SOCIAL NETWORKING FOR ATHLETIC TRAINING CLINICAL EDUCATION A THESIS Submitted to the Faculty of the School of Graduate Studies and Research of California University of Pennsylvania in partial fulfillment of the requirements for the degree of Master of Science by Matthew J. Campbell Research Advisor, Dr. Ellen J. West California, Pennsylvania 2011 ii iii ACKNOWLEDGEMENTS I would like to take this time to recognize the people who have made the most impact in my life, and without their support and guidance I would not have had the courage to complete this task. First, I would like to thank my advisor Dr. Tom West, my thesis chair, Dr. Ellen West, and the members of my committee: Mr. Adam Annaccone and Mr. Mike Meyer. Without their knowledge, expertise, and experience, I probably would not have been able to complete the huge task of completing the thesis and the master’s program. I would like to thank the faculty, and all my new friends for the support and keeping everything interesting and exciting. To my athletes and coaches at California Area High School I would like to thank you for providing me with an excellent experience and keeping me grounded this past year. Finally, I would like to thank my Mom and Dad for their love and support that they have given to me during this new phase in my life and constantly guiding me when things seemed impossible. To Sydney and the whole Harris family thank you for making this a very memorable year, and for the love and food you fed me. I love you all very much iv without all of you this would have been a very daunting task. THANK YOU!! v TABLE OF CONTENTS Page SIGNATURE PAGE . . . . . . . . . . . . . . . . ii AKNOWLEDGEMENTS . . . . . . . . . . . . . . . . iii TABLE OF CONTENTS LIST OF TABLES INTRODUCTION METHODS . . . . . . . . . . . . . . . v . . . . . . . . . . . . . . . . vii . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . . . . . . 5 Research Design. . . . . . . . . . . . . . . . 5 Subjects . . . . . . . . . . . . . . . . . . 6 Preliminary Research . . . . . . . . . . . . . 7 Instruments . . . . . . . . . . . . . . . . . 8 Procedures . . . . . . . . . . . . . . . . . 9 Hypotheses . . . . . . . . . . . . . . . . . 10 Data Analysis RESULTS . . . . . . . . . . . . . . . . 10 . . . . . . . . . . . . . . . . . . . 12 Pilot Study Testing . . . . . . . . . . . . . 12 Demographic Data . . . . . . . . . . . . . . . 13 Hypotheses Testing . . . . . . . . . . . . . . 14 Additional Findings . . . . . . . . . . . . . . 19 DISCUSSION . . . . . . . . . . . . . . . . . . 23 Discussion of Results . . . . . . . . . . . . . 23 Implications to the Profession . . . . . . . . . 28 vi Recommendations for Future Research . . . . . . . 28 Conclusion . . . . . . . . . . . . . . . . . 29 REFERENCES . . . . . . . . . . . . . . . . . 31 APPENDICES . . . . . . . . . . . . . . . . . . 33 APPENDIX A: Review of Literature . . . . . . . . . 34 Introduction . . . . . . . . . . . . . . . . . 35 Social Networking within Medical Professions . . . . 35 Social Networking for Education . . . . . . . . . 38 Social Networking for Professionalism . . . . . . . 47 Issues with Social Networking . . . . . . . . 51 Summary . . . . . . . . . . . . . . . . . . . 55 APPENDIX B: The Problem . . . . . . . . . . . . . 57 Statement of the Problem . . . . . . . . . . 58 Definition of Terms . . . . . . . . . . . . . . 58 Basic Assumptions . . . . . . . . . . . . . . . 59 Limitations of the Study . . . . . . . . . . . . 59 Delimitation of the Study . . . . . . . . . . . 60 Significance of the Study . . . . . . . . . . . 60 APPENDIX C: Additional Methods . . . . . . . . . . 62 Social Networking Survey (C1) . . . . . . . . 63 IRB: California University of Pennsylvania (C2) . . . 69 Cover Letter for Survey (C3) . . . . . . . . . . 80 References (c4) . . . . . . . . . . . . . . . . 82 ABSTRACT . . . . . . . . . . . . . . . . . . 86 vii LIST OF TABLES Table Page 1 Frequency Table of Gender . . . . . . . . . 13 2 Current Academic Standing . . . . . . . . . 13 3 Frequency Table of District Reporting 4 Distribution of Network Usage Time . . . . . . 15 5 Mean Difference of Network Usage Time . . . . . 16 6 Comparisons of Hours Spent in Usage Areas (Paired Samples Statistics and Correlation) . . . . 14 . . 17 7 Comparisons of Hours Spent in Usage Areas (Paired Samples Test) . . . . . . . . . . . 17 8 Social Networks Use Group Statistics . . . . . 18 9 Social Networks Use Independent Samples Test Equal Variances Assumed . . . . . . . . . . 18 10 Frequency Table of Perceived Value of Teachable Moments . . . . . . . . . . . . . . . . . 19 11 Frequency Table of Viewing Evaluations and Procedures . . . . . . . . . . . . . . . 20 12 Evaluation and Procedures Independent Samples Test of Equal Variance Assumed . . . . . . . 20 13 Frequency of Perceived Value of Professional Growth . . . . . . . . . . . . . . . . . 21 14 Professional Growth Independent Samples Test of Equal Variance Assumed . . . . . . . . . . . 21 15 Perceived Value of Increased Quality of Clinical Education . . . . . . . . . . . . 22 16 Clinical Education Independent Samples Test of Equal Variance Assumed . . . . . . . . . . . 22 1 INTRODUCTION The use of social networks has become a major trend in today’s society. These networks have grown beyond just entertainment and recreation into the professional and educational realms of the medical profession.5 These networks have the potential to add valuable educational and networking opportunities to students and working professionals. Social networks pose benefits but they also have their potential negatives. This study examined if entry-level athletic training education programs utilize social networks and, if so, how they are used. The goal of the study was to identify the students’ perspectives on social networks as an educational tool, how social networks are used to help them increase in their education and if the online social networks help increase the number of teachable moments. Other medical professions, such as nursing, use social networks to maintain contacts with colleagues who are separated by distance. Nurses will use these connections for potential job opportunities as well as a contact person to assist with clinical issues and research topics. This 2 type of network also allows medical professionals to remain connected with their patients.5,6 Social networking as seen in other medical professions has been found to be beneficial with helping career growth and development. As stated above it allows colleagues to work together on current cases and research topics. These networks allow professionals to build bonds with others that could become potential job opportunities and help with the individual’s career growth.13-16 Social networks are by far the most popular among teens and young adults.1 For this reason it could be a beneficial tool in education. Social networks allow the user to post videos and articles as well as files created by the user. This ability to have such information available can help aid students in seeing certain techniques, review current up to date research, and even remain current on athlete evaluations and injury progression through dialogue with peers and instructors. With these capabilities it may allow instructors to increase the teachable moments that they have with the students that they may not be getting while they are at their clinical assignment.1-4,7-12 With all the benefits that are associated with the use of these networks, there are also great downfalls and 3 deterrents from their use. These networks allow for the potential of a patient’s private information becoming public. Recently there have been firings because of breaching the patient’s confidential information.17 Social networks can also be viewed as a negative within education by administration because the communication is not taking place in the traditional sense, in the classroom, and it has the potential to open up avenues of communication that could be inappropriate.17-20 One negative with clinical education is the lack of teachable moments that occur between the student and instructor, as well as between students. This is due to the time restraints that are imposed on the clinical instructor with the daily tasks they need to do; the treatment times, the pre-practice routine, and the potential injury that demand the attention of the instructor. With the demands placed on clinical instructors it limits the amount of time that is present for the instructor to have with the students to have discussions on evaluations, as well as domains that need to be covered in the clinical setting. Social networks can provide an additional tool to give the students more teachable moments. They will allow the students to see current evaluations, see techniques that the instructor would like them to learn and to practice, it 4 also gives students and instructors the ability to post research topics and articles. The purpose of this study was to examine the athletic training student’s perspective on how social networks benefit or could benefit their education. Social networks have been found to be very beneficial in other medical professions as well as their educational programs. With the available research in other medical professions that have found that social networks are a viable tool in an educational program’s success, there is reason to believe that this can be a beneficial tool in athletic training clinical education. 