Web 2.0 Tools in Clinical Practice and PT Education: Keeping Current, Sharing Information, and Marketing
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Web 2.0 Tools in Clinical Practice and PT Education: Keeping Current, Sharing Information, and Marketing
- 1. Web 2.0 Tools in Clinical Practice and PT Education: Keeping Current, Sharing Information, and Marketing Dennis W. Fell, MD, PT Andrea Wright, MLIS University of South Alabama
- 5. Source: What Is Web 2.0 - Tim O'Reilly, modified – clinicalcases.googlepages.com/Web2.0inMedicine-2006-2007.ppt Web 1.0 Web 2.0 Portal, like Yahoo Search, like Google Publishing (websites) Participation (blogs, comments) Stickiness, stay on the website Syndication, RSS, Podcast, website follows you Britannica Online Wikipedia Directories, Favorites Tags - De.licio.us MS Word Google Docs & Spreadsheets Ads, like DoubleClick Google AdSense
- 6. wally.rit.edu/blogs/crlwml/web20.ppt Web 1.0 Web 2.0 Reading Writing Companies Communities HTML XML Home pages Blogs Portals RSS Taxonomy Tags Wires Wireless Owning Sharing Netscape Google Web forms Web applications Dial-up Broadband Hardware costs Bandwidth costs
- 7. cuene.typepad.com/MiMA.1.ppt Web 1.0 (1993-2003) Pretty much HTML pages viewed through a browser Web 2.0 (2003- beyond) Web pages, plus a lot of other “content” shared over the web, with more interactivity; more like an application than a “page” “ Read” Mode “ Write” & Contribute “ Page” Primary Unit of content “ Post / record” “ static” State “ dynamic” Web browser Viewed through… Browsers, RSS Readers, anything “ Client Server” Architecture “ Web Services” Web Coders Content Created by… Everyone “ geeks” Domain of… “ mass amatuerization”
- 8. Copyright Jürgen Schiller García - Creative Commons Attribution 2.5 License.
- 9. Top 25 list is based on web statistics gathered by Ranking.com
- 10. Magazine Content Goes Social http://www.marketingcharts.com/print/top-magazine-websites-video-use-doubles-uptake-of-other-web-features-slow-1542/bivings-group-magazine-web-features-2007jpg /
- 13. Is Social Media a Fad?
- 15. RSS In Plain English
- 57. Source: Meng P. Podcasting and Vodcasting: A White Paper . University of Missouri, 2005 http://edmarketing.apple.com/adcinstitute/wp-content/Missouri_Podcasting_White_Paper.pdf
- 67. Wiki – Hawaiian for “quick, hurry, swift” Wiki Many people may contribute to and edit a single document using only a web browser.
- 103. Connotea
- 115. Social Network Use By Adults
- 123. Google
- 135. Office Hours
- 138. The functionality on individual outbreaks remains the same; just mouse over the point to get location details, and double-click to call up ancillary data as a description panel.
- 150. Project Management
Editor's Notes
- The web began about 15 years ago as a group work tool for scientists at CERN a particle physical laboratory. Today it has grown into a global information space with over a billion users.
- Web 2.0 is based on Web 1.0 standards. Controversy over whether Web 2.0 is a reality or whether it is just a continuation of the original web. It has been called the social web and the “People-centric Web” as it connects people. It encourages interaction and a greater sense of community. It opens up new avenues for collaborative learning in health and health care. Web 2.0 emphasizes content creation over content use. Because it encourages interaction between users, it is an asset to e-learning. Barack Obama became the first President elect with his own Facebook , mySpace and Twitter pages, nicely complemented by his personal youTube channel. CNN senior political analyst Bill Schneider believes "Obama has invented an alternative media model" . Even the Vatican is on board, with plans to launch their own youTube channel too . There was an article in the Mobile paper recently noting how politicians are now using the social networking tools to connect with voters.
