Review of the perils and pitfalls of social medicine. How to deal with the explosion in social media and maintain your composure; retain your identity and refrain from ethical and confidentiality breaches as a medical student
It all looks very quiet and peaceful... But lurking behind every corner is another social software animal
http://www.newsweek.com/1995/02/26/the-internet-bah.html Predictions are not predictable. Today I am not going to make any predictions that cannot be substantiated. For example: In 1995 Nicholas Negroponte, director of the MIT Media Lab said: We will soon buy books and newspapers straight over the Internet. Clifford STOLL said......Uh, sure. Yeah right! I can talk about the past, and I can talk about the present - but not the future of the virtual world...
• I'm uneasy about this most trendy and oversold community. • Visionaries see a future of o Telecommuting workers o Interactive libraries o Multimedia classrooms o Electronic town meetings o Virtual communities
Do our computer pundits lack all common sense? o The truth is: ♣ NO online database will replace your daily newspaper ♣ NO CD-ROM can take the place of a competent teacher ♣ NO computer network will change the way research occurs and education is delivered ♣ Computers and networks isolate us from one another ♣ … the Internet is one big ocean of unedited data, without any pretence of completeness
True enough it is new, exponentially growing and appears to attack us from every angle…but it is here to stay, at least in the short term. University medical schools have become obsessed with the Generational shift. Now, more than at any other time in history, the ‘older’ generation (me included) are spending time, money and effort to • Understand the younger generation • Develop programmes to deal with their specific ‘needs’ • Develop social software • Accelerate technological advancement • Pander to the ‘perceived’ needs of the Generation Y regimen
So we know about the internet We know that some people in Australia are using it... But do our IT department realise it exists?? The internet is amazing...but it’s use in health departments and hospitals can be restrictive... To ensure security is maintained health departments are blocking access to sites deemed inappropriate 1) Block inappropriate sites...in this case apple 2) Downgrade browsers...IE9 to 6.0 Unfortunately most of us will be moving into the Health System to do battle with the anti-progress department... Internet speeds slowed, computer RAM stolen http://lifeinthefastlane.com/2010/06/s-h-i-t-4-brains/
THANKFULLY - we have mobile technology top get around most of these problems Technological advancements iPhone - now with multi-tasking iPad - Revolutionary Useful for - collation, interpretation, education, iteration Ultrasound, Heart sound interpretation
The times they are a changin’ Technology has arrived The books kept walking from the department, so they were chained to the desk... Despite the introduction of mobile and hand held technology... http://lifeinthefastlane.com/2010/06/s-h-i-t-4-brains/
...but as well as technology having changed...so to have the medical students and the junior doctors... times have changed The Generations have changed Our needs, wants and desires have changed The baton of power has been handed to a new Generation - the Solar Powered RMO All past predictions, are just that - in the PAST The future knows no bounds ¥ Control what they want to see and how they want it displayed ¥ Explosion in Social Networking ¥ Increased user generated content ¥ Users changing the way they learn ¥ Individuals ‘take control of content’
What is this talk about Why is it important Why should I get involved I am very busy (an ever so important...) I don’t have the time - so are there any efficiencies we can introduce? What is the risk benefit ration Will my identity be stolen??
...so Lets get started on social media - here are the tools Social software - The animals of the jungle! Lets Bring you up to date with the animals of the social medicine jungle...IT IS SCARY Initially they look scary, WILD and untamed… But by gaining an understanding of what they are, why they have been built and how they can be used…we can move forward to a blissful UTOPIA of social software DOMESTICATION.