5 METHODS The methods section of this study describes the procedures used to conduct this research study. This chapter includes sections explaining: (1) Research Design, (2) Subjects, (3) Preliminary Research, (4) Instrumentation, (5) Procedures, (6) Hypotheses, and (7) Data Analysis. Research Design A descriptive research design utilizing a survey was used for this study. The Social Networking for Athletic Training Clinical Education Survey was distributed to 618 students in NATA Districts 1 and 2. There were two sections within this study and each had their own independent and dependent variables. The first was usage patterns and the associated values, which is given a pointvalue based on the five-point Likert rating scale, the second was the potential value, this can be explained as the potential benefit that students perceive they get from online social networks. The independent variable for the first section was the type of network chosen. The 6 dependent variable was the usage score. The independent variable for the second section was current usage of a network (yes or no). The dependent variable was the potential value of the usage area, classroom, clinical, and professional development use. The design of the study possesses the potential to present information that could be beneficial in improving athletic training clinical education. The limitations of this study are the variations in use of social networks for education by the subjects of this study, the lack of use of social networks in the educational setting, technology available to the students, and the knowledge on how to use the social networks. Subjects The subjects used in this study included undergraduate athletic training students from District 1 (Connecticut, Massachusetts, Maine, New Hampshire, Vermont and Rhode Island) and District 2 (New York, New Jersey, Pennsylvania, and Delaware) athletic training education programs accredited by the Commission on Accreditation of Athletic Training Education (CAATE). The survey was emailed to the students associated with the education programs within the two districts. An email list of the sample was created by 7 the National Athletic Trainers’ Association survey system. The entire sample received an email with the cover letter with a link and instruction on completing the Social Networking for Athletic Training Clinical Education Survey. The subjects completed the survey electronically via the Internet on SurveyMonkey.com, and implied informed consent was given upon completion and submission of the survey to the researcher. The study was approved by the Institutional Review Board (Appendix C2) at California University of Pennsylvania. Each participant’s identity remained confidential and was not included in the study. The surveys remained on a secure password protected website (www.surveymonkey.com) and only the researcher and research advisor had access to the surveys. Preliminary Research The survey was reviewed by a panel of experts. The panel members, whom were faculty members at California University of Pennsylvania, added to the content validity of the survey and made any necessary changes. The panel members were sent a cover letter (Appendix C3) explaining the design and the experts’ responsibilities in this study as well as a copy of the Social Networking for Clinical 8 Education Survey (SNCES) (Appendix C1). Following survey review the panel members provided critiques. After the review by the experts, a pilot study was conducted. The survey was administered to the undergraduate athletic training education program students at the University of Nevada Las Vegas (UNLV) in District 8, to test the effectiveness of the survey. The surveys were collected and the results were gathered and scored by the researcher. One week later the survey was administered again to the same group to test the validity of the population. Instruments The survey (Appendix C1) was created by the researcher with the purpose of gathering information about the use of social networks for clinical education. The subjects were asked to identify how or if a social network is used as a tool in clinical education, the types of communication styles presented in the clinical setting, and how additional information or assignments are presented. The survey was estimated to take no longer then 10 minutes to complete. 9 Procedures Prior to start of research the researcher gained approval from the California University of Pennsylvania Institutional Review Board (IRB). A request was sent to the National Athletic Trainers’ Association survey service for email information on the subjects. The NATA survey system sent an email to each subject. The subjects were informed of the purpose of the survey and research in the first email. The cover letter was included in the email, as well as the first page of the survey. The subjects were informed that participation was voluntary and they were free to stop participation at any time without consequence. Once the survey was completed and submitted to the researcher on the survey website (www.surveymonkey.com), informed consent was granted to use this information in the research. The subjects had two weeks to complete the survey. The subjects received a reminder email at the end of the first week and also halfway through the second week. The survey was closed at the end of the second week and no more surveys were accepted. The data from the surveys were collected and analyzed. The surveys were all anonymous, and surveys were kept on a secure password protected website 10 with only the researcher and research advisor knowing the password. Hypotheses The following hypotheses were based on previous research and the researcher’s intuition based on a review of the literature. 1. The amount of time spent utilizing online networks for educational purposes will be dependent on the social network chosen. 2. The students that utilize an online network will spend more time using it for class experience when compared to clinical and professional development. 3. Students who utilize an online network for educational purpose will perceive a higher value in all usage areas when compared to students who do not utilize an online network for educational purposes. Data Analysis All data was analyzed using SPSS version 18.0 for Windows at a significance level of ≤ α = .05 to test the acceptability of the stated hypotheses. 11 Hypothesis 1: An ANOVA was used to compare the mean scores of all networks chosen to determine if time spent using a social network is dependent on the social network that is chosen. Hypothesis 2: An ANOVA was used to find the mean scores of each usage areas. The ANOVA will determine if the mean scores by the subjects is greater in classroom related education when compared to the other usage areas. Hypothesis 3: An independent t-test was used to determine if the students who utilize a social network for education had a higher perception value when compared to the students who do not. 12 RESULTS The following section encompasses the information obtained through the collection and analysis of the Social Networking for Athletic Training Clinical Education Survey distributed to athletic training students in Districts 1 and 2. The results have been divided into the subsequent sections: (1) Pilot Study Testing (2) Demographic Data, (4) Hypotheses Testing, and (4) Additional Findings. Pilot Study Testing The Social Networking for Athletic Training Clinical Education Survey was sent to the undergraduate athletic training students at UNLV, to be used in a pilot study to test the validity of the survey. The survey received equal responses after the two weeks it was administered, and the data was consistent when analyzed by the researcher and determined that the survey was valid. 13 Demographic Data Of the 618 athletic training students from Districts 1 and 2 that received the survey, 94 responded for a 15% return rate. The sample consisted of 69 females and 25 males (Table 1). Table 1. Frequency Table of Gender Gender Frequency Percent Male 25 26.6% Female 69 73.4% The age range of the subjects was 18 to 29 years of age with a mean age of (21.1 years +/- 1.69). Table 2 reports the findings for the current academic standing of each individual that returned the survey. Table 2. Current Academic Standing Academic Year Frequency Percent Freshman 3 3.2% Sophomore 15 16% Junior 36 38.3% Senior 40 42.6% 14 The study focused on students within Districts 1 and 2 of the NATA. District 1 consists of Connecticut, Maine, Massachusetts, New Hampshire, Vermont and Rhode Island. District 2 consists of Delaware, New Jersey, New York, and Pennsylvania. Table 3 reports the findings with the number and frequency of the response rate within these two districts. Table 3. Frequency Table of District Reporting District Frequency Percent District 1 33 35.1% District 2 61 64.9% Hypothesis Testing The following hypotheses were investigated by this study: Hypothesis 1: The amount of time spent utilizing online networks for educational purposes will be dependent on the social network chosen. An ANOVA was used to compare the mean scores of all networks chosen to determine if time spent using a social network was dependent on the social network that was chosen. Mean scores can be found in Table 4. 15 Conclusion: A one-way ANOVA was used to compare the amount of time that was spent using an online network with the possible network choices. A significant difference was found between students that used Blackboard and students that used a “Combination” network (F(4,61) = 3.446, p < .05). Tukeys HSD was used to determine the nature of the difference between the networks that were chosen. This analysis revealed that the mean score of students who chose Blackboard spent less time using the network (m = 3.2, sd = 2.00) than students that chose a combination of networks (m = 6.2, sd = 4.45). The students that chose the other networks were not significantly different from the other groups. Table 4. Distribution of Network Usage Time Network N Mean SD SE 1 5 2.6 1.67 .7483 5 21 3.2 2.00 .4359 6 8 3.4 1.2 .4199 7 2 2.0 .00 .0000 8 25 6.2 4.45 .8901 Total 61 4.4 3.46 .4429  Networks code: 1= Facebook, 5= Blackboard, 6= Desire 2 Learn, 7= Other, 8= Combination of more than 1 network used 16 Table 5. Mean Difference of Network Usage Time (I) Network (J) Network Mean Diff. SE 1 5 6 7 8 *.  