Nurse educators need to be innovative, stimulating, and engaging as they prepare future nursing professionals. Increasingly nursing students enter nursing programs experienced in the latest communication technologies and knowledgeable about various media offerings. Today it is expected that nurse educators will use creative communication technologies to enrich the learning environment (Beldarrain, 2006).

As the global community increases, and healthcare issues become more complex, it is vital that our future nurses be well equipped with the knowledge and strategies to navigate the technological advances that are occurring in the healthcare setting... Burke and Snyder (2008) noted that “having a comfort level with current technology is imperative for educators to be effective in our fast-paced, electronics-based society” (p. 42), adding that YouTube technology offers innovative teaching strategies for use by educators in the healthcare field. A report by the National Center on Education and the Economy (2006) has argued that today’s students must develop a high level of competence not only in traditional academic areas but also in 21^st Century skills and technologies that facilitate collaboration, information literacy, communication, critical thinking, problem solving, and global awareness (Rosenfeld, 2007). These skills are a necessity for all future nurses and other healthcare professionals. As the global community increases, and healthcare issues become more complex, it is vital that our future nurses be well equipped with the knowledge and strategies to navigate the technological advances that are occurring in the healthcare setting as well as in the general public arenas.

Social media can play a valuable role in teaching the communication and collaboration skills that will be needed by future generations of nurses. Social media are becoming important teaching tools for synthesizing and disseminating information to students, patients, and families (Green & Hope, 2010). YouTube is becoming one of the important social network sites in today’s society. The inclusion of YouTube into nursing education is an easy and user-friendly way to increase collaboration skills and integrate technology into nursing education. YouTube offers an “adjunct to a course beyond anything that faculty could have ever anticipated” (Agazio & Buckley, 2008, p. 23) by creating a learning community (Skiba, 2007). It is a web-based, audio/video file-sharing service that allows individuals to (a) construct a public or semi-public profile within a bounded system, (b) articulate a list of other users with whom they share a connection, and (c) view and traverse their list of connections and those made by others within the system (Boyd & Ellison, 2007). This web-based service allows users to download videos that can be shared with others (friends, students, educators) thus maintaining social connectedness within a learning setting.

The use of YouTube in educational offerings helps to introduce technology to the nontraditional learner... The use of social media will be a vital component in the next generation’s ability to practice competently, effectively, and collaboratively with other healthcare providers, and also patients and families (Ressler & Glazer, 2010). The use of YouTube in educational offerings helps to introduce technology to the nontraditional learner; it serves as a natural learning strategy for digital natives who have grown up with technology and who will adapt well to the use of technology, such as YouTube, as a teaching strategy. For nondigital native students YouTube can “offer the student … an opportunity to experience new technology or technology that will provide them with marketable skills for future careers” (Burke & Snyder, 2008, p. 40). Educators are encouraged to nurture the collaborative and networking skills of both digital native and nondigital native students using the social-networking, Web 2.0 world described below (Rosenfeld, 2007).

In this article I will provide information to help educators effectively integrate YouTube into their course offerings. I will begin by reviewing the phenomenon of social networking and discussing challenges and strategies related to YouTube learning experiences. Next I will share some of the legal considerations in using YouTube and describe how to engage students via YouTube. I’ll conclude by describing current research related to YouTube as an educational tool.

Social Networking

The term ‘Web 2.0’ is used to describe web applications that facilitate interactive information sharing. These applications include social networking sites; video-sharing sites, such as YouTube; web-based communities; wikis; and blogs. Some common social networking tools include pod casting, twittering, and blogging, while social networking sites include Facebook, YouTube, Twitter, Linkedin, and Bebo. What makes social network sites unique is not that they allow individuals to meet strangers, but rather that they enable users to articulate and make visible their social networks (Boyd & Ellison, 2007). It should be noted that not all Web 2.0 sites allow for external contributions, although they all do facilitate informational sharing. See Table 1 for a description of some of the common social networking sites and tools.

Table 1: Examples of Social Networking Sites and Tools.

