Using social media for professional development at the Leeds #SMSmhealth

I was delighted to attend a social media event in Leeds today, designed for people interested in mental health. I was asked to deliver a workshop  for people interested in using social media for professional development. I was hoping to Live-Stream the workshop, but wasn’t able to connect to the internet from the room I was in, so I promised to blog about it so that you could share in the conversation and add any comments you might have.

What is professional development?

The group kicked off the session explaining a little bit about who they were, what their level of experience in social media was, and what they felt were important elements of professional development. We were able to identify universal elements of what contributed t professional development, in order to look at how we could apply this knowledge to the online media we chose to use. We picked out the main elements we identified as important and listed them- here’s a picture of the jolly selection we made.

Searching for keywords related to fields of interest

After listing the elements of professional development, we were able to identify key words associated with each element, this gave us an idea of some keywords to search for using search engines or social networks. Some of the group were surprised to learn that social networks could be searched for information in this way, and hadn’t considered doing this before. It was pointed out by a group member that Facebook ha just overtaken Google as the pre-eminent search engine (thanks, @northernlightspr!).

We discussed how finding appropriate hashtags could be a useful tool- not just for Twitter, but in using the same principle to locate search terms for any website we wanted to use to find out things we found interesting. We looked at the example of building a network related to occupational therapy.

Searching for individuals to add to our networks.

Another group member (@philjewitt) was able to contribute that by searching in this way, we could find the individuals who were regularly using these searched-for terms, and hence discover new people to add to our networks. Thanks Phil- this was an important point. So, by searching using a tool like Twitter, we could find not only what people were saying about something, but also find out who said lots of things about a topic- this indicates to us they could be interesting to follow, friend, or connect with, as we are likely to be able to talk with them about our shared interest.

Let’s look at searching Twitter for information about using social media in local government, which was an area of interest to several #smsmhealth group members. We identified search terms that we could use:

• localgovernment
• #lgovsm
• #Leeds (or whatever town we’re interested in)

We can then run a search using Twitter:

We can see that conversations are happening around this hashtag, so we know it was an effective search term. We can see current popular discussions taking place, and we can also see some people who are having conversations about the topic that interests us.

Separating and connecting

The best use of social media for professional development comes from having conversations about things that interest us, professionally. To do this, we need conversational partners. We know of a couple of ways we could search in social media to find both topics that interest us, and the people talking about those topics. So, how do we identify if it is a “useful” conversation to have? How do we know that this connection, this conversation, will add value to our experience?

We don’t. But we can make a good guess based on what the other person is saying, and whether they are willing to connect with other people and have conversations. And, we don’t need to make a “forever” decision we can choose to separate and connect with people according to our own rules, interests, time constraints- it’s really up to you.

At a party, you might decide the person that happens to be in the kitchen with you is a total hoot, and spend the rest of the evening having a great time chatting together, whether you disagree about everything or if you find you have lots in common. Or you may locate the person at the party that you find you have uncomfortable silences with. That’s okay. We are always civil with each other, but we employ the same social skills we use everyday at work or at a party to continue some conversations, and politely separate from others. We’ve got finite attention and time, and we get to choose how we spend it. It’s not a judgement on anybody else.

Building a network

The purpose of all this connecting and having conversations is to build our network. By developing the links we share with people we “meet” in social media, we can gain insights, share experiences, discuss issues that matter to us, and develop in a professional sense. We are developing a network based on shared interests, or a professional practice-based network (or both!)

To develop professionally, it is important to have access to high quality information, access to research, and membership of professional groups (as we discussed earlier). We’re using social media to achieve these aims. If you’re trying out Twitter for professional development (and I recommend you do), then aim to gather about 100 people to “follow” before you decide whether or not the network works for you.

Becoming a “network node”

Building a network and becoming more influential within it is the process of  becoming “network nodes“. This means we are becoming a person or link in the network where information (stories, opinions, facts, fallacies) is efficiently passed further on through the network. The better the network, the better the information contained within it.  As we become “network nodes”, we’re adding value to the overall development of the networks, by virtue of our curation both of the network and of the information within it.

Curating your network

Growing a network is great fun and very rewarding, but how do we avoid becoming overloaded with all this information, and all the conversations we would like to join in with but don’t have time? The answer lies in curating the network, and via this, curating the information flow. This can be done in several ways.

• Trim your follows

As you follow or friend lots of people, you might find it becoming difficult to keep up with everything that’s going on. This is a clue that it’s time to curate, cull, or trim your follows. This can be done in several ways, including by putting people in lists, by using various tools to clear out people who aren’t active members of the network, or just by redefining your own rules about what you talk about or how much time you have to spend on a network.

• Think about time in the network

Are you being strategic about the scare time resource you have in this network? Do you have expectations of doing professional development within a 9-5 framework? Are you able to committ to times when people are having the best conversations? Early morning is my favourite time, but most people Tweet from 7-9pm, that’s why so many Tweetchats are  on at this time.

• Its okay to be non-linear!

Social network chatting is great when you are online at the same time as the person you’re chatting with, but people don’t expect instant responses. We are all busy, and that’s okay. It’s great to send a quick message saying you’d like to pick up a subject with someone another time, but lots of people find it better to write a blog-post to expand an opinion and share it widely by linking to it in social media- commenting on people’s posts and writing your own is a great way to have deeper conversations with other people in your network. So if you find yourself worrying about “keeping up” with what’s being said, please relax. As your network grows and you curate a network that is bespoke to your professional interests, your network will start to filter information. Things that you find interesting will probably be shared several times, from different directions. Trust that the information you need will get to you. It will.

I hope you’ve found the information I’ve shared useful, and I hope you can take away a couple of strategies to apply to your own practice. Social media can enhance our professional development in new ways- and I find Twitter particularly useful. Go on, give it a try!

I’m interested to know what you think- what tips would you share for people who are just starting to think about using social media in this way?

Thanks to all the participants in the workshop at #smsmhealth in Leeds today, and to Leeds and York Partnerships Foundation Trust and Leeds Mind for co-hosting the event.

If you would like to talk to me about delivering training and mentoring in using social media professionally within your organisation or practice, do get in touch.

