reddit for #meded

Reddit is one of those sites that seems to have been around for ever but that I have not understood. More recently it has been popping up in my Twitter timeline and elsewhere more often. So in the interests of learning by discovery I became a redditor a few hours ago and promptly set up a #meded subreddit.

Why?

Well, there seems to be a few good things about reddit.

It allows threaded discussions. 

It contributes to altmetrics on research articles. 

It allows community members to vote up and down content so adding a filter to the masses of new content we come across.

It might allow deeper engagement with content that tweets. 

And there has been some good discussion so far. What do you think? 

What I have learnt about blogging

I blog... by alamodestuff

So if you have known me on Twitter or elsewhere for a while you will know that I am a big fan of blogging and I encourage everyone to start keeping one. Why? You will learn a lot and you will help others learn too!

I started my blog just over 4 years ago. Sometimes I will write a few posts in a week and at other times I leave it for a month or two. How often you write is up to you. It shouldn't feel like a chore.Write when you have something to share, a question to ask.

Blogging is public writing. Think about who your audience is. For me a massive strength is that all kinds of people read and comment here. This means that I can learn about many more different perspectives than if I was to walk down the corridor and ask my colleagues at work what they thought of the random idea I'd just had. But sometimes people won't understand what you say, the language you use or where you are coming from. That's OK. Just as in any communication, if someone doesn't understand you then don't get angry, just try and explain in a different way.

Writing helps me to develop my thoughts and get some way to understanding what has been perplexing me. Usually I ask a question at the end so that people who read the blog know that I didn't just want a soap box but that I am really interested in what they might add.  If no one comments on your blog, and you have wanted them to, then maybe people who were reading didn't know what kind of response you hoped for. Questions really help with this. If you are writing the post because you are developing an idea that arose out of a conversation somewhere else, then make sure that you let the other people involved know so that you can continue the conversation there. If there is someone whose insight you would really like then email them or send them a tweet with the link and ask them to leave a comment. And get into the habit of commenting on other people's blogs too. They will appreciate your feedback.

Sometimes people ask about ethics. Are there any particular ethical concerns? If you were writing for a journal or a magazine you would most likely have an editor who would tell you if what you were writing was really off for some reason. But you don't have an editor on a blog so you do have to take a bit more care and consider what you are writing. My own rules are that I don't mention a patient on my blog without asking their explicit consent. In fact, I don't often write about anything relating to my clinical work on this blog. If I am teaching and I realise that I would like to write a post about something which has come up then I would let the students know when I am with them. Sometimes, I don't realise at the time that I want to write about the episode but I always try to make sure that I at least let anyone involved know that I have written the post later. So I don't think there is anything particularly ethically troublesome about blogging, but if you have any doubts then don't be afraid to pass what you are going to write by someone else first.

Should you blog in your own name? I do. That doesn't mean that you have to. But I think that writing in your own name leads to a richer experience because you can make stronger links between your online and offline worlds.

And some practical tips? You can set your blog up on any number of sites. This is on Blogger, which is owned by Google and is really very easy to use and rarely down. Lots of other people choose Tumblr or Wordpress. Have a look around and see what you think will suit you.

Do make sure that you enable sharing buttons on your blog so that people can easily share it with others. And let people subscribe by email too.

I usually add a picture to my posts because it brightens them up and hopefully helps with understanding too.

I allow anonymous comments here but I moderate all comments, mainly to stop spam getting through. It's easier than deleting.

And you'll hear people say every now and again that blogging is dead. But that's nonsense. How could it be when you have just started? Enjoy!

Digital divide, health records access and online security

Oxford Internet Study 2011 http://oxis.oii.ox.ac.uk/blog/non-users-and-ex-users-looking-lifestage-education-and-income

The 'digital divide' is very real. The Oxford Internet study is conducted every two years and the above chart is from their most recent survey in 2011. Level of income here relates to household income rather than individual outcome. If you live in a household with an income above £40K it is almost guaranteed that you will have online access. If you live in a poor household with an income of less that £12.5K it is most likely that you won't. There are also stark divisions related to age and educational levels described here.

I've just been having an interesting discussion with Amir Hannan, a GP who is a very strong advocate of patient access to their own health records, about how the digital divide means that those who are most likely to have health problems are least likely to be online... bringing us in the direction of a digital 'inverse care law'.

So if you are a GP and are encouraging patients to access their records online what would you say to those who lack the means to be online? Amir said that patients who are not yet online are directed to a course run by the local library which helps to get people online. But what if you can not afford to have your own access at home, should patients be encouraged to access their medical records from public places such as libraries or internet cafes? What are the risks? Or what about using a computer at the house of friends or family?

Of course, it's not only those who don't have their own computers at home who may use other computerss that they do not own themselves. What issues should you be concerned about if accessing your records from a computer that is also shared with your family or from your work place? Or a hotel lobby when on holiday?

A quick search does not reveal guidance about these issues for people in the UK. Here is the log-in page for the EMIS general practice records access. There is no link to information about online security. Contrast this with information which is available from online banking websites on what to look out for when using their services, for example here is a page on online security from Intelligent Finance.