- Some say that the Web 2.0 tools make people more isolated. You have the image of an individual sitting in a room by themselves working on a computer. But at the same time they can connect individuals who have a common interest who might not have made that connection otherwise. And article in PT Magazine noted that the “underlying point is to break down the walls that separate like minded people and get them involved with each other.” For a health care professional in a rural area, it can be a way to connect with others in that profession.
- Another standard for syndication is Atom
- http://www.youtube.com/watch?v=0klgLsSxGsU
- Instead of visiting hundreds of websites per day, let them send information to your Bloglines or Google reader. You may save the feeds to your Internet browser, such as Mozilla Firefox or Internet Explorer similar to bookmarks as well. One of our faculty talked about pull vs push technology over 15 years ago – RSS makes that possible
- Communication tool – usually focused on a similar topic and/or serve as a way to connect people who have a common interest. It can be thought of as an online journal, but probably not peer reviewed. Blogs, however, will contain more current, cutting-edge material than what you would find in journals. Some have readers’ comments Posts to blogs are tagged with subjects or topics. Clicking on a tag will take you to a list of other posts that use the same tag. Can use RSS feed to retrieve An article in PT Magazine noted that blogs can enhance recruitment and retention and can play a role in the marketing of PT practices. Patients interested in a topic such as sports medicine would follow a blog on that topic. The article further notes that consumer education using podcasts or blogs can show the PT not only as a health care professional, but also as an educator. Students on clinical rotation can blog about experiences
- Collection of blogs on the Internet is called blogosphere and in 2006 was doubling in size every 5-6 months, but that is no longer the case because of its size. March 2007 – Technorati tracking > 70 million (57 Million in Oct 2006); 120,000 new blogs created every day (100,000 in Oct 2006); 1.3 posts made to blogs each day in Oct 2006, but posting volume is now growing at a slower rate. There is an increase in tagging – assigning subject headings to the blog posting. Only about 4000 blogs have more than 500 other blogs linking to them
- Technorati tracks blogs. Technorati Authority is the # of blogs linking to a website in the last six months. Technorati notes that English and Japanese are the two most popular languages in the blogosphere with Chinese and #3.
- Some people blog just to have a blog There is a significant # of health-related blogs that are developed by lay-users, usually with no professional input. The potential for misinformation, therefore, is significant.
- Business of Healthcare, Healthcare Issues, IT Issue Dynamics Inc. (IDI) – a public affairs firm
- Blogs can also be used to share information on new topics that may not yet be in the healthcare literature. While the information won’t necessarily be evidence-based, it is still a way to find opinions. I regularly read several blogs that discuss technology in libraries, to try and keep current. Course blogs can be used to share learning experiences, present the students’ comments to the instructor and peers, and to give the students the means to demonstrate their knowledge of the specific learning principles covered in class. Blogs can be used by students as a knowledge management tool for their personal study. Clinical educators may encourage students to reflect and post journals regarding their interactions with patients and clinical staff.
- a blog carnival is is a type of blog event where a variety of blog posts (usually on a specific subject area) are collected and posted on a host site. Usually items are collected and published on a regular schedule (weekly or month) and hosted at another blogger's site. MedLib's Round is a blog carnival of the "best blog posts in the field of medical librarianship."
- A 2008 Journal of General Internal Medicine article reported that among blogs that described individual patient cases, approximately 17% included enough information for patients to identify either their doctors or themselves. “Many blog authors probably didn’t even realize they were identifying themselves”, the article’s author wrote.
- Dates related to the patient, geographic info more precise than state level, any identifying numbers, photographs
- Notice the “tags” on the side column…we will get back to these later.
- Several American Universities have recently distributed iPods to their students and have experimented with podcasting although the final evaluation has not yet been revealed. Some universities are distributing lectures via podcast. Podcasts can also be used for learning to understand specific sounds, like heart sounds or respiratory sounds.
- Meng describes many educational applications of podcasting and videocasting, including: Recordings of lectures for those students unable to attend the lecture in person; Audio recordings of textbook text by chapter, would allow students to “read” or review texts while walking or driving to class (significant aid to auditory learners); and Downloadable libraries of high resolution heart and respiratory sounds for medical students.
