Uživatel:Slepi/Wikiprojects in medical education

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Wikiprojects in medical education[upravit | editovat zdroj]

Slepi, Čestmír Štuka, Martin Vejražka

Abstract—This article describes the role of wikiprojects in medical education. Modern study materials can capture the dynamic growth of medical knowledge and moreover, good accessibility is the major difference between wikiprojects and traditional sources of information.

Introduction[upravit | editovat zdroj]

The amount of information processed in all fields of human inquiry, including the medicine, is increasing exponentially [1]. Static printed materials reduce the opportunity to capture the dynamic discipline in a wider context. A printed monograph becomes outdated very quickly, and a few months after releasing usually needs a revision.

In education, and particularly in medical education, we meet contradictory tendencies. Traditionally the cognitivism approach prevails [2]. Learning in this theory is viewed as a process of input processing and transcoding from the short-term memory to the long-term memory. Memorisation and testing have a great emphasis here. New information is presented in a controlled manner and in line with previous knowledge, in accordance with predetermined curriculum and syllabi.

Critics complain that this approach is very static and has no emphasis on understanding. In this approach, isolated knowledge can gradually fade out of the student's memory. The process of education is different from the context of the whole life: while teaching in institutions is controlled, non-formal education during the following working life goes through internal processes and is uncontrolled. This approach proved to be convenient previously as the knowledge used to be relatively stable. Today, when the average half-life of knowledge has been shortened [1], it is difficult to prepare students for lifelong learning. Moreover, if this static model is applied not only to static knowledge but also to dynamically developing disciplines, there is an obvious incompatibility.

A more dynamic view of learning is brought by constructivism [3]. It reflects the growing importance of individual cognition, internal thought processes and social interactions. Learning is seen as the result of personal initiative and communication with other people. In this approach we store new knowledge based on already existing knowledge. We do not process information as an invariable fact, but information is created by contact and discussion. Thus personal activity and social contacts are the imaginary peak of the pyramid of this theory.

The theory of connectivism responds to the new quality brought by information technology [4]. The idea of constructivism is applied in a new environment with new technologies, media, social networks and other advantages of the contemporary world. It does not look at education as an individual's development but as a whole network development. Each person has some knowledge in the system and makes up only one of the nodes combined with available information resources. When dealing with a specific problem, a temporary dynamic network of participants and information resources is created to help solve the problem.

A typical medium in the concept of cognitivism is printed material – a book or a script which presents facts in a static form without the possibility of feedback. From the constructivist point of view the medium can be an e-learning course (e.g. Moodle). However, e-learning can take different forms – from e-reading, where the electronic form is used only for the static presentation of the topic, through the frontal e-learning where the electronic form is used by the teacher to guide the students through the course, to the desired constructivist e-learning, which is based on the collaboration of a virtual group of students and which ensures maximum perception of the subject matter by actively involving students, models, videos, communications and other methods.

Interactive Web 2.0 tools are the medium of connectivism – social networks, collaborative writing applications, such as wikiprojects. Let's have a look at the wikiprojects in a more detailed view.

Wiki & education[upravit | editovat zdroj]

"Wiki" means "quick" in Hawaiian [5], which is indeed one of the main aspects of wikiprojects. They are open to any active user who may contribute under certain circumstances.

Wiki was created in 1995 and the original WikiWikiWeb site was intended to speed up communication among programmers [6]. Wiki technology and concepts have also been applied in encyclopaedic and educational systems.

Since the start of the encyclopaedic use of the wiki, there has been only a small step to start using it in education. With social constructivism and connectivism in mind, various schools began to engage in Wikipedia or their own wikiprojects [7]. It is known that using the potential of wiki enables active student engagement and collaboration, which then leads to better memorisation and learning, and therefore better learning outcomes [8]. Studies show that students engaged in creating study materials in collaborative writing applications can improve their test results by up to 25% [9].

