American Medical News on Medical Wikis (edited)

(Be sure to check out the List of Medical Wikis)

American Medical News (weekly newspaper of the American Medical Association) has an article this week on AskDrWiki and other medical Wikis titled “Physician wikis: Do-it-yourself textbooks” (Full text available to subscribers and AMA members only).

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(A physician affiliated with our hospital donates his paper copy of AMN to our library, but that won’t come for a few days. If you have digital access, I’d love to see the full text of the article.)
[Edit] Just read the article. For a short article, it touches on a number of important points. Nicely done. I’d love to see what the author could do if she were allowed to do a longer, feature article on the topic.[/Edit]

The author, Pam Dolan, contacted me for an interview a little more than a week ago in preparation for the article and asked some really good questions. In case you’re interested, the full interview is below. Pam’s questions are bolded.

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You said that, conceptually, you are a fan of the medical wikis. Assuming present and future medical wikis learn to vet all their sources, create strict editorial guidelines and become reliable, trusted sources of information for medical professionals, where does that leave the traditional medical libraries? Will medical libraries be forced to adapt to this new source of information or is there room for both?

I think it important to recognize that medical librarians, by and large, do not need to be convinced of the potential value of a collaboratively-created resource for medical information. I’m currently aware of no less than three Wikis created by and for medical librarians. EBM Librarian (http://ebmlibrarian.wetpaint.com/) is a resource promoting the practice of evidence-based medicine in libraries. MLA-HLS (http://mla-hls.wikispaces.com/) is sponsored by the Hospital Libraries Section of the Medical Library Association (http://www.hls.mlanet.org/). The UBC Health-Lib Wiki (http://hlwiki.slais.ubc.ca/) is a project of medical librarians and students of health sciences librarianship at the University of British Columbia. All three of these, like Ask Dr. Wiki, are exploring how the Wiki, as a platform, can best be leveraged to support the work of health professionals.

If Ask Dr. Wiki evolves (as I hope it will) into a large, searchable repository of frequently-updated, high quality medical information with a track record of accuracy and strict adherence to good editorial policies, I think medical libraries will embrace it and add it to the repertoire of tools they currently utilize. In simplest terms, the work of a medical librarian is to find and evaluate medical information. If and when medical librarians embrace Ask Dr. Wiki, it will be the best possible indicator of its success and worth. Medical librarians will never need to be “forced” to embrace a high quality, authoritative resource.

In the interview with the Plain Dealer [available here] you said people shouldn’t rely on Wikipedia as their LAST stop for information. Where do you think medical wikis are in the chain of medical information for doctors? What is the context in which information should be used or even accessed from a medical wiki by medical professionals? (we are assuming the wiki is trusted with professional contributors) When is it more appropriate to turn to a traditional medical library?

This would depend on the individual Wiki and its individual merits. It is important to understand that a Wiki is a kind of platform for building Web sites collaboratively without the need for much knowledge of how the Web works. The fact of being a Wiki doesn’t indicate anything conclusively about the content. Again, professionals in library and information science are developing Wikis themselves at a good clip- so to say that clinical patrons will need to choose between a Wiki and a medical library is a false dichotomy. Given the current state of the medical Wikis I have seen, many may be a good place to begin one’s research into a particular medical topic, but I think even the editors of those Wikis would agree that one’s research shouldn’t end there.

Assuming AskDrWiki vetted all its sources and the information clearly is from reliable sources, are there still limitations to it? If so, what are those limitations and can they ever be eliminated?

A medical Wiki with good editorial policies and vetted contributors may soon contain information of quality similar to an established medical journal or textbook. Again, we must be careful not to confuse the container ( e.g. Wiki, book, journal, Web site) with the content (the information contained therein). I don’t believe the Wiki as a platform or container has any limitations or potential risks that aren’t also faced by other kinds of publishing, whether in print or on the Web.

Dr. Ken Civello compared AskDrWiki to a published medical journal in terms of how several eyes look at all transcripts before it goes out. Yet, corrections are routinely made in medical journals as errors slip through the cracks. If the saying that “the more eyes, the better” is true, then could medical wikis (assuming all sources are professional) be considered more reliable than medical journals since there will always be eyes looking at the content and (in theory) improving it?

I think there may well be some merit in this theory, but there is often significant distance to cover between theory and practice. Medical Wikis are really only getting started, and I think we’ll need to use them for a good while longer before we’ll be able to look back and evaluate them in this manner. Thankfully, many kinds of Wiki software automatically keep a detailed history of any and all changes- this will be enormously helpful in testing the theory.

Dr. Civello also made the point that errors sometimes appear in text books. And when those errors are detected, they can’t be corrected until the next edition. On a wiki, an error can be corrected in a matter of minutes. What do you think the rise of medical wikis will mean to the future of text books?

The implication of this is that Wikis threaten to supplant medical textbooks. I don’t exactly disagree with the implication, but it could be argued that it perhaps understates the shift that is going on in medical publishing. It isn’t only that Wikis (and other kinds of online resources) threaten to supplant books- digital publishing threatens to supplant publishing with ink on paper. The reason Dr. Civello mentions is only one of many reasons for this shift.

Do medical wikis have the potential to change the way medical students learn?

Wikis are already changing the way medical students learn. I’m told by medical librarians who work with medical schools that some medical students are already using Wikis to supplement their textbook reading and that others use Wikis to collaborate on class projects and research. Some medical school faculty members even use Wikis to develop and deliver course materials.

The administrators of AskDrWiki made several changes that were based on your recommendations. Did they contact you seeking advice on how to improve their site or how did that collaboration start?

After reading an article in Nature Medicine by Brandon Keim which discussed Ask Dr. Wiki [The article was WikiMedia by Brandon Keim. News@Nature 13, 231 – 233 (01 Mar 2007) News. I posted about it here: http://davidrothman.net/2007/03/02/nature-medicine-on-wikis/], I wrote a post on my blog (another fairly new platform for publishing) pointing out the problems I saw with it. Drs. Civello and Jefferson replied with detailed comments which led to the exchange of detailed emails which somehow led to them believing I had a good point or two. I honestly never expected them to read my blog or engage with a critic so directly, much less embrace my suggestions. This may be a great illustration of the kind of sharing of ideas and collaboration that these new, digital models of publishing can facilitate in a way never before possible.

One suggestion was the creation of a logo. Was this your suggestion? What does having a logo add to the wiki’s reputation?

That suggestion didn’t come from me, but I like it purely for aesthetic reasons.