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Using wikis to promote the personal and professional development of undergraduate medical students: a report for the CETL in Developing Professionalism.
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Using wikis to promote the personal and professional development of undergraduate medical students: a report for the CETL in Developing Professionalism.


Cite this report as: Varga-Atkins, T; Dangerfield, P; with contributions from Bunyan, N; McKinnell, S; Ralph, M; Brigden, D and Williams D (2009) Using wikis to promote the personal and professional …

Cite this report as: Varga-Atkins, T; Dangerfield, P; with contributions from Bunyan, N; McKinnell, S; Ralph, M; Brigden, D and Williams D (2009) Using wikis to promote the personal and professional development of undergraduate medical students: a report for the CETL in Developing Professionalism. Liverpool: University of Liverpool.

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  • 1. Using wikis to promotethe personal and professional development of undergraduate medical students: a report for the CETL in Developing Professionalism February 2009
  • 2. This project has been funded by the CETL Fellowships funding at the CETL in Developing Professionalism, University of Liverpool. Website: leader: Dr Peter Dangerfield School of Medical Education University of Liverpool, Sherrington Buildings, Ashton Street Liverpool L69 3GE Phone: 44 (0) 151 794 5502Project researcher: Tünde Varga-Atkins Educational Development, Centre for Lifelong Learning University of Liverpool, 128 Mount Pleasant, Liverpool L69 3GW Phone: 44 (0) 151 794 1180With contributions from: Dr David Brigden, PBL facilitator Nick Bunyan, Learning Technologist Dr Steve McKinnell, PBL facilitator Martin Ralph, Blackboard and Learning Technology Coordinator Dr David Williams, PBL facilitatorCover design: Robin SellersWiki logo design: Paul DuvallAcknowledgements: We would like to thank the contributions of all those2007/08 first-year undergraduate MBCHB students at the University of Liverpool who tookpart in this pilot and offered their own time to give feedback.Please cite this report as:Dangerfield, P; Varga-Atkins, T with contributions from Bunyan, N; McKinnell, S; Ralph, M;Brigden, D and Williams D (2009) Using wikis to promote the personal and professionaldevelopment of undergraduate medical students: a report for the CETL in DevelopingProfessionalism. Liverpool: University of Liverpool.
  • 3. Using wikis to promote the personal and professional development of UG medical studentsExecutive Summary ...................................................................................................................................... 7Key terms and abbreviations ...................................................................................................................... 101. Introduction: professionalism and web2.0 technologies ..................................................................... 11 1.1 Originality ......................................................................................................................................... 13 1.2 Scope and limitations of the report ................................................................................................... 13 1.3 Report structure ............................................................................................................................... 132. Aims ................................................................................................................................................... 143. Methodology ...................................................................................................................................... 144. Findings: the learning context ............................................................................................................. 16 4.1 Student engagement in the wikis ...................................................................................................... 185. The benefits of using wikis for students’ development of professionalism .......................................... 21 5. 1 Wikis as a shared resource and knowledge-base .............................................................................. 22 5.2 Wikis as online spaces for developing identity as a professional ........................................................ 246. Teaching & learning, technical and managerial issues of using wikis.................................................... 27 6.1 Teaching and learning issues ............................................................................................................. 27 6.2 Technical issues ................................................................................................................................ 32 6.3 Managerial issues ............................................................................................................................. 337. Project summary and outcomes.......................................................................................................... 38 7.1 Project summary ............................................................................................................................... 38 7.2 Project outcomes .............................................................................................................................. 398. Conclusion and recommendations ...................................................................................................... 43 8.1 Recommendations for the development of professionalism.............................................................. 43 8.2 Recommendations for the future implementation of wikis ............................................................... 43 8.3 Further research ............................................................................................................................... 449. Project impact .................................................................................................................................... 45References ................................................................................................................................................. 46 5