- There are some Podcast search engines that can be used to locate podcasts.
- An article on the APTA web page noted that videocasts are being used at U of N. Florida for subjects emphasizing psychomotor skills like transfer, gait, and should procedures. A Russell Smith, the chair of PT at UNF noted that courses involving demonstrating, practice and application are ideal for podcasts. When you have a large number of students trying to see a demonstration, it is difficult for everyone to get a good view. Having them available allows the students to review before and after the class. This allows more time for practice in the classroom. Smith notes, however, that the videocasts should only be used to achieve a specific educational goal. Smith notes in the article that students use RSS feed to receive their podcasts.
- Must download iTunes to your Mac or PC. Then can search for podcasts or videocasts. Some sites, such as the New England Journal of Medicine, have a iTunes icon on their home page. A professor at the Univ of San Francisco SON produces podcasts of her lectures. This is a trend at many universities. Some make them available only to their students while some make them available to the public
- Must download iTunes to your Mac or PC. Then can search for podcasts or videocasts. Some sites, such as the New England Journal of Medicine, have a iTunes icon on their home page. A professor at the Univ of San Francisco SON produces podcasts of her lectures. This is a trend at many universities. Some make them available only to their students while some make them available to the public
- One author has noted “the ease of use of the tools, their extreme flexibility and open access as some of the many reasons why they are useful for group working. (Ebersbach et al 2006; Lamb, 2004) 1995 – first wiki created; Jan 15, 2001 - Wikipedia introduced An interesting observation is that large public wikis like Wikipedia is that most visitors are only visiting while very few actually contribute content.
- Like all web pages, you have to question the information in a wiki. Some wikis restrict who can post and make changes – important for health related sites; some have RSS feeds to the developer so vandalism can be discovered and corrected. A study in 2006 compared Wikipedia and the online Encyclopedia Britannica. It showed the accuracy on both to be very similar.
- In evaluating web sites, remember the AVOCADO model – accuracy, value, organization, content, authority, date, objectivity
- Wikis can be used for collaborative class projects. An article on the APTA web page noted a project at the U of Maryland, Baltimore County in which biology students used a wiki for a writing project on a specified topic. The World Health Organization has announced in 2007 the revision of IDC will be opened via a wiki to more than expert panels.
- Wiki used by Dennis with his neuro students
- Most wikis offer the ability to subscribe to changes through RSS or email notifications and to revert to earlier versions of the page if you do not like a users edits.
- The Wikimedia Commons is a repository of freely usable media files donated by users.
- Online journal club in which anyone can participate
- Case Western SOM uses wikis extensively in small 9-person case inquiry groups. Dartmouth uses the wiki function in Blackboard (like e-College) for collaborative class projects. The CON at Drexel Univ also uses wikis within Blackboard as a discussion forum for students to create content that can be shared and commented on. Plans include using it for case studies.
- Many wikis, like ours, can now be edited using a WYSIWYG (What you see is what you get) editor similar to that in most word processing programs.
- In an article in PT Magazine, a student noted that a class had to photograph various prosthetic devices and post them to Flickr for other students to identify.
- Students in the Univ of San Francisco SON use YouTube in group presentations. YouTube can be used for instructional videos to supplement classroom instruction, perhaps for a procedure that the student needs to review the correct way to perform it ad demonstrated by the professor.
- It can also be used to develop patient education videos.
- As this article notes, “what happens in Vegas (or the classroom) stays in Vegas” is no longer true.
