689078

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JFNXXX10.1177/1074840716689078Journal of Family NursingIsaacson and Looman

Article
Journal of Family Nursing
2017, Vol. 23(1) 73­–89
Strategies for Developing © The Author(s) 2017
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DOI: 10.1177/1074840716689078
https://doi.org/10.1177/1074840716689078
Communities of Practice journals.sagepub.com/home/jfn

Through Social Media

Kris Isaacson, MS1,

and Wendy S. Looman, PhD, APRN, CNP2

Abstract
This discussion article presents communities of practice (CoPs) and bridging
social capital as conceptual frameworks to demonstrate how social media can
be leveraged for family nursing knowledge, scholarship, and practice. CoPs
require a shared domain of interest, exchange of resources, and dedication
to expanding group knowledge. Used strategically and with a professional
presence, mainstream social media channels such as Twitter, Facebook, and
YouTube can support the family nurse in developing and contributing to
CoPs related to family nursing. This article presents four strategies—curate,
connect, collaborate, and contribute—for establishing and growing a social
media presence that fits one’s professional goals and time availability. Family
nurses who leverage social media using these strategies can strengthen
existing CoPs and at the same time bridge networks to reach new audiences,
such as family advocacy groups, policy makers, educators, practitioners, and
a wide array of other extended networks.

Keywords
communities of practice, social capital, family nursing, social media

1University of Wisconsin–Stout, Menomonie, USA

2University of Minnesota, Minneapolis, USA

Corresponding Author:
Kris Isaacson, Lecturer, Digital Marketing Technology, University of Wisconsin–Stout, 148
Communication Technologies Building, Menomonie, WI 54751, USA.
Email: isaacsonk@uwstout.edu
74 Journal of Family Nursing 23(1)

From telling stories around the campfire to communing in sewing circles and
gathering at the local coffeehouse, we desire connection. Interaction with
others is how we learn from others, disseminate knowledge and ideas, and
engage with those who share similar interests and values. Today, social media
and the Internet have made it easier than ever before to connect with people
from around the globe and participate in multiple social networks at once,
both personally and professionally.
With over two billion people around the world using some form of social
media (Statista, 2016) and competing to be heard, how does one rise above
the crowd? In the early days of the World Wide Web, simply having a website
was enough to establish an online presence; however, simply having a web-
site or in today’s world, a social media account, does not guarantee exposure.
Instead, your voice as a family nursing scholar will likely be lost in an ocean
of billions of posts, tweets, snaps, and shares. To be heard in this climate of
chaos and noise, it is vitally important to find and develop your distinct voice
as a family nursing practitioner, educator, and/or researcher, to speak up
about family nursing, or to advocate for a cause.
No matter how niche your area of interest may seem, your voice contributes
to the global production of knowledge (Jenkins, Ito, & boyd, 2016). Or in the
words or Seth Godin (2015), “Anything worth shouting about is worth shouting
into the wind. Because if enough people care, often enough, the word spreads,
the standards change, the wind dies down. If enough people care, the culture
changes” (paras. 1-2). This means learning to leverage social media becomes a
professional imperative. This is how the ideas and philosophies of family nurs-
ing spread to influence the culture of health care. Social media provides the
platform for family nursing scholars to establish themselves as experts, to culti-
vate rich communities of practice (CoPs), and spread the word beyond their own
CoPs to myriad networks potentially affected by family nursing.
The purpose of this discussion article is not to cover all forms of social
media comprehensively, but rather to propose a framework for considering
social media as a tool for cultivating CoPs, developing social capital, and
bridging social networks related to family nursing. To that end, our primary
focus is on leveraging mainstream social media sites such as Twitter,
Facebook, and LinkedIn to promote and advocate for family nursing. This
does not mean that scholarly social media sites such as ResearchGate (https://
www.researchgate.net/press) or Academia.edu (https://www.academia.edu/
about) are not important pieces to an overall social media strategy. These
sites are designed as platforms to share and promote research; therefore, their
usefulness and benefits are more obvious. The professional merits of using
Facebook, Twitter, YouTube, and other similar social media sites are less
obvious, and this is why we have opted to focus our efforts here.
Isaacson and Looman 75

