Piloting a Monthly Problem-Based Learning Discussion Using a Secure Social Media Based Collaboration Platform in a Busy Neuro Critical Care Unit

Monday, 9 November 2015

Briana Witherspoon, DNP, MSN, BSN, RN, ACNP-BC, CNRN
Assistant Professor in Critical Care, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
Avinash Kumar, MD, FCCM, FCCP
Medical Director Neuroscience ICU, Associate Professor Anesthesia and Critical Care, Vanderbilt University Medical Center, Nashville, TN, USA
Kathryn Braunlin, MSN, RN, AG-ACNP- BC
Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA


The specific aim of this study is to evaluate the feasibility and effectiveness of implementing a social media based online discussion forum for complex case based discussions for nurses in a busy Neuroscience ICU.

Background/Introduction/Literature Review

Systems to meet the on-demand learning needs of nurses in the critical care setting are not well studied outside the traditional classroom models. However, it has been observed that online discussions positively enhance critical thinking among students in an academic setting. Time constraints and challenging staffing models prompted us to pilot this novel point of care learning platform. This online forum was designed for instructors/facilitators to effectively aid learners with knowledge acquisition and development of reflective learning. This collaborative forum serves as a hybrid model to positively engage nurses in education initiatives and to enhance the safe clinical practice in the critical care environment.  



A baseline educational needs survey was performed prior to initiating the pilot project. This helped us identify the areas of educational need in our ICU. To meet this need, we used a password protected social media/discussion forum that is supported by the medical center. Our forum was called "All things NeuroCritical Care". Its user interface structure is similar to Facebook (Facebook Inc, Menlo Park CA). Users can post answers or comments, as well as “like” and “follow” the discussion. Each month, two moderators post a clinical vignette pertinent to neurocritical care with two lead questions. The information is posted on a Monday and the nursing staff has five days to answer the questions, ask additional questions of the moderators, and also share their personal experiences before the clinical discussion closes on Friday. At the conclusion of the case, an updated review article on the topic is posted as a secure download for offline reading.


Participation in the initiative is voluntary. This forum is ongoing, and has been active for eight months. Eight sentinel diagnoses have been presented so far. Currently 34 of 72 nursing team members formally follow the page regularly. Some of the clinical vignettes discussed so far include Complications after subarachnoid hemorrhage, Burst suppression in the ICU, Myasthenic crisis, Posterior Reversible Encephalopathy Syndrome, Stunned Neurogenic myocardium, Polyuria in the ICU and cerebral venous sinus thrombosis. The mean number of discussions strings per case is 8.3 posts. The unique visitors to the page during active case discussions exceed 100 members. More members view the page than actively participate in discussions. Feedback to date has been extremely positive and the nursing staff are continuing to request future topics for discussion.


Our single center pilot project offered a secure online problem based learning discussion format and point of care learning opportunity to our Neuroscience ICU nurses based on their expressed need. We seek to develop this platform further by incorporating topics hosted by clinical experts and enhance engagement of nurses by incorporating continuing education credits (CE) into the current platform in the upcoming academic year.