Social media and journals: Suggested best practices for nursing editors, authors, readers

Social media has revolutionized the way people consume information, created new avenues for disseminating scholarly work, and has provided a nursing perspective on important issues. Nurses are leading and engaged in clinical research. They are expert clinicians who bring evidence-based care to health systems, education, and patients. The voices of nurses needs to be part of the public conversation, providing accurate information in this age of misinformation. Traditionally, it has taken more than a decade for research findings to be incorporated into clinical practice.1 Social media promotion may help ensure evidence reaches healthcare professionals for timely use in improving care.2 However, information on how journal editors, authors and readers choose and use social media is limited.3, 4 We would like to propose some guidance for initiating, managing, and evaluating the impact of social media for nursing journals (editors), authors and readers. An initial step in determining the social media strategy for a journal will depend on the journal's mission as interpreted by the editor and perhaps in concert with the editorial board. For example, does the journal's mission statement dictate a narrow focus on clinical content, or does it go beyond clinical or research content to include discussion of relevant sociopolitical factors that affect healthcare delivery? A journal owned by or affiliated with a society may have additional issues that need to be clarified with the organization in terms of messaging and public statements: does the journal speak for the society or is it an independent voice? Is social media content protected as part of editorial independence? Another step is determining which among the many social media platforms would be a good fit for the journal. What social media sites are popular with the journal's readers? An editor might consider doing a survey of members or subscribers, or just start with a widely used—and easy to use—platform. Currently, Twitter is the number one social media application used by nursing journals for post-publication promotion.5 Devising a plan and process for social media, from initial implementation (choosing the platform and account name, passwords, who gets administrative access, etc.) to posting and monitoring feedback is important. Few journals have the resources to hire someone specifically for managing the dissemination of digital content. Recruitment of a specific person with social media expertise to serve on the journal's editorial board and is charged with journal social media outreach has been recommended by nurse editor leaders.6 Some journals rotate social media responsibilities among editors or editorial board members, depending on the platforms that they are comfortable with. A social media editor or manager has multiple responsibilities providing oversight for various channels and monitoring responses. Their primary responsibility is to post messages to social media applications, such as Twitter and Facebook, to disseminate content from the journal and encourage engagement with the journal.4 Social media editors should have technical knowledge of the various social media applications, including their general operations, what services each provides and how privacy and security are handled. They also need to have knowledge of and be familiar with the content being published by the journal. Beyond highlighting published content, there may be other communications that can be disseminated through social medica such as calls for papers or reviewers, to publicize an event or special issue, to pose a question to gauge interest in a topic, or to engage in relevant conversations in the nursing social media community. Writing a short summary of an article in a post with a limited number of characters takes precision and is a learned skill. A thoughtful and creative social media editor can use images, polls, graphics, or videos in posts to make them more eye-catching and engaging. When highlighting journal articles, there should always be a link to the original article; using a URL shortener (e.g., https://tinyurl.com) will allow for more characters to be available for messaging. Adding handles of relevant individuals or groups and hashtags will amplify dissemination and engagement (e.g. #NP; #ANA; @INANEEeditors). If possible, enabling readers to access the article for free for even just a short time will help bring readers back to the journal's website; readers may not return to sites if they are continually blocked by paywalls. Managing social media does take time, but editors can gain efficiencies by planning tweets and using a scheduler (see Table 1). Social media management software can help the social media editor with calendar reminders and the ability to post across multiple platforms on different dates and times. Posting the same post at different times of the day allows the post to appear at a time when viewers in different time zones are likely to see it. Some software, such as Hootsuite (Vancouver, BC, Canada), also analyzes when posts are viewed and make recommendations for optimal scheduling times. Depending on the extent of their role, social media editors may also be responsible for responding to direct messages and notifications. They may also plan, implement, and evaluate special events like twitter chats or journal clubs. Another popular activity is live postings from events like conferences, workshops, or press conferences. The social media editor has an ethical responsibility to the journal and the publisher or organization it represents, that is, postings should not reflect the personal views or “attitude” of the social media editor but rather those of the journal. Primary importance is placed on copyright of any material included in a post and protection of privacy and human dignity. Social media posts can potentially be shared worldwide so the social media editor must also consider global issues of differences in culture and context.7 Accuracy matters—always check the facts before posting. Check any URL or site before sharing—ensure that it’s valid and appropriate. Consider if anyone might take offense or misinterpret a post. Ensure free use of or secure permissions for images used in posts. Ensure post is in keeping with journal's mission and image. Enlist editorial board members and authors to participate in sharing social media posts. Add hashtags to increase visibility by interested groups. Authors can personally, and in conjunction with the journal, increase the reach and potential impact of their work. Authors want their work disseminated, whether it is research or clinical information that informs more research or influences changes in practice. Traditionally, dissemination required those interested in a specific topic to use a search engine to find new evidence, but with social media, authors can push their publications to those with common interests, especially with the use of hashtags. Journals welcome authors to