Unlike the use of social media for personal purposes, which are often
without focus or direction, developing an expert voice and becoming an
advocate for family nursing necessitates an understanding of how participa-
tory CoPs function and how they differ from other types of social networks.
It also takes time and effort, and most importantly, a strategy. This article
draws upon two theoretical frameworks to illustrate how and why online
social networks are so powerful. The first framework, CoPs, defines a spe-
cific social construct wherein individuals come together with shared interests
and a common goal to learn from one another and to find solutions for shared
problems and concerns (Wenger, 2006). The second framework, bridging
social capital, demonstrates the productive benefits brought about by indi-
viduals who bridge various social networks and have formed relationships in
different social circles (Putnam, 2000). Finally, based on these frameworks,
we present four strategies (curate, connect, collaborate, and contribute) to
assist you in leveraging what you know, developing your own specialized
voice and expertise, and cultivating a productive and effective social media
network.

CoPs
Whether in academia or in practice, individuals often work independently; if
collaboration does happen, it is usually only for the life of a particular project.
However, social participation, especially through CoPs, can further learning,
expand knowledge, and provide multiple perspectives (Wenger, 2009).
Wenger suggests, “participation shapes not only what we do, but also who we
are and how we interpret what we do” (p. 211). Furthermore, these participa-
tory communities work together to share information and teach each other;
“[t]hey help each other find their personal and collective voice and provide a
context through which they can articulate their common interests and shared
values. Ultimately these communities encourage conversations about social
and political change” (Jenkins et al., 2016, p. 152).
The CoP framework was established prior to widespread use of the Internet
and certainly before the ubiquitous nature of social media. This being said,
the affordances of social media reduce or eliminate altogether the geographic
restrictions of more traditional CoPs, resulting in diverse viewpoints and
more opportunities for sharing knowledge and learning from one another.
Social media applications such as Facebook and LinkedIn make creating
groups and interacting with others easy; however, just creating and participat-
ing in a group does not mean it is a CoP.
According to Wenger (2009), three primary characteristics of CoPs—the
domain, the community, and the practice—must exist. The first characteristic
76 Journal of Family Nursing 23(1)

is the domain, which means that the individuals who make up the group share
a common domain of interest, such as family nursing (Wenger, 2006). The
members may or may not be defined as experts and their competences may
not be recognized outside of the group, but the community to which they
belong “value[s] their collective competence and learn from each other”
(Wenger, 2006, p. 2). The community is the second characteristic and means
that the members of the group participate in joint activities and discussions
regarding their shared interest and these activities serve to enhance each oth-
er’s knowledge of the subject (Wenger, 2006). Members of the community do
not need to reside or work in the same physical location, nor do they have to
interact on a daily basis (Wenger, 2006). For instance, participating in regular
Twitter chats or contributing to a LinkedIn group, where members are around
the world, come together to share knowledge about a particular topic (e.g.,
family nursing) with the goal of learning new information could be consid-
ered a CoP. Simply sharing the same job title and/or working in the same
location does not necessarily mean that there is community or that it is a CoP.
The third element of a CoP is the practice, which consists of a repertoire of
resources, such as tools, stories, experiences, and “ways of addressing recur-
ring problems” (Wenger, 2006, p. 2). In examining the three characteristics of
CoPs, it becomes obvious that they are more than groups of people who have
mutual interests, such as enjoying the same type of movies, but instead the
members have a mutual interest, share experiences or issues related to the
interest, and interact on a regular basis to learn from each other and work to
collectively improve the group’s knowledge. CoPs do not need to be formal
with regular, defined membership; they can also be informal as seen in the
following example from Wenger (2006):

[N]urses who meet regularly for lunch in a hospital cafeteria may not realize
that their lunch discussions are one of their main sources of knowledge about
how to care for patients. Still, in the course of all these conversations, they have
developed a set of stories and cases that have become a shared repertoire for
their practice. (p. 2)

Through the use of technologies, such as online discussion forums, social

media, email, text, and video chat, individuals can come together from around
the world to exchange ideas about a common interest or concern and to learn
from each other.
Now that you have a basic understanding of what it takes to constitute a
CoP, think about the groups (online and offline) that you belong to; you are
most likely a participant in several CoPs. Furthermore, think about ways in
which Facebook, Twitter, and LinkedIn, for example, can be used to nurture
Isaacson and Looman 77

and create CoPs through a shared interest, a desire to learn from other mem-
bers of the group, with the intention of solving mutual problems and/or build-
ing shared experiences, tools, and stories to enhance and expand existing
knowledge or understanding.