The high participatory nature of YouTube makes it a very ‘cool’ media application, i.e. an application that requires users, for example nurse educators and students, to be active participants. The process of searching for videos, including YouTube videos, is called ‘hunting.’ This process involves active participation on the part of the ‘hunter.’ Trier (2007, Part I) has written that searching for videos does not allow for the passivity associated with being a spectator in the learning situation Trier has conceptualized the act of searching YouTube for videos relevant to pedagogical and learning purposes as “a form of cool hunting and gathering” (p. 410).

The hunting process involves the gathering of various videos and the viewing of the videos followed by a group discussion. In the educational realm educators can select the video they desire to post, or they can include students in the hunting process. The hunting process involves the gathering of various videos and the viewing of the videos followed by a group discussion. For example, in an online course the faculty person can provide students with a few links to YouTube videos pertaining to specific content. Students can then hunt for additional, related videos; gather and post the links to these videos on an electronic educational platform, such as Blackboard, for all students to view on their own time; and then collectively engage in a discussion-board dialogue. In an online Woman’s Health course, I provide students with descriptive words (tags) to hunt for YouTube videos pertaining to woman-health issues. Students hunt for videos and gather links to relevant videos. Then a group of five to seven students views and discusses the specific video chosen.  Finally, a summary of their discussion is posted online on the class discussion board, along with a link to the video viewed.

‘Time shifting’ is defined as “the capacity to engage with the text whenever the reader wishes rather than only [when] the text is broadcast or shown in some prescribed place and time” (Trier, 2007, Part I, p. 411). It is useful in the process of cool hunting and gathering because YouTube videos are virtual and hence can be viewed at any time and any place where Internet access is available. ‘Space shifting’ is another useful YouTube feature. It refers to one’s ability to view YouTube videos in an array of locations in which there is an Internet connection. Space shifting allows students to view YouTube videos at work, at home, in the library, or in a café, thus enhancing online learning. Students and educators have access to course content anywhere, at anytime, in any location. Thus learning can occur anywhere…time…place.

Challenges and Strategies Related to YouTube Learning Experiences

YouTube offers educators and learners alternative/supplemental sources of timely, health-related videos (Burke & Snyder, 2008). However, there are unique challenges associated with using YouTube in an educational setting. One challenge is that of availability. It is important for the educator to know about the availability of a given video because some videos are available for only a designated period of time.

Faculty do need to review and evaluate all videos before including them in the course content. The quality of the content is another important consideration. Faculty need to note the date of the video content to assure that the information is not outdated (Freeman & Chapman, 2007; Keelan et al., 2007). Sometimes the accuracy and/or quality of YouTube videos is poor (especially if they are homemade), and some clips may not be appropriate for a classroom setting due to profanity or unacceptable scenes (Agazio & Buckley, 2008). As Ressler and Glazer (2010) have noted, issues of privacy, inappropriate sharing of information, and professional-personal boundary issues must be addressed. They suggest this rule of thumb when evaluating an item to post: would I be comfortable using this item in a public forum when my employer, patients, and/or colleagues are present. Faculty do need to review and evaluate all videos before including them in the course content.

Another challenge arises when searching for videos. Some searches may produce too many video options. One way to narrow down the options is to focus on the user-name of the person who has uploaded (posted) the video. By clicking on the username, you are taken to the user’s personalized YouTube page, which includes all of the other videos the user has also uploaded (Trier, 2007, Part II, p. 589). Clicking on the user-name of the person(s) who downloaded the video will send you to the ‘user-name channel.’ This provides a detailed profile of each user and links to their other videos. An added benefit of clicking on the user name is that sometimes similar and related videos also appear on the user’s page, thus providing additional resources and links. Another tip is to search the video titles for patterns (Trier, 2007, Part II). This search that will provide more precise details for tags (keywords/descriptors) of exactly what you are looking for in your search criteria. This is similar to searching on key words in a journal search. Finally, be conscious of the tags used by video uploaders to describe their video. These descriptive terms, if they recur often, can help identify related videos (Trier, 2007, Part II).

I often seek the assistance of the university librarian in teaching students how to search for YouTube videos. When helping students to search for videos themselves, the educator can provide students with tags (descriptors) based on the subject content, thus helping students to find videos on a given topic. This searching enhances active participation and facilitates dialogue on the part of the students as they search together. Although the process of actually searching for videos on YouTube is relatively easy, Burke and Snyder (2008, p. 41) provide a helpful description of the ‘how to do it’ process for this searching. Green and Hope (2010) have noted, “using…Web-based tools must support the underlying objective of an assignment, and students must be adequately prepared to use the tools effectively or they will be frustrated” (p.127).