Sig. 5 -.6381 1.5962 .994 6 -.7750 1.8287 .993 7 .6000 2.6839 .999 8 -3.560 1.5715 .172 _______________________________________________________ 1 .6381 1.5962 .994 6 -.1369 1.3327 1.000 7 1.2380 2.3738 .985 8 -2.9210 .9495 .026* _______________________________________________________ 1 .7750 1.8287 .993 5 .1369 1.3327 1.000 7 1.3750 2.5360 .982 8 -2.7850 1.3030 .219 _______________________________________________________ 1 -.6000 2.6828 .999 5 -1.2381 2.3738 .985 6 -1.3750 2.5360 .982 8 -4.1600 2.3573 .404 1 3.5600 1.7515 .172 5 2.9219 .9495 .026* 6 2.7585 1.3030 .219 7 4.1600 2.3572 .404 The mean difference is significant at the 0.05 level **. Networks code: 1= Facebook, 5= Blackboard, 6= Desire 2 Learn, 7= Other, 8= Combination of more than 1 network used Hypothesis 2: The students that utilize an online network will spend more time using it for class experience when compared to clinical and professional development. An ANOVA was used to find the mean scores of each usage areas. The ANOVA will determine if the mean scores by the subjects is greater in classroom related education when compared to the other usage areas. A table of means can be found in Table 6. 17 Conclusion: A one-way repeated measures ANOVA was calculated comparing the amount of time that students spend utilizing online networks in the three educational usage areas of class, clinical, and professional development; when compared to each other. A significant effect was found (F(2,122) = 14.06, p < .001). Follow-up protected t tests revealed that an increase in time spent increased significantly from clinical use (m = .9, sd = 1.10) to professional development use (m = 1.3, sd = 1.32) and again from professional development to class use (m = 2.1, sd = 2.07). Table 6. Comparison of Hours Spent in Usage Areas (Paired Samples Statistics + Correlation) Pair Mean N SD Pair 1 Class 2.1 62 2.07 Clinical .9 62 1.10 Pair 2 Class 2.1 62 2.07 PD 1.3 62 1.32 Pair 3 Clinical .9 62 1.10 PD 1.3 62 1.32 Table 7. Comparison of Hours Spent in Usage Areas (Paired Samples Test) Pair Mean SD T df sig(2-tailed) Class-Clinical 1.1 1.85 5.093 61 .000 Class-PD .8 2.16 3.059 61 .003 Clinical-PD -.3 1.37 -2.042 61 .045 Hypothesis 3: Students who utilize an online network for educational purpose will perceive a higher value in all 18 usage areas when compared to students who do not utilize an online network for educational purposes. An independent samples t-test was used to determine if the students who utilize a social network for education had a higher perception value when compared to the students who do not. Conclusion: An independent-samples t test comparing the mean scores of the students that use online networks for educational use and students that do not found a significant difference between the means of the two groups (t(85) = 2.614, p < .05). The mean of the group that utilizes online networks was significantly higher (m = 3.2, sd = .92) than the mean group of students that do not (m = 2.6, sd = 1.06). Table 8. Social Networks Use Group Statistics (Yes(1)/No(2)) Value N Mean SD 1 57 3.2 .92 2 28 2.6 1.06 Table 9. Social Networks Use Independent Samples Test Equal Variances Assumed t df Sig. (2-tailed) Mean Diff. SE 2.614 83 .011 .58605 .22417 19 Additional Findings Additional t-tests were completed to obtain additional findings of further questions asked of the subjects that were not related to findings dealing with the hypotheses. The subjects were asked additional questions to gain their perceptions on how an online network may further benefit their clinical education. A relationship was calculated comparing perceptions of how online networks could aid in the increase of teachable moments in clinical education between subjects that already use social networks for educational use and the subjects that do not. No significant difference was found (t(87) = .994, p > .05). The mean perception value of the students that use online networks for educational use (m = 3.2, sd = 1.13) was not significantly different from the mean perception value of the students that do not utilize an online network for educational use (m = 2.9, sd = .82). Table 10. Frequency Table of Perceived Value of Teachable Moments Value SNuse Total 1 2 1 6 1 7 2 10 7 17 3 15 13 28 4 24 8 32 5 5 0 5 Total 60 29 89 20 A t-test was used to calculate the mean scores of the students that use online networks for educational use and students that do not to see if there were significant findings on their perceived value of being able to view evaluations and procedures on an online network for education. It was found that there was a significant difference between the two groups (t(89) = 2.312, p < .05). The mean of the students that use an online network (m = 3.8, sd = .97) was higher than the mean score of students Table 11. Frequency of Benefit of Viewing Evaluations and Procedures Value SN use Total 1 2 1 2 1 3 2 5 8 13 3 8 4 12 4 33 14 47 5 12 2 14 Total 60 29 89 Table 12. Evaluations and Procedures Independent Samples Test of Equal Variance Assumed t df Sig(2-tailed) Mean diff. SE 2.312 87 .023 .524 .227 A t-test was used to calculate the mean scores on the perceived value of the how online networks could increase communication in clinical education of the two groups of students that already use social networks and the group that does not. 21 The mean scores of the two groups were calculated using an independent t-test to find if there was any significance for the effects of using online network to help with professional growth in athletic training. No significant difference was found between the two groups (t(87) = .713, p > .05). The mean scores of the students that utilize an online network for education was not significantly higher (m = 3.9, sd = 1.15) than the students that do not use an online network for education (m = 3.7, sd = .90). Table 13. Frequency of Perceived Value of Professional Growth Value SNuse Total 1 2 1 3 0 3 2 5 3 8 3 7 6 13 4 21 14 35 5 24 6 30 Total 60 29 89 Table 14. Professional Growth Independent Samples Test of Equal Variance Assumed t df Sig. (2-tailed) Mean diff. SE .713 87 .478 .174 .243 An additional independent-samples t-test was calculated comparing the mean score of students who use an online network for education to the mean score of students that do not use an online network for education on the perceived value of how online networks could increase the 22 quality of clinical education. No significant difference was found (t(87) 1.640, p > .05). The mean of students that do use an online network (m = 3.2. sd = 1.01) was not significantly higher than the students that do not use an online network for education (m = 2.8, sd = 1.002). Table 15. Perceived Value of Increased Quality of Clinical Education Value SN use Total 1 2 1 4 4 8 2 10 4 14 3 19 15 34 4 24 5 29 5 3 1 4 Total 60 29 89 Table 16. Clinical Education Independent Samples t-test of Equal Variance Assumed t df Sig (2-tailed) Mean diff. SE 1.640 87 .105 .372 .277 23 DISCUSSION The discussion section will be divided into three subsections: 1) Discussion of the Results, 2) Implications to the Profession, and 3) Recommendations for Future Research. Discussion of the Results The purpose of this study was to examine athletic training student’s perception on how social networks benefit their education or could be a benefit to their education. Research has been completed dealing with the student’s perception of the benefit of online social networks for education. There is little research done with the true effectiveness of this tool in the educational setting. The results of the Social Networking for Athletic Training Clinical Education Survey are subjective and some subjects may have perceived a greater value than others based on the educational setting and the social network that was used for that educational setting. Since this survey was not standardized there was margin for error in 24 assessing the student’s true perception of the benefits that these social networks may provide. This study found that there were significant findings depending on the network that was used for athletic training education and the amount of time spent using the network. The significant difference was found between students that use Blackboard and a combination of networks (Table 5). These combination networks consisted of Facebook and Blackboard, Blackboard and Desire 2 Learn, Blackboard and Ning, Blackboard, Twitter, and Facebook, and Blackboard and other networks not included in the survey. This finding could be a result of the total number of combination networks and the time spent between these multiple networks was significantly higher than the use of one network alone. Although Blackboard, Desire 2 Learn, Ning, and the other networks that were chosen are not typically considered “social networks” they do have a social networking aspect built into them. Despite the difference between the networking capabilities of each of the networks the combination networks had significantly more time spent on them than students who only used Blackboard (Table 5). The idea behind the theory of hypothesis one is that if the student took a higher interest in the network that they were using than they 25 would spend more time on the chosen network. This revealed similar findings to Skiba’s research11. These findings supported the statement in hypothesis one that students will spend more time using an online social network based on the network chosen and the findings revealed that students spend more time using multiple online social networks than simply Blackboard alone. According to the research in this study, students that use an online social network spend more time using the network for class experience when compared to professional development and clinical use and also for professional development more than clinical