Bridging Social Capital

As can be seen, CoPs are an effective way to develop collective knowledge
and share ideas and experiences; but over time, if there is not a regular influx
of new members, CoPs can become stagnant. The traits necessary to form
and nurture CoPs—shared domain of interest, exchange of experiences,
tools, and resources, and dedication to expanding group knowledge—can
also breed complacency. According to boyd and Ellison (2007), social net-
working sites such as Facebook, Twitter, LinkedIn, Instagram, and YouTube,
are defined as

web-based services that allow individuals to (1) construct a public or semi-

public profile within a bounded system, (2) articulate a list of other users with
whom they share a connection, and (3) view and traverse their list of connections
and those made by others within the system. (p. 211)

It is boyd and Ellison’s (2007) third point, the ability to reach beyond an inner
circle of connections and to reach out to new connections to expand personal
or professional networks, which is the focus of this section. To avoid stagna-
tion, we turn to the power of social capital and weak social ties to bridge
multiple networks.
Social capital is a form of cultural capital based on reciprocity, trust, and
cooperation to bring about positive consequences, such as mutual support,
cooperation, trust, and institutional effectiveness (Putnam, 2000). Steinfield,
Ellison, and Lampe (2008) described social capital as “an elastic construct
used to describe the benefits one receives from one’s relationships with other
people” (p. 434). Social capital can be thought of as a bank, but instead of
money and financial transactions, individuals are exchanging intangible con-
cepts, such as ideas, favors, knowledge, and human capital or resources. Let
us look at an example that might better illustrate the concept.
Danielle has been working as a nurse at the community hospital for nearly
5 years. She and some of the other nurses have formed a casual CoP, where
they meet once a week to share work stories, discuss new knowledge or tech-
niques they have learned, and talk about happenings within the hospital.
Danielle has recently taken part in a Twitter chat that discussed a new way of
working with patients and their families that she shares with the group. They
78 Journal of Family Nursing 23(1)

Figure 1.  Weak ties expanding knowledge by bridging different social networks.

discuss the idea and decide to adopt some of the ideas shared during the
Twitter chat. Over the years, Danielle has “banked” up a significant amount
of social capital within her CoP; therefore, they are willing to listen to what
she has to say, and value her input. Ted, who recently graduated and started
at the same hospital only a few months ago, has been invited to join Danielle’s
CoP. Trying to prove himself, instead of taking time to familiarize himself
with the community, Ted starts sharing ideas, some of which are pretty radi-
cal. His colleagues acknowledge his ideas, but choose not to discuss or imple-
ment them into their practice. It is not that Ted’s ideas are bad and Danielle’s
ideas are good; instead, it has more to do with the amount of social capital
each has collected. Because Danielle is a trusted member of the group and
has shared good ideas in the past and has listened to what others in her net-
work have had to say in the past, the group is more likely to implement her
ideas. Ted, however, has not built up the necessary trust, and even though he
may be bringing in innovative and fresh ideas that would genuinely improve
their jobs, he needs to take the time to earn social capital within this group.
Bridging social capital (Figure 1) is a specific type of social capital that
takes advantage of the “weak ties” or “bridges” that span “two sets of socially
dissimilar individuals in a system” (Rogers, 2003, p. 306). This is what has
happened in the example above, when Danielle introduced the ideas that she
heard about while participating in a Twitter chat. She is the “bridge” between
her CoP and another social network—the participants in the Twitter chat—in
which she also belongs. And it is this type of communication that exists
Isaacson and Looman 79

between weak ties that allows information to spread into and out of otherwise
homophilous networks (Rogers, 2003). The ability to participate in and tra-
verse multiple networks at the same time, which encourages and enhances
the flow of information, is one of the biggest strengths of social networking
sites. In the next section, the authors share ways in which you can use CoPs
and bridging social capital to make social networking work for you.

