I’m thrilled to joining the team of bloggers for the APTA Health Policy & Administration Technology Special Interest Group. Today, I published my first post on the APTA Tech SIG’s blog – the first in a series I’ll be writing about Twitter in society and health care. Here’s an excerpt:
“There is no doubt that Twitter has legions of passionate users, myself included. But I’ll be the first to admit – Twitter is a tougher nut to crack than many other social media sites, and these data underscore the legitimate questions about whether it is a broad source of information or a niche service. And, even though it’s been around since 2006, there continues to be many misconceptions and lots of misinformation about Twitter. Over the next several weeks, I’ll be sharing a series of blog posts about Twitter in society, health care, and physical therapy. I’ll start with the basics, discuss what data tells us that people are actually doing on Twitter, and talk about how Twitter is used in physical therapy and health care. I hope this series of posts will demystify Twitter for non-users, help potential users understand how Twitter may (or may not) be useful for them, and give current users a new perspective on how Twitter is being used in society and how it may be used effectively in physical therapy and health care. I also hope it generates at least a little discussion and debate about what the future holds for Twitter, and social media in general, in health care and physical therapy practice.”
This year, we added social media communication as a professional competency in our Doctor of Physical Therapy curriculum. During their 5-week Professional Interactions course, our first-year students were required to complete a number of assignments on the social media sites Twitter and LinkedIn. For their last Twitter assignment, students were asked to reflect upon their choice of PT as a career, and to participate in a tweet chat using the hashtag #WhyIchosePT. I tweeted an invitation for other students and professionals to join in, resulting in over one hundred #WhyIChosePT tweets from physical therapy professionals around the country and the world.
With so much talk about our “broken” health care system, it is refreshing and inspiring to read stories about why so many of us chose (and continue to choose) PT as our profession. If you’re a physical therapy professional, #WhyIChosePT will remind you why you chose the field in the first place. And – if you’re not – I dare you to read these tweets without wishing that you chose PT, too
This is just the beginning. You can view the entire #WhyIChosePT story on Storify by clicking here.
My view from the floor of the APTA House of Delegates
Earlier this month, I attended my very first session of the American Physical Therapy Association’s House of Delegates. There were a couple of large issues – namely governance review and what is now known as Physical Therapist Responsibility and Accountability for the Delivery of Care (formerly discussed as RC 3-11 & RC 2-12) – that dominated House this year, as well they should have. Both of these have to potential to bring large changes to our profession and the APTA itself. I enjoyed these discussions and learned a lot in the process. But, as a researcher with an intense interest in the role of social media in physical therapy practice and education, it was a much smaller motion that I was interested in this year: RC 23-12.
RC 23-12, Standards of Conduct in the use of Social Media, was proposed by the Washington Chapter. Prior to the House, RC 23-12 caught the attention of a group of physical therapists (including myself) who actively use social media for professional and educational purposes. This resulted in a social media discussion of the social media motion, including my post on PT Think Tank, a Google+ Hangout, and an ongoing Twitter conversation using the hashtag #RC23. It was exciting to be a part of those conversations, and I (somewhat naively) thought that it was likely that no one was paying much attention to them besides social media users. My intent, as a delegate, was to get feedback about this motion from physical therapy professionals who actually use social media so that I could take that feedback to the House of Delegates. I learned that not all Delegates viewed my social media use so favorably. Participating in the House of Delegates was an eye-opening experience and, now that the final Post-House packet and House summary documents are posted on the HOD online community (accessible to members), I think it might be time to finally share some of my experiences and lessons learned.
Lesson #1: RC 23-12 was totally unnecessary and – as written – doesn’t really DO anything
The final language of RC 23-12, adopted by the 2012 House of Delegates, is available in the House of Delegates online community (available for APTA members). I’m told it will be “published” (I assume that means public) when it is officially approved in September. I was very involved in modifying the language, and I do think the policy is much more positive now (the first sentence does, after all, recognize that social media offers new “opportunities” for communication). But I still voted no on the motion, because I think the policy is unnecessary (as most social media policies are). The APTA – like most other health care organizations and institutions – has a Code of Ethics and Standards of Conduct. These documents outline expectations for ethical and professional conduct that apply to all forms of communication, including social media. By adopting a social media policy, we followed other health care organizations (most notably the AMA). And I’m sure many thought that having a policy that recognizes professional use of social media was a progressive position. But I would argue that the true progressive position would be to recognize that social media is simply another form of communication and doesn’t warrant any additional policies. That said, I think RC 23-12 is essentially harmless – it isn’t any more restrictive than the existing Code of Ethics, so I don’t think it is a game-changer.