...just kidding Lets take some baby steps... Lets break up the problem of information overload, the mass of social software out there Lets divide the animals up into their genus
hospitals appear to be getting on board... They have chosen to use the simplest and most mainstream social software platforms... In the US at least http://ebennett.org/hsnl/ US hospital online presence Ed Bennett has analysed the hospital social media strategies for keeping the public informed and interacting with the staff and public using social media
Australian online presence We are starting... http://lifeinthefastlane.com/resources/aussie-hospital-social-network-list/
Then...there are the physicians... How many of the audience use Facebook...Twitter...Google Wave...Buzz EXACTLY Social Medicine in Australia - It’s a ZOO not a JUNGLE Australian social medicine jungle Australian view of the social media jungle Look but don’t touch
Based on recent report published in Med Teach Journal June 2010 – the figures for the Background: A wide range of social software has become readily available to young people. There is increasing interest in the exciting possibilities of using social software for undergraduate medical education. Aims: To identify the nature and extent of the use of social software by first year medical students. Method: A structured self-administered questionnaire survey of 212 students. Results: Over 90 percent used instant messaging and social networking sites were highly used (70 percent). There was no significant difference between males and females. Blogs were read by about a fifth of students and a small number (8%) wrote their own blogs. A fifth of males stated that they were users of media sharing and contributed to wikis. Social bookmarking was rarely used by either sex. Conclusion: Medical educators need to recognise the potential of social software in undergraduate medical education but it is essential that students maintain the informality and privacy of these sites. The challenge for all medical educators is how to integrate social software into current curricula and institutional Virtual Learning Environments (VLEs).
So lets break the Jungle down into the ANIMAL groups First lets look at the animals Learn the creatures habits: What does the creature like? How can it the animal be used to your advantage? How can this beast be used for good not evil… and how do you not get bitten (learn to protect yourself) Animals often travel in herds or groups and these groups include display certain specific characteristics. Over time in the jungle they have had to adapt to the changing environment and become synergistic with each other as communities (SHARING) Open Professional Networking (The ELEPHANTS) Define: • Never forget • Slow moving • Herds Examples: • Visual CV • LinkedIn • Zoominfo • Xing • Naymz Effectively they are your professional persona Your Google placeholder. The displacement factor. Get recommendations Share learning experience, demonstrate to employers what you can do and have done http://lifeinthefastlane.com/2009/04/physician-social-professional-networks/ http://lifeinthefastlane.com/2009/11/is-social-media-the-rocknroll-of-health care/
Animals often travel in herds or groups and these groups include display certain specific characteristics. Over time in the jungle they have had to adapt to the changing environment and become synergistic with each other as communities (SHARING) 2. Closed Networking: Doctor to Doctor (peer to peer) networking In isolation Squirrel: Furtive, isolated, slow, dull, introverted, closed One track mind (his nuts)
3. Open Social Networking Professional...to closed introverted groups...now loud talkative members... Monkey : Loud, talkative, chatter, friendly, open, inquisitive
4. Social Sharing Groups - Social bookmarking Reddit, Delicious, Diigo, Digg Meerkat : Outstanding vision, protective, sharing – sense of community Always on the lookout for danger and interesting stuff Curious
5. The Vibrant colour of the jungle The Parrot Lifestreaming Digital Media – The EYES of the Jungle • Flickr • Picassa • YouTube • Vimeo
Oddly enough...starting to run out of social software analogies at this point... The Observation Platform from which to view the seething throng of the jungle animals Platforms ever changing to incorporate enhanced user experience such as Safari, Explorer, Chrome, FF,
All the animals need to feed Feed distributions include Google reader, podcasts, feedly
Blogging Multiple blogging platforms
How do we define the ‘ blogging ecosystem ‘ Let me take you 10 years into the future… The books have gone…We no longer have to shred the forests to read… The blogging organism requires a few essential elements to survive, develop and grow. As with any living plant the essential elements for growth include sunlight, water, nutrients and a stable environment. http://lifeinthefastlane.com/2009/01/twitter-essential-blog-nutrient/ http://lifeinthefastlane.com/2009/09/the-library-and-the-ecosystem/
Sunlight : A diffuse and radiant energy – your readership . Every blog requires some semblance of light to grow. Increased growth will spread the blogs branches tall and create a canopy. However this canopy (being essentially phototropic) can sway towards the readership desires – beware the angry venters!
