Reading Journals in the Era of Tablets

I recently wrote a blog post on why readers don't use their tablets to read journal articles.  There were several possible reasons.

1. Wanting to work with PDFs rather than HTML
2. Difficulty annotating the PDFs on tablets (not knowing best tools for this)
3. Hyperlinks may not work in PDFs
4. Wanting to flip between a citation# in the text of the article and the reference in the bibliography.  This is easier to do on paper.

The workflow that might meet most of these needs (except #4 scroll to bottom for a work around for this):

Model workflow for annotating Journal PDFs on Tablets

1. On you Desktop/Laptop
1. Get table of contents and abstracts of Journals sent to my Google Reader via RSS feeds
2. When you want, you get the full text of the article and save to Dropbox
3. Journals are now increasing providing PDF with OCR which allows for highlighting.  If the PDF cannot be interpreted as text by the PDF reader, then the words cannot be highlighted, or the hyperlinks will not work.
2. On your tablet
1. Use EZPDF which is a full featured PDF reader and annotator.  It has some awesome features like:
1. Highlighting
2. Adding notes
3. Drawing free text
4. Adding arrows, circles or rectangles
5. Night more (background becomes dark and font is white)
6. Text to speech - actually reads the article for you.
2. Go to Dropbox on you tablet and open the PDF with EZPDF
3. Start reading and annotating (Long tap).  
4. Choose not to make a copy of the article for annotation. Annotate the original in Dropbox. This will leave the annotated article in Dropbox as opposed to another folder on your tablet

This is a video of how to use EZPDF on an Android tablet.  There are more details on a blog here by Sleepless Ninja

The annotated PDFs are stored in Dropbox which has pros and cons.  This is good because the library automatically syncs with all your computers.  The negative is the inability to use this library to cite when writing an article or when creating bibliography.

The alternative work flow that supports citations and bibliography is to use something like Zotero.  Since Zotero introduced the standalone product that works with Chrome and Safari in addition to FireFox it has become even more attractive.  There is a tool called Zotfile that allows connecting your Zotero library to Dropbox and syncing with the tablet.

I have not explored Zotfile yet but I love Zotero so look out for an update in a future post.

Add:
If the journal does not have hyperlinked references in its PDF format, go to the HTML format and check if these are available.  If they are, then use Adobe Acrobat to create a PDF [File>>create PDF>>from web page>> enter URL
This will maintain all the hyperlinks that are in the HTML version.

Academic Journals - will you read them on eReaders and Tablets?

I recently became involved in redesigning the web presence of a journal of a national academic medical society.  The company tasked with the web design process conducted a small number of interviews with current and potential journal readers.
They interviewed 3 people, with various backgrounds, training levels and interests in technology.

Some of the responses on these interviews were quite interesting and maybe surprising.  Here are two opinions that were quite unanimous.

1. Everyone wanted to have the ability to download articles as PDFs.
2. None of the respondents (wanted to) read the articles on a mobile device (even a large screen one like a tablet).

As I was pondering about this, I saw a piece about eBooks and whether they impact learning negatively. The article discusses how one uses one's visual memory to link information with its location in a text book and why this can help recall.  You can read the piece on time.com at http://healthland.time.com/2012/03/14/do-e-books-impair-memory/.
I had a great discussion on this article with some folks over on Google+.  The piece also has a nice video of how people use visual channels to remember information.

This morning I saw a presentation by Michael A Mabe,CEO of International Association of STM Publishers recorded at the UKSG 35th Annual Conference in Glasgow, March 2012.  I found a link to this talk on posts on Google+ by 2 folks who are thinkers and terrific curators on information in my areas of interest - Bertalan Mesko' and A.J. Cann. The presentation discusses what researchers and readers want in their academic publishing and why these needs have led to the current format of the print journal and why technology has not made much of a change in this format.

Just to make matters more interesting, I remembered reading a piece by Clay Shirky on Social reading.  I had saved it to my Evernote and I dug it up again. It is titled "How we will read" and you can find it here http://blog.findings.com/post/20527246081/how-we-will-read-clay-shirky. 

Clay talks about how when he used to read on the original Kindle it did not have e-mail to distract him.  He mentions Nick Carr and the use of Frost's quote as a book is a "momentary stay against confusion".  He talks wistfully of the times when he was bored and the importance of boredom as a way to recognize the 

gap between what you are interested in and your current environment.  But he moves on to discuss the benefits of annotating on his new Kindle and the value of social reading.

Maybe with evolution of the appropriate apps on mobile devices and as readers experience them, we will change our habits? Here is an image from @gtuckerkellog describing his workflow for reading his scientific literature on tablets.  TechCrunch has an article about how Netizine might be a solution.

Where did I read the Clay Shirky interview?  On Evernote app on my Motorola Xoom of course!

"Benevolent" Social Engineering for Behavior Change!

The health care industry is heavily regulated and health care workers need to be aware of these rules and regulations that relate to personal and patient safety, security of data, etc.

The big question is whether the training leads to changes in behavior.  Of course, being aware of the information is necessary; no one would dispute that.  But education alone is in most cases a weak intervention for behavior change unless it is accompanied by something I call "benevolent social engineering".  The phrase social engineering has evil connotations and thus the modifier "benevolent".  

What do I mean by this?  Lets take the story of recycling.  

Say, someone crawls out from under a rock and sees a blue recycle bin somewhere.  He would have no clue what to do with it.  He would benefit from a brief training on importance of recycling and how to do it.  Suppose after the training, he decides he wants to recycle his can of soda   If the nearest recycle bin is 250 meters away, but there are 3 trash cans within 10 meters, he is  somewhat unlikely to recycle the can.  On the other hand if there were recycle bins within easier reach, a fewer trash cans, we could change behavior relatively easily.

What implications does this have for health care?  

The IDSA and ATS guidelines for community acquired pneumonia recommend either a fluoroquinolone or macrolide+beta lactam for inpatient cases.  For some hypothetical reason (like local susceptibility patterns), your institution guideline is to not use fluoroquinolone alone for community acquired pneumonia (CAP).  What if you notice that the residents in your hospital are using inappropriate antibiotics to treat patients admitted CAP.  You educate them about the guidelines, formulary, costs and susceptibility patterns and advise them to use azithromycin + ceftriaxone unless there are contraindications like allergies.  You study the effect of your intervention and notice no change in behavior.  You do a focus group of residents to see why they still use a fluoroquinolone alone.  It is possible that you may find that there is an order set in the electronic health record that makes it easier to order a fluoroquinolone rather than the preferred combination.  You change the order set and it is quite possible that you will see a big change in behavior.

Besides making things easier or more convenient, benevolent social engineering sends a message that something is more important.  Otherwise the hidden curriculum of the education intervention is, "We are just paying lip service to this.  Keep doing whatever you were doing."  Seeing the old order set for fluoroquinolone sends the same message as the multiple trash cans - "We don't think recycling is important".  When an institution backs up its educational efforts with the measures that make action easier, it tells the health care worker that it is a priority!  Its like putting your money where your mouth is!