Lesson #2: The APTA, as an organization, is pretty progressive when it comes to social media
As an organization, the APTA takes a lot of heat about being non-responsive to members (and non-members), and that includes criticism about its use of social media. What I learned at the House of Delegates is that APTA staff, as well as the Board of Directors, are actually extremely progressive when it comes to social media, and seem to be excited about its potential. There are two APTA staff members (shout-out to Jason and Amelia!) who are social media experts, and I had many exciting conversations with them about their ideas to continue to expand APTA’s social media presence. I was also approached by several Board of Directors members who said that they followed the Twitter discussions or viewed the Google + video and were excited by what they saw. They saw potential for future social media discussions, and appreciated the opportunity social media provided to educate members on the APTA governance process (how many of you learned how to contact your Delegate?). From the top, the APTA seemed to be very supportive (and even a bit intrigued) by the potential use of social media to discuss association issues and even House motions. It was my fellow APTA members who seemed a bit more uncomfortable with it, which leads me to…
Lesson #3: APTA members (or at least those who are delegates) are very traditional, which results in a lot of hesitation, skepticism, and even fear of/about social media
The only negative reaction to social media use (at least that I heard) came from my fellow Delegates, many of whom seemed to be upset about the use of social media to discuss and share House issues. There were questions about whether the #RC23 Twitter conversations were “appropriate,” and lots of feathers were ruffled when I (and a few other Delegates) tweeted during the candidate interviews. I heard delegates say things like “I’m not a social media kind of person, I never will be,” and there was much grumbling about how many delegates were using devices (laptops, iPads, and smart phones) during the House. All of these comments seemed to come under the guise of concerns about “professionalism,” but I think it’s about something else altogether. The House of Delegates is an extremely traditional environment. Not only does social media have the potential to make House happenings more public and transparent (can someone please tell me why that would be a bad thing?), but it also levels the playing field so that everyone gets a voice. The truth is, many delegations answer to their Chief, vote as a block, and are asked not to post to the discussion boards or discuss motions with other delegations (all that has to go through the Chief). When you understand this, you understand why social media may make some Delegates uncomfortable, and how some (particularly Chief Delegates) may worry that one of their own delegates could go rogue and (gasp!) post their own opinions in a public forum. Don’t get me wrong – there are many progressive, technologically-savvy folks in the House – but there are also many who cling to (and seem to thrive on) tradition and hierarchy, and that doesn’t leave a lot of room for social media. Frustrating, indeed, but an illustration of how far our profession (and health care in general) has to go when it comes to social media and technology.
Lesson #4: Some issues just can’t be discussed in 140 characters or less
One of the biggest lessons I learned on the House floor is that the APTA Staff, Board of Directors, and Delegates work hard to tackle tough, complex issues. I thought I understood “RC 3” (adopted as Physical Therapist Responsibility and Accountability for the Delivery of Care) before I arrived, and quickly realized that I had no idea the breadth and complexity of this issue. The House discussed it for an entire day, and that’s not because we were a “do nothing” House. It’s because changing how we provide physical therapy services is a big deal, and there is much to consider. It may seem simple to a private practice PT that we should have adopted a policy that allows physical therapists total freedom to delegate physical therapy to anyone. But it seems equally simple to a PTA that he/she has a special skill set and should be the only support personnel qualified to provide physical therapy. There is much uncertainty about health care reform. Many members want the alternative payment system to be the priority of the APTA, and have concerns that any profession-altering policy may put that in jeopardy. And there are pediatric physical therapists, like me, who have concerns that the models put forth in RC 2-12 don’t represent pediatric practice (particularly school-based and early intervention therapy). The idea here isn’t to debate this policy, but rather to illustrate how complex these issues really can be when you are trying to represent an organization of over 80,000 members that practice in extremely diverse environments. The truth is, many (most) of these issues just can’t be discussed in 140 characters or less, or we’d conduct House business over Twitter and call it a day. As much as I love social media, I appreciate it for what it is – a place to connect, network, share, educate, and learn. It is a wonderful environment for gathering information and forming relationships – a jumping off point for “real-life” discussion – but isn’t really an effective place for debate. The power of social media – its simplicity – is also the danger sometimes. We can’t have nuanced discussions or solve complex issues facing our profession in 140 characters or less. And so, while it was exciting to tweet news and updates from the House floor, I left the conversation when it turned to debate. And I’ll continue to do that, because it’s not where I want to put my social media energy.