use, Table 6 supports these findings. There were significant findings between the three pairs of data (Table 7). The data collected from the subjects supported the second hypothesis that the students that use an online social network will spend more time using the online social networks for class use than for clinical and professional development. The findings for time spent for class and professional development where similar to what was found in other research in other medical professions.7-12 The differences between clinical use and professional development in this study were unexpected to the researcher. These findings were unexpected because athletic training education has a central focus on clinical 26 use the researcher anticipated that the students would respond with more time spent using the online social networks for clinical use then what was responded. The data found on this hypothesis are original but the data findings are similar to other research done in other medical professions. Nursing and podiatry studies report a lot of use with the social network for class use7-13 and for professional development.7,9,11-13,15 The final hypothesis stated with the perception value of students that use an online social network as a tool in their education being higher than the perceived benefit of students that do not us these online networks. The data supported this hypothesis. The independent t-test revealed that the mean perception value of students that used online social networks were significantly higher than the perceived mean value of students that do not (Table 9). This information supported the researcher’s anticipated data findings, but the mean scores were not as high as expected. This could be attributed to the networks used the most were not used effectively or did not provide adequate tools to meet the needs of the students, which lead to lower mean values. The data of this hypothesis were original and do not support any available research found, but were anticipated by the researcher. 27 Additional t-tests were done on questions in the survey that were not associated with the data of the hypotheses. Of the five additional questions that were asked only one had significant findings. The mean scores of viewing evaluations and procedures were higher for students that use an online social network than the mean score of students that do not use an online social network. Findings might suggest students that do use these online social networks understand the benefits that these networks give to them that having this additional tool would benefit them even further (Table 12). As stated above the other four questions did not have any significant findings. Although the findings were not significant the data found supported findings in other research based on issues with teachable moments, communication, and professional growth.1-4,9-11 The additional information was interesting because it provided high mean scores for both groups of students although statistically not significant. Of the 618 students attending an athletic training education program in Districts 1 and 2 of the NATA in which the survey was sent, 94 responded. The total response rate was 15%. Due to this low number of completed and returned surveys these findings may not be completely accurate and indicative of the population. 28 Implications to the Profession The findings of this research provide some possible implications for the profession. The research in this study shows that many athletic training education programs already provide students with the tool of an online social network for their education. This provides the potential of a specific online social network being created specifically for the use in athletic training education and athletic training clinical education. The online social networks could provide a new tool to better communication between students and their educators and or clinical instructors. This tool would need to be original and created based on the needs of the students and be able to be altered and changed as the educational demands at each institute change. Recommendations for Future Research The research study, Social Networking for Athletic Training Clinical Education has explored one very small population(ATEP students in Districts 1&2) and one potential tool of online social networking that could be 29 more utilized in athletic training clinical education. The results of the study have yielded a few primary recommendations by the researcher. The first recommendation is to further look into the use of social networks as a tool on a broader scale. Expanding the sample size so that all athletic training student’s perceptions are collected and analyzed. The data could provide a different outcome the than the small sample of the two districts that were utilized in this study. The second recommendation is to find what applications within the social networking program are the most beneficial to the students. If a program is designed directly for the use in clinical education, it could be designed directly to what the students believe would best benefit them. Conclusions The results of the study revealed the following major conclusions: 1) Students that use a combination of networks for their athletic training education spend more time on those networks then students who only use Blackboard for their education. 30 2) Students spend more time using online social networks for class use over clinical and professional development. And also use online social networks more for professional development than clinical use. 3) Students that use online social networks in their education perceive a higher benefit that this tool provides their education than the perceived benefit than students who do not use these networks in their education. 4) Students that use online social networks in their education feel that being able to view evaluations and procedures on online social networks would have a higher benefit to their education than students who do not use the online social networks. 31 REFERENCES 1. Berry D, Miller M, Berry L. Effects of clinical field- experience setting on athletic training students’ perceived percentage of time spent on active learning. J Athl Training. 2004;39:176-84. 2. Rich V. Clinical instructors’ and athletic training student’s perceptions of teachable moments in an athletic training clinical education setting. J Athl Training. 2009;44:294-394. 3. Henning J, Weidner T, Jones J. Peer assisted learning in the athletic training clinical setting. J Athl Training. 2006;41:102-109. 4. Weidner T, Noble G, Pipkin J. Athletic training students in the college/ university setting and the scope of clinical education. J Athl Training. 2009;41:422-427. 5. Wynn P. Social networking craze connects nurses. Healthcare Traveler. 2010;17:18-9, 2. 6. Puertz BE. Networking. PUBLIC HEALTH NURS. 2007;24:577-579. 7. Supe A. Networking in medical education: creating and connecting. IJMS. 2008;62:118-123. 8. Delisio E. Merging online education with social networking: welcome to present. Podiatry Management. 2009;28:73-74,76. 9. Hansen M, Erdley S. Youtube and other web 2.0 applications for nursing education. OJNI. 2009;13:120. 10. Skiba D. Nursing education 2.0: social networking. Nursing Education Perspectives. 2008;29:370-371. McKenzie AB. What about social networking? JCEN. 2009;40:436-437. 11. 12. Moule, P. E-learning for healthcare students: developing the communities of practice framework. JAN. 2006,54:370-380. 32 13. Owens L, Young P. You’re hired! The power of networking. JVR. 2008;29:23-28. 14. Allen L. Business Side. Tap into social networking. Massage & Bodywork. 2009;24:24-27. 15. Kaweckyj N. Networking within your professional association. Dental Assistant. 2009;78:12,14-15, 54. 16. Wolf G, Moser K. Effects of networking on career success: A longitudinal study. JAP. 2009;94:196-206. 17. Facebook firings show privacy concerns with social networking sites: remind staff about slippery slope with online postings. Healthcare Risk Management. 2009;31:49-52. 18. Taylor L, McMinn M, Bufford R, Chang K. Psychologist’s attitudes and ethical concerns regarding the use of social networking web sites. PROF PSYCHOL-RES PR. 2010;41:153-159. 19. Minerof P. Social networking: can it harm…. or benefit your practice? Do you have a face book page yet? Podiatry Management. 2010;29:117-118, 120, 122. 20. Foulger T, Ewbank A, Kay A, Popp S, Carter H. Moral spaces on MySpace: pre-service teacher’s perspectives about ethical issues in social networking. JRTE. 2009;42:1-28. 21. Watson M. Social networking: an opportunity for health and social care. Journal of Integrated Care. 2008;16:41-43. 33 APPENDICES 34 APPENDIX A Review of Literature 35 REVIEW OF LITERATURE The purpose of this literature review was to focus on how social networking has become a major component of communication in today’s society. The review examined how other allied health care professions use these social networks within the respected professions. With this popular use of social networks comes the issue of disclosure of personal information, and in the medical/education fields, patients’ medical records. The review of literature centered on the following sections with each having their own respective subsections, (1) Social Networking Within the Medical Profession, (2) Social Networking for Education, (3) Social Networking for Professional’s Growth and Career Building, (4) Issues With Social Networking. Social Networking within the Medical Profession The use of social networks has become a trend within society today. It allows for individuals to communicate with each other for free while removing the issue of distance. The social networks like Facebook, MySpace, and 36 Twitter are the top three networks that provide these advantages to their members.1 There has been an increase in popularity with these sites among medical professionals. It allows them to network within their respective fields to collaborate and exchange ideas with each other as well as promote potential job opportunities. An article by Wynn1 investigated how nurses use social networks. One nurse that was interviewed worked fulltime, raised a family and still had time to spend approximately 20 hours a week on a social networking site. She mostly used a social networking site called allnurses.com, a social networking site that was geared directly to and for nurses. It allowed nurses to discuss clinical issues and problems, job postings and discussion forums. The use of social networks in the professional domain can be very beneficial to medical professionals. An article by Puertz2 discussed creating a circle of people that one works with or has a very good relationship with is a great asset to one’s career. The author discussed that this type of communication benefits everyone that is involved whether directly or indirectly. The relationships that are built can range from educational to professional. These relationships can expand career opportunities for the individuals that are involved. 