  • 4. Using wikis to promote the personal and professional development of UG medical students 6
  • 5. Using wikis to promote the personal and professional development of UG medical studentsExecutive SummaryIntroductionThe purpose of the study was to introduce wikis in a problem-based learning context and explorehow this web2.0 technology may be used to enhance medical students’ learning in a blendedenvironment, especially relating to their development of professionalism.AimsThe research questions were: to what extent the use of wikis can enhance student learning in the area of students’ personal and professional development; what are the facilitators and barriers to student learning in professional and personal development, in particular, those associated with the use of such technology?MethodsThe use of wikis was piloted with four first-year problem-based learning groups (32 medicalstudents) at the University of Liverpool. The study took an interpretivist approach gatheringqualitative data in the form of focus groups and a small-scale survey on the perceptions of theparticipants as to their self-assessed impact of the pilot on their personal and professionaldevelopment. Triangulation of methods involved both students, as well as their facilitators, in thedata collection, combined with online system statistics. Transcripts of the focus group sessions wereanalysed using thematic content analysis.Findings The problem-based learning (PBL) groups were an important part of students’ learning, both academically and socially. Students displayed a range of collaboration patterns in-between PBL sessions, including offline and online modes such as informal chatting, using online social networks, email and phone calls. Students demonstrated a range of engagement patterns in the wiki, some posted contributions, some only viewed others’ posts and some did not log on at all. Students most frequently posted web links to the wikis.BenefitsThere were two main ways in which wikis were beneficial to medical students’ learning in a problem-based learning context: Wikis acted as a shared resource and knowledge-base with students being able to share their identified learning resources which answered their identified learning objectives on personal and professional development in-between their face-to-face sessions. Wikis promoted students’ development as a reflective professional by having to think about the quality of resources that they contributed to the shared wiki space. This reflection, in turn, then had the benefit of creating an online identity, which promoted students’ sense of developing professionalism through interacting in a more formal, online space. 7
  • 6. Using wikis to promote the personal and professional development of UG medical studentsFacilitators and barriersFacilitators and barriers which influenced student engagement with the wikis have been identifiedas: Those students who were more aware of what the purpose of wikis was, were more likely to engage with them. The trusted, safe environment of private, small-group wikis was seen more conducive to student participation than large-group wikis, as students claimed to be more confident in making postings to a private wiki. Positive group dynamics were an important indicator for students’ engagement. Members of effective groups were more likely to share their resources both face-to-face and online. As no one wanted to be the first to post in a wiki, a wiki pre-populated with some resources and links on personal and professional development was seen as encouraging to students. Confidence in one’s own information skills facilitated engagement. Where students were unsure about the reliability or the quality of the resource they found, they were less likely to post it. Some students found their current methods of learning ‘good enough’. They lacked motivation to use wikis in order to share their learning. A number of students found the wiki tool’s interface as ‘plain’ and ‘boring’, especially in comparison with online networking sites such as Facebook. This directly hindered their engagement. More importantly, the lack of alert-function in the examined wiki tool meant that students were not notified when new postings were made in their group wiki. This made it more difficult for students to engage; students were used to the comfort of their online social networking sites (Facebook) alerting them about group member activities. Hands-on demonstration of the wiki tool was preferred to written guidance. The history function of the wiki was less known to students. This knowledge may have helped those less confident in making contributions when they were unsure about the quality of resources to be posted.ScalabilityThe report highlighted a number of issues with regards to scalability of the pilot. These included: Access and privacy: who has read/write access to the wiki? The remit of the wiki: what is the remit of contributions? Wiki lifecycle: can future students use the wiki and its contributions? Wiki functionality: what functions does the tool have? Support needs and resources: how to balance benefits versus support needs?RecommendationsA set of recommendations on the future implementation of similar projects included: Making pre-loaded resources on professionalism available in the wikis, where possible, quality-assured by staff. Introducing the various purposes of wikis to students (from sharing resources to discussion/questions forum) and negotiate their use based on their preferences as awareness of purpose seemed to increase engagement. 8