An alternative to YouTube, launched in March 2007, is TeacherTube, a free online teacher community for posting and viewing educator-made, instructional videos. As an educator who utilizes YouTube, I often seek the assistance of the university librarian in teaching students how to search for YouTube videos. We schedule a one-hour workshop in a room in the library having computers with Internet access, student computer access, and an overhead screen. Then either I, or the librarian, provide(s) an overview of how to navigate YouTube and how to hunt for and gather videos based on various descriptors we have provided. This hands-on, preparatory process can alleviate the students’ stress, especially in the non-traditional students who are not familiar with YouTube.

An alternative to YouTube, launched in March 2007, is TeacherTube, a free online teacher community for posting and viewing educator-made, instructional videos. TeacherTube eliminates the process of searching through amateur videos and may offer more appropriate content for students (Burke & Snyder, 2008). This site is also recommended to educators as a good repository for their educator-made videos.

Legal Considerations in Using YouTube

Copyright questions do come into play with YouTube. Many YouTube videos are available via online service providers. An ‘online service provider’ is defined as a provider of online services or network access, or the operator of facilities there for, including any entity offering the transmission, routing, or providing of connections for digital online communications (U.S. Copyright Office-Online Service Providers, 2011). Some common online service providers (OSPs) include Internet service providers (ISPs), email providers, news providers (newspapers), entertainment providers of music and movies, electronic shopping sites (online stores), finance or banking sites, health sites, and government sites. The Digital Millennium Copyright Act, signed into law on October 28, 1998, amended the United States (U.S.) Copyright Act, Title 17 of the U.S. Code, to provide in part certain limitations on the liability of online service providers for copyright infringement. Subsection 512(c) of the Copyright Act provides limitations on service provider liability for storage, at the direction of a user, of copyrighted material residing on a system or network controlled or operated by or for the service provider.

This act provides a cushion for Internet service providers and Web companies regarding infringing material that might have been posted to their servers, provided the material is removed after they are notified (Pike, 2007). YouTube has been extremely active in the removal of video streams after receiving complaints about copyright infringements and is currently working with media companies either to remove or license infringing material (Pike). Based on copyright conflicts, thousands of self-made YouTube videos have been removed (Arango, 2009). It is expected that Google’s oversight and control over YouTube videos will increase due to copyright infringement restrictions and court battles over fair use (Kellner & Kim, 2010).

The use of video file-sharing in the educational setting is permissible. The use of video and still picture files within classrooms is considered fair even with the school website providing links to these files (Talab & Butler, 2007). However, it must be noted that copyright infringements do need to be taken into account with YouTube videos. Copyright infringement occurs when a copyrighted work is reproduced, distributed, performed, publicly displayed, or made into a derivative work without the permission of the copyright owner (YouTube, 2011). For example, a professional organization that shows a YouTube video at its professional conference (charging the customary registration fee) might be infringing on the copyright protection held by the person who created the video or still picture file. It may be permissible to include small excerpts from copyrighted material if what you intend to use is ‘insubstantial’ (YouTube, 2011). For more information, it is advisable to refer to the U.S. (or your country’s) copyright law and fair use regulations. U.S. copyright regulations/guidelines are available at the following websites:

• www.copyright.gov/fls/fl102.html
• http://fairuse.stanford.edu/Copyright_and_Fair_Use_Overview/chapter9/
• www.copyrightwebsite.com/Info/Law/FairUse.aspx
• http://chillingeffects.org/fairuse/

It is important to remember, however, that copyright and privacy laws, with regards to audio and video file-sharing sites, are still in their infancy (Smith, 2006). YouTube does offer its own “Copyright Tips” to assist users in understanding the dynamics of copyright law and fair use (YouTube, 2011).

At this point in time the best advice for educators considering the use of learning strategies involving YouTube is to consult the TEACH Act and the Educational Multimedia Fair Use Guidelines. The TEACH Act Toolkit is an online resource for understanding copyright and distance-education privileges prepared by Talab and Butler (2007).

