Innovative network brings B.C. nurses and other members together virtually
Apr 05, 2015, By: Noreen Frisch, RN, PhD , Pat Atherton, MPA , Grace Mickelson, RN, MA
The British Columbia Nursing Research Initiative, through the Michael Smith Foundation for Health Research (MSFHR), funds programs that support B.C.’s nursing workforce. These programs focus on three priority areas: nursing health human resources, practice-relevant education, and quality and safety of the practice environment. Our program, the INnovative health Services and Practice Informed by Research and Evaluation Network (InspireNet), was launched in 2009 with a mandate to increase nurses’ capacity for health services research (HSR) in B.C., with a crosscutting theme of interprofessional health care. InspireNet was designed to attract nurse clinicians, managers, educators, researchers and students as members. In 2013, the network’s mandate expanded to include all health-care professionals.
Grant funding provides the infrastructure and the support for one network manager and one part-time administrative support person. All other activities are carried out on a voluntary basis, including team leadership and the work of the academic and practice co-leaders of the network.
InspireNet was envisioned as a virtual network from its inception in recognition of its provincewide mandate. Because of its accessibility and member-controlled content, the network has grown exponentially and beyond our initial expectations.
InspireNet operates on a Web 2.0 platform, which means anyone can contribute content, whether it’s uploading a document or commenting on someone else’s materials. The network consists of a website with a password-protected area reserved for members only. The public-facing portion of the website includes links to research and knowledge translation skills training materials, HSR resources, funding opportunities and conference listings. In the password-protected area, members can access the member database to find individuals with like interests, or they can join a specific team (see table).
Teams are made up of volunteers and follow a distributed leadership model, which means they are set up by members who share an interest in a topic area. Any InspireNet member may join an action team; the closed teams are for established research teams to conduct their work virtually, and the coordinating teams are open to members wishing to support InspireNet’s operational functions. Each team has the ability to set up discussion groups, wikis, blogs and webinars to accomplish its goals.
To supplement the virtual activities, InspireNet members convene an annual conference. The program features keynote speakers and network members who present their research and evaluation projects as electronic posters (ePosters). The ePosters are subsequently archived on InspireNet’s website and accessible to anyone with Internet access.
Evaluation and results
Evaluation of the network, conducted with research ethics board approval, is performed through annual surveys and is based on a comprehensive plan tied to our logic model. Other evaluation work includes interviews with members, annual reports to MSFHR and website analyses using Google Analytics. Through our evaluation processes we’ve learned a great deal about the challenges nurses encounter in a primarily virtual HSR environment. Evaluation reports are available on the website.
InspireNet’s membership growth has vastly exceeded our original expectations. As of the end of February 2015, more than 3,800 individuals have joined the network: about 61 per cent work in health authorities; about 24 per cent work or study in academic settings; and about 15 per cent work in government, smaller organizations and non-governmental organizations. Approximately five per cent of our members are located outside B.C., from across Canada and as far away as Australia and the U.K.
InspireNet currently hosts 10 action teams and 30 closed teams. About 1,700 members participate in action teams. We’ve learned through recent website analysis that 50 per cent of the traffic to our website is generated by closed team members who access an electronic Community of Practice (eCoP).
A key outcome of InspireNet’s work is strengthening knowledge translation (KT) in HSR. InspireNet conducts KT activities and also provides educational sessions for members to increase their understanding of KT best practices. The KT team has established an action plan and initiatives to develop capacity in both integrated KT and end of grant KT, as defined by the Canadian Institutes of Health Research.
KT activities include the blog, which has had over 20,000 page views to date. The blog is authored by InspireNet members and covers a wide range of topics, such as research challenge programs conducted by the regional health authorities, how to compose an argument for publication purposes and tips on how nurses can become involved in research projects.
ePosters, the innovative form of knowledge dissemination featured at our annual conference, have had strong uptake. So far, 48 ePosters have been presented by 97 members; these ePosters are displayed on InspireNet’s website and have had 7,330 visits.