  • 7. Using wikis to promote the personal and professional development of UG medical students Drawing attention of students to how participation in online collaborative spaces may be relevant in their future career, e.g. by introducing them to other online professional spaces and showing them examples of practitioners communicating online. Considering other wiki tools which have an alert system, a user-friendly interface and flexible access-rights functionality. Considering a two-level wiki which consists of small private group areas and a joint year- group area. Creating a trusting environment to overcome the issue of student confidence when posting to the wiki.Further researchThe study has also identified further areas of research including: The benefits and issues that may arise when the pilot is scaled up to a whole year group; the benefits and issues that may arise when students use wikis over successive academic years in the form of a long-term study; the role of the moderator in the wiki; the appropriateness of other tools which may serve a similar purpose to wikis (e.g. social bookmarking).Project impactThe study has contributed to the scarce evidence-base on the use of web2.0 technologies in medicaleducation and identified both practical issues for the future implementation of similar projects aswell as further areas for research. 9
  • 8. Using wikis to promote the personal and professional development of UG medical studentsKey terms and abbreviationsKey termsProblem-based learning Problem-based learning in this report refers to a student-centred method of learning in which students collaboratively solve problems, identify their learning objectives, seek and evaluate relevant learning resources and reflect on their experiences.Professionalism Defining professionalism would be the remit of a whole project. Thus without attempting to offer a finite definition, professionalism will be used to refer here to the individual who possesses the knowledge and skills that enables them to join the medical profession as well as a high standard of work ethics, behaviour and attitude. One essential characteristic of a ‘professional’ is their ability to reflect on their own learning, attitudes and behaviour.Web2.0 tools/technologies Second generation web (or web2.0) tools or technologies are user-centred tools based around collaboration and sharing. Examples include multimedia sharing sites (YouTube, Flickr), social networking sites (Facebook), wikis and blogs etc.Wikis Wikis are web2.0 tools; they are public or private websites that allow the non-technical user, or groups of users, to write, edit and update web content easily. Wikipedia is one example of a public wiki.AbbreviationsCETL Centre for Excellence in Teaching and LearningICT Information and Communication TechnologiesPBL Problem-Based Learning 10
  • 9. Using wikis to promote the personal and professional development of UG medical students 1. Introduction: professionalism and web2.0 technologiesThis chapter introduces today’s healthcare context and the role of professionalism, describes whatweb2.0 technologies, especially wikis, are – together with the rationale for the study which tests theuse of wikis in the development of professionalism with medical students. It describes the originalityof the study, its limitations and the report structure.The purpose of the study was to introduce wikis in a problem-based learning context and explorehow this web2.0 technology may be used to enhance medical students’ learning in a blendedenvironment, especially relating to students’ development of professionalism.Professionalism has an important role in the current healthcare context. Today’s medical studentsnot only need to acquire knowledge and skills but also develop professional attitudes and behaviour(GMC 2001, 2003), and so acquiring a new identity as a doctor or medical professional (Wagner et al2007). Practising professionals are increasingly employing and relying on technologies that sharepatient information, interacting with institutional computer systems, seeking information orparticipating in online communities for their own professional development. Recent years have alsoseen a greater emphasis on collaboration in the UK healthcare system, with healthcare beingdelivered through practitioners working in teams with their own and other professions. Thesechanges towards the importance of collaboration have been taking place in parallel with the adventof a new group of technologies, also called as ‘web2.0’ tools (Figure 1).Figure 1 Examples and characteristics of web2.0 tools‘Web2.0’, or ‘second generation’ tools: are highly collaborative; are easy-to-use; users do not need to have technical expertise or web design skills; include social networking sites (e.g. Facebook, MySPace), wikis (e.g. Wikipedia), blogs (web diaries), social bookmarking (e.g. etc. 11
  • 10. Using wikis to promote the personal and professional development of UG medical studentsWikis, the technology used in this study, are one example of web2.0 tools. Wikis are collaborativewebsites. They allow a public or a private group to collaborate on web content, documents andmultimedia resources and build up a shared resource to which all the group members cancontribute. An important feature of a wiki is its history function, which displays users’ contributionsin chronological order, with an option to revert to previous versions, if necessary. All these featuresmake wikis a potentially useful tool for student learning.The rationale for this study was to pilot the use of a particular web2.0 technology, wikis, in medicaleducation. The characteristics of medical undergraduate students, the curricular context of problem-based learning and the nature of wikis all converged to this end. Various current research dealingwith today’s generation of students (also called the ‘NetGeneration’) has found