Putting Social Media to Work for You

In the film Field of Dreams, Kevin Costner’s character builds a baseball dia-
mond in the middle of an Iowa cornfield at the urging of some mysterious
voice, “If you build it he will come” (Gordon, Gordon, & Robinson, 1989).
Once he builds the ball field, the ghosts of former great baseball players come
out of the cornfield to play ball. If, as Rogers (2003) argued, the diffusion of
new and innovative ideas within networks is a social process and as of this
writing, nearly one third of the global population uses some form of social
media (Statista, 2016), then it is not difficult to see how one’s posts or tweets
might get lost in a sea of information and noise. Unlike Field of Dreams, if all
you do is create a social media account, people will not automatically “show
up.” Social networking requires time, patience, and a strategy or plan of
action in order for you to develop a following and expand your reach.
Just as health care providers would not treat a patient without an overall
plan for care and benchmarks that indicate improvement, the use of social
media also requires a goal and plan of action. Examples of goals may be to
learn more about the field of family nursing, to connect with like-minded
individuals within the CoP, to promote and share research in the field, to
become an advocate for family health care or some related domain of interest,
to conduct or participate in public scholarship, or to become recognized as an
authority on a particular subject. Determining goals and establishing a pur-
pose as to how social media will be used can guide you as to what type and
frequency of posts will be made, how much time is invested, and the best
channels to use to meet desired outcomes.
An examination of who uses social media and how it intersects with nurs-
ing shines a spotlight on why using social media to promote research, advo-
cate for a cause, or to connect educators, researchers, and practitioners is both
timely and advantageous to family nursing. Table 1 provides a demographic
overview of the nursing population in the United States; nurses are predomi-
nantly female (90%; American Nurses Association, 2014), are mostly
between the ages of 30 and 49, followed closely by those who are 50 to 64
(U.S. Department of Health and Human Services, Health Resources and
Services Administration, 2010). The majority of nurses in the United States
80 Journal of Family Nursing 23(1)

Table 1.  Demographic Characteristics of Registered Nurses in the United States.

Characteristic %
Gendera
 Male 10
 Female 90
Ageb
 18-29 10
 30-49 46
 50-64 37
 65+ 7
Educationc
  High school 1
  Some college 3
  Associate’s degree 33
  Bachelor’s degree 53
  Master’s degree 8
 Doctorate 1
  Median income (in U.S. dollars)a 66,200
aAmerican Nurses Association (2014).
bU.S.Department of Health and Human Services, Health Resources and Services
Administration (2010).
cDepartment for Professional Employees, American Federation of Labor and the Congress of

Industrial Organizations (2015).

have a bachelor’s degree (Department for Professional Employees, American

Federation of Labor and the Congress of Industrial Organizations, 2015), and
as of 2014, the median income of registered nurses was US$66,200 per year
(American Nurses Association, 2014). These statistics are generally compa-
rable with other countries across the globe in terms of the demographic pro-
files of nurses (World Health Organization, 2008) and social media users
(Poushter, 2016).
When the nursing demographic information is overlaid with the demo-
graphics of social media users (Table 2), it becomes clear that the profile of
nurses and social media users intersect in significant ways. For example, 83%
of adult women who are online versus 75% of adult men who are online use
Facebook and of those who use Facebook, 55% (of men and women) reported
using it multiple times per day (Greenwood, Perrin, & Duggan, 2016).
Furthermore, 84% of individuals between 30 and 49 use Facebook
(Greenwood et al., 2016), which coincides with the largest demographic of
people within the nursing field (U.S. Department of Health and Human
Isaacson and Looman 81

Table 2.  Demographics of Adult Social Media Users in the United States.

Characteristic Facebook Twitter LinkedIn

Gender
 Male 75 24 31
 Female 83 25 27
Age
 18-29 88 36 34
 30-49 84 23 33
 50-64 72 21 24
 65+ 62 10 20
Education
  High school or less 77 20 12
  Some college 82 25 27
 College+ 79 29 50
Income
  Less than US$30,000/year 84 23 21
 US$30,000-US$49,999 80 18 13
 US$50,000-US$74,999 75 28 32
 US$75,000+ 77 30 45

Source. Data from Greenwood, Perrin, and Duggan (2016).

Note. Data are percentages of online adults. Percentages that intersect with the demographics
of nurses in the United States are highlighted in boldface.

