Heidi Allen Digital Strategy

A not insignificant amount of time ago, I ventured into the world of Second Life, to see what it had to offer for universities and medical education.  Not only did I discover that I was hopeless at flying, but I also found that getting dressed was no easy matter and for some time I was close to wandering around starkers.

Notwithstanding the challenges I had a gander around the brave new world of avatars and found the Ann Myers Medical Centre. It was inspirational. At that time they provided lectures, events & training tools in areas of psychology, oncology, gastroenterology, general practice and surgery.

Today, I ventured back to have a look and it has to be said although second life has also progressed, the world of avatars is as wierd and wonderful as ever.  On login I have no idea where I am.  Some avatar called ‘Rhys’ wants a chat:

• Rhys: hello
• Me: hi, am i near the ann myers hospital?
• Rhys: i don’t know that hospital

I decide me and Rhys have had enough of a chat and attempt to fly to get an idea of where I am but it seems I am geographically challenged even in second life, so I use the Ann Myers Medical Centre teleport link and Voila! I have arrived.

There are notices around the place you can click on if you need more information. Within the AMMC you receive a welcome message and guidance on navigating the building:

“On the floor you see a green line if you follow it you see a yellow and red line branching off it.  The green line guides you from psychiatry, general practice, diabetes, leukemia, oncology to the women health centre.  When you follow the green path and enter the clinics/departments you can find some pretty amazing creations.”

Clearly the centre has expanded and there is plenty to see and do, but the limitations are still much the same as they were two years ago – limitations of second life not the centre.

AMMC was created for the virtual training for First Life medical and nursing students. I cannot vouch for the quality or level of the medical education, but what I did want to look at were the possibilities second life has to offer for medical education today.

I would say, there are still significant difficulties – learning to move, interact and navigate with the equipment and information is still cumbersome, but as a virtual structure the AMMC has shown what can be done, not only in building the centre but also in collaborating with different educators in different languages across the globe.

The AMMC say they would like

• To assist students to become more proficient in initial exam history and physicals.

• A second aspect to the history and physical is to train students to truly care for their patients.

• Link telemetric builds (ECG, oxygen saturation machines, etc.) to real-time outputs via URLs so that a students will be taken to a URL, where they will have to accurately diagnose the medical issue through analysis of telemetric outputs.

• Train students in the analysis of MRI s, CT and X-rays.

It will be interesting to know how close the AMMC are to achieving their aims and student uptake. AMMC currently has a voluntary staff consisting of Psychologists, Hematologists, Oncologists, Radiologists, Cardiologists, Midwives, Emergency and Trauma Specialists, general physicians, interns, educators and several nurses.

Do you remember the doubt, uncertainty, ‘it will never take off’, ‘how do we know the content is good’, ‘Wikipedia is dodgy and students should avoid using it at all costs’ that was around when Wikipedia was first launched Jan 15th 2001? The whole concept that anyone could contribute anything and it still be quality information was revolutionary.

It now describes itself as the “multilingual, web-based, free-content encyclopedia project”, and as a resource (a good one in my opinion) it’s well an truly here. Take a look at this:

The percentage of all American adults who use Wikipedia to look for information has increased from 25% in February 2007 to 42% in May 2010. This translates to 53% of adult internet users who use Wikipedia

Education level continues to be the strongest predictor of Wikipedia use. The collaborative encyclopedia is most popular among internet users with at least a college degree, 69% of whom use the site.

Those are some nice stats on Wikipedia from PEW

Happy Birthday Wikipedia!

A twitter conversation as to merits of using social media for high value journals took place recently.  High value as in top medical journals in the world, such as the New England Journal of Medicine, NEJM. I have no idea of their subscription rate, but would venture a guess at a gazillion.

This conversation centered around accessibility of articles – free articles (also known as open access) means they can be shared, whereas subscription articles, means that the journal makes money but only subscribers can read them.

The story goes like this: A bunch of juicy looking articles come up in my email – one set  is from the Scientific American Journal Mind (part of the Nature group of journals now – Nature also being highly esteemed in research circles), the other is NEJM.

