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#hcsmca discusses wikis and collaborative writing applications

December 2, 2013

This week’s #hcsmca chat (December 4 at 1pm ET) Patrick Archambault (@patarchambault) and Tom van de Belt (@tomvandebelt) will examine issues and answer your questions about wikis and collaborative writing applications based on a paper they wrote Wikis and Collaborative Writing Applications in Health Care: A Scoping Review with the help of an amazing group of international researchers and decision makers. I invited Patrick to give us some background on the findings of the paper in preparation for Wednesday’s chat.

Patrick ArchambaultBy Patrick Archambault (@patarchambault)

The overarching goal of our paper Wikis and Collaborative Writing Applications in Health Care: A Scoping Review was to explore the depth and breadth of evidence about the effective, safe, and ethical use of wikis and collaborative writing applications (CWAs) in health care. We conducted our scoping review with the following specific objectives:

  1. to map the literature on the use of wikis and other CWAs in health care,
  2. to compare the applications’ features by investigating how they were used in collaborative writing projects,
  3. to synthesize the applications’ positive and negative effects as knowledge translation interventions in health care,
  4. to inventory the barriers and facilitators that affect how they influence health care delivery, and
  5. to produce a research agenda delimiting areas where further knowledge synthesis is needed and where more primary research remains to be done.

To gather your feedback and stimulate discussion with the #hcsmca community, we would like to focus on the following topics:

  • T1: How can we get more healthcare professionals to contribute to wikis?
  • T2: How can we improve the reliability of information within wikis?

Health care decision makers—providers, patients, managers, and policy makers—are failing to use research evidence to inform their decisions [1]. By involving knowledge users in the creation and dissemination of knowledge [2], social media—highly accessible, Web-based, interactive vehicles of communication—have the potential to empower users to apply knowledge in practice. Acknowledging this potential and recognizing that social media capitalizes on the free and open access to information, scientists, opinion leaders, and patient advocates have called for research to determine whether social media can equip decision-making constituencies to improve health care delivery [3,4] decrease its costs [2,5,6], accelerate knowledge discovery [711], and improve access to knowledge within developing countries [4,1217].

Wikis and Collaborative Writing Applications in Health Care: A Scoping Review Poster Presentation

Poster presentation from Medicine 2.0’13 conference London, UK

Collaborative writing applications (CWAs) [18,19] are a category of social media that has surged in popularity in recent years, including within the health care sector [2,6,18,20]. CWAs consist of software that allows users to create online content that anyone who has access can edit or supplement [21]. With these contributions, CWAs can become rich multimodal communication tools enriched with hyperlinks, images, videos, and audio. For example, Internet users have turned to wikis [22,23] to produce a Wikipedia entry on the Global Plan to Stop Tuberculosis [4]; to Google Knol [24,25] to exchange research on influenza at the Public Library of Science [26]; and to Google Docs [19,27] to review the literature on emergency medicine [28,29]. Although now defunct, Google Knol was a Google project that aimed to include user-written articles on a range of topics that could be edited only if the original authors gave access to editing the text. CWAs can also be classified based on who has access. There are open or public CWAs such as Wikipedia, which can be edited by anyone in the world and can also be seen by anyone. There are also partially public CWAs, which can be seen by anyone, but can be edited only by certain members of a restricted community (eg, Ganfyd [30]). There are also closed or private CWAs, part of central knowledge management systems (eg, Intelink [31]) or online learning systems (eg, Blackboard [32]), which are edited by members of the institution and are visible only to members of the institution.

Among the types of CWAs, wikis and its most famous representative—Wikipedia—are perhaps the most popular. Wikipedia is an online encyclopedia whose medical articles are viewed about 150 million times per month and exist in 271 languages [4]. Moreover, readership of Wikipedia’s medical content is continuing to increase [33]. New wikis have appeared in all fields of health care [18,28,3441], and studies of developed countries report 70% of junior physicians using Wikipedia weekly [42]. Patients use wikis to share their experiences [43] and to find information [4]. The Canadian Agency for Drugs and Technologies in Health is exploring the use of wikis to update knowledge syntheses [4446]; the United States’ National Institutes of Health is training its scientists in editing them [47,48]; and the World Health Organization is using a wiki format to update the International Classification of Diseases [49]. In addition, academic institutions have started using wikis to train health professionals [18,22,32,5054]. Wikis have come to exemplify social media’s tremendous promise to enable health professionals, patients, and policy makers to implement evidence-based practice at remarkably low cost [5,28,29,55,56]. In doing so, they could contribute to improving the health of millions of people around the world [4,13].

However, questions remain about the safety [5759], reliability [6064], lack of traditional authorship [65,66], and the legal implications for decision making [67,68] regarding the use of CWAs in health care. Researchers question clinicians’ intentions to use the applications in their practice [28] and to contribute knowledge collaboratively [4,29,69]. Furthermore, it is unknown how CWAs can enhance the delivery of health care (eg, by empowering patients in decision making [70,71], by improving health care communication and education [18,27,32,72,73,74,75]), and benefiting health in developing countries [4,76]. While researchers have conducted systematic reviews on Internet and communication technologies (ICTs) [77,78] social media in health care [7984] and research on Wikipedia in general [85], none have specifically focused on wikis and CWAs in health care. Not all social media share the same mechanisms of action [21], therefore examining CWAs in health care is important.

Our methods and results are summarized in this abstract

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