When this study began in February 2018, the sample of nursing schools was drawn from US News and World Report’s 2017 list of the top nursing schools with master’s degree programs. As such, each table in this manuscript illustrates a step in the data analysis process that would otherwise be opaque to readers if the step was simply described in the narrative. Democratizing Twitter analysis requires greater transparency regarding the methods used. Methods have been described in detail using plain language so that researchers can easily replicate the study without needing specialized knowledge in natural language processing or machine learning. The resulting study is a comprehensive analysis of 4 years of tweets from the top 44 schools of nursing in the United States. In addition, the scope was expanded to include an in-depth analysis of the types of hashtags used by schools of nursing. In December 2020, the timeframe was expanded to encompass 2 more years of data so that before and after Woodhull Study Revisited analyses could be conducted. Preliminary findings using 2016-2018 data were intriguing but were not published with the rest of the results of The Woodhull Study Revisited. When this study began in 2018 as a last-minute addition to The Woodhull Study Revisited, I sought to determine the extent to which the top 50 schools of nursing were using hashtags that could attract/invite attention from journalists on Twitter. While there is an abundance of research regarding the use of hashtags by health care professionals on Twitter, little is known about the ways in which schools of nursing used Twitter to invite attention from and engagement with journalists, policy makers, and the general public in the 2 years before The Woodhull Study Revisited was published in September 2018 and the 2 years after its publication.

Shattell and Darmoc argue that nurses should consider using Twitter to make their “practical, real-life knowledge or…research findings or insights on current issues… available for the public” and to “harness attention from some more traditional media sources”. Because Twitter was not launched until 8 years after the Woodhull Study was conducted, the researchers obviously could not look at Twitter data in their analysis. Mary Chaffee wrote that “his lack of visibility limits nursing’s ability to communicate important health information, impedes nursing’s ability to define its role and contributions in the health care delivery system, and restricts nursing’s ability to advocate for health policy”. When the landmark Woodhull Study on Nursing and the Media was published in 1998, the voices and faces of nurses were found to be largely absent from news stories. In 2018, hashtags were widely used on Twitter to make tweets easy to find for other Twitter users interested in a given topic. In his proposal, Messina wrote that his primary interest was “simply having a better eavesdropping experience on Twitter”. Hashtags first came into use on Twitter in 2007 when a user named Chris Messina put forward a proposal for “…improving contextualization, content filtering, and exploratory serendipity within Twitter”. Hashtags are words or phrases (without spaces) that are preceded by a pound sign (#). Twitter is a microblogging website where users can post “tweets” (brief messages, images, and videos) to share with “followers” (people who have chosen to follow their Twitter account). The 2016-2018 data set containing 16,939 tweets was merged with the 2018-2020 data set containing 40,368 tweets, resulting in 57,307 tweets in the 2016-2020 data set. On excluding retweets, there were 40,368 tweets in the 2018-2020 data set. The Twitter data for the 44 schools of nursing were obtained for the time period covered in the second phase of the study (February 23, 2018, through December 13, 2020), and the most recent 3200 tweets were extracted from each of the accounts. Three accounts that were no longer active were removed from the 2016-2018 data set, resulting in 16,939 tweets from 44 schools of nursing. In December 2020, 44 of the original 47 schools of nursing still had public Twitter accounts under the same name used in the first phase of the study.

After 13,429 retweets were excluded, 18,333 tweets remained. There were 31,762 tweets in the time period covered (September 29, 2016, through February 22, 2018). The most recent 3200 tweets were extracted from each account and analyzed. In February 2018, 47 of the top 50 schools of nursing had public Twitter accounts.

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