I click on Scientific American and get a bunch of  ‘accessed denied’ ‘log in’ ‘subscribe’ rude messages to each and every article I click.  The shame of it is, I would have shared it to a twitter and facebook network – mine and a research network, Body in Mind. They would have had double whammy exposure.  But I couldn’t access them, so I didn’t share.

Then I read NEJM articles – the first two articles I clicked were both open access. I read. I shared.

Here’s the clever bit -and what they are currently navigating – they have a subscription model (they still need to make money to run the journal) and they have open articles, using social media to enable us to share.  BUT, not all to the full advantage. The better the use of social media, the greater their exposure, the greater their chance of more subscriptions.

Discussing this conversation recently with a Journals Publisher at Elsevier this is a big deal at the moment in journals publishing. So, for publishers especially, this twitter conversation is worth a squizz, it is between me and @DrVes – an advisor to NEJM, amongst other things, blogger, expert user of social media in a clinical and research context. At his suggestion I have gathered the tweets. NEJM do some things well, some things poorly, and some almost a criminal waste of opportunity to share their expertise. (in the tweets below SM = social media)

and so I did go to the NEJM facebook page to see if they had interacted with any of the people who had commented on the facebook page. Each link they post generates a shed load of comments by readers (seriously, loads). To my utter surprise there were no replies from the NEJM.

Go on @NEJM – do some podcasts, blogging, real time social media.  Please.

Google’s new Body Browser is in Beta – but what an opportunity for web3D for medical education.  No more expensive anatomy books (sorry publishers)

Body Browser is a detailed 3D model of the human body. You can peel back anatomical layers, zoom in, click to identify anatomy, or search for muscles, organs, bones and more. You can also share the exact scene you are viewing by copying and pasting the URL.

Recently I gave a presentation to Woodhead Architects and then selected a small part to share on social media channels.  Preparing a presentation takes time and there are others that might be interested, so sharing them on different channels makes sense. These are some suggested steps:

Prepare presentation in Keynote or Powerpoint

Select which parts of the presentation is applicable to wider social media audiences, this is what I selected:

1. Upload onto slideshare

2. Blog about it, then

3. tweet your blog post

4. link it to your LinkedIn profile,

5. and Facebook page,

6. Make it into a video for YouTube

Which is, indeed, what I have done. Giving those that are interested a choice of platforms to view.

Total: one presentation, six different places to see it.

A GP who is also an education professional and an expert user of social media, Anne Marie is a natural and presents a superb discussion posing some difficult questions of her readers:

How are people using social marketing in health? Now you have surgeries tweeting, blogging, opening YouTube accounts but what has social media got to do with me as a health professional?  What does ‘engagement with consumers’ using social media, ‘establishing a brand’ got to do with health and health care organisations?

Anne Marie has a real life example of a Government organisation encouraging people to use twitter to contact a sexual health nurse, Zena.  Zena is using twitter, a website and a facebook page to contact patients. But:

• What about private issues being discussed between health professional and patient on a public site?
• How to guide patients online? To use it in a safe way?

This is what this presentation is about – well worth a listen to and if you are really struck with how good this is, the comments on Anne Marie’s blog from health professionals including Zena and patients are enlightening too.

Health professionals and social media

And my two pennies worth: – I admire what this sexual health nurse is doing – not only getting her head around the technology, but putting herself out there as a professional in social media opens her up to all sorts of discussions, comments and criticisms, in a very public way.

I agree with Anne Marie’s concerns that what happens online stays online.  Forever. And from the comments from patients here it’s worth remembering how vulnerable people are especially when they have health problems, their concerns may overtake their care for privacy.

I see what professionals like this nurse are doing as advertising good information to people on a variety of networks, giving them the channels to communicate/find someone, and then taking the conversation off line.

Even if you have the best expertise in health – if you don’t use social media how are patients going to find you?

In response Anne-Marie wrote

“I agree that social media may be a useful way to disseminate contact details. But I do have grave concerns about encouraging its use a contact medium. And it may be heresy but the people who probably most need Zena’s help probably have the least access to social media in any form. This is where enabling patients to make contact by SMS is really useful. Those are 140 private characters.”