Other blogs about #smsmhealth:

@VictoriaBetton http://digitalmentalhealth.co.uk/wp/?p=271

@_jonb http://smsmhealth.tumblr.com/

Resources for Social Media for Professional Development

@claireot on demonstrating clinical leadership through using social media http://theclnnetwork.blogspot.co.uk/2012/06/social-media-not-just-peter-andres.html

@claireot How to Tweet http://claireot.wordpress.com/2012/03/19/how-to-twitter/

@wenurses Twitterversity guide to Twitter http://www.wenurses.co.uk/Resources/twitterversity.php

The Not So Big Society blog with great example of how NOT to do it http://notsobigsociety.wordpress.com/2012/09/18/how-not-to-debate-with-health-professionals-on-twitter/

@claireot on Littlefeet- a case study of the consequences of poor staff digital literacy in a mental health inpatients unit http://claireot.wordpress.com/2012/01/04/censorship-or-duty-of-care-little-feet-blogging-on-an-acute-mental-health-inpatients-ward/

and the Littlefeet case study develops the Streisand Effect http://claireot.wordpress.com/2012/01/06/little-feet-pursues-pals-an-update-in-the-mental-health-inpatients-blogging-debate/

OT Resources:

OTalk and Occhat Blog

OTalk and Occhat Twitter

OTalk and Occhat Facebook Page

OT4OT Facebook Group

OT24Vx- the 24hr Virtual Exchange- on Facebook

#MedEdMOOC, #HCPMOOC or #HealthMOOC?

The process of developing the MOOC for HCP continues apace, but there are still issues we need to hammer out in order to see the maximum possible engagement in the event, and the greatest possible learning opportunities presented to the greatest possible number (at least, that’s where I’m coming from).

There are currently 240 000 Allied health professionals in the UK alone, and over 350 000 nurses and midwives. But the focus of the MedEdMOOC, from the naming of it onwards seems to reflect almost exclusively the narrow group that is concerned with the education of Medics. I am glad that Dean Jenkins picked up on this idea in his recent blog, and that it is reopened for discussion.

But, how did this happen? Is it that medics are ahead of other HCP groups in their use of online technology? Is it that medical educators are a particularly technologically gifted group? Is it that other HCPs dont yet have an understanding of the potential of online technology? Is it that somehow we are excluding other HCP from the development process? I’m not sure of the answers to these questions, but I think it is useful for me to frame them such that I may reflect on them throughout the process and beyond. If you have any views about this, I would love to hear them in the comments.

The topics we are planning to cover over a six week spread are based around these working titles:

Week 1. Theory- Connectivism vs constructionism

Week 2. Learning- where are we now on the social web?

Week 3. Doing- Improving healthcare delivery in a networked world

Week 4. Collaborative Models (including CPD in social spaces)

Week 5. Barriers- what are they and how can we overcome them?

Week 6. Content to be decided by participants.

Now, looking at these titles for the weeks’ content, there is nothing that is exclusive to medics- in fact, all these topics can be used by any healthcare professionals. As a MOOC is likely to contain more content than any one person wishes to engage with, it may be that there are profession specific items that appeal more to one profession than another. But it is interesting to me that event though I have been involved in the planning of the event, I am holding prejudices about the process; doubts about whether my professional skills are of value to the process; wondering why more Allied Health Professionals are not on board with the development of the MOOC.

For what it’s worth here are my thoughts.

The name MedEdMOOC is an exclusive title, implying that content to be developed must be relevant to medical practice and be concerned with the education of medical practitioners. In my view, we could re-visit this naming decision to reflect a more inclusive title.

The development team is composed largely of medics. This means every decision is taken through that filter. Decisions are unconsciously made using the frame of reference from within medicine and medical education.

I’m excited about taking advantage of the principles of the MOOC to explore connectivity, horizontal flows of information, networked learning and professional developments that include exposure to the broad range of models used in healthcare delivery. But, to do that successfully, we either need a broader range of HCP involved in the planning, or very committed participants from different disciplines, who will then generate further content.

I also believe that the event will benefit from some real life experiences that participants can choose to be a part of. Myself and two colleagues are delivering a “Social Media Surgery” at our professional conference in Glasgow during the MOOC. This will provide us with the opportunity to explore either LiveStreaming an element of the workshop, or at least utilising Skype chat facility or similar to ensure people outside the room can be included. We may also choose to deliver an additional session for the participants online (venue and organisers’ indulgence permitting!)

I am planning an event in Leeds towards the end of June. I aim to get together the community of practice surrounding the #nhssm Tweetchat and some health and social care stakeholders. I hope that this event will similarly be able to be integrated into the MOOC, perhaps as an opportunity to ask questions, perhaps to hack some solutions to challenges we have identified in the uptake of some of these technologies.

Please do engage in the debate surrounding these ideas- we know this is the first health related MOOC planned, and its success is entirely dependent on how well we can identify and meet your learning needs!

Nhssm at the Nursing and Midwifery Council for Social Media Week #smwldn #smwnmc #nhssm

I was delighted to see that as part of this year’s Social Media Week, the Nursing and Midwifery Council (NMC) played host to a live #nhssm event. This was entitled “Talking with patients online: what are the boundaries?” and it featured some great speakers from the intersection between digital and new media and modern Nursing practice. It was accompanied by an article in the Guardian promoting the event.

“Nhssm” is a weekly Tweetchat that discusses the challenges and opportunities posed by using Social Media within the NHS. There is an accompanying blog, which hosts summaries of the weekly chats, and there are regular contributors to the body of knowledge in this area- if you would like to know more, simply search for the #nhssm hashtag on Twitter to see the most recent Tweets.

This is one of the earliest communities of practice that I joined on Twitter, and it has been a fantastic experience to connect with people who share my dedication to examining the issues presented by increasing use of digital and social media within the NHS. I have regularly contributed to the weekly chats for a few years, I’m one of the “old guard” of the group now- a strange thing to be saying in relation to the use of social media within the NHS!

My thoughts about this event:

• The event was “live-Tweeted” through both the @nmcevents and @nhssm accounts- this means that both accounts were used to capture and publish snippets of what was said during the chat. The advantage of this was that it meant important statements were more likely to be picked up and amplified. Because the team members who were behind the accounts were experienced in this use of social media, they functioned as true engagement tools, rather than simply broadcasting the event. Our regular weekly #nhssm Tweetchat was scheduled during the event, and so our contributors who were unable to make it in person to the event were able to engage with the format by asking and answering questions, and by offering informed opinions. Alex of nhssm blogged about his impressions of the event, and also feels that using two accounts to live Tweet the event worked particularly well.
• Using digital as part of our NHS communications toolbox is new in itself- using social media as part of the toolbox of clinical staff within the NHS is newer still. Formal policies and procedures are available, but in this emerging field, we are still sketching out the agreed boundaries of practice. I disagreed with Anne Marie (@amcunningham) during the chat as I felt that conventions do exist within these spaces. On reflection, I think that I must be careful not to assume that just because I am aware of subtle differences in culture between platforms that other people, particularly newer people to this space, are as aware as I am. So, I concede your point, Anne Marie!
• We have no agreed method for disseminating examples of best practice in the use of social media by clinical staff. Although communities will develop their own norms of behaviour, it is my experience that staff need to have a mentor, coach, or social media “surgeon” available to assist them in their understanding of how to use these tools. This can presently be frequently found informally within communities of practice online. It is my hope that more NHS Trusts and professional organisations will begin to see the value in having formal training and e-learning opportunities for their staff available as part of their professional development planning. I believe that formalising this process will add value to the use of these tools by staff, and enable outcomes in engagement and participation of client groups to be generated.
• I believe that social media communication channels should be offered to patients and carers of people needing NHS services. I believe that we have a responsibility to make information flow in the way that is most convenient for the patient, whilst recognising our special responsibilities for Information Governance and professional practice. I love Agency Nurse’s blogged reflections of how she aims to use her clinical skills in forming good quality therapeutic relationships through the newer media that we use- and I couldn’t agree more! Part of the issue is that many of our clinical leaders and people within the upper reaches of NHS heirarchy are not fluent with the use of these tools. They may, therefore, not see the benefit that others (perhaps particularly the networked generation) take for granted every day, whether patients or staff.

Here’s the transcript of the event. By looking at he analytics regarding the event, we can see that we had 97 participants in the conversation (surely some kind of #nhssm record?) and a total of 627 Tweets within the timeframe of the event plus an hour each way. This shows just how active and engaged the audience were. The most popular links shared were:

1. The Agency Nurse fantastic blog- “Getting Nurses Talking” which contained a very useful Guide to Twitter, applicable to many HCPs, not just nurses, I’m sure!
2. Agency Nurse coming up trumps (again!) with a great presentation showing how nurses can create a community of practice online by curating Tweets under the #nurseuk banner
3. The weekly #Nurchat Tweetchat and accompanying blog. Another great event hosted by Agency Nurse. This discusses relevant content that changes each week. It is on Tuesdays at 8pm on Twitter.
4. Link to the NMC presence on Social Media, with further link to their guidance on social media use for nurses and midwives.

Once more, I feel encouraged and supported on my own journey into social media by this fantastic community built around the use of a social network. I hope that you join in with our next chat, too.

If you would like to talk to me about how I can help your organisation deliver training and coaching around the use of these tools by your clinical or corporate support staff, do get in touch by email to tech4health (at) gmail.com or by leaving a comment.

Great to see further write up here in the guardian by @PamNelmes007 http://www.guardian.co.uk/healthcare-network/2012/feb/16/social-media-nurses-communicate-public?newsfeed=true

Little Feet pursues PALS- an update in the Mental Health Inpatients Blogging debate

As I wrote in an earlier post, blogger @ChaosandControl, or Little Feet, was recently prevented from blogging whilst an Inpatient in an Acute Mental Health Unit by staff who confiscated her phone to prevent her having access.

Without my knowledge, staff read through the archives of my blog and my twitter stream…

…During a subsequent meeting with staff, I was notified that the archives of my blog and twitter stream had been read. I was asked to stop blogging and my mobile phone was confiscated for 24 hours. I agreed to stop blogging for the duration of my admission. While I did not want to stop blogging, I agreed to because I felt to do otherwise might have been detrimental to the care I was receiving. I enquired as to whether it would be possible to retain my mobile phone but agree with staff not to blog. I was informed that this would not be possible because a team decision had been made to confiscate my mobile phone.

As a result, she has had to re-evaluate her existence as an award winning mental health blogger and may feel unable to continue to operate her Chaos and Control blog.

She has updated her blog readers with the news that she has emailed her Trust PALS (Patient Advice and Liaison Service) with a view to gaining clarity about the decisions made in this case, and to highlight what may be a misguided interpretation of current guidance from the Care Quality Commission about Inpatient’s rights to communication.

Little Feet also makes clear that she has no wish to apportion blame to the staff who made this decision, since they were not in possession with up to date training in the ethics and guidance in this area.

She also points out the potential risks faced commonly by whistleblowers and has (as we would expect from an accomplished blogger) a fair-minded assessment of the internet convention for right to reply, in this case by the Trust concerned.

I feel it important that I pursue this matter through local channels in the first instance. I do not want to cause detriment to my current or future care I may need by skipping straight to national media and social networking sites. I believe the Happyvillesire Mental Health Trust should have the opportunity to respond to my request for clarification of policies.

As was pointed out during the #nhssm Tweetchat this week:

The ‘Streisand effect‘ is the inverse relationship between the attempt to surpress information and the internet’s tendency to make the information freely available and easily searchable due to the interest such decisions provoke.

So, the Trust concerned is now decidedly on the back foot in terms of managing the message about their brand, and only Little Feet’s sensitivity in leaving them unnamed is holding back the opprobrium of the blogging community. I need hardly point out the irony of this, since confidentiality was cited as a justification for the Trust’s actions!

As we saw in my last post, the Trust’s reactions in this case were probably due to a lack of preparedness for the new networked reality. We saw how they are occupying the bottom layers of Maslow’s hierarchy, whilst Little Feet comfortably negotiates higher levels.

How could the Trust learn from this matter, and put in place measures to prevent this kind of publicity and negative brand association in future?

The organisation, or at least some individuals within the organisation need to make their journey up the levels of this pyramid to improve their business readiness for a future scenario.

Traditionally, the individuals within a Trust organisation concerned with the perception of their brand are located within the corporate Communications structure. We can see that in this instance, as in many other potential scenarios, this is a risky situation. Communications professionals are not embedded into practice areas, where these judgments will, increasingly, have to be made by clinical staff and managers. So, even if a Trust had a competent communications structure that was conversant with the conventions and corporate risks inherent in social media, they may not be available to consult with clinical staff in a timely manner.

It becomes clear that in fact it is the clinical, customer facing roles that must develop capacity and be sufficiently strategically resourced and trained in current corporate policy in this area. This flies in the face of the traditionally centralized business model for corporate communications within the NHS.

What is the solution?

Communications through social media are an organisational game-changer. We must move with the times and adopt a new way of doing business, where we empower clinical staff with the training and resources they need to support the efforts towards self-actualisation of people in recovery.

How do we do this? We must re-visit our centralised model of corporate communications, following on from the lead shown by notable public sector organisations such as Monmouthshire County Council, who recently allowed all employees to respond directly to customer enquiries. We should all prepare to move towards a “honeycomb” communications model, where all members of an organisation are empowered to understand the rules and conventions that govern response in the social space. Staff should be resourced such that they are able to identify which communications should be handled by communications professionals, and feel confident to handle the rest as the excellent brand ambassadors that NHS staff invariably are.