37 Social networks’ education opportunities are endless. They are fast, free, and more importantly fun according to an article by McKenzie.3 The fun atmosphere allows everyone to engage in the topic of discussion or staying up to date with people that are in ones “circle” of friends discussed by McKenzie. McKenzie3 also discussed social networks can benefit students and professionals, which are in a setting that have time constraints, by allowing them to remain connected with customers and patients. The social networks allowed the patients to give feedback and maintain some kind of dialogue with their healthcare provider, which provided additional tools of communication to maintain a good relationship. Another research study performed by Park4 examined the popularity of social networks. Park4 surveyed nurses to see what they were looking for from a social network and what gratifications were gained from them. It was found that nurses needed a social network that provided them with a place of socialization, entertainment, status selfseeking, and information. As changes in demographical data occurred, such as age, sex and location, so did the needs from the social network that the individual used. The younger group desired for the social, and entertainment, while the older group had a need to maintain business 38 contacts and information on research to maintain the gratification in the network. With the social networks being the current craze and the fastest, easiest of communicating within other medical professions, it is evident how such networks or something similar created for athletic trainers, and athletic training students, could benefit the profession. By giving clinical instructors, athletic trainers and athletic training students a place to correspond about new and current research will help aid the students in becoming more informed researchers and clinicians. Social Networking for Education The use of social networks is the most popular among teens and younger adults. The use of social networks in education can be a major tool in athletic training clinical education. Websites like Facebook and Youtube provide instructors the ability to post videos of techniques that can benefit the students. It allows the students an additional communication tool with instructors and fellow classmates when they are not in class. This type of communication gives instructors and students the ability to 39 post links and information to new and current research that may benefit the class. In an article by Moule5, the author studied the use of e-learning for healthcare students. The author examined whether health care students were able to develop communities of learning when engaged in online education. The author found that students were able to develop some essential elements of a community of learning. These elements included mutual engagement, joint enterprise, and shared repertoire. The author found some issues with this type of learning as they lacked an element of trust that students get from face to face interactions in the class room, and the students were not all committed to their assigned group. The author concluded that these types of community learning would work well with students that share common interests and are separated by distance. Berry6 studied the effects of clinical field experience setting on how student athletic trainers perceived the amount of time that they spent actively learning. The authors studied how much time that the students actually spent actively learning at their clinical site. The authors used a questionnaire to evaluate how the students felt the time at their clinical site was being used. It was found that the students spent about half of their time actively 40 engaged in learning at their clinical site while 17% was unengaged activities, 23% waiting for assigned tasks and 9% working on some kind of managerial task. The authors discovered that the type of clinical field experience setting and the assignment had an effect on the amount of time spent actively learning. The authors concluded that each clinical site needs to evaluate the students experience on an individual basis to meet the needs of the students to keep them actively engaged in learning. In an article about peer assisted learning Henning7 studies the effects on peer assisted learning in the athletic clinical education setting. The author focused on finding the prevalence of peer assisted learning in the clinical setting and how the students feel about this style of learning. The authors found that a large number of the students spent a majority of their time at their clinical site engaged in learning with their peers. It was found that over 60% of the students reported that they felt less anxious when practicing and performing their skills in front of peers than for their clinical instructor. The author suggested that peer assisted learning should not take the place of the student- clinical instructor learning atmosphere. They proposed that allowing students to use each other to learn as well as collaborating with their 41 clinical instructor that it will greatly increase their learning. In a recent article done by Rich8, the author studied clinical instructors and athletic training students’ perception of the teachable moments that occur in the clinical setting in athletic training education. The author explained that there is no universal definition of a teachable moment within athletic training clinical education. The objective of Rich’s8 research was to recognize and define a teachable moment in clinical education and to identify the barriers that prevent teachable moments from happening. The following were the three major themes that the author found where a teachable moment became clear; (1) professional discourse about skills, techniques, research and special cases; (2) authentic experience or actual hands-on experience; and (3) skill development or time for skill instruction, practice, role playing and simulations. A few of the barriers found by the author included lack of time, clinical instructor being busy with other duties, and lack of student initiative. The author concluded that teachable moments would enhance the quality of clinical instruction and education. The author found that once the clinical instructors and students were aware of these teachable 42 moments that both sides began to seek out the opportunities to have them occur. Brady9 recently studied the use of social networking sites in the higher educational setting. The author focused on a new social networking site called “Ning” while conducting their research. The author found that an increasing number of higher education instructors are beginning to use social networking sites in their classes as an educational tool. Ning has been shown to build communities of practice and to help facilitate a kind of social presence for students that use it. The author explored the use of these networks for distance education and the attitudes of the students to the use of this tool for education and its productivity for teaching and learning. The author found that education based social networking sites can be used effectively for distance education. In an article by Supe10, the author examined the increasing fade of social networks use among students. The author discussed how the networks help to create high educational bonds and allows students to learn collectively with each other. One of the major topics that the author discussed in this article was how networking in the professional setting can become blurred with work related 43 issues and social issues. Supe10 discussed that by linking the two together it increased the bonds within the work place and the classroom. By increasing these bonds, it allows the students to clear up confusing information with each other and to communicate with each other their own experiences with certain situations. Supe10 also reported that social networking in education increases the student’s ability to connect with potential employers and increases the number of people who they know within the respected profession. Delisio11 in an article examining merging online education with social networking, discussed that linking online education with social networking can benefit student’s education. The author investigated a podiatry website that allows residents to take their classes and at the same time be linked with other students, professors, and other doctors within the profession. The website gave students the ability to access their weekly assignments, giving them access to forums where doctors present case studies. These forums allow doctors and students to comment on the cases and give the