Viewpoint

Web 2.0 and Medical Education: It's Here. Are You Ready?

By James B. McGee, M.D.
Associate Professor of Medicine
Assistant Dean for Medical Education Technology
Director, Laboratory for Educational Technology
University of Pittsburgh School of Medicine

"Web 2.0" is a term used to refer to a diverse collection of Web sites and Internet services that focus on user-centric design. Well-known examples include YouTube, Blogs (Web-logs), and Wikipedia. The social networking sites MySpace and Facebook each received 60 and 19 million visitors, respectively in August of 2007 and are becoming part of students' every day life. A first year medical student recently advised me, "if you're not on FaceBook, you don't exist." These sites emphasize user-based content creation, social interaction and shared editing within communities of common interest and shared trust.

Many schools are already experimenting with social networking, wiki-based document editing and interactive blogs (Web-logs). Faculty and administrators can benefit from understanding, preparing, and utilizing this increasingly popular approach to Web-based communication.

Web 1.0 versus Web 2.0

What is different about these sites that make them popular and induces strangers to interact and share their personal stories, images and videos online? A Web 2.0 site puts the user in the center. Information comes to and from him or her, into a personal Web space that the user controls. On a Web 2.0 site users,

• provide the content themselves,
• direct others to content through ratings and recommendations
• combine data from more than one location ("mash up"), and
• share their opinions, thoughts and questions.

The power of this approach comes from decoupling of knowledge from its source and the collective wisdom of many. These sites get better the more people use them. Web 2.0 may be described as more of a philosophy regarding Web site design than a technology.

In contrast, on a Web 1.0-style site, content comes from a single authoritative source and cannot be edited, ranked or appended by the site's users. The original design of commonly used learning management systems (LMS) such as Blackboard, WebCT, and Angel, are examples of this approach, however, newer LMS's have added some Web 2.0 options.In contrast, on a Web 1.0-style site, content comes from a single authoritative source and cannot be edited, ranked or appended by the site's users. The original design of commonly used learning management systems (LMS) such as Blackboard, WebCT, and Angel, are examples of this approach, however, newer LMS's have added some Web 2.0 options.

Web 2.0 in Medical Education

The millennial generation, born between 1980-95 is now in medical school and beginning their postgraduate training. This cohort grew up connected to the Internet and to each other via instant messaging and social networking. This group of students is already using Web 2.0 whether or not curriculum administrators are aware. They share class notes and create study guides using tools like Google Documents. They share images and diagrams with Flikr (photo sharing), and opinions and ideas using Blogger (Web-logs) and other freely available Web applications.

Specific, sanctioned uses of Web 2.0 are emerging. At the University of Pittsburgh, each pre-clinical course has a "Course Director's Blog" on the course's LMS home page. Here directors relay daily, informal updates regarding the course and field questions from students. At the University of Edinburgh in Scotland, students use blogs as diaries to reflect on clinical learning experiences (McGee, Begg 2008). The University of Vermont in Burlington has given students their own course wikis. Wikis are Web sites made up of documents that anyone can edit using word processor-like online tools. Students use these to work together to create their own supplemental course content each year.

A student-centric approach to curriculum and online learning management is emerging at health science institutions and could replace the traditional LMS. The student is at the center of a "Personal Learning Environment" where knowledge comes to him or her based on preferences and individual learning needs. From here they interact with each other, the faculty and external knowledge sources.

Caveats

Resistance is not unexpected since Web 2.0 philosophy can be incompatible with institutional political structures (Begg, Ellaway, et al, 2007). Releasing control of educational content school-run Web sites raises questions of legal responsibility and enforcement of copyright restrictions. A minority of students is hesitant. They question the value of information provided by their peers and are only concerned with the content from their professors' since it reflects what will be on their summative tests. Web 2.0 may require educators to rethink their approach to assessment with less reliance on recall of facts and more emphasis on the processing of information.

Is the wisdom of crowds better, worse or simply different from expert knowledge? This issue is debated among authors (Keen 2007, Surowiecki 2004). There are many examples of how blogs and wikis can be more up to date and accurate than traditional sources such as textbooks. Wikipedia benefits from its millions of users who act as editors and watchful eyes updating and monitoring content on an ongoing basis. Conversely, these Web site are susceptible to bias and malicious manipulation. Web 2.0 sites' open approach is both its strength and its Achilles' heel. Restricting editing access to a community of learners with a shared responsibility can temper these concerns.

Conclusions

Web 2.0-style Web sites continue to gain in popularity due to the fact that people enjoy interacting with each other. Whether it's to discuss and debate, to share new ideas or refute old ones; it is how we naturally work and play. This new approach to Web site design allows us to interact with each other on a worldwide scale. By appropriately applying Web 2.0 techniques to medical learning, students, trainees, practitioners and even patients can benefit from the collective intelligence of a global audience.

References

Begg M, Ellaway R, et. al. (2007). Logos and Mythos: the political dilemmas of Web 2.0 in an accreditation-driven educational environment. ICE 2007 - Ideas in Cyberspace Education, Loch Lomand, UK

Keen A (2007). Cult of the Amateur. Doubleday

McGee JB, Begg M. What medical educators need to know about Web 2.0 Medical Teacher 2008; 30(2): 164-169.

Surowiecki, J. (2004). The Wisdom of Crowds. New York: Doubleday

Selected Web 2.0 Web sites