Water : Environmental news sources, news feeds, information aggregators, RSS feeds
Information Mulch : The combination of organic material [life experience] with water [environmental news resources] in shaded conditions [thinking time] – creates the ‘information mulch’
Decomposers : The natural decomposers on the forrest floor are the Twitts and the Tweeple – these are not your normal readership – these are friends in feed . They are natural decomposers of information able to rationalize good content, break down longer posts or hefty journal articles and provide shortened, pre-digested pearls of information…’nutrients and humus ‘ Nutri ents : [Ma cronutrients and micronutrients] Essentially the tweeple [consumers and decomposers] are able to disaggregate and disambiguate to ‘enrich the soil’ and ‘stabilize the mulch’- they are the ‘catalysts of the blogging ecosystem and produce ‘tweets’ and ‘twitterings’ – the essential aggregated macronutrient for a blossoming blog.
I write a number of blogs using various platforms... Ensure you are able to SEPARATE personal from professional Posterous and Wordpress are my favourite It is important to have a balance between the two, just as it is important to balance your work and social life and your social and professional networking http://lifeinthefastlane.com/ http://sunandsmiles.com/
AN EXAMPLE OF USE: Example of what you can do... In the audience...a blogger walks amongst you Shikta Dey is a 3rd year medical student at the University of New South Wales Stumble Upon, Facebook, twitter and Blog Stumble Upon and shared information
If you are going to blog...here is some advice... Advice to bloggers 1) Write as if your boss and your patients are reading your blog every day • Find the proper balance between your use of social media and your other work. - Do not blog anonymously . List your name and contact information. - If your blog is work-related, it is probably better to let your employer know. - Inquire if there are any blogging guidelines. If there are, comply with them strictly. - Use a disclaimer, e.g. &quot; All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice.&quot; - Get your blog accredited by the Heath on the Net Foundation • Be transparen t and authentic; • Be responsible for what you write; • Be authentic and consider your audience; • Protect confidential and proprietary information; • Post factual, meaningful and courteous comments; • Use common sense and common courtesy;
What is the value in a blog? Can I trust the information?
USING THE ENVIRONMENT To survive in the jungle we must adapt With the exponential growth in technological awareness and availability and the explosion of social software, so a unique opportunity arises to deliver even more education through multimedia Listen to the sounds of the jungle Watch, learn, re-watch, iterate... Remember the ABC of digital medicine - Airway Breathing Camera There is always a unique learning experience around every corner...not just for you, your peers and your supervisors...but there to be shared with the world This has led to the birth of the TED talks and organisations such as Academic Earth TED Talks - TECHNOLOGY, ENTERTAINMENT, DESIGN Not for profit organisation Amazing speakers on unique ideas worth spreading Academic Earth - Online degrees and video courses from leading universities Including Medicine and Healthcare Watch the lecture, download the podcast, share with friends, read the transcript Grade the course From Universities such as Stanford, Yale, Harvard, NYU, Oxford, MIT Education is the GIFT - that just keeps GIVING
Education continues through technology and with the Gen Y so called Learned Resourcefulness You are all here for education? Right? What else would you be here for? So I have had a chat with the Deans of the Universities and we thought it would be a great opportunity to see which of the sober medical students has actually learned anything at medical school so far... We have agreed to come up with a challenge for all of you Six simple questions to Get that competitive spirit going Thanks to the guys at MCQexams.com, Elsevier and the FutureHealth web development team So we have a challenge!! http://FutureHealth.com.au/ http://MCQexams.com/ Times have changed The ed ucation delivered has changed, the mode of delivery has changed, expectations have changed, courses have changed...but the patients have not. Since the introduction of PBL there has been a steady decline in the provision of anatomy in education. Relying on alternative education resources, and the provision of enhanced self-learning packages to assess.... mcqexams.com ONE of the craziest and most counter-intuitive moves ever made was the