Tuesday, 20 January 2009

How can we involve (e)patients in medical education?

I have some ideas about this but I would really love to hear from (e)patients.

How do you think you could contribute to medical education? Do you think that students and doctors could learn from reading the blogs of (e)patients or seeing what the hot topics are in discussion forums? How would you feel about letting a medical student take your history in Second Life? How can we help medical students develop the skills to support patients negotiate the online world?

Wednesday, 14 January 2009

PLEs and Medical Students....

I started this blog with the aim of recording my web 2.0 learning journey and also in the hope that I would find a community of people interested and participating in medical education. Today this bore some fruit as I participated at a distance in an online seminar about these topics.

The presentation by @ajcann, University of Leicester, reported on courses to help students develop skills in the use of web 2.0 and information literacy. The slides and document give a good summary of the findings. Students appeciated tools, like customised google searches and a Pageflakes page, that helped them find resources more quickly. But they did not use the social aspects of tools provided. There was not evidence of the formation of a community of practice.

There was no audio-visual streaming of the seminar, so I could only pick up on the talk in the room through the tweets of those present. You can find them here: #UOLTAN. I am sure that this means that I have missed out on a lot of valuable interaction and responses to the material presented. I commented that I was not surprised that medical students did not use social bookmarking because despite looking for the past few months I have only managed to find one doctor who uses social bookmarking to record sites that are cliically relevant. And if I was looking for information on how to manage stable COPD, see last night's post, my instinct would not be to start searching delicious to see what others in my network had saved.

So what does that tell me? Well, if clinicians are not yet using web 2.0 to help them with their day to day clinical work, is there any point in us worrying about whether or not sudents are interested in developing these skills? I don't mean that only 10% of GPs or hospital doctors are using social bookmarking and blogs to keep up to date. Or even that only 5% are. I doubt that even 1% are. Early adopters of web2.0 tools for clinical practice do not seem to exist yet.

One of the report conclusions reached was that "Students are reluctant to change their habits unless there is a clear tangible benefit to them. If we believe literacy skills are worth developing, we must make them a requirement not an added extra."

I think that before doing that we need to figure out if these tools actually deliver something that is useful to medical students and to doctors. What gap are they actually filling? Medical education can certainly be improved. But we need to describe the problems before we come up with the solutions.

Tuesday, 13 January 2009

Accessing Evidence-Based Medicine

There is discussion in blogs at the moment about the limits of Evidence-based medicine and how it may be impacted by web2.0 technologies. Laikas, a Dutch librarian, posted about this recently. Sarah Stewart, a midwife from NZ, replied by describing some of the difficulties faced by the public in accessing EBM and the resulting asymmetry of information between doctors and patients.

This reminded me of a You-Tube video I came across last year.

It is an interview Muir Gray, the NHS Chief Knowledge Officer (a post he first floated in 1998 in the BMJ), describes his view of the future of information in the NHS. Resources will be equally available to patients, (or to use his term, citizens) and to professionals. As a clinician and citizen I think this is an enlightened policy. I find much of the content on the NHS choices website very exciting, including Behind the Headlines. BtH gives an evidence-based critique of health stories in the press. I do not like Map of Medicine..... but more about that later:)

To illustrate some of the different sources of EBM available I am going to look at guidance on the management of stable COPD (chronic obstructive pulmonary disease).

First of all here is the page from the BMJ's Clinical Evidence site. I find this very unhelpful. If I wanted to know about one particular treatment and the evidence base, or lack of, for it's use in the management of the condition, this would be useful. But it is not at all useful for a brief synopsis of how to manage the condition.

Next, Clinical Knowledge summaries COPD page. This has many different levels of information and takes quite a lot of clicking around. But it is likely to be useful to a clinician in a surgery. And probably to patients/citizens as well.

GP Notebook is in my experience a favourite of UK GPs. Looking at it's info on the management of stable COPD it is clear that the guidance is related to the NICE guideline on the topic because it references the NICE guidance, and describes different steps for mild/moderate and severe levels of disease. This looks the easiest to access and most clinically relevant so far.

Lastly, we have the Map of Medicine stable COPD page. This annoys me on many levels. For one we are told under 'indications for referral' that this should be considered for severe COPD, but you have to go down to 'follow-up care in severe disease' to find out what the criteria for diagnosing severe COPD is.

What do you use to access EBM? Are different sites useful for different purposes? I'd love to hear your thoughts.

EDIT 11/8/10 I've reviewed the Map of Medicine page (previous link had died- new one is current) and it still does not make diagnosis criteria clear, unfortunately. Time to drop them a tweet!

Power of social networking....

I started this blog a few months ago. Quite rapidly I started learning so much that it was hard to keep documenting my progress. So I find, like all reflective journals, that it is hard to keep it up. But sometimes something happens that really shows the progress you have made so I thought I would tell you a little story about some interactions in the last few hours.

Earlier I was looking at the Health Foundation's webpage. I saved it to my delicious and noticed that someone else had saved it too. The other person had lots of bookmarks interesting to me but no webpage or email address saved. I have been lamenting before about how it is hard to find people on delicious sometimes, but this person had actually twittered about their delicious account so their twitter ID showed up on this page when I googled their delicious ID. Yay! I had found @jranck!

Earlier I had noticed that jranck had bookmarked a blog about developing a communications network using old mobile phones, in a primary health care project in Malawi. The latest post describes analysis of the content of the text messages sent and also included the text of the messages. Somewhere in the last few months I also learned about wordle, and I thought this could do with one so I pasted the text and created a wordle:
Wordle: Mobiles In Malawi- what everyone is texting about
I was then able to share my wordle with @jranck and @joshnesbit (the Mobiles in Malawi site creator) through twitter. Within an hour or so my wordle was being bookmarked by other people because of their tweets.

So that is my snapshot of the power of social networking as I see it today:)

information asymmetry


Posted via email from amcunningham's posterous

Tuesday, 6 January 2009

Happy New Year....7 things you don't (need to) know about me

Let the frivolity not end yet. I have been tagged by Sarah so here goes:

1. I climbed the highest mountain in Northern Ireland for the first time last week. I grew up a few miles away from it.
2. My first trip outside the British Isles was to Croatia a few weeks after my 21st birthday. I spent the summer working as a volunteer in a refugee camp. I travelled from Belfast to Zagreb by bus.
3. I got a super crew tie-pin for selling 47 quarter pounder with cheese deluxes in one weekend. This was in Belfast's first McDonalds in 1991.
4. In 1998 I stood in the first elections to the Northern Ireland Assembly. I wasn't elected.
5. My mum made and embroidered my Irish dancing costume when I was 8.
6. My husband is great at roasting things.... intentionally, like chicken.
7. I go to bed too late.

Thanks Sarah:)