- Wikipedia defines social bookmarking as the practice of “classifying resources by the use of informally assigned, user-defined keywords or tags.” A tag is a keyword, subject heading or topic label that is added to a digital object by the user. Site are available to save links to web pages, to journal articles and to books. These citations can be shared with others or can be marked as private. With some sites, contact can be made with individuals who have assigned tags of interest to you. Del.icio.us is probably the most popular site for social bookmarking. Three web sites on the references on the course wiki, CiteULike, Connotea and Zotero can be used to save article references. These tags are sometimes called “folksonomy”. Folksonomies are built from the bottom up, rather than having a group of “experts” determine which terms are allowed. An important difference between using tags and using folders in your browser bookmarks/favorites is that you can use more than one tag to describe a page. Using these tags enables users to utilize the insights of others to locate information that is related to their research topic, even in areas where the connection would not be obvious. This, in turn, could open up new directions. Tag clouds is the term used to describe the collection of tags. This is a visual depection of content. Usually a tag with a higher frequency of use is displayed in larger text or in bold type. The bookmarking sites, along with their tags are constantly evolving so users need to check back often if they are tracking a particular topic. An article in Educause Review noted that there are five ways in which social bookmarking sites enhance collaborative information discovery. 1) act as a outboard memory for storing and organizing in one place a large number of scattered links that might otherwise get lost. 2) facilitate locating people with related interest; 3)can offer new perspectives for research by revealing new or related subjects 4) can be useful for team projects and 5) can give insight into the owner’s research.
- CiteULike can be used to store organize and share academic papers. When you browse journals via CiteULike and see a paper on the Web that interests you, you click a button and add it to your personal library. This tool and other social networking tools allow “tagging” You can see that these citations have been tagged with balance, falls, stroke and stance . If someone else were interested in finding article on these topics, these citations would be retrieved. This is similar to the MeSH terminology you are used to in Medline, but is assigned by the user rather than the indexer. Web 1.0 used taxonomies while 2.0 uses folksonomies. A research study that Dennis and I supervised for DPT students found that bookmarks in Citeulike were more practice specific for PT than MeSH headings in PubMed or keywords in Scopus. However, the terms are not strictly regulated. For example, if you were looking for articles on “stroke” in PubMed you would search cerebrovascular accident. But in Citeulike, you might need to search stroke, CVA, cerebrovascular accident, etc. In a book entitlled Wisdom of the Crowd, the author suggests that collective intelligence often trumps that of experts. Collective intelligence invites self-policing and community watchfulness. He notes that this leads to the “Darwikinism” of the Web 2.0 content. The Darwinian process allows for pages to undergo by a evolutionary selection process, a change in which “unfit” information is edited out and replaced with more “fit” information. For some searchers, using top-down toxonomies with agreed upon headings, like MeSH results in more efficient search. Other find the use of user assigned tags more efficient. Perhaps the most effective searching would be a combination of the two. PT students Spring 2009 semester have started a cite-u-like assignment, loading their bibliographies from the Neuromuscualar PT Examination course projects onto cite-U-like with appropriate tags. 467 articles in June in the "Neurology Physical Therapy" group…this week 1206. http://www.citeulike.org/group/8259 They did some tag analysis before the student project (basically documenting almost nil PT-related tags on cite-u-like), and will do again after the PT640 course, then again after the PT641 course (May 2009), then again after the PT 642 course (summer 2009) and then again six months later to see if the presence of PT-related tags increases the incidence of PT tags. Before there were no physical therapy tags at all. Now there are lots! That is exciting, even though the class has done almost all of them. However, several other people starting to use PT tags now. After today’s class, we expect even more!
- Connotea, like delicious, but designed for scientists.
- Zotero is a little different than the previous tools we mentioned. It began as a Firefox browser addon that offered an open-source, free citation management tool similar to EndNote or RefWorks, but with its latest release Zotero also offers group libraries, online storage, and sharing.