The Slideshare presentation linked to in the last post includes an excellent triage flowchart for staff using Social Media by Jeremiah Owyang. This could be used as a baseline for your policy.

Source:DavidArmano,Edelman  (http://www.flickr.com/photos/7855449@N02/5042953763)

@HelReynolds of Monmouthshire County Council and ReynoldsPR.com has some tips- I recommend the article.

What do you think?

If you would like me to help your business change the centralised communications culture, and train your staff in how to respond on the social web, please don’t hesitate to contact me tech4health(at)gmail(dot)com.

Censorship, or Duty of Care? “Little Feet”, Blogging on an Acute Mental Health Inpatients Ward.

This blog is inspired by a post I have read today by @Chaosandcontrol, who blogs as Little Feet. Please do read the original post and comments in their entirety, and excuse me for quoting from it in addition.

Here, Little Feet describes her actions in  password protecting her entire blog:

I was readmitted to hospital on 28 December and discharged today (3 January). On 29 December, I was notified by staff that my blog had come to their attention. Staff read through the archives and my phone was confiscated for 24 hours. I made a verbal agreement with staff that I would not blog while I was in hospital.

She then posted about how because of this lack of privacy, she no longer felt safe to continue with her blog. She has currently stopped. I have so many things to say about this short statement. Im afraid they may come tumbling out helter skelter, so please bear with me.

Staff probably defend their actions by claiming they are acting to protect either the organisation (and staff), the patient, or the other patients. Each of these defences relies on slightly different clinical reasoning. Let me go through them.

First, let us consider Maslow’s famous hierarchy of needs.

An individual travels up this pyramid  from a baseline of meeting physiological needs, through safety, then social and emotional needs towards self expression and self actualization. By transferring the principles contained within this model, we can look at the organisation’s equivalent succession of needs within the social space, using a term coined by Jeremiah Owyang at the 2011 Leweb conference in Paris- the ‘Social Business Hierarchy of Needs’

If you haven’t got 20 minutes to watch the video, you could look at the Slideshare presentation.

climb-the-social-business-hierarchy-of-needs-leweb-keynote-2011?player=js

What we can learn from this is that the hospital in which Little Feet found herself was still concerned with the bottom layers of the pyramid- those regarding security and safety, whilst Little Feet had progressed past these layers in her digital interaction and was performing at a much higher level, concerned with self-exppression and self- actualisation.

We can see  that because of this disconnect in the digital literacy of the staff and organisation, and the population it is serving, the efforts by the staff to take control of the situation by using their power over their patients was (expectedly) experienced as oppressive by Little Feet, and also by the blogging community leaving comments on Twitter and on the blog itself. I am sure this was not the way they wished to be experienced, as I am sure they are good people who are just terrified by this new technology and way of communicating. But actively preventing someone from operating on the higher levels of Maslow’s pyramid is never going to be experienced as anything but oppressive, and services need to wake up to this fact and work out how to deal with their concerns about safety and move along in their own journey with social media.

Learning about patients from sources other than from within the clinical relationship and information from friends and family WITHOUT EXPRESS PERMISSION is not on. We are able to work that out from first principles, because one of the pre-eminent concerns of healthcare professionals is consent. Without consent, we must tread very carefully in what we do, using reflection, interdisciplinary learning, and close regard for the legal and policy framework for what we do (e.g. sectioning, deprivation of liberty). Little Feet did not consent for the staff to read her blog. They did not happen across it as a blog by an unknown individual, they had inside knowledge at the time of reading of Little Feet’s clinical presentation. That’s not cricket.

It’s unethical- In the same way that we would be justifiably angry if we found someone has read a secret diary, EVEN IF WE LEFT IT OPEN ON OUR INPATIENT BED we can have an expectation that clinical staff will form their clinical opinions based on presentation, symptoms, and medical history.

Discovering additional information about our clients is one of the cautionary tales warning clinical staff (and teachers for that matter) off from using SNS. The belief is that learning these insights will damage the therapeutic relationship, and cloud the (supposedly impartial) process of developing a diagnosis or formulation. That’s why your GP probably won’t friend you n Facebook.

It’s not that digital sources of information are irrelevant- but THIS SHOULD BE EXPRESSLY CONTRACTED WITH THE PATIENT.

What we present to the world is a series of faces, like the sides of a prism. None of them entirely explains our essential essence, each one is slightly different. How Little Feet appears in her blog is quite different from how she appears to her clinical team, I’m sure. After all, they are presented with a real life, flesh and blood version, perhaps with tears, anger, occasional incoherence, and frustration with the inherent power imbalance of mental health treatment- just like you or me in a mental health crisis.

The clinical team need to focus on the clinical presentation if they are to avoid bias, prejudice and all sorts of personal opinions from creeping unseen into the clinical situation. That’s why we have such developed conventions for clinical consultation. Contracting to source additional information pertinent to the clinical relationship could be appropriate, but it must be done with consent.

So, we can see that protecting the patient by removing her ability to express herself and self-actualize runs counter to the principles of recovery, which are about supporting progress up Maslow’s pyramid, not forcing someone down it. We have also seen how clinical treatments should not use information gleaned from  relationships outside the clinical arena without consent.

Protecting other patients is a little more difficult, in that we know that they will have a range of digital literacies and understanding of the consequences of being referred to within the blog. They will all occupy different levels of Maslow’s hierarchy. Confidentiality is a complicated issue, becase someone can be identified by a clinical picture (if unusual enough) just as easily as from a photograph. The difference here is that the staff hold the responsibility for protecting confidentiality, service users do not. That is why at the start of clinical group work, protecting confidentiality is generally introduced as a ground rule- to make sure it is in the mind of the participants.

However, what exactly are the patients here being protected from? In fact, there is no difference between Little Feet’s potential to discuss her descriptions and those of other patients. It is the medium of the descriptions that worries the staff.

Where conversations about services are confined to individuals, organisations feel happier because they are perceived as less threatening. What is frightening for the organisation about digital media is related to their lack of understanding of it, as discussed above. The old ‘command and control’ model of communications is so prevalent in health organisations dealing with digital media because they are operating in an unfamiliar medium and are just on the initial steps of Maslow’s pyramid.

There is excellent clinical practice out there, and there are both practitioners and organisations whoa re prepared for the journey they must take in understanding social media. But there are so many others who still haven’t framed the question, never mind worked out an answer.

Little Feet’s blog has served a critical purpose with the final post. It illustrates the difficulties that are facing health organisations who are treating individuals with much higher digital literacy than themselves. It’s time we woke up and started to play catch up in this arena.

What are your experiences of this?