that students relyheavily on the web and information technologies both in their studies and, even more so, in theirsocial lives (Conole et al 2006). A recent survey revealed that over ninety percent of students usesocial networking and about fifty percent are users of blogs and wikis (JISC/IPSOS MORI 2008). Thatonline social interactions take central place in students’ lives has been shown by other studies too(see e.g. Sandars and Morrison 2008). This is further evidenced by the growth in the use of theseweb2.0 tools in the last two years (Kennedy et al 2008).The problem-based context in which this study was introduced is based around students negotiatingtheir own learning objectives, needing to draw on their information literacy skills in locating,synthesising and evaluating resources to fulfil these objectives. Students then integrate these withtheir prior knowledge and share their understandings within their problem-based learning groups.Learning about professionalism (at least at the location of the study, the University of Liverpool) isone explicit strand of these identifiable learning objectives. As Cruess and Cruess (2006) argue, muchof learning about professionalism is based on socialisation and interactions with the peer groupbeing an important source of learning for these students (Sandars and Morrison 2008). Theprinciples of interactions, socialisation and peer collaboration are essential characteristics of web2.0technologies. Studies have also shown that students are more likely to employ these tools in theirsocial interactions and are less aware of their potential for their studies (Trinder et al 2008; Boulos etal 2006).How wikis may benefit students’ learning has been described by other studies. One such studyargues that the collaborative nature of wikis, i.e. that students can edit and comment on pagescreated by others, facilitates group work in an online environment (Doolan 2007) and these peercontributions help students by ‘regulating one another’s learning through online technologies’(Boulos et al 2006). Learning about professionalism requires students to think critically, reflect, makelinks and structure their ideas. Studies have found that the asynchronous nature of the tool as wellas its organically growing structure, which students need to manage, can be linked to increasedreflectivity (Nicol et al 2005). In the context of this study focusing on students’ learning aboutprofessionalism, students would not only see where others are up to in their own thinking throughtheir wiki contributions, but how others develop theirs, jointly constructing their understandingsaround themes of professionalism. Thus, introducing web2.0/wiki technology in a problem-basedlearning context seemed pertinent in exploiting the collaborative potential of this online tool, as wellas responding to the cultural gap between students’ and their educational institution’s use ofweb2.0 technologies (Trinder et al 2008). In particular, McGee and Begg (2008) recognised the 12
  • 11. Using wikis to promote the personal and professional development of UG medical studentspossibilities offered by wikis for students to add information and materials relevant to their ownlearning aims to small group wikis and hence to contribute to their learning.1.1 OriginalityAlthough the use of wikis is getting more and more widespread in teaching and learning, their usehas been mainly reported from disciplines other than medical education (such as architecture,engineering, media etc.) (e.g. Rick and Guzdial 2006). The originality of the proposed study was dueto the lack of research evidence available from within medical education on the use of wikis. Thestudy aimed to close this gap. It aimed to combine the strengths of this technology for the pedagogiccontext in medical education and make available the valuable lessons learned not just about how ICTcan enhance student learning, but how such methods can be effectively designed and delivered tostudents. Whilst the project offered insights into the use of wikis in a medical PBL context, otherdisciplines which also use PBL may also benefit from this approach.1.2 Scope and limitations of the reportThis report aims to capture the outcomes of introducing the use of wikis in a first year medicalcontext. It reports on an innovative and experimental pilot during which a range of data wascollected and analysed to ensure the rigour of findings. Nonetheless, the report and its findings areconstrained to some extent by limitations such as the small scale of the pilot as well as the relativelyshort timescale in which it was conducted. In this sense, the hope is that this study has been able toilluminate the various opportunities and issues that can, and have, arisen through the introductionof such innovative technologies. Whilst the authors are also mindful that the technology employed isconstantly evolving.1.3 Report structureThe remaining chapters of the report is organised as follows: Chapter 2 – describes the aims of the study; Chapter 3 – introduces the methodology; Chapter 4 – elaborates the learning context; Chapter 5 – summarises the benefits of using wikis in student learning on professionalism; Chapter 6 – details the various teaching and learning, technical and managerial issues of the implementation, with special reference to the scalability of the pilot; Chapter 7 – summarises and discusses the project findings; Chapter 8 – concludes the study with recommendations; and finally, Chapter 9 – highlights project outcomes. 13
