ACP Internist on Medical Wikis

Jessica Berthold has written a very good, short article for ACP Internist about medical wikis for which I was interviewed in November.

The entire text of the interview is below.

What are your thoughts on the latest iteration of AskDrWiki? In the last few months, the site has taken many of your suggestions– for eg, posting an editorial policy, verifying the credentials of contributors. Does it still have flaws that need corrected?

I’m sure it does, but the use of wikis for this purpose is still a very new idea. If critics keep being vocal and if AskDrWiki’s administrators continue to constructively respond to criticism, AskDrWiki may help establish for others the best practices through which a medical wiki can be built and maintained.

What, in your opinion, is an acceptable way for a practicing physician to use AskDrWiki, and what is unacceptable? Does this apply to all medical wikis?

A physician could reasonably use AskDrWiki the same way a high school student would use Encyclopaedia Britannica (or Wikipedia)- as a starting point at which to begin research. An inadvisable use would be to stop one’s research there.

Of course, the most ideal use of AskDrWiki by a physician would be for the physician to register, read critically, and make changes where he/she sees room for improvement. The more health professionals who are keeping an eye on the content to ensure accuracy, the better.

Based on some of the criteria I’ve seen you write about, I am guessing that you would rank AskDrWiki and PubDrug at the top of the list of existing medical wikis, in terms of having reliable, trustworthy information. Is that true? Are there other medical wikis you find equally, or more, reliable?

I think that ganfyd approaches the credibility that AskDrWiki and PubDrug have earned. However, some excellent wikis really have different goals than to be “a medical Wikipedia”. The MacSurgWiki would be a good example of this.

It is easy, when discussing wikis, to mistake Wikipedia as a paradigm instead of one application of the wiki as a tool for collaborative document development.

Some of the traits you’ve named that indicate a reliable medical wiki include a detailed editorial policy, a review process for submitted information, verification of contributors’ credentials, and a clear listing of the names of editors and administrators. Are there other traits?

As a very general rule, active revisions are another good sign in a medical wiki. By looking at the recent changes page of a wiki [examples at Ganfyd and AskDrWiki] one can get an idea of how actively the wiki’s community of contributors is adding or editing content. This can indicate that the information is being kept up-to-date or that there is an active community keeping an eye on the content to ensure accuracy of the information. An unchanging wiki is not a healthy wiki.

Do you think medical Wikis will ever replace textbooks? What needs to change in order for that to happen?

In some ways, some wikis are already replacing textbooks for some purposes. I’m told by colleagues in medical school libraries that medical students frequently make use of wikis and other convenient, free online resources.

However, the larger trend here is not that wikis threaten to supplant books, but that online resources, whether free or subscription-based, threaten to supplant paper-and-ink resources.

I believe there will always be need for authoritative literature and that textbooks will never go away, but wikis and their descendent technologies will probably influence the way that online medical resources are managed and revised.

As medical wikis currently stand, what can they practically offer to a doctor that no other medium can?

Medical wikis currently contain no kinds of information that cannot also be found in other resources, online and on paper. The edge wikis have is not really in content, but in being free and convenient to use.

As a whole, what do you think of the quality of the existing crop of medical wikis?

The quality of medical wikis varies tremendously and virtually nothing can be said about them as a whole. One of the reasons I first started making notes on them individually was to highlight the fact that each wiki must be evaluated on its own merits in the same sense that any book must be examined on its own merits. It is as ridiculous to say “wikis are good” or “wikis are bad” as it would be to say that “books are good” or “books are bad.” Some books are great, others…not so much. Same for wikis.

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