How Health Care Professionals Use Social Media to Create Virtual Communities: An Integrative Review

Background: Prevailing health care structures and cultures restrict intraprofessional communication, inhibiting knowledge dissemination and impacting the translation of research into practice. Virtual communities may facilitate professional networking and knowledge sharing in and between health care disciplines. Objectives: This study aimed to review the literature on the use of social media by health care professionals in developing virtual communities that facilitate professional networking, knowledge sharing, and evidence-informed practice. Methods: An integrative literature review was conducted to identify research published between 1990 and 2015. Search strategies sourced electronic databases (PubMed, CINAHL), snowball references, and tables of contents of 3 journals. Papers that evaluated social media use by health care professionals (unless within an education framework) using any research design (except for research protocols or narrative reviews) were included. Standardized data extraction and quality assessment tools were used. Results: Overall, 72 studies were included: 44 qualitative (including 2 ethnographies, 26 qualitative descriptive, and 1 Q-sort) and 20 mixed-methods studies, and 8 literature reviews. The most common methods of data collection were Web-based observation (n= 39), surveys (n= 23), interviews (n= 11), focus groups (n= 2), and diaries (n= 1). Study quality was mixed. Social media studied included Listservs (n= 22), Twitter (n= 18), general social media (n= 17), discussion forums (n= 7), Web 2.0 (n= 3), virtual community of practice (n= 3), wiki (n= 1), and Facebook (n= 1). A range of health care professionals were sampled in the studies, including physicians (n= 24), nurses (n= 15), allied health professionals (n= 14), followed by health care professionals in general (n= 8), a multidisciplinary clinical specialty area (n= 9), and midwives (n= 2). Of 36 virtual communities, 31 were monodiscipline for a discrete clinical specialty. Population uptake by the target group ranged from 1.6% to 29% (n= 4). Evaluation using related theories of "planned behavior" and the "technology acceptance model" (n= 3) suggests that social media use is mediated by an individual's positive attitude toward and accessibility of the media, which is reinforced by credible peers. The most common reason to establish a virtual community was to create a forum where relevant specialty knowledge could be shared and professional issues discussed (n= 17). Most members demonstrated low posting behaviors but more frequent reading or accessing behaviors. The most common Web-based activity was request for and supply of specialty-specific clinical information. This knowledge sharing is facilitated by a Web-based culture of collectivism, reciprocity, and a respectful noncompetitive environment. Findings suggest that health care professionals view virtual communities as valuable knowledge portals for sourcing clinically relevant and quality information that enables them to make more informed practice decisions. Conclusions: There is emerging evidence that health care professionals use social media to develop virtual communities to share domain knowledge. These virtual communities, however, currently reflect tribal behaviors of clinicians that may continue to limit knowledge sharing. Further research is required to evaluate the effects of social media on knowledge distribution in clinical practice and importantly whether patient outcomes are significantly improved.