students an additional venue for education by allowing them to learn through the experiences of others. The site also incorporated a few programs that 44 allow the students to have live meetings and conferences among themselves and their professors. In an article by Hansen et al12 it was discussed that Web 2.0 programs like Youtube and Facebook helped to enhance all health professionals’ proficiencies in basic information technology. The author reported these types of programs serve as a great teaching tool for health professionals. It was discussed that these tools enhanced learning by giving students the ability to view procedures in a non-pressure situation. The procedures are posted on the site and can be viewed as often as needed by the viewer. The students can then post links of these procedures on a different network page or their own so that their classmates may view this same procedure. An article by Skiba13 followed the same focus as the article by Hansen.12 The article focused on how to educate students on how to use their social networking site as a link with colleagues, so that students can communicate information better among each other. Skiba13 is also interested in how to better educate students on how to make their social network more professional. The author believed that this is important because it is a way for many colleagues communicate with each other. The author 45 discussed that this type of communication with social networks saves money for everyone that is involved. An article by Young14 examined the use of mentoring and networking among male and female administrators in the NCAA. The study found that the administrators involved regularly mentored students as well as young professionals. It was found that most mentoring and networking took place in both informal and formal venues. The study found that the subjects felt that networking this way is very important to an individual’s professional and personal development. Lou’s15 article on social networking websites looked at how students use online social networks to socialize with their peers and how to develop a professional network based on the information that they found. The author studied both Facebook and a social network that was created on one university campus. The study found that social networking online was the second most popular form of socialization by the students at the university. The study gathered information on how to create a social network that would remove hindrances that the students reported they had with social networks that they used. Gunawardena16 performed research in higher education that was interested in online communities of practice that 46 are within social networking; it was found that the use of Web 2.0 technologies is challenged the existing learning theories. The author hypothesized that this is because the theories were developed when online communication was not so vast and not possible. The authors suggested that the Web 2.0 programs are changing the learning theories and are no longer adequate at describing how to properly learn with these programs. The authors felt that because of this a new theoretical framework needs to be developed. The author believed that the best way to use social networking with education is to develop a community of practice, which has incorporated the three structural elements of education, domain, community and practice, which would take the place of conventional education. Using social networks would be an excellent tool for athletic training clinical education. Social networks will provide students with a place to collectively work on a current issue within athletic training or on an evaluation that they performed at their clinical site. They allow for the clinical instructor the ability to post case studies for the students to work on while offering their feedback on the issue to provide guidance. Social networks provide the ability to increase the teachable moments that students 47 can gain from their clinical site and their clinical instructor. Social Networking for Professionals: Growth and Career Building Social networking for professional use can greatly benefit ones business and help increase the number of patients that visit a practice. Additionally, it is a great public relations tool. Social networks allow professionals to connect with colleagues, discuss current cases and work together on research. The use of these networks help to build long term relationships that benefit everyone involved. In an article by Owens et al17 the authors looked at how to social network after being hired. They discussed that networking can grow relationships among coworkers, other professionals, as well as potential clients and future employers. Owens17 commented in the article that networking isn’t about “closing the deal,”17 that it should be about building long term relationships with all that are involved. Owens17 pointed out that networking should not be done just to find a job, it should be done to create connections with people that have similar interests in the 48 profession, and that if there is a potential job available then it will make itself available at the right time. Allen18 wrote an article looking at how social networking has benefitted massage therapists. Allen18 found that many therapists like to twitter to help with public relations for their business. It was found that most therapists like to use these social networks to notify clients of vacant time slots and to fill cancellations. Allen18 found that they also used the social networks to keep updated with fellow colleagues. It allows them to stay up to date with conferences that are coming up and meetings. Additionally it allows them to learn new techniques that are being used and to discuss the effect of them. Finally, Allen found that therapists that use Facebook get special notifications about new products that have recently came out on the market. In an article in Dentist Assistant, Kaweckyj19 looked at how dentists networked. The author discussed the importance of networking face to face as well as using technology to network. The American Dental Assistant’s Association has its own Facebook page that allows dentists to exchange ideas and to discuss topics within dentistry. The author stated that the use of the social network is a convenient way for professionals to students and young 49 professionals in the profession. The author also found that it is an easier way for them to reach out to patients that are hearing impaired. The networks allow them to schedule appointments and to present information about procedures to them so that they better understand what is going on. A study done looking at the effects of networking on career success, the author, Wolf20, found that there is a strong correlation between networking ability and the relation of strong career success. The author also found that this ability to network provided the individual with the ability to better themselves in their career and held a higher position within their respected field. Wolf20 found that there are six scales to networking: (1) building internal connections, (2) maintaining contacts, (3) using the contacts, (4) building external contacts, (5) maintaining the contacts, and (6) using the contacts. The study showed individuals that maintained their contacts had an increase in annual income. In an article by Honor21 on how nurses networked, Honor21 found that networking along with collaboration and partnering help to enhance the practice of the profession. The study showed that it had an even greater effect with nurse practitioners, and more advanced nurses. The research stated that exploiting certain networking situations and 50 goals are the key to success with networking. It was also reported in the research by Honor that networking allows for mentoring to happen which allows more experienced professionals help newer younger professionals advance their skills in the field. In a study of athletic trainers done by Pitney22, athletic trainers who worked in the high school setting socialized and how they networked within the profession of athletic training. The researchers were interested in getting a better understanding of the profession and the position that they are in. The study found that athletic trainers in the high school setting did not have a lot of socialization in the field and that they did not network well to benefit themselves. Watson23 wrote an article investigating how social networking is done within the medical profession. The study found that employers discouraged the use of such networks because they were afraid that if the employees used them that it would take away from productivity. The author also found that social networks need to be easy to use. Watson23 also discussed that professionals need to find a framework that works for them and that will meet their needs. 