Wiki & medicine[upravit | editovat zdroj]

The success of the wiki concept and technology in encyclopaedic projects has attracted the attention of medical professionals as well. A number of highly specialised wikis have been created to collect information in individual medical fields [10], [11]. Conversely, we do not find many widely-conceived wiki projects in medicine. For example, Medpedia was an encyclopedia of medical articles designed primarily for medical professionals. Some of the articles also had a simplified version for the lay public. Medpedia was founded in 2007 to share and develop medical knowledge [12]. Unlike Wikipedia, Medpedia's creators tried to get more accuracy and professional quality of the material. Medpedia was therefore not open to editing and writing articles to all, but only to biomedical academics. Several top universities have supported this project [12]. The motivation for the authors was the prestige resulting from collaboration on an exclusive project supported by elite universities. Therefore, unlike other wikiprojects, the identity of the author was more emphasized, the authorship of the texts was individual, and the role of the author was conceived in the same way as in printed scientific articles.

The project was canceled in 2013, it lasted six years and several million dollars was spent. The reason was that the project never exceeded the contribution limit to success (low growth dynamics and low attendance). In the discussions which analysed the causes of the fail of this promising project, it was argued that it was an attempt to use Web 2.0 tools to implement a concept of Web 1.0. Its failure has been interpreted as a demonstration that new Web 2.0 tools are not in themselves a guarantee of success. The form itself is not enough if the overall concept betrays the ideas of the Web 1.0.

Another problem in the foundations of this project was its "elitism", which undermined the dynamics of the project by limiting the number of potential contributors [13].

However, other, more viable, open wikiprojects emerged. For example, WikiVet [14] intended for students of veterinary medicine. Another good example is UMMedWiki, written by students and run by the University of Minnesota [15]. Another open wiki is WikiSkripta, a website for students of medicine in the Czech language. It was created at the 1st Faculty of Medicine, Charles University [16], [17], [18].

These projects extol the ideals of connectivism, students and educators work together on educational materials, which then serve to teach other students. Managing materials and updating them is very fast, so it covers the dynamic evolution of medicine much better than static textbook ever could.

Problematic aspects of educational wikiprojects[upravit | editovat zdroj]

Like any teaching method, neither the connectivist approach of wikiprojects is self-sustaining. It is often stated that the problem of teaching and professional texts created and maintained by students is less accurate, less complete and balanced when compared to the best monographs.

These objections must be seen in the context of the real situation. Students of medicine or beginning physicians often feel under time pressure, and open access texts can be acceptable for the first information about the matter. However, it can not be denied that reliable resources are more suitable for deeper study and specialisation.

However, we also have to discuss the methodological problem of assessing the suitability of wikiprojects in education. Very often the connectivist projects are judged by cognitivism metrics.

Some work evaluate the accuracy and completeness of medical articles in Wikipedia. For example Azer [19] has reviewed some of the physiology articles in Wikipedia and declares that the objective was not to compare Wikipedia with textbooks of medicine, because the purpose of Wikipedia is not to serve as a learning resource for medical students. However, he does not recommend Wikipedia as a learning material for students. However, the aim of wikiprojects in education is not only to read articles, but to cooperate with others, and after thorough study, improve or even create texts in collaboration with experts. Only this creative activity leads to the desired pedagogical effect according to the theory of connectivism, as stated in the introduction. If Wikipedia is offered to students as a source to read, it will of course fail, because it is not suitable for this purpose. A similar problem with the methodology is the comparison of Wikipedia with the official medical literature, as Hasty did [20].

Azer and Alaswaidan [21] attempted to measure articles in Wikipedia by the metrics of impacted journals: they vainly sought a sufficient density of relevant references and quotes, criticised the citation manners and other formalities. Based on this data, they do not recommend using Wikipedia, although they did not judge the information value and the practical applicability of its articles.

Wikipedia and wikiprojects can not be used as a primary source when writing scientific articles, as Bould pointed out [22]. Although Wikipedia is useful in scientific work when used correctly, it should serve primarily for an initial acquaintance with the problem rather than as a separate source suitable for quoting in an impacted journal.

Incorrect views of the real utility or misunderstanding of wikiprojects can lead educators and researchers to damn wikis and the whole idea of open projects. Nevertheless, wiki is extremely popular among patients [23], students [24], young doctors [25], [26], and experts [24], [27] and Wikipedia's results are mostly placed on the first page of search engines [28]. Despite all the criticism, it must be admitted that wikiprojects also have tremendous advantages, as shown below.