It may sound frustrating, and at times it was. But I’m a glass-half-full kind of gal. So here’s the silver lining… Technology and social media are often referred to as “disruptive innovations” in education an health care. Although social media has been around a few years, I think this year was the tipping point for the APTA. This year, social media was just disruptive (and visible) enough to get everyone’s attention. My hope is that this is the start some real conversations among APTA members, staff, and leadership about how to harness social media and use it to engage members and promote and advance the profession. About how to encourage more participation in the House of Delegates and have broad, transparent discussions about House issues. As in all professions, there is resistance to change. There always will be. But as we move forward, we must recognize that – in a changing world – the biggest risk associated with social media may be not using it at all.
I recently attended a meeting for rehabilitation managers in my community titled, “New Graduates and Generation Y: Training for Emotional Intelligence and Face-To-Face Communications Skills.” This is Part 3 in a series of posts on the themes of that discussion about the Millennial generation. You may also want to read Part 1 and Part 2.
Yesterday, the New York Times ran a story about a kindergarten class that tweets 3 days a week. After reading the story and viewing the accompanying video (see below), I couldn’t stop smiling. With her class project, kindergarten teacher Jennifer Aaron is addressing the “technology gap” using a brilliant strategy, one I think we should model in our professional health care education classrooms as well as our clinics. She has become familiar with the technology, has learned how to use it, and is teaching her students (and probably their parents) how to use it, too.
One of the themes that arose – and involved much discussion – during the area rehabilitation managers meeting I attended last week were concerns about students’ and new grads’ use of technology:
“Students and new grads are always texting, playing Words with Friends, and checking Facebook. They don’t have good professional boundaries when it comes to checking and using their mobile devices. They know how to Facebook and text, but they struggle with “real-life” communication and relationships.”
These concerns are valid and often true. We have some of these same frustrations with “kids these days” in professional education. And why wouldn’t we?
Although there are many well-documented characteristics (stereotypes?) associated with the Millenial generation, what really sets them apart is their use of technology. They are curious and fearless when it comes to technology. They are constantly connected to their friends, family, and world in a way no other generation has before. They enjoy mobility (smart phones) and real-time interaction (Twitter and texting). They don’t want to be tethered to a PC (or even a laptop) or wait for email. This technology has been around as long as they can remember, and they often identify as “digital natives.” They are accustomed to using technology in every aspect of their lives – except education and practice. The “head-in-the-sand, if-we-ignore-this-maybe-it-will-go-away” approach we’ve taken to technology (and – in particular – social media) in education and health care has not served our students well. Suddenly, they enter professional education or a clinical internship (or even a first job) and they’re told they’re supposed to put their mobile device away. But they don’t wear a watch, so how will they tell time? And what about the anatomy app on their phone they use for quick reference? They should hide their social media profiles (or at least make them private). But what if they want to “like” the America Physical Therapy Association on Facebook? Tweet a link for a new Physical Therapy Journal article they just read? Or start a blog and a Facebook page where they can (gasp!) friend their patients so they can share good, reputable health care information?
The truth is, many Millennials don’t know how to use technology and social media in a professional, appropriate way because no one is teaching them. No one is modeling it for them. They are figuring it out on their own, and when they make mistakes, us old folks wag our giant fingers at them and say, “I told you that texting/tweeting/Facebooking/smartphone app using wasn’t a good idea. We should just ban it all.” How’s that working for us?
We all need to take a cue from Ms. Aaron and her kindergarten class. Part of the professional PT education curriculum should be about appropriate, professional use of technology and social media. Instead of telling our students to “turn off and put away” their mobile devices, we should be using them during class as an opportunity to engage students in education and the profession, all the while teaching them to be better digital citizens. Schools and health care facilities should re-think broad policies banning mobile devices and social media. It is time that we recognize that social media is part of “real life,” and that the next generation of health care providers will be expected to have technology and social media skills. Their patients (and the public) will demand that they engage with them using social media. They will walk into a clinic with no Facebook page, no Twitter feed, and no blog; see a physical therapist walk up to them with a paper chart and a medical reference book and wonder, “Is she practicing physical therapy like it’s 1995, too?”
It is time to stop approaching technology and social media in health care and education from a risk management perspective and start approaching it as an opportunity to educate, learn, engage. An opportunity to elevate our practice and the profession.
