Using online focus groups to explore why healthcare

professionals belong to a practice-focused virtual community

Kaye Rolls1,2, Prof Margaret Hansen3, Prof Debra Jackson4, Prof Doug Elliott1

1 University of Technology Sydney; 2 ACI-ICCMU; 3 University of San Francisco; 4 Oxford Brookes University

INTRODUCTION Social networks are formed where individuals or organisations are linked by a common tie such as

shared working environment or professional group (Borgatti & Halgin, 2011).

Many of the current challenges of evidence based practice are related to ineffective internal and

external social networks (Oborn, Barrett, & Racko, 2010).

There is significant potential within multi-disciplinary virtual communities (VC) to facilitate the

transfer of knowledge by overcoming professional and organisational boundaries (McGowan,

2012).

Although healthcare professionals have been using the Internet to form VCs since the early 1990’s

(De Witt, Gunn, P, & Streat, 2004; Murray, 1996) little is known regarding why they join or remain a

member because most research has focused on the perspective of ‘posters’, who form a minority

of members.

Virtual community use by healthcare professionals Current evidence suggests that healthcare professionals (HCP) have established a VC to improve

access to colleagues so they can discuss relevant professional issues and share knowledge (Rolls,

Hansen, Jackson, & Elliott, 2014). Analysis of posting behaviours however found that 60-89% of

members rarely post online (Macdonald, MacPherson, & Gushulak, 2009; Morken, Bull, & Moen,

2009).

Given these findings what motivates HCP to join a VC, and what do they find in these communities

that influence them to remain members?

Online focus groups Online or virtual focus groups are becoming more common as they enable participation of

geographically distributed time-poor individuals and are less expensive to conduct (Liamputtong,

2011; Williams, Clausen, Robertson, Peacock, & McPherson, 2012).

Asynchronous focus groups using a discussion forum have two key advantages:

1. Participants have more time to consider their posts or responses, and can post at a time of their

convenience

2. The participant-controlled, real-time data collection enhances both data analysis (Kenny, 2005;

Liamputtong, 2011) and study credibility (Shenton, 2004)

Intensive Care

Virtual Community

a 24/7 free conference that connects members to a broad

professional community

the credible colleague with expertise & quality knowledge

a ‘water cooler’ talking place where clinical practice

questions are illuminated

I generally scan the emails at work and it may generate some discussion with other

nurses who also subscribe Low poster –Nurse educator

I value the high quality of expertise in the contributors on IC-VC, thereby I am able to rely on

information provided or at least follow their guidance to view recommended sites to research

Non-poster – Retrieval nurse

METHODS A naturalist design using three asynchronous online focus groups was undertaken. The focus groups were

held between October and December 2014 with each group running over three weeks using a closed secure

discussion forum.

Participants were invited to participate via a VC post and after registering were stratified into a focus group

by their online posting behaviours between September 2012 and August 2014

1. Frequent posters – members who posted more than five times

2. Low posters – members who posted between one to five times

3. Non-posters – members who had not posted

A moderation approach was developed based on the principles of focus group method (Liamputtong, 2011)

and e-moderation (Salmon, 2011).

A question guide was used to guide participant discussion. This was modified from 11 to seven questions

after the first focus group.

KR was the moderator with DE a non-participant observer

A research diary and field notes were maintained in NVIVO (QRS International, Melbourne Australia), which

also supported data analysis NCapture was used to extract the discussion threads from the forums

Data analysis A thematic approach (Braun & Clarke, 2006) to data analysis was used, framed by the ‘Diffusion of

Innovation’ (Rogers, 2003).

Study setting The ‘Intensive Care - Virtual Community’ (IC- VC) is a professional listserv established in 2003 by a state

health department (Rolls, Kowal, Elliott, & Burrell, 2008) to reduce a sense of professional isolation and

improve knowledge distribution between intensive care units.

In mid-2014 there were in excess of 1600 members, reflecting an Australian-wide, multi-disciplinary and

multi-organisation communication network (Rolls et al., 2014)

RESULTS Twenty nine VC members registered with 23 actively participating in online discussions (FG1 – 3; FG 2 – 13;

FG3 – 7).

Participant demographics:

• 20 nurses and one bureaucrat, physiotherapist and physician.

• Located in five Australian jurisdictions [NSW (12), Western Australia (4), South Australia (3), Victoria (2)

and Queensland (1)] and Canada (1).

Early themes were identified during the focus groups (see figure 1), discussed within the research team and

checked with focus group participants

DISCUSSION Early data analysis suggests that the social network characteristics of this virtual community are influential

on membership decisions.

The common ties between members are caring for critically ill patients and a desire to ensure these patients

receive the best care possible.

By linking members to a broad professional community IC-VC has overcome current clinical silos, thus

facilitating knowledge flow across geographic, professional and organisational boundaries (McGowan,

2012).

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Study Aim To explore why members belong to a practice based VC for healthcare professionals who care for intensive

care patients.

ICU events/conferences, which are great but primarily annually..are costly…need PD time off work..IC-VC provides me exposure to the ICU community, their thoughts,; interests; discussions and topics;

free of charge and easily accessible from work Low poster – Senior physiotherapist

Figure 1