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Background Physiotalk was launched in December 2013. Its main purpose is to help physiotherapists learn, share, influence and ultimately improve services for patients and communities through fortnightly tweetchats and related blogs. In 2016 analysis of usage demonstrated the reach of the Physiotalk community both within the UK and globally . There was, however, a need to explore further beyond these metrics to look at the impact of taking part in a Physiotalk tweetchat on participants with particular reference to their continuing professional development (CPD). Purpose CPD is mandatory for UK physiotherapists. CPD can be undertaken in many ways and there is a growing sense that social media can be used as a platform to improve professional practice [2,3]. The use of Twitter as an educational tool has been found to have positive benefits for physiotherapy students , medical students  and nurses . There is, however, a paucity of research investigating the impact of participating in a Twitter-based community on health care professionals. There is, therefore, a need to investigate whether tweetchat participation impacts on the practice of those involved, thereby constituting useful CPD. This study aimed to explore the impacts of taking part in Physiotalk tweetchats on CPD and professional practice, from participants' perspectives. Methods There were two stages of data collection within a phenomenological approach. Stage one involved a large, online, semi-structured focus group using a #Physiotalk tweetchat. A tweetchat is formalised discussion held via Twitter at a set time, on a predefined topic, with questions tweeted out at regular intervals and bound by the use of a common hashtag. Stage Two enabled people to respond more fully through email or direct messages. The tweets from the set hour long research tweetchat and the emailed responses were then analysed for the purposes of this study. During the hour long Tweetchat participants were invited to respond to the question 1. 'What does Physiotalk mean to you' with follow-up questions 2. 'How do you use Physiotalk?' 3. 'What prompts you to participate in Physiotalk activities?' 4. 'What affects your participation in Physiotalk activities?' 5. 'Has taking part in Physiotalk impacted on or contributed to your CPD?' 6. 'Has taking part in Physiotalk impacted on your practice?' The subsequent tweet and email response analysis followed the process of: • Open coding where similar ideas are grouped to form initial categories. • Axial coding where categories of text are grouped to form themes that start to make sense of the ideas and form connections. • Selective coding where the themes are organised in a way that illustrates and demonstrates connections that are supported by text and interpretation to develop understanding of the phenomenon (impacts of Physiotalk). Results During the chat 73 people took part and 683 tweets using the hashtag were recorded. Two people took the opportunity to email a fuller response. Axial coding resulted in 31 categories which were grouped under two main overarching themes: those demonstrating connectedness supported by the structure and function of tweetchat; and those supporting constructive change as an impact of participating in a chat. Connectedness: the structure and function of a tweetchat Physiotalk was seen as an enabling, relevant community. It was reported as important that the community was outside participants' usual circle of physiotherapy colleagues and recognition that there was an opportunity to widen this further with a global perspective: 'this is potentially biggest win of #physiotalk- actively encourages engagement with people from the #globalpt community' There was a great sense of the breadth of the community on twitter as well - with all voices equally valued, including patients and other health care professionals. There was contrasting recognition that a specific 'type' of person may be attracted to a tweetchat and so despite the diversity, there is also an element of like-mindedness. Overarching this was the sense that Physiotalk itself creates a positive structured space with its regular tweetchats. Twitter is a public space and the tensions between being accountable while promoting critical debate were recognised. For some, the often fast-paced nature of an hour-long tweetchat was a barrier: 'I think it takes some getting used to! My first few tweetchats=chaos but now I'm ok'. However, Physiotalk was considered to have an enabling culture: 'I've found #Physiotalk community to be very welcoming and supportive of ideas/contributions'. Constructive change: Impact of taking part The impacts of taking part in Physiotalk with specific reference to participant's professional practice could be split into four broad themes: networking, a platform for representation, influencing and innovation, and of course CPD itself. Networking opportunities were seen as enabling and facilitative: 'use for networking - reaching out and also just following 'threads'. Have made some great contacts via #Physiotalk'. Tweetchats were also seen as a way of developing leadership advocacy and strategic influencing. The themes of influencing and innovation were also inextricably linked to ideas generation and testing. Physiotalk was reported as being a safe space where ideas could be tested in a way that would not invite negative comments: '#Physiotalk supporting collaboration, encouraging discussion, friendly'. Physiotalk was seen as relevant, increasing awareness of current trends and issues, although selective engagement according to topic was reported by some: 'I try to follow things I am less interested in [to] broaden mind and a more fun way to do it'. Finally, Physiotalk was seen as a tool for CPD, over and above all the previous impacts discussed. As one participant put it: Readymade CPD=winner. This category was differentiated into: personal development, engagement with research and evidence, and broadening views. Participants derived personal development and practical outcomes from tweetchats. These included mentions of specific career development as a result of tweetchats; 'I used #physiotalk as a student to highlight 'real-life' current issues physios were facing - this really helped in interviews'. Chat hosts reported additional personal development and 'lurkers' also reported positive outcomes for their CPD. Tweetchats were seen by some as a starting point, with participants continuing linked CPD activities after the chat, often focussed on post-chat reading activities. There was an appreciation you could develop practice based on information gathered from a tweetchat or have the confidence to continue with a service development based on the encouragement of others: 'Sometimes someone favouriting or RT [re-tweeting] your tweet gives you confidence in progressing the idea or service development'. A note of caution was also raised: 'have to avoid meaningless conversations for an hour - it has to change practice or enlighten'. An important CPD outcome from a tweetchat was reported as increased engagement with research and evidence, facilitated by instant and easy access by the Twitter or Physiotalk platform and format. There was also a suggestion that the evidence shared during Physiotalk was trustworthy, potentially linked to the planned and facilitatory nature of a Physiotalk tweetchat and participants engaging with the chat. Further added value from CPD through a tweetchat was opportunity to broaden or challenge one's own views through stimulating engagement on a topic or through crossing speciality and geographical boundaries with a wide range of participants: 'Students, professors, clinicians, PTpresid participate in #physiotalk, that variety is of value'. Conclusions A social learning space is seen by Margolis and Parboosingh  as a place of 'genuine encounter among learners where they can engage their experience of practice' and the findings of this research suggest that tweetchats are a way of creating this social learning space. The results of this international Twitter focus group demonstrate that where people feel facilitated and welcomed in an online discussion forum, there is great potential for constructive change at individual, local, national and international levels that may culminate in developments that impact positively on patients, professionals and services. This is, but also goes beyond, continuing professional development for participants. Margolis and Parboosingh  suggest that connections are enhanced by 'network weavers' and the facilitators during a tweetchat may be acting in this respect. It is important to note that there is only a small pool of people who regularly engage in Physiotalk tweetchats. Further exploration of barriers to engagement is important and possible ways of facilitating participation to achieve these benefits more widely. Implications Professional tweetchat communities can be promoted as facilitating a valid and form of CPD, enabling international viewpoints and experiences to be shared. Networks and collaborations formed through these chats can lead to wider constructive change in practice and the profession. Participation in tweetchat communities and related CPD benefits could be facilitated by educators and leaders in professional practice.
Thomas, J., McVey, N., & Bulley, C. (2017). Physiotalk: connectedness and constructive change – a qualitative study. European Journal of Physiotherapy, 19(sup1), 5–7. https://doi.org/10.1080/21679169.2017.1381312