joined the conversation if they have any questions. Some participants choose not to make comments during a chat, which is acceptable.
However, there may be others who were not quick enough to get their comments online and who have questions that need to be asked. A statement such as “Our conversation moved very quickly tonight, so I want to give those who haven't had a chance some time to ask their questions” may slow down the conversation long enough for everyone to have an opportunity to contribute.
Begin to wrap up the session about 10 minutes before the scheduled end time. Announce that there are 10 minutes left and ask for final questions or comments.
It also may help to prepare participants for the chat experience. Chat sessions can be overwhelming for new users. The following guidelines for chat participation should be shared with patients or colleagues who will be joining a chat session for the first time:
Allow enough time before the chat starts to download software if it is needed. First time users are often required to download software, called a chat client, before beginning. This software is typically offered as freeware or shareware on the Internet and is easy to install.
Be prepared to choose a user name. Participants in public chats with strangers are often advised not to use their real names to protect their privacy.
Keep comments short and to the point. If a user takes a long time to compose a message, the group may have moved on to an entirely new topic by the time the message gets posted.
Be prepared for chat lingo in public chat rooms, Abbreviations like BTW (“by the way”) and emoticons (typographical symbols that represent emotions or facial expressions such as:) for winking) are commonly used.
Do not worry about typographical errors and grammar. Chat programs do not have spell checks, and not everyone is an experienced typist. People who are frequent chat users learn to overlook spelling errors.
Chat works well as an online communication modality for many people. Patients who are homebound or isolated may benefit from having the opportunity to participate in education programs or to receive answers to their questions without leaving home. Likewise, many health-care professionals would benefit from being able to access professional education that allows real-time discussion and dialogue.
However, some limitations of chat must be considered. Because chat requires that people be online at the same time, scheduling conflicts and time zone issues may result in less accessibility than asynchronous forms of electronic discussion. Also, as mentioned earlier, because of the fast pace of most chat discussions, it may be difficult for some patients to keep up with the dialogue.
Patients with certain disabilities, who are ill, and/or with low literacy levels may find it difficult to participate if the group moves along quickly.The future for electronic communication is exciting. The technology to add audio and video components to online conferencing is available and is becoming more refined and less expensive every day. Chat and other types of conferencing software also are becoming more sophisticated, allowing for more control and greater ease of use.
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