Engaging Students with YouTube

Integrating specific videos from YouTube allows students to develop a deeper appreciation of the subject and presents an opportunity for experiential learning of not only the subject matter, but the technology used as well. YouTube facilitates dialogue about course content and exposes learners to new insights and skills. There are many ways to integrate YouTube into an educational setting.

In the undergraduate curriculum YouTube videos can be used to provide a visual portrayal of a variety of medical conditions, providing students with the opportunity to actually see what occurs in the body and individual cells in these conditions. Sharing and providing links to videos on electroconvulsant therapy (ECT) can help psychiatric nursing students learn how patients experience this treatment. See Table 2 for a listing of general nursing YouTube videos and Table 3 for a listing of videos for undergraduate courses.

Table 2: General Nursing Courses YouTube Videos.

Table 3: Undergraduate Curricula YouTube Videos.

Graduate level nursing courses can integrate YouTube into theoretical foundations courses, offering a variety of student and professionally made videos describing the lives and theoretical perspectives of our nursing theorists (Agazio & Buckley, 2008). Viewing highlights from various conferences and proceedings provides an engaging opportunity for student dialogue and exposure to professional meetings. See Table 4 for a listing of YouTube videos for graduate level courses.

Table 4: Graduate Curricula YouTube Videos.

Research Related to Using YouTube

Additional research is clearly needed to assess YouTube effectiveness in the educational domain.  The research related to using YouTube as a pedagogical tool is limited (Burke & Snyder, 2008; Kellner & Kim, 2010). To date this research has taken various forms. One form is that of textual analysis of YouTube videos which enables researchers to investigate this emerging technology, as a new mode of communication, with specific cultural and political contexts (McKee, 2001). Another type of research involves the study of YouTube users’ reflections on YouTube postings and videos. In this type of research users share with the researcher how they organized their thoughts, comments, and opinions as they viewed a given posting. This allows researchers to study how viewers engage in the fundamental process of making meaning in their everyday lives (Kellner & Kim, 2010). An Australian study examined the effect of web-based lecture technologies on teaching strategies and found that students appreciated the flexibility of, and support for learning with web-based applications (Gosper et al., 2008; Kellner & Kim, 2010). Additional research is clearly needed to assess YouTube effectiveness in the educational domain.

Conclusion

We are only beginning to recognize the benefits of using YouTube in the classroom setting. We are only beginning to recognize the benefits of using YouTube in the classroom setting. The educational and instructive potential of YouTube is in its infancy. This highly interactive, participatory teaching strategy is limitless in its potential for exciting students about learning. The application and uses of the millions of YouTube videos are limited only by faculty and student creativity and imagination. Integrating and incorporating YouTube videos into all facets of education is a vital component of the Web 2.0 world; it is essential for all students, digital natives and non digital natives alike. However, we must remember that optimal use of YouTube requires an involved educator who is knowledgeable regarding the selection of YouTube videos and skilled in incorporating these videos into the course content. Nurses are change agents; we need to embrace engagement with social media tools as we work with students, patients, and the broader healthcare arena, working together to shape a healthier global community (Ressler & Glazer, 2011).

Author

Leighsa Sharoff, EdD, RN, NPP, AHN-BC
E-mail: lsharoff@hunter.cuny.edu

Dr. Sharoff is an Associate Professor at the City University of New York in the Hunter College School of Nursing (SON). She is the Coordinator of Simulation and Learning Resources for the SON. She is also a psychiatric nurse practitioner and an advanced certified holistic nurse. Dr. Sharoff has been an early adapter regarding the process of integrating technology into nursing curriculum. She is currently conducting research to explore the efficacy of novel preparation material currently being utilized by faculty and students in association with the simulation experience at Hunter College SON. Dr. Sharoff has presented nationally and internationally on the topics of both holistic nursing and also simulation and the integration of technology into nursing curricula. Dr. Sharoff received her baccalaureate degree from Adelphi University in Long Island City, NY, her master’s degree from Hunter College, and her Ed.D. from Teachers College/Columbia University in the city of New York.

© 2011 OJIN: The Online Journal of Issues in Nursing
Article published August 17, 2011