decision about 25 years ago (coincidentally, shortly before my oldest child was to start school) to drop grammar and spelling from the primary school curriculum. At the time, I was horrified, but the education department boffins were convinced they were right and would not listen to the protests of parents with a different view. This left a group of children with motivated parents to conduct covert grammar and spelling tuition at home while the remainder were destined to become semi-literate, relying on the future invention of spellcheck on their yet-to-be-invented home computers to cover their deficiencies. It is difficult to imagine a life devoid of past participles and the future perfect, so ingrained in my early understanding of language was the development of a grammatical vocabulary. I must say I have exactly the same thoughts about the medical schools that decided in their infinite wisdom to severely curtail the teaching of anatomy. A study of anatomy teaching recently found that some Australian medical schools provided as few as 56 hours of anatomy tuition over a five-year course, while others provided 10 times as much over six years (ANZ Journal of Surgery 2010;80:212-16). As well as showing a marked historical decline in teaching of anatomy, the survey also showed that more than half of Australian medical schools did not even examine students in the subject. I cannot imagine practising medicine without a solid background in anatomy. Learning it was intense and tough, but it left us with a detailed brain map of what lies under the surface when our patients present with their descriptions of symptoms and a vocabulary for communicating with our colleagues across other specialties. I acknowledge that I rarely need to plumb the recesses of my undergraduate memory to summon up the mnemonic for the tributaries of the inferior vena cava (“I Like To Rise So High”). But I do know one exists, and I do have a reasonable concept of where all of the bits go and what they do. I was thrilled to see that popular culture has provided a new mnemonic for the cranial nerves with deference to Harry Potter: Oh, Oh, Oh, They Travelled And Found Voldemort Guarding Very Ancient/(Secret) Horcruxes. You might as well be off hunting for ancient horcruxes if you are trying to follow the demonstration of a surgical technique without knowing the names and locations of the body parts involved. They might as well be speaking Parseltongue. An Australian medical graduate should have a comprehensive knowledge of and vocabulary for the structure and function of the human body. Graduating doctors without that knowledge would be like asking me to look under the bonnet of my car and fix the carburettor. I expect my auto mechanic to know exactly where it is and what it does, what it is connected to and what needs to be done to fix it if there is a problem. Our patients expect us to know where their parts are, what they do, what they are connected to and what needs to be done to fix them when there is a problem. There have been calls for a standardised national curriculum and perhaps even a standardised national examination for anatomy, and I couldn’t agree more. It should be a matter of urgency for all medical schools before the next student intake, with the unanimous backing of the specialist colleges. It won’t happen by just waving a magic wand.
Back to the serious stuff.... Understanding the jungle animals! Twitter has analytics 1) Now up to 50M tweets per day 2) Commonest age group is 18-34...young professionals 3) We can monitor when, and why people tweet. People tweet after earthquakes, natural disasters etc 4) TPS: New phenomenon with the Tweet-o-meter 5) Located predominantly in NSW>VIC>QLD... .then Tasmania (so close they only have to shout ) 3500 TPS for the ‘goal’ that never was England versus Germany Sitting on your couch watching the soccer alone? - not any more, now you have twitter to talk to, to converse with and to watch the tidal developments, flux and flow of opinion - REAL TIME PROBLEM : Out of the 50M tweets per day...how many will actually help you? How many will hinder you?
Is twitter really all it is cracked up to be?? Certainly there are a lot of users on the books, all signed up and raring to go... But who are they and what do they actually do and say?
Facebook has more than 400 million active users and an average user has 130 friends. Within Australia, Facebook is currently the most used social media site with nearly 8 million monthly active users, although only 1 million of these are under 18 years old Twitter is on the rise, but MOST Australians are now able to use cross platform social media to sign in to multiple accounts and interact...