  • 12. Using wikis to promote the personal and professional development of UG medical students 2. AimsThe research questions of the project were: • to what extent the use of wikis can enhance student learning in the area of students’ personal and professional development; • what are the facilitators and barriers to student learning in professional and personal development, in particular, those associated with the use of such technology? 3. MethodologyThe use of wikis was piloted at one institution, the University of Liverpool, where problem-basedlearning (PBL) sessions provide the main vehicle for medical students to acquire the knowledge-baseof the ‘core curriculum’. Students each week had to identify a set of learning objectives from theirproblem-based scenario related to personal and professional development (PPD), which they thenneeded to research.Figure 2 A problem-based learning session - identifying learning objectivesThe study was carried out with ethical approval from the University. Four PBL groups involving 32first-year medical students were selected on the basis of the facilitators volunteering to take part.Once the facilitators’ and the groups’ approvals were received, a group-wiki was set up for eachgroup on the aspects of personal and professional development for each PBL scenario underdiscussion.1The wiki tool used for the project was TeamsLX, the tool available in the institutional virtual learningenvironment, Blackboard. Each student was introduced to the project at the first PBL session in thesecond semester. They all received a printed guide describing how they could use and interact withthe tool. One wiki was set up for each module and group so that only the group’s members and thefacilitators could access the wiki. Students used the wikis to share resources or ask questions relatingto these learning objectives on professional development (they also had the option to relate them tothe other strands of objectives such as ‘structure and function’ etc.).1 Each two-week module is based around an imaginary clinical scenario, from which the PBL group deriveslearning objectives. From each scenario, students are expected to identify learning objectives under the fourcurricular themes - Structure and Function (SF); Individuals, Groups and Society (IGS); Population Perspective(PP); and Professional and Personal Development (PPD). 14
  • 13. Using wikis to promote the personal and professional development of UG medical studentsEach wiki was pre-structured but students were informed that they could develop their ownstructure should they wish to. Due to the short timescale of the pilot, the use of wikis involved adiscrete medical learning scenario (from conception to birth) spanning a four-week period in theirsecond semester (Feb-April 2008). This meant that two wikis per group were set up initially. As thewiki pilot was extended for a further three modules until May 2008, a further three wikis werecreated for each group.With such a small, exploratory study it was important to look, not for immediate changes instudents’ assessed performance, but at their views, attitudes and behaviours about their ownlearning experience. Hence the study took an interpretivist approach using qualitative data to informdevelopments in the use of the tool as well as collect perceptions of the participants as to their self-assessed impact of the pilot on their personal and professional development. Tutors’ perceptions asto the professionalism-related learning outcomes of students were also collected and comparedwith those of students.Triangulation of methods ensured that research findings were checked against one another byinvolving both students and tutors in the data collection, combined with system statistics on the useof the tools (such as access and student contributions). Each participating student was given a briefquestionnaire at one of the PBL sessions with a confidential return envelope. Altogether eightquestionnaires were returned (25% response rate). A focus group session, with a free-lunchincentive, was arranged at which students could return the questionnaires and discuss their projectexperiences. Eight students took part in the focus group, predominantly from one PBL group. Thismay have showed some bias in that the participants were amongst the keenest who also workedwell as a group (see Section 6.1 on group work and sharing).In order to boost data collection and minimise this bias, the other groups were also followed up andthree further, brief, focus groups were set up with the participating student groups in March/April2008. A follow-up focus group with two of the groups were arranged at the end of May 2008 so thatstudent reflections could be gained after a more extended period of wiki use from the participatingstudents. Interviews were also conducted with two of the three tutors who facilitated theparticipating PBL groups in order to gain their perspectives on the student learning experience andproject outcomes.The focus group sessions were transcribed. These transcripts and the qualitative survey data were allanalysed using thematic content analysis. Frequency tables of the survey data were also prepared.Being mindful of the limited response rate and potential bias in representation, this small-scalequantitative data has therefore only been used as illustrative of student experiences in the projectcomplementing the qualitative analysis. 15
  • 14. Using wikis to promote the personal and professional development of UG medical students 4. Findings: the learning contextThis chapter contextualises the research findings by describing students’ learning patternsand perceptions of professionalism and concludes with the project findings in terms of howstudents engaged with, and interacted in, the wikis made available to them.It was important for the research to locate students’ experiences with this new technology byplacing it in the context of their overall learning experience. Therefore, the study gathered data onstudents’ learning patterns within the problem-based learning context, which also included theironline behaviour within and outside the course requirements. Since the purpose of the study was tolook at how the use of web2.0 technologies may enhance students’ learning on professionalism,students’ perceptions of professionalism