If there are issues around the online security of accessing health records online, then those who don't have their own internet access at home, are more likely to be at risk. Do you have any examples of links to information in easy to understand forms which will help people to understand and address these issues? Or is it not an issue at all?

EDIT: some great guidance from BCS on accessing records http://www.bcs.org/upload/pdf/social-care-records.pdf <- they state if possible not to access from public computers, but if you do to clear browsing history.*** note this guidance is draft and NOT FOR CIRCULATION but I found it through Google ;-) ***

Renal #meded on Twitter

Twitter for a/e triage?

Ethical responsibilities of leaders of tweetchats?

That way by justinbaeder
Over a year a go, Natalie Lafferty and I hosted the first #meded chat on Twitter. Ours was between 9-10pm UK time, and 5 hours later a similar chat was held for participants in the US.

We had some really great and very wide-ranging discussions. In the UK we had a lot of participation from students and doctors in training. This made for particularly rich and informative debates, for example on portfolios and competency. Over the summer we wound the chats down and didn't get them started again, although the US chat has kept running. But thanks to some calls on Twitter we have got some momentum building again and it looks as if our first session will be announced soon.

In advance of this I wanted to clarify what someone who participates in these chats could expect. I am not so interested in etiquette. We didn't really have any problems before, and participants seemed to be relatively sophisticated users of Twitter, so saying 'be nice' would seem to be a bit superfluous, and a little prissy.

But there are some other issues that I think we should address. The first is the issue of archiving. Anyone can archive anything on Twitter, but I think we should be clear with users that we ourselves will be archiving tweets and the implications of that. Up to now we had been using Symplur's archiving tool but we need to check whether individual tweets can be removed if they breached the confidentiality of patients or others. Again this did not arise before, but it is a serious enough governance issue that I think we should draw attention to it.

Next is the issue of research. As we are forming a community with the participants we would not consider researching the community without making participants aware. However, others outside our community might make us an object of research without making us aware. We can not do anything to stop that but we can make participants aware at least.

So given all that, here is a first draft. It is a fully editable document so please leave a comment here or directly on the document. What else do you think we need to add?

For students, can any social platform compete with Facebook?

Facebook like button by Sean McEntee

At #amee2012 last week Facebook was talked about a lot. It came up in the excellent  social media workshop that was lead by students and in several posters and short communications. Search this 500+ page book of abstracts to see how often!

But as might be expected there was not agreement on whether Facebook should have any place in medical education. Whilst there were reports of it being used to support student learning in informal and formal ways Imperial College, London, other students and faculty argued that Facebook is a social space and not a learning space. In the past any mention of Facebook at a medical education conference usually concerned being unprofessional, so the fact that people were starting to consider the possibility that it might be educational platform was very interesting in itself.

It was also suggested (including by me) that we might have responsibility to provide  safe spaces for students and faculty to model and develop digital professionalism. Quite a few of the issues I heard discussed were raised in the comments of two blog  posts I had written last April.

This post is also a  follw-up to a discussion on our LinkedIn group 6 months ago. It was started by Bernadette John asking if any medical schools were looking into developing  and supporting social platforms for students. King's had just started a project with Elgg but was also thinking about Mahara. Why would a medical school want to do this? Some suggested that the VLE should support social learning interactions. But they don't. Blackboard does not feel social, certainly not social like Facebook.

Today a colleague told me that the University of Wales, Newport (who don't have a medical school) had started using NING , a 'social community tool', in 2008 to support first year students. How might we use something like NING in a medical school? What value would it have? My thoughts are that it would be useful to have a space where students and staff could get to know each other in a semi-formal way. Most of the NHS staff who our students meet do not have profiles on the university site, but it might be useful for students to know some more about what their special interests are clinically, and in research. And vice versa, it would be excellent if teachers could know more about the students they meet on placements.

But later I found out that Newport had stopped using the NING. It was only used by students in the first few weeks of the course to make contacts with each other before they migrated to their own Facebook groups. And if you can't beat 'em, join 'em!! This year Newport is setting up a Facebook page for students to like and post to throughout their university careers.I imagine that even if activity does tail off over the next few months this might still be quite a good channel for the university to communicate with students through.

So can any social platform compete with Facebook? Is there any merit in trying to encourage students to use another 'social learning' platform? A separate platform would mean that students are at less risk of being accused of digital unprofessionalism because they minimise their contact with faculty there *although I would rather see a re-calibration of what is considered unprofessional in the first place- if my ears did not deceive me I think I even heard a medical student volunteer that they were urged not to like a One Direction page on Facebook for fear that it may be seen as unprofessional*.

A separate platform would also mean that faculty with Facebook antibodies could avoid it. Other faculty might be just as concerned as students about mixing personal and professional presences online. There was some talk of dual profiles at AMEE but that is against Facebook terms and conditions. Facebook would rather see professionals create 'pages' to project their work-relate personae.

So some questions. Would students or staff see value in a social platform? For more ideas on how that might work see this post on location and learning.  If yes, could that platform ever be Facebook?

(Edit: Here's an interesting post by Donald Clark in January, "7 reasons why Facebook is front runner in social media learning"