Facebook and the big players have now responded with increased privacy restrictions http://www.facebook.com/privacy/explanation.php http://www.allfacebook.com/2009/02/facebook-pri vacy/ http://youtubeaublog.blogspot.com/2010/06/more -choice-for-users-unlisted-videos.html
...but that still doesn’t stop you saying something completely STUPID
UNDERSTAND THE RISK MINIMIZE YOUR RISK Hospitals, physicians, and healthcare providers face new challenges that accompany the use of social media to network and communicate. Leads to a redefining of boundaries Patients may request to become friends on Facebook/twitter etc Patients then may have access to personal information and may be associated with inadvertent breach of confidentiality Lying down on the job...Seven UK doctors and nurses were suspended from their hospital after administrators discovered they had posted pictures on Facebook of themselves pretending to sleep on trolleys, in baths and on the helipad as part of the online craze, the Lying Down Game http://www.nejmjobs.org/career-resources/social-media-and-physicians.aspx http://www.medicalobserver.com.au/news/protecting-your-online-reputation
UNDERSTAND THE RISK to MINIMIZE YOUR RISK Egosurf to determine what information Google already has on you...you will be surprised! This will allow you to track down sources with unwanted information AFL footy players get a 2 week training session in managing the media...maybe medical students and physicians should as well... Aim to maximise the benefit of education delivery, and minimise the risk of social media exposure Having a defined online persona and determine the details you release Managing your persona can enhance the ability to define the boundaries between social and professional social medicine practices Remember that there are great ways to have a positive identifiable online persona - without having to befriend EVERYBODY, post Sexing messages, play STUPID games etc etc If you are going to be an idiot OFFLINE...you will probably be an idiot ONLINE
Understanding is half the battle... Your personal and professional persona’s had the same battle BEFORE social media came along...dating patients, sexually inappropriate behaviour etc etc Very much like everyday life - you are building a reputation, contacts and respect from peers..not patients Applying the same principles to your professional online presence will be of great benefit. because of the explosion in social media awareness, a partial/incomplete/poorly managed online presence will lead to WEEDS growing in your garden - very soon it will become overgrown and deifficult to manage...understand the context is the KEY
Take Home Message: Social Media is here to stay - at least for the short term As more businesses get involved, so the technology will be improved, the infrastructure will develop at pace and you will be rewarded with more time efficient learning strategies. Stretch your mind and your capabilities to beyond the classroom walls and into the jungle of social media - it is a walk well worth taking Get involved: Test your knowledge with the MCQ Exams Review your social standing Get LinkedIn Join me on some networks MESSAGE: Keep Safe – animals bite – know your enemy Don’t run Don’t be overwhelmed Beware the snake in the grass Embrace social medicine – it has lots of advantages Get involved in the conversation – tame the animals, grow trees, expand the jungle, live green, participate Social media is here to stay
EXAMPLE OF USE: Efficiency of information dissemination - Persona can take many forms AS LONG AS IT REALLY IS YOU The use of the HashTag Cross platform posting
Take Home Message: GET INVOLVED IT IS NOT THAT SCARY! Earn some cash and Become an Ambassador for Medical Students...(Pop in to the Elsevier stand to see Annabel to get in on the action) Read blogs, and make comments Start your own BLOG! Become part of the Open medical community in Australia If you see something you enjoy...use your networking structure to save, highlight, annotate, share, and disseminate... Use the Like Button, Stumble, Digg, Mixx, Fark...the more you explore, the greater the benefit will be... Use technology Embrace Social software Be Gen Y... Social Media is here to stay - at least for the short term As more businesses get involved, so the technology will be improved, the infrastructure will develop at pace and you will be rewarded with more time efficient learning strategies. Stretch your mind and your capabilities to beyond the classroom walls and into the jungle of social media - it is a walk well worth taking Get involved: Test your knowledge with the MCQ Exams Review your social standing Get LinkedIn Join me on some networks MESSAGE: Keep Safe – animals bite – know your enemy Don’t run Don’t be overwhelmed Beware the snake in the grass Embrace social medicine – it has lots of advantages Get involved in the conversation – tame the animals, grow trees, expand the jungle, live green, participate Social media is here to stay
The Internet....Bah! <ul><li>“I’m uneasy about
this trendy and oversold community” </li></ul><ul><li>“Visionaries of the future predict: </li></ul><ul><ul><li>Tele-commuting workers </li></ul></ul><ul><ul><li>Interactive libraries </li></ul></ul><ul><ul><li>Multimedia classrooms </li></ul></ul><ul><ul><li>Virtual communities” </li></ul></ul>BALONEY!