were also elicited. Finally, online observation of how thedifferent student groups engaged with their wiki is summarised. All these contextual data served asthe basis for the discussion and analysis of project outcomes in subsequent chapters. The students’learning experience is considered first.With regard to the first-year students who took part in the pilot study, the problem-based (PBL)learning group to which they belonged, seemed to be an important part of their learning experience.Not only educationally, but through the social bonds, friendships that they have made wereimportant in providing a safe, trusted learning environment where their confidence as universitystudents and would-be-professionals grew. Students frequently mentioned that these peer-groupinteractions were particularly useful at the initial stages of their course when they were ‘feeling theirway’ around the university, “double-check*ing+ yourself with the group as you go along” (FocusGroup 3).Students also talked about developing various strategies and patterns of learning in the firstsemester, which helped them with the shift from school to university. These included working outwhich resources were useful to consult, including resources in the institution’s virtual learningenvironment, Blackboard: “It’s like you know *that+ for S+F *structure and function+ you use this textbook, for PPD [personal and professional development] you use that textbook, use the internet for this, then you do that and it’s just getting … your efficient habits.” Focus Group 3As far as collaboration between the problem-based learning sessions was concerned, students’behaviour tended to vary. Some collaborated in various forms with one another, whilst others didnot necessarily draw on members of the group. Those who collaborated tended to do so via face-to-face and online methods, the latter including social networking, email, telephone and instantmessaging. Sharing resources, such as web links and books, were predominantly an unplanned andincidental aspect of these personal interactions, both face-to-face and online (McGee and Begg2008). 16
  • 15. Using wikis to promote the personal and professional development of UG medical studentsFigure 3 Students range of learning patterns in-between PBL sessionsOne way that students interacted and shared resources online was setting up online socialnetworking groups in Facebook2 for their PBL group; this was particularly the case in the firstsemester when social bonds were forming. Out of the four PBL groups in the second semester, whenthe pilot was conducted, only one formed an online social network on Facebook for their group. Arecurrent theme was how students differentiated between their social and academic (“work”) livesand did not like the two to get mixed up with one another: “if with PBL when you are sharing information, you are just sharing it. But if it’s *VLE/wiki+ like, it seems like it’s work!”Confirming the findings of other studies (e.g. Trinder et al 2008), this study’s students also preferredto keep their social and academic spheres separate. They preferred to interact socially in theirunmonitored, informal online social networks and conduct their academic learning – anything“work-related” – in the institutionally provided space of the virtual learning environment: “I would be more likely to put things on that [wiki] or look at [the wiki] the same time as going on VITAL to check my emails because it is work. On Facebook, I just want to check what other people are up to or talk to other people.” (Focus Group 1)As far as students’ ICT (information and communications technology) context was concerned, moststudents claimed that they were relatively confident with ICT and most had their own PCs or laptops.Students’ perceptions of professionalism were also elicited in the study. The small-scale survey datashowed that students claimed to understand the concept of professionalism in general and inmedicine, and understood what personal and professional development was. They also viewed theproblem-based learning process positively in that it raised their awareness of professionaldevelopment and, in the majority, their interest in ethical issues. Focus-group discussions elaboratedthe picture of their perceptions. When asked about what professionalism meant to them, studentsresponded with a few typical answers such as: “careers. What’s the role of GPs. Job descriptions.”2 17
  • 16. Using wikis to promote the personal and professional development of UG medical studentsThis response indicated a narrow view of professionalism, i.e. the boundaries of job roles and careerpaths. Other students had a more formed, complex view of professionalism (Jha et al 2006), such as: “Professionalism is the process of tackling daily activities in a serious manner alongside the application of the related principles, laws and ethics of the profession.” (survey response).In one instance, a student articulated: “Professionalism is not something you can learn over the internet. It’s a social skill. It’s a lifestyle.” (Focus Group 1)These different perceptions of professionalism could be attributed to the different strategies thatstudents employed in their learning about professionalism. Those students who mainly identifiedprofessionalism with the learning objectives related to personal and professional development,which tended to be job roles, seemed more likely to have a more narrow interpretation of it. Whilstother students, who associated professionalism with other aspects of their medical career such asattitudes, behaviour and interactions had a more developed, holistic view of it.Key points – Findings: the learning context The problem-based learning (PBL) groups were an important part of students’ learning, both academically and socially. Students displayed a range of collaboration patterns in-between PBL sessions, including offline and online modes such as informal chatting, using online social networks, email and phone calls. Students preferred to keep their social and work spaces separate. Therefore, when it came to ‘doing work’, they did not want this to encroach in their private online social networking spaces; they were happy to work in the institutionally provided wikis and virtual learning environment. Students demonstrated a range of perceptions with regards to professionalism, from seeing professionalism as purely concerned with job roles, through to more developed understandings.What follows next is a description of project findings with regards to how students engaged in thewikis which were set up for them on a voluntary basis.4.1 Student engagement in the wikisA private wiki was set up for each problem-based learning group for each of the two modules, whichspanned four weeks (Figure 4). 18