If you would like to know how I can help your organisation or clinical staff move on in their understanding of digital and social media, get in touch at tech4health(at)gmail(dot)com.

#24OTvx: The Comedown Review

Yesterday, the fantastic 24hour long Virtual Exchange for Occupational Therapy ended. Before we go any further, let’s just take a moment to appreciate the huge effort by the entire OT4OT team that was behind the event. This, the second of such events held to celebrate World OT Day, was built around the theme of “Pay it Forward”. I can’t imagine the effort, the sheer bloody minded force of will that it must have taken to get this event to happen, but I am deeply grateful to Sarah Bodell, Angela Hook, Merrolee Penman, Anita Hamilton, Susan Burwash and Karen Jacobs for taking it on. I must also thank Sarah Stewart, a midwife in New Zealand who inspired the OT community to create this event replicating her model based on the International Day of the Midwife. I’m sure I speak for all the participants when I say it has been a real career highlight!

During the event, OTs from around the world shared their expertise, listened to presentations, networked in a virtual classroom, and challenged each other to improve their practice. I was lucky enough to be presenting a session this year, so I thought I would write a little about the experience.

Before the presentation

When I was asked to present, I’ll admit I was a little anxious. I had various self-defeating thoughts, such as “why me? I’m nothing special”, “what could all these eminent OTs learn from me?”, “what if I’ve been ‘off work’ for so long I no longer think in an OT way”? It’s interesting to me when I spot a reaction like that in myself. Once it is brought to consciousness, I am able to challenge these thoughts- I knew I had experiences that are rare and that sharing within my profession would be useful to many. I knew that the event was purposely designed to hear new voices from OT, not to hear from the regulars on the lecture circuit. I knew that my skills as an OT had deepened and become richer as a result of all the reflective time I had spent since last being in my usual post. I wondered if it was a feature of women- the idea that we are generally slow to put ourselves forward, socially conditioned to take a “back seat” in terms of professional development. I wondered if it was a feature of my own lack of confidence stemming from a period of occupational disruption and subsequent occupational adaptation to my changed circumstances.

Considering all these factors, I decided to challenge myself to engage with the process. After all, we don’t grow by doing the same things we have always done. I have interests in using digital tools in practice, so I knew it would be a valuable learning opportunity to deliver a webinar to a global audience. I also felt that it would provide me with an opportunity to reflect on the changes that my family and I have been through over the past few years. I thought that it could be an emotional and physical effort to re-visit all that had happened, but I knew from my understanding of occupational adaptation that by fully integrating these experiences I would move into a new phase of Recovery.

Developing the Presentation

I suppose that I had underestimated the emotional impact of embarking on this journey. My life over the past few years has changed so much- my life is almost unrecognisable from the life I had before in terms of daily activities performed. As I started to develop the presentation, I looked through many family photos to find ones that illustrated occupational “key events” that would illustrate the story. It was a tough process, particularly when considering the period when my new born baby had been critically ill. I’m sure it’s understandable that in order to continue to fulfil our parental role to our eldest child, we had been cautious about expressing the helplessness and hopelessness we felt when she had been in hospital. I’m not sure any parent would ever really “get over” something like that, but it is true that through the process I was able to start to notice more positive things that I had missed before. For instance, I was happy to notice the efforts we had made as a family to adapt our environment at home to accommodate my disability. Through the photos, I could see how the experience had brought us closer as a family, now very much inter-dependant with each other, whereas before we had been three individual units with our own interests and activities.

Putting together a presentation using Powerpoint was very simple. I had used the tool before, so I knew I would be able to manage it, but it was interesting to me to see how that lack of confidence was affecting my self-perception. I had to consciously remind myself of the many times I had successfully used the tool, and all the positive feedback I had gained from previous presentations, in order to keep my motivation to complete the task high. It is important to remember this for the next time I have to create a presentation.

Using Elluminate Virtual Classroom

Having developed the presentation, and gone through an emotional journey in the process, I was now faced with attempting the truly unknown part of the exercise: the presentation in the virtual classroom. This entailed becoming familiar with an entirely new platform for working, Elluminate.

Sarah Bodell was the facilitator for my presentation, and she couldn’t have been more helpful and more accommodating (thank you!). She was unflappable about my presentation coming in a bit late, my erratic availability on email, and all the other factors that as a result of the chronic fatigue I experience makes working professionally additionally challenging.

Once in the classroom, it was quickly clear to me that the skills I have developed in other online environments would be transferable, and I quickly developed confidence that I would master the platform sufficiently for the presentation. I wouldn’t have felt confident to manage the comments and chat simultaneously, so I was grateful for the presence of my facilitator for the session to both “hand hold” and to take care of the questions as they arose through the chat box.

Having tested out the technology, there was nothing else to do but wait for my turn to deliver the presentation. And to tidy up my references, which has always been the last job to finish in every presentation or written work I have produced. I have started to use another new tool, Mendelay, which will allow me to input my Harvard style references into a list as I develop the presentation, which will hopefully address this on-going learning need.

Anxiety

The last few days before the presentation, particularly the immediate few hours before it started were full of anxiety for me. Once more, it was important to give myself positive self-talk in order to manage the anxiety. I told myself that I had delivered many presentations in the past, and always managed whatever unexpected outcomes they had delivered. I printed out a handout of the slideshow to refer to should something unexpected happen to the technology. I also made sure I had enough sleep and rest in the days preceding the presentation so that I would feel confident I could give it my best attention. I am sure that no matter how experienced one is at delivering presentations there is always an element of anxiety about them. The important thing I have found to be helpful is to not allow the anxiety to paralyse me during the preparation period. Knowing that some of the audience would be made up of people who I “know” from collaborating online, Tweeting and Facebook helped, as I could remind myself it was a presentation delivered in a reasonably informal way to an interested and supportive audience. It was also helpful to remember that people were not expected to attend- that anyone could choose to attend, but that if they felt it did not interest them or was not helpful to their practice, they would simply leave the virtual classroom. This would mean that anybody listening would be choosing to listen to the talk, and therefore a sympathetic audience.

The presentation

Once I had ensured there were no distractions during the presentation by unceremoniously instructing my family to leave the house for several hours, I knew I could give the presentation my full attention. As I started to deliver the presentation, many of my anxieties simply disappeared, and I became absorbed by the task at hand and able to present the narrative of my experience without the strong emotions I had felt preparing it. I felt supported by the audience whenever I glanced at the chat box, and the presence of my facilitator allowed me to relax into the experience. Despite my many anxieties, I did not sneeze; forget my thread, stammer, or any of the other ways I had vividly imagined I could run into trouble. No presentation ever goes without a hitch, and sure enough, during mine the phone rang. Despite this distraction, which I was able to acknowledge and quickly move past, the presentation flowed in the way I had planned. Timings were kept to, allowing for a period of questions and discussion at the end.