- Facebook stats indicate that the average user has 120 “friends”, that more than 3 billion minutes are spent on Facebook each day (worldwide) and that more than 18 million users update their status at least once a day.At a recent session I attended on Facebook, the instructor suggested that faculty include their interests for the students to see as it helps to build relationships. She also noted that it is best for the student to make the “friend” request instead of the instructor. Facebook should be used as a communication tool between student and instructor, not as a social application. Reported Jan 2009 on the Facebook blog -- Today, we reached another milestone : 150 million people around the world are now actively using Facebook and almost half of them are using Facebook every day. This includes people in every continent—even Antarctica. If Facebook were a country, it would be the eighth most populated in the world, just ahead of Japan, Russia and Nigeria. When we first started Facebook almost five years ago, most of the people using it were college students in the United States. Today, people of all ages—grandparents, parents and children—use Facebook in more than 35 different languages and 170 countries and territories. The full potential of the web is to make the world more open, so everyone has a voice and can share what is important to them. With 150 million voices and counting, we can't wait for the rest of 2009, and we look forward to offering even more ways for you to connect with the people who matter most. Some Universities have a Facebook policy. Facebook is also a great way to keep in touch with alumni as you don’t have to keep up with changes in their mailing or e-mail addresses. Sermo -online community where physicians around the nation exchange the latest medical insights with each other and improve patient outcomes. For MDs and ODs only. It offers physicians working in rural or remote locations in the US another means to collaborate and communicate with their peers. There are some concerns as to how Sermo gets its financial support. Big money drug reps can’t join, but there are cases where doctors have promoted one drug or product over others. There are some paying Sermo clients, which Sermo says “will use data collection from Sermo system to help forecast potential problems or new uses for commercially significant medical products and therapies, gain early insight into outbreaks and other changes in disease states and conditions that can affect the public health, perform epidemiologic research investigations, survey the opinion of practicing physicians on topics related to medical care, assess, the success and adoption of best practice recommendations, look for opportunities to improve medical practice and protect and promote patient safety and the public health. Online communities are also being used for patient support groups.
- Group: Using Facebook in Education Some instructors have suggested that students working on a group project form a Facebook group to facilitate communication. Students or instructors can then post videos, add appropriate links and can announce study groups.
- Article in Chronicle of Higher education noted that new features offered by Facebook will allow colleges and other organizations to create a centralized public profile and publish a live stream of announcements for their followers.
- Facebook's growth does not appear to be slowing and it is now growing at more than 700,000 users per day! It now has 10% of the global internet population. However, individuals need to be aware of how what they post, maybe be viewed by others, as this article shows.
- According to Wikipedia, Twitter is a social networking and micro-blogging service. It enables its users to send and read other users' updates (known as tweets ), which are text-based posts of up to 140 characters in length. Updates are displayed on the user's profile page and delivered to other users who have signed up to receive them. Senders can restrict delivery to those in their circle of friends (delivery to everyone being the default). Users can send and receive updates via the Twitter website, SMS , RSS (receive only), or through applications such as Tweetie , Twitterrific , and Feedalizr . As of this spring, Twitter has over 100 million users. Dramatic scenes from the emergency landing of a US Airways flight into the Hudson River were first seen on social networking site Twitter . A Twitter user was aboard a ferry used to rescue stranded passengers, and uploaded photos to TwitPic from his iPhone during the rescue. His caption read 'There's a plane in the Hudson. I'm on the ferry going to pick up the people. Crazy.‘ Reported in the Seattle Times following a recent snow emergency, a King County council member noted…"Given the increasing sophistication of modern phones and wireless Internet providers, I encourage Metro to take immediate action to use instant messaging, Twitter, neighborhood blogs, and customer self-reporting systems to keep Metro operators and riders connected,“ The Pew Report in Feb 2009 noted: “11% of online American adults said they used a service like Twitter or another service that allowed them to share updates about themselves or to see the updates of others.” “Twitter users are overwhelmingly young. However, unlike the majority of other applications with a similarly large percentage of youth, Twitter use is not dominated by the youngest of young adults. Indeed, the median age of a Twitter user is 31. In comparison, the median age of a MySpace user is 27, Facebook user is 26 and LinkedIn user is 40.” “ More than three-quarters (76%) of Twitter users use the internet wirelessly – either on a laptop with a wireless connection, or via PDA, handheld or cell phone. In comparison, 57% of those who go online but do not use Twitter, and 59% of internet users as a whole connect to the internet wirelessly.” Twitter is used at conferences to arrange dinner plans, take notes on a speaker or tweet their opinions and thoughts on a session. At the 2009 MLA meeting, there was a Twitter
- No guarantee that those involved are who they say they are. There are also questions of libel and copyright about postings.