51 Issues with Social Networking There have been recent issues with medical professionals using social networks, and then losing their jobs in cases where patients’ medical records have been leaked onto the web. These job loses have had a negative effect on the use of social networks within medical professions. Without intentionally meaning to disclose this private information when looking for guidance on certain cases from mentors or other professionals it has resulted in termination of their employment. Many businesses fear by using these networks it will result in the loss of privacy and potential liability. In an article by Scott et al24 covering recent firings of nurses who used Facebook it was found that the nurses posted private patient information on their social network. The authors discussed that risk management advisors need to discuss the importance to the employees of not posting any private information online, and if they question whether or not they should post, they probably should not. Good privacy training and implanting sanctions for people who do post this information will protect the employer as well as the employee. It was also found that the employees within a 52 profession that are most likely to post this kind of information are the young employees and the new hires. Taylor et al25 conducted a study that investigated graduate psychology students and their use of social networks to see who posted patient information and if they had posted any unethical information. The study looked at 695 students and their online social network profiles. The authors concluded in the study that most of the students did not have a social networking page or did not really know how to use it. The main focus of this study examined if students posted unethical information on their page. The authors also found that because not many people used the sites, or knew how to, it showed that they lacked people that could police the sites to insure that patients records are being protected. Breslin26 wrote an article that investigated the issues when social networks enter the workplace. The author found that when professionals are allowed to use social networks at work that the quality of work done by the employees drastically decreased. The author discussed that these networks leave employees susceptible to possible termination for posting pictures and private information on their network page. Information technology (IT) employees that were interviewed state that by not allowing employees 53 access to these social networks while at work will better protect the patients’ records and at the same time protect the employees’ jobs. Minerof27 reported in an article dealing with social networking within the podiatry field that many of these professionals are very hesitant to use a social networking page for their practice as well as a personal page. The article reported that the professionals are concerned with using social networks with fear that they will be liable for loss of personal privacy as well as medical records. The author discussed that even though there are many negatives with using social networks for professional use, they also offer many benefits. The social networks strengthen connections with patients and colleagues, and help to reach out to new potential cliental. Rigiero28 suggested in an article concentrated on social networking post in the professional setting, that when individuals are looking to run for a professional office or applying for a prestigious position at a hospital they need to be cautious with the information that they shared on social networking sites. The author suggested that individuals need to consider the information that they post about them on social networking sites because once the information has been posted it cannot be taken back and 54 will always be posted on the networks framework. The author discussed that it is important to never post anything on social networks from a job related, or work place computer network. The author stated that this is important because the information can be traced by IT, and it is professional courtesy to the company or work place. In an article looking at ethical issues with social networking in education, Foulger29 reported that these social networks, such as Facebook and Myspace are innovative tools that surpass the norms of traditional social interactions. However, in some instances, when these tools have been used they have had negative reactions. The authors have developed a case-based reasoning intervention to support more informed decisions by the teachers. The results were criteria for students who participate in social networking sites were created. The authors believed that these types of guidelines will harness a positive potential in education that will remain professional and positive. 55 Summary Every day hundreds of millions of people access online social networks. The use of social networks has added many benefits to the medical field. This tool of communication has aided other medical professionals’ in maintaining connections with those colleagues that are either close, or a large distance away. With this increased communication it has benefitted them to collaborate on research, issues with patients’ health, and potential job opportunities. The use of online social networks also has proven to have the potential to be an exception tool for educational use. It allows students the ability to work on case studies and work with their peers on certain issues, while at the same time still having the guidance of their instructor. By using social networks in clinical education there is a potential to help increase the likelihood of teachable moments between instructors and students. Social networks also have a benefit for professional use and career building. Social networks allow for connection with colleagues all around the world which can help increase an individual’s career growth. By implementing social networks in clinical education the athletic training students can learn how to properly network and begin to grow their 56 network base with their peers and instructors. With the added benefit of social networks there are many issues with patients’ personal information being posted and many people becoming liable. Students learning how to use social networks in a monitored environment and with guidance of their instructor will help reduce the likelihood of students posting confidential information. Overall, by using online social networks as a tool in clinical education, it has the potential to greatly benefit the students’ education and set them up for success in their future career in athletic training. A platform needs to be created based on the needs of the students, and that can be easy changed and adapted to meet the needs of the institution following some of the guidelines that Watson23 stated in his research. 57 APPENDIX B The Problem 58 Statement of the Problem The purpose of this study is to examine the use and the effect of social networks in athletic training clinical education. Social networks have become a major component in communication today at the personal and professional level. An issue with clinical education is that there is a lack of teachable moments between the instructor and the students due to the high demand on the clinical instructor’s time, and at times a lack of student initiative. If we know what the students feel is the most beneficial way for them to learn in the clinical setting, then we can limit the restrictions on education. Additionally, with the popularity of the social networks, we can incorporate them as a tool within clinical education to increase the teachable moments and help provide information to the students in a fashion that may meet their needs. Definition of Terms The following definitions of terms will be defined for this study: 59 1) Social Networks- a social structure made up of individuals or organizations which are connected by one or more specific types. 2) Web 2.0- associated with web applications that facilitate interactive information sharing, interoperability, user-centered design, and collaboration on the World Wide Web. 3) Teachable Moment- the time (in education) at which learning a particular topic or idea becomes possible and easiest. Basic Assumptions The following are basic assumptions made in regards to this study: 1) The subjects were honest when they completed the demographic portion of the survey. 2) The subjects answered the survey questions to the best of their ability. 3) The survey provided beneficial information regarding the student’s perceptions on education. Limitations of the Study The following are possible limitations of the study: 1) The validity of the survey has not been established. 60 2) There is no current research regarding this topic. 3) Students may not know what they want out of education. 4) The resources may not be available to the students to gain access to the online networks. 5) The students may not have the knowledge about how to use these online networks. Delimitation of the Study The following statement reflects the potential delimitation of the study: 1) Only student NATA members of Districts 1 and 2 were surveyed. 2) Students only had two weeks to complete the survey. 3) Only current students where surveyed. Significance of the Study The results of this study provide athletic training clinical instructors and educators with information suggestive of what the students believe they need from clinical education, with the use of social networks as a tool. This information is very important to the field of athletic training education because it will tell us how to can best meet the needs of the students in terms of social networking. In an era where education has not evolved with the ever-changing technology environment, this study will 61 provide feedback to what needs to be changed. It will also provide information and insight of what students need out of clinical education, which they may not currently be getting. 