Services, Health Resources and Services Administration, 2010). Percentages

that intersect with the nursing demographics found on Table 1 have been
highlighted in bold in Table 2.
The intersection of the demographics of nurses and online adults only tells
half of the story. According to the American Nurses Association (2014),
between 1980 and 2008, the percentage of nurses younger than 40 years
dropped from 54% to 29.5% and the average age of nurses increased from 39
in 1990 to 44 in 2014. This might indicate that the use of social media is not
critical—Why use it if the population is aging and older adults are less likely
to use social media? While the average age of nurses has been increasing,
there has also been a continual increase in the number of people graduating
with nursing degrees, passing their board exams, and receiving their nursing
licensures. This number has gone up 22.8% from the period 2005-2009
(117,141 licensures) to 2010-2013 (143,809 licensures; American Nurses
Association) and the average age of those graduating is 30 (U.S. Department
of Health and Human Services, Health Resources and Services Administration,
2010). This means there is a growing number of younger people entering the
82 Journal of Family Nursing 23(1)

nursing profession and they are the most digitally connected population in
our history. If the proverbial torch is to be passed from one generation to the
next, it is important to connect with this incoming generation where they
are—and that is on social media. This is why it is important to not only culti-
vate CoPs but also to open the doors and bridge social networks, inviting
younger generations and new nurses into community. Doing so allows the
flow of information and new ideas to expand as nurses from a variety of CoPs
come together to share their knowledge; young nurses sharing what they
learn at university and accomplished nurses sharing their research and expe-
riences, nurses from different parts of the world sharing practices, urban
nurses connecting to rural nurses, and educators, practitioners, and research-
ers interacting on a number of topics.
This may seem daunting and the idea of disseminating knowledge or
speaking from a place of authority via social media may be uncomfortable;
that is why we have developed the four Cs—curate, connect, collaborate, and
contribute—to fit various levels of participation and commitment to social
media. Each of the four Cs stem from the theoretical foundations of CoP and
bridging social capital. Throughout this section, we provide you with strate-
gies and approaches to launch and grow your social media presence depend-
ing on your purpose, established goals, and time commitment.

Curate
Family nurses can add value to the world of available information by curating
and sharing knowledge that is relevant to the domain of interest. The amount
of information available to CoPs is immeasurable and can seem overwhelm-
ing. This is where the benefit of engaged members of a CoP comes into play.
Seitzinger (2014) defined social curation as “the discovery, selection, collec-
tion and sharing of digital artefacts by an individual for a social purpose such
as learning, collaboration, identity expression or community participation”
(p. 415). Social curation for family nursing is the discovery, collection, and
sharing of artifacts related to family nursing for the purpose of engaging a
CoP. This process may include using an RSS (really simple syndication) feed
or Twitter hashtags (e.g., #familynursing, #familyhealth, or #IFNAorg) to
discover content directly related to family nursing. It may also include explor-
ing and collecting content in related domains such as psychology (#family-
therapy), education (#edchat), or a condition-specific domain such as a
community for families experiencing dementia (#dementia).
CoPs need to curate content that fits the domain of content, contributes to
the community, and encourages further user generated content (Kilgour, Sasser,
& Larke, 2015). It is the family nurse’s unique perspective and expertise that
Isaacson and Looman 83

adds value to this content through thematic connections among pieces of infor-
mation. Individuals who use Twitter are more likely to generate innovative
ideas than non-Twitter users, according to a study by Whelan, Parise, de Valk,
and Aalbers (2011). As “idea scouts,” these individuals are well connected to
knowledge sources outside a smaller CoP and tuned to emerging developments
that are broadcast globally (Whelan et al., 2011). For example, a family nurse
who is an idea scout with expertise in the family experience of ambiguous loss
might curate content from scholarly journals, practice settings, and social net-
working communities related to soldiers who are missing in action. A social
media search using #ambiguousloss reveals a community of caregivers, pro-
viders, advocacy groups, and providers sharing content, including Ambiguous
Loss UK and a network of individuals with an interest in this experience. At the
intersection of content on family, nursing, and health lies valuable information
about ambiguous loss from a novel perspective.

Connect
Idea scouts are most effective when they are linked with idea connectors,
those with extensive networks and the skills to distribute information; they
know “who is doing what” and possess the social capital needed to connect
the best ideas to the people best situated to implement those ideas (Whelan
et al., 2011). Based on interviews with top idea scouts, Whelan et al. (2011)
found that Web resources were the primary means through which these scouts
kept abreast of emerging technologies and trends. Yet these idea scouts were
not effective in getting these ideas implemented unless they worked with idea
connectors—those who ensure that the information found the people best
equipped to act on that information. This is further supported by Rogers
(2003) who argues that despite obvious benefits, new ideas and different
ways of thinking do not “sell themselves.” Instead, “most people depend
mainly upon a subjective evaluation of an innovation that is conveyed to
them from other individuals like themselves who have previously adopted
the innovation” (Rogers, 2003, p. 18). In other words, ideas are spread by
idea connectors who are (a) able to recognize the expertise and experiences
of idea scouts who have previously adopted new ideas and (b) possess sig-
nificant social capital and are able to bridge social networks. “[D]iffusion is
a very social process” (Rogers, 2003, p. 18). Family nursing needs both idea
scouts and idea connectors to curate information and to connect that informa-
tion with sources that can implement it. Connections through social media—
such as Twitter and LinkedIn—can facilitate linking curated content about
family nursing to larger networks that can both disseminate and strategically
employ the information.
84 Journal of Family Nursing 23(1)