After the presentation

I received positive feedback from the participants, and was also pleased to get feedback through my social media channels (mostly Twitter) that enabled me to feel confident the presentation had been a success.

I was able to reflect on the presentation, and revisit the reflections I had made about the emotional impact of my personal narrative, the illness of my baby and the other content of the presentation. It was interesting to see the experience reflected back at me by their reactions. It felt very validating- I felt that they had understood the situation well and understood the challenges our family had faced. I felt they had accepted the gentle challenges I had made about improving practice, with reference to my own experiences. I felt very warmly supported by my community of practice, and proud to be a member of a profession that was reflective, and that showed such an interest in the experience of a user of the service they provided.

I was very fatigued after the presentation, and the relief from the anxiety I had been feeling. But I must have also been affected by adrenaline, as I felt able to continue (after a few hours rest) to work on projects that were important to me. In fact, I felt reluctant to go to bed and call an end to a day that I had enjoyed so much and achieved some success in. This confirms to me the importance I place on the life role of Occupational Therapist, and confirms my desire to find a way to continue my career, despite the challenges that my disability has created, and their effects on my expected career path.

Summary

I have reflected on my experience of presenting at the 24OTx partly for my own professional development, but also with a view to being able to offer my insights to other OTs who may be considering presenting next year, or at another event of a similar nature.

The process was emotional for me, as a result of the topic that I was presenting which held a lot of personal feelings and memories. However, as I suspected, the process of engaging with those sometimes difficult emotions has led to arriving at a positive outcome of further integration of the experiences into my personal and professional identity.

I don’t believe it is possible for many people to say that presenting doesn’t trigger an anxiety response in them. I have been anxious before every presentation I have given. I can see a change in my reactions when I revisit old reflections on practice, in that I am increasingly successful in using positive self-talk techniques to counter this anxiety. Capturing the thought behind the feeling of anxiety allows me to work through this emotion and manage the anxiety with increasing success. I am able to grow personally and professionally as a result. I can see how the experience of anxiety triggered the release of sufficient adrenaline to give me the “good stress” that results in an increased ability to attend to information during the session, enriching the experience of delivering the presentation (e.g. reacting to the phone ringing).

I now feel confident to engage with other opportunities to explore how more of my practice could be delivered in an online environment. I intend to post this personal reflection online on my blog, in keeping with this year’s 24OTvx theme of Pay it Forward.

If I were asked for advice about whether or not to participate as a presenter in the next 24OTvx, I would say unreservedly GO FOR IT! It has been a fantastic experience for me, developed my confidence, my presenting skills, my ability to adapt to new online environments, and I have felt honoured to work with such a fine selection of some of the very best examples of Occupational Therapists- the OT4OT Team.

 

 

Blogs for Breakfast, lunch and dinner, please!

Last week was very exciting for we Social Media and Healthcare types in Leeds. “Blogs for Breakfast” was held on Thursday 13th October, an event run as part of both the Leeds Digital Festial and the Love Arts Leeds festival It was a real crossover event, celebrating how to use digital technology to support wellness, to promote good mental health, and  for personal expression.

This was exciting for me, and the other parnellists (@re_connection, @wellnessHQ, @MikeChitty and @PhilKirby) and represented a huge success for the organisers,  @LoveArtsLeeds and @LeanneBuchanan of @LDSdigital.
The audience was very varied- I spotted people from the digital sector, from statutory and voluntary services, people with a personal interest in the topic and people looking to respond as professionals using the tools discussed. The event also trended on Twitter in Leeds, which goes to show the intensity of some of the surrounding Social Media discussion.

For those, like me who have been able to see the possibilities for using Social Media in Healthcare (specifically, both in clinical applications and in terms of staff development), it was wonderful to see how gradually, more and more people are sharing that vision.

Far from being a fringe interest of the statutory, voluntary and business sectors, the issue is becoming mainstream. The efficiencies, added value and opportunities to improve the end user experience of healthcare mean that as more people understand these opportunities, the number of people interested in talking about the possibilities grows and grows.

All photos from Kilo75 FlickR group- Blogs for Breakfast Set.

Thank you @MonicaTailor

It was great to share ideas and insights with other panellists. As always, it is a great experience to meet up with others who “get it”. But the best feeling comes from showing some people the possibilities; from sharing personal experience; from allaying some of the fears and anxieties that are barriers to Social Media use. When that happens, it feels like all the hard work put in behind the scenes to work out how to use the tools, the efforts to integrate that knowledge with other understanding, including professional learning- when it feels like there is a new “convert”- that’s the best feeling in the world.

In fact, without these regular experiences, my wellbeing would really suffer.

Identifying this is important, because it motivates me to continue to get out there and talk about my vision of how Mental Health and Wellbeing Services could be improved by use of Social Media and digital technology. We all need to continually assess our drive and motivation to complete the tasks we have set ourselves, whether in paid work, volunteering, community activity, or however we define “productivity”. Reflecting on these gives a depth of appreciation for the opportunities we have.

So thank you to everyone who came to the session, who asked such great questions and shared their own experiences and knowledge so generously. I can’t wait to see you again, soon. Let’s keep growing, together.

@WellbeingHQ has also blogged about his reactions to attending this event.

Blogs for Breakfast, #blogsforbreakfast at the #loveartsleeds Festival

I am very excited to say that I am a pannelist at Blogs for Breakfast, on Thursday 13th October in Leeds, an event which is part of the Love Arts Leeds Festival.

The purpose of this event is to

…debate how digital media is affecting how we communicate about mental health and wellbeing both personally and professionally:

• Blogging about personal experiences

• Campaigning on Facebook

• Personal and professional identities on Twitter

We hope to offer advice and information to anyone who would like to know a little more about how to use Social Media tools, in order to express themselves.

It’s exciting to me, because I have found blogging here to be an excellent tool for professional development. Using Social Media has allowed me to make contact with a “Community of Practice” online that would never be achievable off-line. I regularly collaborate with other OTs and healthcare professionals from all around the world. We use Facebook Groups and Pages, Google Groups, G+ Hangouts and Huddles, Skype, Twitter, and Blogs in order to discuss ideas, formulate projects, and disseminate research and best practice. The choice of tool is often dependent on the information which warrants a discussion, and flexible ability to deploy a range of tools means almost any situation can be accommodated.