The Internet....Bah! <ul><li>“ Do our
computer pundits lack all common sense?” </li></ul><ul><li>“ The truth is: </li></ul><ul><ul><li>NO online database will replace your daily newspaper </li></ul></ul><ul><ul><li>NO CD-ROM will take the place of a competent teacher </li></ul></ul><ul><ul><li>NO computer network will change the way research occurs and education is delivered </li></ul></ul><ul><ul><li>Computers and networks isolate us from one another” </li></ul></ul>BALONEY!
Whirlwind Tour <ul><li>What is the
Internet? </li></ul><ul><li>What are the Technological advancements? </li></ul><ul><li>What is Social Software? </li></ul><ul><li>What is Social Medicine? </li></ul><ul><li>When does the bar open? </li></ul>
Iteration Education Knowledge maximal gain
minimal effort communication technology status updates Discussion Dissemination Socialnomics TRUST highly visual Computer savvy Learned resourcefulness impatient Expect MORE for LESS feel entitled work less hours for more money minimal input maximal gain Everywhere but nowhere Tweet’n’Treat Integration Consolidation Rationalisation Abbreviation Know enough, not enough Information highway rapid response visual stimulation short attention span channel surfing Solar powered RMO
Social Medicine <ul><li>What is Social
Medicine? </li></ul><ul><li>Why is it important? </li></ul><ul><li>Why should I get involved? </li></ul><ul><li>How do I evaluate the risks? </li></ul><ul><li>How do I protect my identity? </li></ul><ul><li>Isn’t social media just another time-wasting FAD? </li></ul>
Blogging Advice <ul><li>Write as if
your boss and your patients are reading your blog every day </li></ul><ul><li>Do not BLOG anonymously </li></ul><ul><li>Let your employer know (if blog work related) </li></ul><ul><li>Use a disclaimer </li></ul><ul><li>Be transparent and authentic with common sense and courtesy </li></ul><ul><li>Ethical and Confidential - Obtain patient consent for any identifiable images or case study </li></ul><ul><ul><li>Get accredited by the Health on the Net Foundation </li></ul></ul>
You may take a wrong
turn along the way... Virtual World ...but it happens in the real world as well Searching for quality peer reviewed education in the
Pitfalls in Social Medicine <ul><li>Redefine
boundaries </li></ul><ul><li>Patients requesting to become friends </li></ul><ul><li>Inadvertent breach of confidentiality </li></ul><ul><li>You are what you tweet </li></ul><ul><li>Lying down on the job... </li></ul><ul><li>Understand the Risk to Minimise the risk </li></ul>http://www.nejmjobs.org/career-resources/social-media-and-physicians.aspx http://www.medicalobserver.com.au/news/protecting-your-online-reputation
Tips and Tricks <ul><li>Egosurf </li></ul><ul><li>Review
your privacy settings </li></ul><ul><li>Define boundaries between social and professional medicine </li></ul><ul><li>Risk/benefit analysis </li></ul><ul><li>If you are an idiot OFFLINE, chances are you will be an idiot ONLINE </li></ul>
My Advice <ul><li>Social media is
here to stay (for now) </li></ul><ul><li>Take advantage of its great educational offerings </li></ul><ul><ul><li>Passive: Understand/watch/listen/observe </li></ul></ul><ul><ul><li>Active: Tag/blog/like/stumble/annotate </li></ul></ul><ul><li>Social bookmarking </li></ul><ul><li>Social and professional networking </li></ul>