Positive benefits and effects of wikiprojects[upravit | editovat zdroj]

Many examples of successful educational wikis confirm that these projects can effectively improve knowledge, brainstorming and collaboration skills among students and educators [29]. It is known [30], that the use of official medical databases for students is too complex. For the purposes of teaching, the difference between, for example, UpToDate and Wikipedia is negligible from the view of student test results.

Librarians and educators, who know that students prefer searching in Wikipedia, show [31], that students' attempts to improve some article in Wikipedia can improve mutual collaboration and show students how to handle wikiprojects properly.

Improving the content of wikiprojects by professionals can also help students. The motivation for teachers is to help students (in this case, for example, to correct factual mistakes, to correct grammar or to remove vandalism), feeling responsibility for education and the dissemination of knowledge (physician trying to spread medical knowledge, etc.), and to share wiki philosophy or to fulfill personal conviction [32].

For example, articles on psychiatric illnesses in Wikipedia achieve accuracy, timeliness, quality of reference, and depth of footage comparable to renowned printed encyclopaedias. Some other articles also contain enough relevant citations of official sources [33]. The fact that different authors attempt to measure wikiprojects with "official" resources (e.g., a famous article comparing the accuracy of the Encyclopedia Britannica with Wikipedia [34]), is proof of the importance of wikiprojects. The comparisons of wikiprojects with traditional information sources are also published by highly prestigious journals with the highest impact.

Although neglected, however, from our point of view, accessibility is the major difference between wikiprojects and traditional sources of information. For students it is much easier to access openly published information collected in one place and quickly accessible by conventional search engines than to search information published in highly specialised impacted journals. This necessarily leads to the fact that students are reaching for wikiprojects as one of the first sources. One very important aspect of wikiprojects is the active involvement and cooperation of students. Teacher and student cooperation is key to the proper use of the wiki. Subsequently, the quality of the materials increases and, additionally, the collaboration is in itself a learning process according to the theory of connectivism. Students will gain a much better experience of the knowledge when they search for relevant resources and formulate own their own text based on a social interaction with classmates or educators. Such acquired knowledge is even better utilised in the tests [9].

Conclusion[upravit | editovat zdroj]

Wikiprojects in medicine are undoubtedly beneficial. Teachers and students can cooperate in education and improve the results of pedagogical work. If the projects sufficiently meet the needs of the target group, they are frequently visited and can be sustainable in the long term. By engaging teachers or other professionals, students' work develops a better quality.

The learning theory of connectivism says that the learning process is internal, and can not rely solely on one's own acquired knowledge. During life, it is necessary to evaluate and also use the external knowledge acquired, for example, through social interactions [1]. It is important to realise that the knowledge, although up-to-date, is not definitive and valid but is dynamically evolving. Using external knowledge in medical practice means that you need to be able to handle information resources and contacts. Formal education can prepare future physicians for this career stage through information literacy.

It is undisputed that the quality and availability of the information the student can experience differs in a variety of sources. The best sources are traditionally articles in impacted journals and renowned – and usually very expensive – monographs that thoroughly analyse the problem. The availability of such a resource can be limited, not only by its price, but also by the difficult extraction of a simple conclusion from a long and highly expert text.

A subjective assessment of the importance of a resource may change for a particular user with his current academic career position. Students passing through education will need other requirements in comparison with academics who are more involved in scientific research. University education should show students how to work with different types of information resources. By using the principles of connectivism and wikiprojects, participants can be exposed to the necessary interactions and become actively involved in the creation of educational texts. They develop the skills to maintain external knowledge, which they can use during their further lifelong education.

In literature there can be found controversial examples of wiki usage. If we evaluate wiki as a static textbook, i.e. we will assume a cognitivist approach, the proper results will not be reached. The cognitivistic educators will in a given situation correctly point to the shortcomings they have found. However, if we exploit the potential of the wiki and prefer the connectivist principles in all steps of its creation and use, the probability of its success is high, as numerous active and prosperous wikiprojects at different medical faculties confirm.

References[upravit | editovat zdroj]

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