Many of these goals can be achieved by more traditional means, but if we look at published academic journals, the time frame between submission and publication can be as long as 2 years. This allows for peer review, it is true, but it slows the progress of information through a profession, and subsequently there is not open access to the published research as most Journals require paid subscriptions. The process using blogging has less guarantee of academic peer review, but blog audiences are remarkably good at calling out errors in interpretation and analysis- the comments on blogs tend to show interesting discussions around the topic by other contributors whether professionals, service users, carers, or others. In addition, links can be made for professional networking opportunities with other people with similar interests, which would take attendance at a huge number of conferences at huge expense to replicate!

Mental Health Recovery means something different to everybody. Self expression is vital to wellbeing. For many people, writing may feel like a very difficult thing to start. But I believe that using a photoblogging site (e.g. FlickR) could offer opportunities for someone who wanted to document their story in other forms than words.

Video blogs can be used (e.g. YouTube channel) and can act as a diary, attracting people with similar life experiences, and sharing about different cultures. So blogging can be used even if you fear your writing skills are not up to scratch, or you would like to make your blog accessible to people who might have difficulty reading it.

I am frequently asked about the issue of personal and professional identities on Twitter and other Social Media platforms. My Twitter presence reflects my increasing comfort with open-ness about my shared personal and professional interests, but using Social Media is a process and for many people, there remains suspicion about having profiles which reflect both their personal and professional identities. To an extent, I share this feeling, hence I maintain separate personal and professional blogs. It will be interesting to debate this further in the context of the event.

If you would like to join us for this event, there are still tickets available. I hope to see you there.

Other Social Media reactions to this event:

Emachi Enje (@WellnessHQ) has used blogging in his personal Recovery story

I discuss this event at my personal blog which has helped me transition as a person with a disability.

Social Media and the Medical Profession

I have followed with interest an excellent reflective post by Anne-Marie Cunningham, who wrote about some “overheard” Tweets from doctors, who were using language that some people could be offended by.

“The terms used were ‘labia ward’ and ‘birthing sheds’ to refer to the delivery suite where women give birth, and “cabbage patch” to refer to the intensive care ward where many patients are unconscious.”

I have to thank Anne Marie for raising this issue. All the contributions to the debate have been very interesting to follow, as both the original Tweets and the debate that follows shed light on how much progress has been made in the education of medical professionals in the use of social media.

It has been interesting to note the different tones of the contributions on the blog, on Twitter, and on the Medical Registrar’s Page on Facebook.

I don’t think this is an issue confined to medical staff, I think all healthcare workers are still finding their feet in social media and appropriate behaviours (Lane & Twaddell, 2010). As with the ‘crowded bus’ analogy, I always think “would I be happy to say this in the lift at work?”, when posting in social media. As one commenter on the Facebook discussion stated:

“Discussions like this that take place in forums frequented by the public paint the medical profession in a decidedly un-professional light.”

Many posters agreed that

“I guess we like to think of Facebook and twitter as having a pint with our friends, whereas actually what we post on here is more like shouting something at the top of our voices on a crowded public bus. I don’t think this is about ‘thought police’ but about courtesy in public and the reputation of our profession.”

It’s a topic discussed with increasing frequency in the literature, as our patients and service users become more tech savvy, so must we (Brown, 2011 and Nacinovich, 2011).

As e-patient Dave so succinctly put it, in his response to Anne-Marie’s post,

“I say, one is responsible for one’s public statements. Cussing to one’s buddies on a tram is not the same as cussing in a corner booth at the pub. If you want to use venting vocabulary in a circle, use email with CC’s, or a Google+ Circle.

One may claim – ONCE – ignorance, as in, “Oh, others could see that??” It must, I say, then be accompanied by an earnest “Oh crap!!” Beyond that, it’s as rude as cussing in a streetcorner crowd.”

And equally sound advice from a poster on Facebook,

“Some of you need to really take a long look at the dehumanising nature of your jobs and try to rise above it… Social media makes the world a smaller place. Sometimes you should refrain from writing down your thoughts in public places like to FB and Twitter.”

If you want to post more… ahem… *colourful* content, my advice would be to set up closed groups in Facebook and only invite other doctors, or have profiles under nom de plumes and network on high privacy settings with people who you know IRL only. Otherwise, if we are to pursue congruent online and offline identity (and I think we must, for sanity’s sake) then be aware that everything you say online is actually covered under the same code of ethics and professional demeanour that covers the rest of your career. What you post privately today may well become available tomorrow, as privacy settings can be altered with frequency, for example on Facebook. Inappropriate online comment could be subject to complaints from members of the public, other professionals, patients, carers etc., and could lead to disciplinary action. I would counsel against posting comments such as the following, if you value your future career

“wow, really… if you’re offended, fuck off and don’t follow them on Twitter, and cabbage patch to refer to ITU is probably one of the kinder phrases I’ve heard…”

There is emerging literature available to guide the use of social media in medical education (Farnan et al., 2009; Landman, Shelton, Kauffmann, & Dattilo, 2010)

Blogging, and Anne Marie’s blog is a fine example, has been stated to be an appropriate developmental tool for clinicians (Bodell et al., 2009) and it would be a shame if clinicians failed to take advantage of such tools for fear of being accused of misconduct.

N.B. I have chosen not to identify posters who have written content which portrays them in a less than professional light.

• Edit [17/09/11] Today’s Telegraph commented on this post, and has attracted interesting comments

• Edit [18/09/11] Further discussion in the MSM today regarding this event, which is being dubbed #hcsmgate on Twitter.
• Yesterday’s Telegraph discusses the terms used as “banter”, and additionally yesterday’s post linked to above is available, as is a dictionary of medical terms used by some doctors. h/t @health20paris for Tweeting the link.
• Today’s Mail on Sunday discusses whether terms such as those used by the doctor @amcunningham blogged about have any place in modern, patient-centred care. h/t @Pillmanuk for Tweeting the link.
• It is interesting to see such polarisation in the comments between people who say black humour is a way of managing stress and we should all “lighten up”, and people who think that patients deserve respect in all settings, and that includes being protected from abusive, derogatory and bullying talk. I have to say, I agree with the latter view. Comments in public should at all times uphold the values of the profession.
• Edit [18/09/11] I responded to this blog post regarding the topic http://runningahospital.blogspot.com/2011/09/storm-brews-across-pond.html?m=1
• Edit [19/09/11] further comment from the blogosphere:

1. @PaulLevy’s post in Not Running a Hospital
2. @Thinkbirth‘s post
3. @sarahstewart‘s post
4. @laikapoetnik  in Laika’s MedLibLog

all are recommended posts.