If Ms. Aaron and her kindergartners can do it, we can, too.
Earlier this week, I posted a Facebook link to a New York Times story on the Ohio school shooting:
The post generated some interesting discussion on bullying and teacher-student interactions, but one comment in particular really got me thinking. One of my friends posted a link to an article describing a disturbing Facebook post written by shooter TJ Lane back in December, ending with the phrase, “Die, all of you.” My friend commented that the shooting “maybe could have been prevented if the grown-ups paid attention to social media.”
Before I go on, I want to point out that it is easy to say – in hindsight – that this tragedy could have been prevented if someone had been “paying attention.” For the most part, I think we all make the best decisions we can with the information we have. Sometimes we don’t do enough, do nothing when we should have done something, or do what turns out to have been the wrong thing altogether. My heart goes out to all the students, teachers, and families who have experienced this nightmare, and I can only imagine the innumerable conversations among them beginning with the words “If only I would have….” I myself have experienced a situation with a tragic and irreversible result, and I understand the depth of that kind of guilt. I am heartbroken for all involved and – simply put – no one is to blame except for one very disturbed young man who did something to ruin the lives of many, including himself.
But I do think this tragedy and the events leading up to it illustrate the need to re-examine the conventional wisdom that teachers should never “friend” their students. Last summer, my home state of Missouri passed a law preventing teacher-student “friendships” on social networking sites. The ill-thought-out law was designed to “protect” students from inappropriate interactions with teachers, and was repealed a few months later. I think what happened in Missouri is a perfect example of how social media (and teachers for that matter) tend to get demonized, usually by people who’ve never logged onto Facebook themselves. It is easy to fear what you don’t understand, and I’m sure Missouri lawmakers thought that “protecting the children” would be popular with voters. But we have to realize that social media isn’t a whole new world of communication. It is simply another way to communicate. A teacher who would interact inappropriately with a student (and – despite what the media would have us believe – I don’t think there are many) is not going to be deterred by a law preventing them from “friending” a student. And, frankly, there are a lot of positive interactions that could occur between students and teachers on Facebook and other social networking sites (not to mention the growing body of evidence, including some of my own work, that social media can actually be an effective part of education). When teachers aren’t allowed to “friend” students – whether because of State law or simply an unwritten “rule” dictating that it’s inappropriate or creepy – there are missed opportunities for meaningful interactions in a space where kids today are doing a whole lot of interacting. And what about the student like TJ Lane, who uses social media as a place to write things he can’t figure out how to say out loud? As a place to cry for help? If no one’s listening, then no one can reach out. No one can intervene. Nothing can change for TJ. And we saw the absolute worst outcome from a situation like that this week in Ohio.
I don’t mean to pretend that there aren’t serious considerations for teachers who “friend” their students. As an educator myself, I’ve done a lot of soul-searching on the subject (although, admittedly, it’s a bit less messy for me since I teach graduate students who are all adults). I’ve come to the conclusion that I’m okay with “friending” my students and former students, but I don’t ever make the request. I understand the privacy settings on all my social networks, and I use the lists feature on Facebook. I monitor my accounts closely. I don’t pose with alcohol and never post or allow myself to be tagged in any picture that could be viewed as questionable or suggestive. I am certainly not afraid to share my personality and am not shy about my parenting philosophies and political leanings, but I strive to also post content that is relevant to who I am as a professional. I abide by the “front door” rule: if I wouldn’t post it on my front door, I won’t post it to social media. By letting my students into my social media “world,” I hope to serve as an example of how social media can be used to develop an online identity that is honest yet thoughtful, and that matches who you are and how you want others to see you. Social media can help you meet people, brand yourself, learn new things, make connections, and get ahead. And that’s probably the most important lesson that can be taught to a student on Facebook.
Social media are the way the next generation of students are communicating, like it or not. A lot of bullying and cries for help are now occurring in the form of posts, tags, tweets, and uploads. We are inundated with stories of young people posting inappropriate and damaging things on social media, and I’m convinced we have to do more than just “pay attention.” We have to act when we see something troublesome and teach kids how to use social media thoughtfully and responsibly. And I’m not sure how to do that without us grown-ups taking a deep breath and hitting the “accept friend request” button.
- Love these students and this project! #GoBabyGo @VarietyKids @VarietyKC twitter.com/rockupt/status… 2 days ago
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- RT @chronicle: When the world’s collective knowledge is at our fingertips online, what becomes of college? chroni.cl/1Tszvy9 5 days ago