publicize their articles to promote readership of the journal, but articles may only be free for subscribers. Some journals may be willing to make an article free for a short time, especially if authors agree to actively drive traffic to the journal's website, thus bringing potential new subscribers to the journal. Some disciplines are beginning to consider indicators of reach and shares and social media engagement in addition to citations as a measure of the impact of scholarship. Alternative metrics, such as PlumXmetrics and Altmetrics, include measures of article use such as downloads, shares, likes, saves and dissemination on social media sites, including pick-up by news outlets and global distribution. Most publishers of nursing journals now report some form of alternative metrics (see Figure 1). The altmetric donut Post a link to your article on your social media sites. LinkedIn is a popular site where many share articles. Share or comment on the journal's post about your manuscript. Include relevant hashtags to get others who might also be interested involved in the dissemination. PubMed Central and many nursing journal websites have social media plugins. This makes sharing yours or other colleagues' work on your social media application possible with one click. Offer to write a blog post if the journal has a blog. Post a “selfie” video summarizing your article and where it can be found. Share it or “tag” it to an advocacy group related to the topic. Frequent posting on related matters may help establish you as an authority in this area. Studies demonstrate that most nurses use social media, however, their use is primarily reported to be personal not professional.8 Use of social media for sharing knowledge related to healthcare may be different depending on the cultural context. A recent study of 648 registered nurses in China reported that 84% stated social media had positively influenced their clinical practice; 98% had searched for medical knowledge on social media and shared or reposted medical knowledge.9 Nurses are busy and may not have time to read many journals. Nurses can keep up-to-date on topics that are important to them by following journals on social media. Nurses should ensure the journals they follow are legitimate, evidenced-based and peer reviewed. The Nursing Journal Directory, which is maintained jointly by the International Academy of Nursing Editors (INANE) and Nurse Author & Editor is a vetted and curated directory nursing journals which is freely available at the Nurse Author & Editor website (https://onlinelibrary.wiley.com/page/journal/17504910/homepage/nursing-journals-directory). Using the directory can help ensure that nurses do not inadvertently follow a predatory publication. Use of this directory may also help determine which journal(s) to follow on social media based upon areas of interest and practice focus. Not all journals on this list currently have social media platforms, but many do with more journals planning to initiate this practice.5 Nurses who follow journals on social media can share their own ideas and can comment on the journal's postings about the latest research findings and/or clinical practice information. Readers/users should always validate the accuracy of information before posting or reposting. However, nurses should feel confident that information published in a reputable peer reviewed nursing journal has already been vetted for accuracy and validity during the peer review process. Best practice is to “quote” instead of reposting, but if you repost then add a source, comment and/or tag to increase dissemination. Inter- and intra-professional connections beyond the traditional geographically based groups can increase diversity of connections.10 Follow your favorite nursing journals on their social media platforms. Post with quotes from a journal's post and be sure to include the link to the original article. Share journal posts with your professional network. Add your own comments to a journal post. Include hashtags for individuals, topics or organizations that might also find the post interesting when you post. The evidence remains inconclusive on whether the use of social media by nursing journals increases traditional citation counts, although there is anecdotal evidence that social media does increase attention and drive traffic to content. There is more research on this topic from other health professions journals.11, 12 Along with the traditional bibliometric data of impact factors and citations, consider using alternative metric measures to evaluate reader usage. Social media applications all have metrics available and scheduling software may offer even more, depending on what's needed and affordable. Alternative metrics may demonstrate use that is not just for scholarly purposes but clearly enhances dissemination of nursing scholarship. Increasing awareness of nursing research, nurses' work in improving quality and safety, advocating for issues important to the public, and raising nursing's voice on key health issues are all worthy reasons to use social media. Methodologies for evaluation of social media impact have been diverse so comparisons between studies are difficult. Clearly describing measures and defining these newer metrics can assist nursing publications in determining the value of social media to promote nursing journal content, and the scholarly work and research of nurse authors. Studies in nursing are exploratory at this point and more rigorous study designs are needed. As nurses, we are called to seek out evidence and to disseminate it to those who can benefit from it. Today, social media is a source of information for millions of people. According to the Pew Research Center, which has been tracking social media use since 2005, 72% of Americans use some form of social media.13 If that's where the public is getting health information, then nurses need to be visible on those sites. Nursing journals and editors can do their part by providing that connection through social media to the content of their journal. Nurse authors and readers can amplify the dissemination of nursing voices within their own professional networks, to the broader health care community, and to health care consumers. All nurses can become ambassadors for accurate health related information sharing. Julee B. Waldrop, DNP, FNP-BC, PNP-BC, CNE, FAANP, FAAN is the Assistant Dean and Director of the Doctor of Nursing Practice Program at Duke University School of Nursing, Durham, NC. She has is the Editor-in-Chief of The Journal for Nurse Practitioners. She can be contacted at julee.waldrop@duke.edu. Jayne Jennings Dunlap, DNP, APRN, FNP-C is an Assistant Clinical Professor at Texas Woman's University. She is an Editorial Board Member and Director of Social Media for The Journal for Nurse Practitioners. She can be contacted at jdunlap1@twu.edu. Maureen Shawn Kennedy, MA, RN, FAAN is the Editor-in-Chief of the American Journal of Nursing. She can be contacted at shawn.kennedy@wolterskluwer.com.

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