62 APPENDIX C Additional Methods 63 APPENDIX C1 Social Networking for Clinical Education Survey 64 65 66 67 68 69 APPENDIX C2 Institutional Review Board – California University of Pennsylvania 70 71 72 73 74 75 76 77 78 79 Institutional Review Board California University of Pennsylvania Psychology Department LRC, Room 310 250 University Avenue California, PA 15419 instreviewboard@cup.edu instreviewboard@calu.edu Robert Skwarecki, Ph.D., CCC-SLP,Chair Mr. Campbell, - - Please consider this email as official notification that your proposal titled “Social Networking for Athletic Training Clinical Education” (Proposal #10045) has been approved by the California University of Pennsylvania Institutional Review Board as submitted, with the following stipulations: In the consent form/cover letter: In the phrase “discontinue participation at any time” the text “without penalty” must be inserted. The following must appear “This approval is effective 02-24-11 and expires 02-23-12” [actual dates will be provided by the IRB]. Once you have made this revision, you may immediately begin data collection. You do not need to wait for further IRB approval. [At your earliest convenience, you must forward a copy of the revised consent form for the Board’s records]. (1) (2) (3) (4) The effective date of the approval is 02-24-2011 and the expiration date is 02-23-2012. These dates must appear on the consent form . Please note that Federal Policy requires that you notify the IRB promptly regarding any of the following: Any additions or changes in procedures you might wish for your study (additions or changes must be approved by the IRB before they are implemented) Any events that affect the safety or well-being of subjects Any modifications of your study or other responses that are necessitated by any events reported in (2). To continue your research beyond the approval expiration date of 02-232012 you must file additional information to be considered for continuing review. Please contact instreviewboard@cup.edu Please notify the Board when data collection is complete. Regards, Robert Skwarecki, Ph.D., CCC-SLP Chair, Institutional Review Board 80 APPENDIX C3 Cover Letter 81 Date 5/6/11 Dear Athletic Training Student: My name is Matthew Campbell and I am currently a graduate student at California University of Pennsylvania pursing a Master of Science in Athletic Training. Part of the graduate study curriculum is to complete a research thesis through conducting research. I am conducting survey research to determine if Social Networks can be used as tool in clinical education. Athletic training students from CAATE accredited programs in NATA Districts 1 and 2 are being asked to participate in this study; however, your participation is voluntary and you do have the right to choose not to participate. You also have the right to discontinue participation at any time during the survey completion process, without penalty, at which time your data will be discarded. The California University of Pennsylvania Institutional Review Board has reviewed and approved this project. All survey responses are anonymous and will be kept confidential, and informed consent to use the data collected will be assumed upon return of the survey. Aggregate survey responses will be housed in a password protected file on the CalU campus. Minimal risk is posed by participating as a subject in this study. I ask that you please take this survey at your earliest convenience as it will take approximately 10 minutes to complete. If you have any questions regarding this project, please feel free to contact the primary researcher, Matthew Campbell at (cam3225@calu.edu) you can also contact the faculty advisor for this research Dr. Ellen West at (west_e@calu.edu). Thanks in advance for your participation. Please click the following link to access the survey: https://www.surveymonkey.com/s/RX8GY8J Thank you for taking the time to take part in my thesis research. I greatly appreciate your time and effort put into this task. Sincerely, Matthew Campbell, ATC Primary Researcher California University of Pennsylvania 250 University Ave California, PA 15419 207-694-1914 cam3225@calu.edu Ellen J. West, EdD, ATC Faculty Advisor California University of Pennsylvania 250 University Ave California , PA 15419 724-938-4356 Email: west_e@calu.edu 82 Appendix C4 References 83 REFERENCES 1. Wynn P. Social Networking craze connects nurses. Healthcare Traveler. 2010;17:18-9,22. 2. Puertz BE. Networking. PUBLIC HEALTH NURS. 2007;24:577-579. 3. McKenzie AB. What about social networking. JCEN. 2009;40:436-437. 4. Park N, Kee K, Valenzuela S. Being immersed in a social networking environment, uses and gratifications, and social outcomes. Cyber Psychology & Behavior. 2009;12:729-733. 5. Moule, P. E-learning for healthcare students: developing the communities of practice framework. JAN. 2006,54:370-380. 6. Berry D, Miller M, Berry L. Effects of clinical fieldexperience setting on athletic training students’ perceived percentage of time spent on active learning. J Athl Training. 2004;39:176-84. 7. Henning J, Weidner T, Jones J. Peer assisted learning in the athletic training clinical setting. J Athl Training. 2006;41:102-109. 8. Rich V. Clinical instructors’ and athletic training students’ perceptions of teachable moments in an athletic training clinical education setting. J Athl Training. 2009;44:294-394. 9. Brady K, Holcomb L, Smith B. The use of alternative social networking sites in higher educational settings: a case study of the e-learning benefits of “Ning” in education. JIOL. 2010;9:151-170. 10. Supe A. Networking in medical education: creating and connecting. Indian Journal of Medical Sciences. 2008;62:118-123. 11. Delisio E. Merging online education with social networking: Welcome to PRESENT. Podiatry Management. 2009;28:73-74,76. 84 12. Hansen M, Erdley S. Youtube and other web 2.0 application for nursing education. OJNI. 2009;13:1-20. 13. Skiba D. Nursing education 2.0: social networking. Nursing Education Perspectives. 2008;29:370-371. 14. Young D. Mentoring and networking: perceptions by athletic administrators. JSM. 1990;4:71-79. 15. Luo L. Social networking websites: an explanatory study of student peer socialization in an online LIS program. J EDUC LIBR INF SCI. 2010;51:86-102. 16. Gunawardena C, Hermans M, Sanchez D, Richmond C, Bohley M, Tuttle R. A theoretical framework for building online communities of practice with social networking tools. Educational Media International. 2009;46:3-16. 17. Owens L, Young P. You’re hired! The power of networking. JVR. 2008;29:23-28. 18. Allen L. Business Side. Tap into social networking. Massage & Bodywork. 2009;24:24-27. 19. Kaweckyj N. Networking within Your professional association. Dental Assistant. 2009;78:12,14-15, 54. 20. Wolf G, Moser K. Effects of networking on career success: a longitudinal study. JAP. 2009;94:196-206. 21. Honor N, Tracey C. Networking for nurses. Nursing Management. 2007;13:26-29. 22. Pitney W. The professional socialization of certified athletic trainers in high school settings: a grounded theory investigation. J Athl Training. 2002;37:286292. 23. Watson M. Social networking: an opportunity for health and social care. JIC. 2008;16:41-43. 24. Scott D, Troutman AK. Facebook firings show privacy concerns with social networking sites: remind staff about slippery slope with online postings. Healthcare Risk Management. 2009;31:49-52. 85 25. Taylor L, McMinn M, Bufford R, Chang K. Psychologists’ attitudes and ethical concerns regarding the use of social networking web sites. Professional Psychology: Research and Practice. 2010;41:153-159. 26. Breslin T. When social networking enters the workplace. Massachusetts Nurse. 2009;80:14. 27. Minerof P. Social networking: can it harm, or benefit your practice? Do you have a face book page yet? Podiatry Management. 2010;29:117-118,120,122. 28. Rigiero. Golden Rules for posting on social networking sites. Massachusetts Nurse. 2010;81:15. 29. Foulger T, Ewbank A, Kay A, Popp S, Carter H. Moral spaces on myspace: pre-service teacher’s perspectives about ethical issues in social networking. JRTE. 2009;42:1-28. 86 ABSTRACT Title: SOCIAL NETWORKING IN ATHLETIC TRAINING CLINICAL EDUCATION Researcher: Matthew Campbell Advisor: Dr. Ellen West Date: May 2011 Research Type: Master’s Thesis Context: The reason for this study was to evaluate the use of social networks in the athletic training educational setting, and the perceived benefit of how the students believe it aids in their education and the potential benefit for clinical education. Objective: The purpose of this study is to examine the use and the effect of social networks for athletic training education and clinical education. Design: Descriptive research study Setting: The NATA survey system distributed via email the (Social Networking for Clinical Education Survey) to athletic training education program students of District 1 and District 2. Subjects: Athletic training students of CAATE accredited programs within NATA Districts 1&2. Interventions: The independent variables within the study were the type of network selected and the current use of a network of educational use (yes or no). The survey was created by the researcher and was administered via email by an online survey system (www.surveymonkey.com). The email list was created by the NATA survey system, the cover 87 letter and link to the survey was emailed to the subjects. The data was analyzed using SPSS at a significance level at α ≤.05. Measurements: All data analyzed at a significance level at α ≤.05 for all hypotheses. H1: an ANOVA was used to compare mean scores of time spent with network that was chosen. H2: an ANOVA was used to compare time spent between the usage area for class, clinical and professional development use. H3: an independent t-test was used to compare the mean values of the perceived benefit between students who use an online social network and students who do not use an online social network. Results: All hypotheses had findings that were significant. H1: (F(4,61) = 3.446, p < .05). H2: (F(2,122) = 14.06, p < .001). H3: (t(85) = 2.614, p < .05). Conclusion: The study revealed that undergraduate athletic training education program students who use an online social network will spend more time using multiple networks than just Blackboard. Students that use an online social network will spend more time using it for class use than for professional development and clinical use, and more time for professional development than clinical use. Students that use an online social network for education have a higher perception value of the networks than students that do not use an online social network for education.