Family nurses are not the only ones who benefit from curated content
about family nursing. Indeed, some might argue that family nurses have an
obligation to connect with others outside the family nursing CoP. Social
media can provide a means through which highly involved individuals can
represent a CoP in a positive and strategic way to their broader networks
(Kilgour, Sasser, & Larke, 2015). For example, strategic connections across
disciplinary or professional boundaries through social media can expose non-
nurses to important perspectives about family health. Based on an analysis of
over 3,300 health-related Twitter conversations by more than 2,700 users,
Xu, Chiu, Chen, and Mukherjee (2015) found that the most salient themes in
these conversations were knowledge sharing (33%) and health-related activ-
ism, advocacy, and promotion (24%). The participants in these conversations
included health care providers, engaged consumers, advocacy organizations,
policy makers, and media, suggesting that family nurses who use social
media in health-related conversations have the potential to harness bridging
social capital to connect with a network of highly engaged consumers and
activists who may not encounter family nursing content in other venues.
Using the example of the family nurse who curates content related to
ambiguous loss for families of missing soldiers, Tweets that share key find-
ings of studies related to the needs of families can be delivered to the feeds of
military families, policy makers, and support networks. Including the
hashtags #ambiguousloss and #familynursing links this content to the family
nursing CoP while also taking advantage of the weak ties that bridge to other
networks. It is the weak ties, or individuals who bridge multiple social net-
works and are influencers in each of their networks, that push homophilous
groups to expand, grow, and adopt new ideas. This represents a cosmopolitan
orientation to the world outside one’s local social system, that is, a disposi-
tion that involves “balancing one’s position in the world with a consideration
of others and our obligations to them” (Hull & Stornaiuolo, 2010, p. 91).
Kapp, Hensel, and Schnoring (2015) noted that nearly all (95% to 100%) of
health policy makers use Twitter and suggest that health researchers have a
role in educating policy makers on relevant evidence to inform the translation
of research to policy.

Collaborate
Beyond connecting is the act of collaborating, or interacting toward a common
goal. Strategic curation and connecting by family nurses through social media
will facilitate collaboration within and across our CoPs. Social media offers
efficient platforms for collaboration with existing and potential family nurs-
ing colleagues. Veletsianos (2016) referred to individuals who “make use of
Isaacson and Looman 85

participatory technologies and online social networks to share, improve, vali-

date, and further their scholarship” (p. 2) as networked scholars. Networked
scholarship can enable family nurses to collaborate with others from different
disciplines in ways that were not possible before social media was available.
Kilgour et al. (2015) noted that the primary reason people use social media is
to communicate and connect with others. To motivate sharing across disci-
plines, family nursing as a CoP needs to identify common threads “and touch
points for relevancy and engagement” (Kilgour et al., 2015, p. 334).
One way that family nursing as a CoP can identify these common threads
for relevancy and engagement across disciplines is through the Healthcare
Hashtag Project (www.symplur.com/healthcare-hashtags), a website that
tracks and archives health-related Twitter conversations. Trending conversa-
tions in 2016 included health care ethics, palliative care, elder care, health
care communications, and mental health nursing, with participants represent-
ing patients, caregivers, providers, and advocates across the globe (Symplur,
2016). Xu et al. (2015), in their analysis of health-related conversations in
this space, found that community building was a salient theme, suggesting
that these conversations foster the social relationship element that character-
izes CoPs. This collaboration across disciplines through social media requires
strategy. Marwick and boyd (2011) asked microbloggers how they navigate
their “imagined audience” of followers and found that users with numerous
followers used a variety of techniques to curate, connect, and collaborate.
Examples of strategies for collaborative networking are maintaining a consis-
tent message, creating relationships with new followers, providing informa-
tion, and spreading news (Marwick & boyd, 2011).

