Paving the desire paths of health information needs: Teaching students to edit Wikipedia

Research recently published in BMC Medical Education found that pharmacy students can improve access to quality medicines information by editing Wikipedia pages. Here, Prof. Tina Brock and Prof. Dorie Apollonio describe the research performed by themselves and their colleagues and its potential dual benefits for students and society.

Health professionals express concern when we see patients influenced by medical misinformation. We know that poor-quality information is convenient and widespread. We worry that it will lead people down pathways that diverge from professional guidance. We are uneasy when we consider the potentially devastating health effects of such deviations. We have seen first-hand howmisinformation can negatively influence health behaviors in areas like vaccines and cancer treatment.

Educators express frustration when we see students use abundant, lower quality sources of information while they are training. We watch as they collectively cut corners, meaning the trails of their habits are self-reinforced. With health professional students, we fear the resulting lack of practice in using high quality evidence will influence medical decision-making in patient care. Furthermore, we find that after graduation, even those who can use strong health evidence often cannot adapt medical terminology to meet the literacy needs of their patients.

What can we do about these challenges? We can sigh, grumble, and finger point. We can lecture our patients and our trainees about the woes of seeking medical information from the same sources they use to find information about their hobbies, pop culture, politics, and the like. We can shout that clinicians don’t communicate information at a level appropriate to the lay public, driving the most vulnerable to the sources that do. We can keep teaching the way we have been teaching, watching the distance between educators and students grow.

Or we can respect that patients, health professionals, and students have chosen their preferred route. We can advocate for new methods. Wikipedia is the most used online resource for health information worldwide. Although it was not originally intended to provide health information, it has proved to be what transportation planners call a “desire path,” i.e., an informal shortcut created to more easily arrive at a destination (see Figure 1). This desire path has become well-trodden. So why not legitimize and strengthen it by teaching health professional students to edit and improve Wikipedia pages? Why not use tools designed specifically for that purpose to monitor the impact of their edits? When we pave this desire path, we have the potential for dual benefits – both students and patients can learn.

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Building on the example of an innovative Wikipedia editing elective at the University of California, San Francisco (UCSF) School of Medicine, we saw an opportunity to improve a traditional educational activity in the UCSF School of Pharmacy. Instead of the usual academic practice of having pharmacy students write and edit summaries of key information about new medicines, we had them improve information about specific medicines posted on Wikipedia. We then evaluated whether they developed the professional communication skills expected, and at the same time provided better information to a wider audience.

The project we used as a role model, which involved UCSF medical students, included up to a dozen self-selected students completing an intensive elective unit, in which individual Wikipedia editing was the only academic commitment. For our pharmacy project, we were interested in determining whether similar outcomes were achievable on a larger scale. Our study enlisted an entire class cohort of more than 100 students. Wikipedia editing was only one of many assignments the students completed in across multiple classes during that term. To compensate for these competing demands, the pharmacy students worked in small groups and received support through peer training. For a summary of the Wikipedia-inclusive medical and pharmacy courses at UCSF, see Figure 2.

Our results suggest that editing medicines-related Wikipedia pages as an educational activity can improve both public-facing information and student communication skills. The impact of the student edits on the Wikipedia pages was substantial; demonstrated by improvements in the accuracy and comprehensiveness of the medicines pages and increased page views, which amplified the results of the intervention.

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We also found that students learned more about the inner workings of Wikipedia and, as a result, many viewed this resource differently. A few said that they would consider editing Wikipedia pages again in the future, suggesting that this type of assignment can motivate continued efforts to improve public health information outside of formal assignments.

Encouraging pharmacy students to play a role in improving health-related Wikipedia pages is both valuable and feasible. We suspect the dual benefit to students and to society is not limited to pharmacy. We call on other health professional education programs to embrace these “perfect expressions of natural purpose” by adapting traditional health information assignments to include Wikipedia editing.

This project was supported by a partnership with the Wiki Education Foundation, Wiki Project Medicine Foundation, and Wiki Project Pharmacology. We used freely available tools designed specifically to support using Wikipedia for formal instruction. Through similar partnerships, university students are increasingly improving science information on the Internet and making real-world impact through their work.

 

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