Incorporating Web 2.0 tools in a Workshop on Web 2.0 tools for lifelong learning

Recently I organized a workshop for 1st year medical students on using Web 2.0 tools for lifelong learning.

Some educators have assumed that medical students are digital natives or early digital immigrants and thus just because of the year of their birth have an innate understanding of the Web and Web 2.0 tools.  This is an assumption that people are now questioning.

People currently in their 30s to 60's straddle the Web era having spent a significant portion of their "cognitive" lives prior to 1990.  They experienced "traditional education" and are in the unique position of understanding Social Media by activating their prior knowledge.

As I set about planning this workshop I had several questions:

• How could I gauge the students' prior experiences with these tools? (begin without assumptions of the students experience and understanding due to being early digital immigrants)
• How could I get them engaged in this topic?
• I did not want to use a traditional lecture format to help them understand Web 2.0 education tools.  How could I incorporate actual Web 2.0 use into the education experience?

This is how I set up the workshop:

Preparation:

1. Asked the class to create Google and Twitter accounts (could create an account that they could delete later if they did not want to share their real accounts with class).
2. Created a spreadsheet on our internal Sharepoint site for students to enter their names, Google account and Twitter handles
3. Invited the class to Google+ and put them all in one Circle.
4. Asked the students to include me in one of their Circles so they could see my post.
5. Asked students to follow each other on Twitter.  They did not have to follow everyone but maybe the colleagues from their PBL small groups.
6. Asked the students to go to Google Reader and subscribe to PLOS  One Alerts (http://www.plosone.org/article/feed).
7. Click on the drop down next to PLOS One Alerts and click on "More like this" and choose Science Current issue.
   I could also have asked them to do the following but did not think of this then:
8. In the search box type Google and Memory and see the results show the article we were discussing on Google+
9. Read any article they liked from the 2 feeds and send to Twitter.  

Pre-Workshop Activities:

1. Posted the Science article on how use of Google has changed the way we remember on Google+.  I limited this to the circle of students.  No one outside the Circle could see their comments.  Also disabled re-sharing of the post to keep the conversation private.
2. Put some guiding questions under the link to the article:
1. When you read information on the Internet/Web do you
   Remember the information or
   Remember how to find it or
   Both orNeither? 
2. How does this apply to how you study and learn medicine?
3. Asked the class to comment on the article and these questions.
4. I checked back and added comments to students' responses

At the Workshop:

1. This was a 2-hour session.  I planned to spend the time covering
1. Concept of Information Overload
2. Need to use Web 2.0 tools to create filters
3. Transactive and external memory
4. Use of Google Reader and Diigo as examples of creating a Web 2.0 external memory system
5. Define Social Media and types of SoMe
6. Community of Inquiry model (Randy Garrison et al)
7. Social Constructivism (Vygotsky) and how it relates to Social Media
2. What we actually did:
1. Audience response to gauge use of FB, Twitter, Google+ (could have used PollEverywhere.com but just went with our clickers)
2. ARS to see how many had tried the Google Reader exercise
3. Discussion on these 2 topics
4. Discussion on formal and informal learning and need to become life long learners
5. Demonstration of Google Reader and how I use it, including sharing articles and commenting on them with residents and students.
6. Demonstration of Diigo - especially the ability to highlight bookmarked pages and to take notes.
7. Ask them to log into Twitter and post what they thought about the use of Google Reader and Diigo using a specific hashtag
8. Break - I started Twitter Fountain and projected the posts with the hashtags on the screen.  As students came back into the classroom, they were able to see what everyone else had posted about what they had learned.
9. Reviewed the discussion on the post on Google+ on the Science article.
10. Examples of Twitter case discussions, Twitter journal clubs, Google Hangout
11. Discussion and close
3. What did I learn?
1. Awareness of Feed readers and social bookmarking tools was very low.
2. These were very enthusiastically received by the students.  A number of twitter posts were about how they planned to start using these.
3. Students felt use of Social Networks in education was more appropriate for later stages of their training when they were more scattered and in less formal settings e.g. during practice, during clinical rotations etc.

Collaborative learning in Medical Education - Where is the Patient?

For a while now I have been muddling over a few thoughts in my head. These were prompted by

1. Medicine's incredible success at treating acute problems and thus bringing chronic problems to the forefront e.g. patient survives a stroke but is left with bed sores, incontinence OR survives an acute heart attack and is left with congestive heart failure. A William Schwab put it at a recent grand rounds, "Success brings failure" and thus our success in treating acute problems has brought us an excess of chronic problems.
   
2. Increasing popularity of social media tools like Facebook, Twitter and Second Life. A recent study that I discussed earlier showing students were more likely to use Facebook for a course discussion than the University's learning management system.
   
3. Medical education moving from a traditional "talking to the boards" model to a small group collaborative problem solving model - can we use this momentum for including patients into the learning "group"? This thought was resurrected by a post I read by Anne Marie Cunningham.
   

It seems that learning how to treat an acute problem is something we can do well in our current model of education which has minimal involvement of the patient (in most schools). As our population ages, has more chronic problems, a model that does not involve the patient in the learning process is not going to succeed.

Thus we know what an obese patient with poorly controlled diabetes needs to do to bring his/her condition under control and maintain it there. Patient also often knows this. Still optimal outcome occurs only rarely and if it does, it is not sustained.

In managing chronic conditions, the patient has to learn to take control of his/her condition and the physician is only a part of the solution to make this happen. Our medical students learning is designed to occur either in classrooms or in hospitals - both of which are perfect for acute condition management. The exposure to outpatient chronic condition management where they can interact with the same few patients longitudinally does not occur in most schools.

The reasons for this are mostly logistic. Scheduling students to be in the clinic the same time as specific patients is a logistic nightmare. How about a model using social media?

Can we have students create limited, private accounts in a social media site like Facebook or create a specific site using Ning and invite consenting patients to be their "friends". We could have a list of patients with different conditions and abilities to use these social media tools. The sites would not be accessible except to invitees. The students would collaborate with a set of patients over their entire medical school experience. The patients would post/tweet about their symptoms, office visits, hospitalizations, test results and the students would learn/read up about these and explain these to the patients. In addition, they would work on skills like motivational interviewing, negotiated goal setting to help the patients take better control of their conditions.

This model will allow students to learn the role they have to play in management of chronic conditions and prepare them for the future!