Contribute
Beyond curation, collating, and collaboration, family nurses must also
actively contribute content related to our CoP. This is essential because fam-
ily nurses have access to and are generating new knowledge about our unique
domain of expertise. Contribution by family nurses to social media is also
important if there is to be a critical mass of active social media users. Barnes
and Böhringer (2011) found that the presence of a perceived critical mass was
significantly predictive of a person’s habit in using a microblogging service
such as Twitter. Rogers (2003) defined a “tipping point” at which people
perceive a certain number of others who have adopted a certain behavior after
which they are much more likely to adopt that behavior. As more nurses
decide to use social media for routine benefits, others in their network will
perceive social media to be beneficial for their own use. Perceived usefulness
is a significant predictor of a person’s intention to continue a behavior such
86 Journal of Family Nursing 23(1)

as microblogging (Barnes & Böhringer, 2011). Furthermore, social media

supports the idea of a participatory CoP where passive participants (or lurk-
ers) can easily transition into active contributors, building identities as
authorities and as individuals who have real contributions to make (Jenkins
et al., 2016). Because social media engagement by family nurses is still
emerging, there is an especially urgent need for the contribution of useful
content through social media by family nurses. Each individual needs to
determine the level of contribution that best fits his or her level of comfort,
time, and capacity for engagement in social media. While many remain pas-
sive participants in this space, the transition to active participant might be
facilitated by those who are willing to take risks for the benefit of the family
nursing CoP.

Conclusion
Social media has made connecting with and learning from like-minded indi-
viduals in virtual CoPs across expansive geographical distances not only pos-
sible, but also easy—Over two billion people around the world are active on
some form of social media. These same social media platforms have also
made it simple for individuals to build social capital and participate in mul-
tiple social networks with different interests and motivations. Because of this,
an individual making use of Facebook, Twitter, YouTube, or other social net-
working sites is able to bridge social networks and speak simultaneously to
different audiences. This enables ideas to disseminate and move beyond
one’s narrow focus.
Therefore, time spent on social media can be a productive way to
advance the ideas and philosophies of family nursing to a broader audience.
Social media sites such as Twitter can serve to strengthen existing CoPs and
at the same time bridge networks to reach new audiences, such as policy
makers, educators, practitioners, and a wide array of other extended support
networks. Innovation in family nursing research and education requires
new habits of curating, connecting, collaborating, and contributing. Take
action. Educate yourself about social media, create accounts, learn how to
use the tools, and reach out to other family nurses in your network and find
out what they have tried and what has been successful. Then determine
your personal strategy for developing your expert voice and become an
authority. Family nursing needs transformational leaders—idea scouts and
idea connectors—to pave the way and to grow the existing social media
network so that others will engage in supporting family nursing education,
practice, and research.
Isaacson and Looman 87

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.

Funding
The authors received no financial support for the research, authorship, and/or publica-
tion of this article.

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Author Biographies
Kris Isaacson, MS, is a lecturer in the information and communication technologies
department at the University of Wisconsin–Stout, USA. She is also a PhD candidate
in the College of Education and Human Development learning technologies program
at the University of Minnesota, USA. She has nearly 20 years of experience designing
and developing websites for a variety of clients and industries and her research inter-
ests include digital and media literacies, and finding ways to attract and retain more
women and other underrepresented populations into computer science fields.
Wendy S. Looman, PhD, APRN, CNP, is an associate professor and chair of the
Child and Family Health cooperative unit in the School of Nursing at the University
of Minnesota, USA. She studies care coordination and systems of care for families of
children with medical complexity, with a focus on the role of the advanced practice
nurse. She teaches family health theory in a doctorate of nursing practice program and
has a faculty practice as a pediatric nurse practitioner in a cleft and craniofacial clinic
at the University of Minnesota. Her recent publications include “Confessions of a
Reluctant Tweeter: Using Social Media to Advance Family Nursing” in Journal of
Family Nursing (2016), “Effects of a Telehealth Care Coordination Intervention on
Perceptions of Health Care by Caregivers of Children With Medical Complexity: A
Randomized Controlled Trial” in Journal of Pediatric Health Care (2015, with M.
Antolick et al.), and “Development of an International School Nurse Asthma Care
Coordination Model” in Journal of Advanced Nursing (2015, with A. Garwick et al.).