- In 2006, 2/3 of the population searching for health information started at a search engine. The trend was so obvious, they stopped updating the number.
- Objective To determine how often searching with Google (the most popular search engine on the world wide web) leads doctors to the correct diagnosis. Conclusion As internet access becomes more readily available in outpatient clinics and hospital wards, the web is rapidly becoming an important clinical tool. The use of web based searching may help to diagnose difficult cases.
- In a comparison of Google Scholar and PubMed reported in the March 2009 issue of Annals of Pharmacology, it was reported that there were no significant differences identified in the number of target primary literature articles located between databases. PubMed searches yielded fewer total citations than Google Scholar results; however, PubMed appears to be more specific than Google Scholar for locating relevant primary literature articles.
- Zoho has a module for Project Management QuickRead allows users to view Microsoft Office documents directly into IE or Foxfire
- .
- Moodle is a course management system (CMS) - a free, Open Source software package designed using sound pedagogical principles , to help educators create effective online learning communities.
- Project Manager plus Shared Documents, wiki, chat, calendar etc
- Google Docs has the ability to create web or email forms and then automatically fill out a Google Spreadsheet in your Google Docs account with the data. It can be analyzed in Google Docs or exported to Excel.
- Survey Monkey is an easy survey creation tool. Free for a basic account.
- Maintain database online, not HIPAA compliant. Zoho Database and Reports allows you to import data from a spreadsheet and create charts and reports.
- With budgets cuts at Universities, travel has been curtailed. Web conferencing makes it possible to conduct meetings without travel regardless of the geographic dispersion of those involved. Web conferencing is also being used for webcasts for training purposes by vendors who are also looking for ways to cut costs. This technology could also be used for professional development sessions, with the instructor in one location and the students in others. Recorded webcasts, while not interactive allow for “any time, any place” learning.
- One way of looking at privacy and security for Web 2.0 resources is that it means giving up control and ownership of information. To post something in Wikipedia is to invite others to edit the document. Another way to look at the issues is to examine how much personal information is shared. With tools, like Facebook, you can set different privacy settings for different people. Unfortunately many who use Web 2.0 tools are not concerned with privacy and security. My view of privacy is much different than that of one of our librarians who is in her mid-20s. There is a balance with privacy and convenience and each person has to determine what that is If there is a concern about use of the information, for example, a student on rotation reporting on their experiences, the tool can be restricted to those involved in the project and not opened to the public. Security is another concern. A report issued in 2008 by Georgia Tech noted that the interactive nature of the tools allow hackers to insert malicious code onto a web site.
- Don’t just do it. Do it for a reason. Don’t utilize the tools or add them to your coursework simply because it is new or cool or trendy. Use them to achieve a specific goal. Don’t use them to do the same thing, but explore how you can improve the process with the tools. The Web 2.0 tools can be used to engage and involve the student, thus enhancing the educational process. But focus on the educational process not the tool itself. As noted in the article in PT Magazine, “whatever technology is used should clearly offer an improved educational benefit.” Remember to use the technology to enhance what you are doing, not just for the sake of using the technology. As evidence-based practice becomes more and more important in the field of physical therapy, therapists could work together to develop EBP portals for the discipline in various 2.0 tools, i.e., Delicious, CiteULike and Library Thing.
- Boulos (2007) article “Virtual communities of practice where advice and expertise, and even multi-medial clinical elements, can be easily shared among clinicians and where they can all learn from each other and keep up to date with the latest advances in their specialties. This is particularly useful for professionally/educationally disadvantaged clinicians who are isolated from the typical urban clinical centers of excellence in remote and rural areas.” Maybe on the clinic or hospital web page will be podcasts or videocasts for patient education. Maybe members of APTA will join together to create a evidence-based “best practice” wiki. What will Web 3.0 be like? Web 3.0, sometimes called the Semantic Web, will simplify the interface between humans and computers. This concept involves assigning metadata (information about information) to web content so that computers can “understand” the meanings of content that being processed. This will allow the user to have more control over how information is accessed and aggregated.