References

Bodell, S., Hook, A., Penman, M. and Wade, W. (2009). Creating a learning community in today’s world: how blogging can facilitate continuing professional development and international learning. British Journal of Occupational Therapy. 72(6) June pp. 279-281. Retrieved September 16, 2011, from http://docserver.ingentaconnect.com/deliver/connect/cot/03080226/v72n6/s7.pdf?expires=1316166667&id=64421118&titleid=6174&accname=College+of+Occupational+Therapists+Referrer+URL&checksum=1511D65AE17D156D5E8AF7A6E7F47B11

Brown, T. (2011). Are you a digital native or a digital immigrant? Being client centred in the digital era. British Journal of Occupational Therapy 74(7) July, p.313. Retrieved September 16, 2011, from http://docserver.ingentaconnect.com/deliver/connect/cot/03080226/v74n7/s1.pdf?expires=1316165615&id=64420866&titleid=6174&accname=College+of+Occupational+Therapists+Referrer+URL&checksum=54AC84699E58AB65668EDD2090BBC134

Farnan, J. M., Paro, J. A. M., Higa, J. T., Reddy, S. T., Humphrey, H. J., & Arora, V. M. (2009). Commentary: The relationship status of digital media and professionalism: it’s complicated. AAMC Academic Medicine Journal of the Association of American Medical Colleges, 84(11), 1479-1481. Retrieved from http://journals.lww.com/academicmedicine/Fulltext/2009/11000/Commentary__The_Relationship_Status_of_Digital.11.aspx

Landman, M. P., Shelton, J., Kauffmann, R. M., & Dattilo, J. B. (2010). Guidelines for maintaining a professional compass in the era of social networking. Journal Of Surgical Education, 67(6), 381-386. Elsevier Inc. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21156295

Lane, S. H., & Twaddell, J. W. (2010). Should social media be used to communicate with patients? MCN The American journal of maternal child nursing, 35(1), 6-7. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20032752

Nacinovich, M. (2011). Rx to communicate: The E-patient will see you now. Journal of Communication In Healthcare, 4(2), 65-65. doi:10.1179/175380611X13097840494027

Excuse me, I think I just did a MOOC.

I stumbled across this description of a MOOC when reading this OT blog last week.

Blimey. I thought. That’s what I’ve been looking for. In fact, that’s what I’ve been doing!

In fact, I haven’t. Not by a long chalk. Helen has been participating in an incredible event, called #eduMOOC2011, which is an eight week course now into it’s fifth week. So it’s not exactly what I’ve been doing, but rather, something I wish I’d been doing…

It really is a great concept aiming to develop networked learning. This reminds me of how knowledge is spread through insect colonies.

In a bee hive, for instance, the various worker bees go out to find food. On their return , they perform little bee dances to tell the other hive members about what the food is, where it is, how far you have to fly, and all the other stuff bees like to know. Excuse my rather vague handle on this- I’m no entymologist!

My point is, that this is how social media works. Like the bees, we tell others in our networks where the good information is, and others then follow our pointers to events, to URLs, to engage in “clicktivism”, whatever.

Gradually we develop trusted networks for curation of content and they become a short-cut- we know we can trust their opinion on how useful the content is.

(Question- do bees ever tell lies about food? or do they have better and worse bees/colonies for successfully transmitting information? I would love to know!)

Over time, we develop networks of people who are looking for similar content. Like the bee hive, we are greater than the sum of our parts, because we can utilise far greater “processing power” by collaborating together online than we can as individuals.

Okay, I’m going to leave the analogy there, and talk about MOOC.

As the video above explains, MOOC is just a way of describing the process of acquiring knowledge which, in previous times, may only have been available through learned institutions, and through diligent attention to books, journals, or lectures. People without access to these forms of learning could therefore be left behind. But as this clip from RSA shows, how we conceive of education now has to change, for several reasons.

• Cost. University education is now very expensive. For people who do not wish to become endebted, it could be the case that this form of learning is an effective way to continue to develop and learn without attending university. Perhaps universities will spot this and offer a discounted rate for people to sit qualifications without access to their limited spaces in lecture theatres?
• Social exclusion. People who experience stigma because of mental illness or other reasons could find that they are able to learn removed from the pressures of the social environment of a university? I wouldn’t want to recommend this as an adaptive response to social phobia or fear of stigma, but I can imagine circumstances (Asperger’s?) where this would make accommodation for someone’s particular needs or sensory sensitivities.
• Lifestyle. People who are looking after children or other family members may wish to work from home, in hours of their own choosing. This could offer a solution for those groups, much like the OU does, but again, at less cost.
• Bad experiences in formal education. So many people have felt excluded from education due to their bad experiences at school. Some of them may not have been diagnosed with learning difficulties such as dyslexia, dyscalculia or dyspraxia until later in life, and suffered bullying in school from pupils or staff. Many people who have had poor experiences could be encouraged to gain basic skills, or update their knowledge ahead of trying out more formal routes of education, in a supportive network of people.

So what is my point?

What I am thinking of, as ever, is the application of this understanding to my OT practice and to the possibilities for growth it represents.

• I love learning. I intend to continue learning all my life. I am determined to engage with the idea of a MOOC, just to see where it takes me.

• I would love to see an OTMOOC event shape up- perhaps after this year’s virtual exchange we could plan one to culminate in next year’s virtual exchange? However, for the time being, I’m going to MOOC about using the online resources I already have.

1. My network of OT blogs that you can see on the right hand side is a good place to start——–>
2. And if you are dipping your toes in the water of online technology as an OT, I would strongly urge you to complete this short survey to provide us with more of an evidence base about how our profession is using online tech (add your email at the end if you want to be entered into the prize draw for an iPod!)
3. Also, are you aware of the OT4OT blog? It’s a good place to share information about how OTs are using online technology.
4. Coming up is the 24 hour OT Virtual Exchange- widely billed as the conference you can attend in your pyjamas- on 26th October 2011, 24 presentations from around the world highlighting a range of different OT approaches available at a computer near you, and at absolutely no cost. Check out the facebook group.

• As ever, we need to remember that there are possibilities for practice within this model.

1. One of the roles of the OT is in health education. We can offer our unique occupational perspective through this technique as much as any other.
2. Education about aids and adaptations can be hugely useful. I have lost count of the numbers of people I have shown products to through websites when they would never have set foot into a mobility showroom. We could make great strides in ensuring our service users have access to this information online.
3. Perhaps videos of people who are doing Occupational Therapy, to show how this benefits them? (With all appropriate consents etc.)

Once more, this doesn’t solve the problem of digital exclusion. That has to be tackled. But as more and more people have access to technology such as smartphones, we can hope that the day is not far off that we can ensure fair and equitable access to information.

On that day, we can all MOOC together.

I like the sound of that. Do you?