We believe that webinars have likely had the greatest impact on our InspireNet community. Webinars are offered in real time, with members participating live (synchronously), and they are also recorded and linked on our website, providing members with the opportunity to view them on demand (asynchronously). At the time of writing, 138 webinars have been offered. More than 2,000 members have participated in these synchronously, but the real reach of webinars is seen in asynchronous participation, with over 12,000 webinar views counted so far.
In terms of education, we have hosted a series of KT-specific webinars. Other webinars supported by topic-based action teams have included knowledge-to-action work, such as discussions with researchers about practice implications of their work and journal club meetings to learn and evaluate best practices.
Levels of participation
InspireNet members are able to participate in the network at any level, whether it’s watching/leading a team, reading/adding content, sharing resources with colleagues, or observing/running a webinar. The literature has well described the varying degrees of engagement in online communities, known as the one per cent or 1-9-90 principle: one per cent are super users; nine per cent are contributors; and the remaining 90 per cent are watchers or audience members who participate peripherally, learning from the actions of the more active users (van Mierlo, 2014). Based on our evaluation metrics, InspireNet’s users seem to mirror the 1-9-90 theory.
Implications for practice
Clearly, nurses have taken up membership and become engaged in our HSR virtual network. That being said, we have encountered barriers: issues with accessing our website from workplace computing devices and browsers; member reticence to adopt virtual ways of working; and, most significantly, time constraints with volunteer leaders and members. We implemented the following strategies to address the barriers:
Community management. A majority of InspireNet members had never participated in a Web 2.0-based network. Community management is an emerging discipline consisting of professionals who manage virtual communities to optimize participation rates. The InspireNet community manager has a central role in managing the e-platform, vendors and staff, supporting the members, “curating” the content and social media, training and supporting teams’ startup, and collaborating on strategic advancement of the virtual network.
Team leaders. Teams are led by InspireNet members who volunteer to develop the team’s mandate, welcome new members and drive content and activities. This role requires individuals who are interested in learning how to lead virtually and have time to take on the work to foster relationships.
Ongoing support. We provide our annual conference and webinars for team leaders, plus regular progress reports from the network manager. The watcher audience gains benefits without necessarily engaging in network activities.
Social media. More nurses are engaging with social media for professional purposes. We have found value in participating in social media conversations, specifically for knowledge dissemination.
Our members have been instrumental in clarifying the lessons we’ve learned during the development of our network to its current mature stage of life. They have taught us that InspireNet has been meaningful to their professional endeavours and has resulted in changed behaviour and improved care, as illustrated in the following comment:
[I have] learned skills on how to present by webinar to a provincial audience [and have] learned how to run a webinar as the webinar host. This has been the most inspiring and useful strategy for nursing in my 30-year career. To see nurses from both leadership positions and the bedside participating in research to change patient care has been nothing short of incredible. Their work will change evidence and practice — it has already from the work that has occurred over the last few years. [InspireNet] must continue, to allow the nursing profession in B.C. to continue to grow and reach out to others across the province and world.
– Member, personal communication, 2013
In response to overwhelming support from our members encouraging continuation of the network, we are currently exploring potential partnership models for the sustainability of the network after MSFHR funding ends in late 2015.
We believe that this virtual network model could be used in other jurisdictions to animate discussion with nurses and other health-care professionals in interprofessional research and practice contexts. The network has demonstrated value to the health-care workforce, and the associated costs have been minimal. There is potential for successful future virtual networks in or beyond HSR in any jurisdiction interested in adopting new technologies to bring people together to explore and learn.
The authors acknowledge the support of the Michael Smith Foundation for Health Research, the British Columbia Nursing Research Initiative and our two host institutions: the University of Victoria, School of Nursing (academic host), and the B.C. Provincial Health Services Authority (clinical practice host).
van Mierlo, T. (2014). The 1% rule in four digital health social networks: An observational study. Journal of Medical Internet Research, 16(2):e33. doi:10.2196/jmir.2966.
Noreen Frisch, RN, PhD, is the Director of the University of Victoria School of Nursing.
Pat Atherton, MPA, is InspireNet network manager, University of Victoria.
Grace Mickelson, RN, MA, is co-leader of InspireNet and is corporate director – academic development, Provincial Health Services Authority, Vancouver.