  • 17. Using wikis to promote the personal and professional development of UG medical studentsFigure 4 The group wikis set up for each module in Blackboard (TeamsLX wiki)This was then extended on an optional basis to include a further three modules (for a further sixweeks). Students were provided with a ‘how-to guide’ on using the wikis, but interestingly, theytended to find out how the wiki worked on a basis of trial-and-error. Due to the short lead-in timeavailable in the pilot, it was not possible to do a hands-on demonstration for each group. Somestudents found wikis easy to use, whilst other students did not find them as straightforward. Therewere also a number of students who initially did not see the purpose of using the wiki for theirlearning. Students displayed a variety of attitudes in terms of their interactions in the wiki. Someposted items by editing their group’s wiki pages, some only viewed others’ interactions and therewere students who had not logged on to the wiki at all. The four groups differed in the extent oftheir wiki participation, with some groups being more active than others. In terms of the postedmaterial in the wikis, web links were the most frequently contributed items (Figure 5).Figure 5 A student contribution to the group wiki – a web reference on professional roles 19
  • 18. Using wikis to promote the personal and professional development of UG medical studentsStudents also posted book references. In one case, when a student felt that he was struggling withone learning objective, he posted a question to the others in the group. In another instance, a wholesection on the role of the health visitor was posted (Figure 6).Figure 6 A student contribution to the group’s wiki: the role of the Health visitorDespite the short lead-in time and duration of the pilot, students engaged with the wiki and editedthe wiki pages with their contributions. In terms of the wiki structure, the pilot phase set out a pagestructure which students could follow (i.e. they only had to edit the pages with their contributionsrather than having to create their own pages afresh). Some students followed this structure andsome created their own new pages. After the initial focus group session at which the wiki structurewas further discussed with the participating students and slightly re-organised for the subsequentmodules, there was a tendency for these students to use the pre-set structure. This suggested theusefulness of a negotiation process between students (and/or the facilitator) about the wikistructure. Students had a better understanding of how they were to structure their contributionsand grow the wiki pages in a logical fashion.Key points – Findings: student engagement in the wikis Students tended to get to know how the wiki worked on a trial-and-error basis. Students demonstrated a range of engagement patterns in the wiki, some posted contributions, some only viewed others’ posts and some did not log on at all. Students more frequently posted web links rather than typed-up content to the wikis. Some PBL groups were more active than others in the wiki. Involving students in negotiations about the structure and purpose of the wiki enhanced students’ understanding of how they could make better use of the wiki for their learning. 20
  • 19. Using wikis to promote the personal and professional development of UG medical students 5. The benefits of using wikis for students’ development of professionalismThis chapter summarises the way in which wikis can enhance student learning onprofessionalism. Findings point to two main ways in which this can happen. Firstly, wikis canact as a shared knowledge-base and resource for students’ learning about professionalismby way of helping them to collate useful links and resources which answer their identifiedlearning objectives on personal and professional development. Secondly, interaction in themore formal wiki space can promote reflection and the development of the online identityof medical trainee students.Chapter 4 discussed students’ perceptions of professionalism and the two main strands in whichstudents engaged with it in their learning. At a more direct level, students identified discreetlearning objectives related to personal and professional development for each of their problem-based learning scenarios and attempted to fulfil these objectives during and between their PBLsessions. At a more indirect level, students’ PBL discussions, as well as other curricular activities,contributed to and promoted their development as future medical professionals. On the basis of thisstudy’s findings, two main areas of benefits have emerged in relation to these two ways of students’learning about professionalism.Firstly, wikis helped students in finding, compiling, evaluating and sharing resources related to theirlearning objectives on professionalism. That is: wikis acted as a useful collaborative learningresource and knowledge-base. Secondly, it was demonstrated by the study that the online wikispaces could have a role in enhancing students’ development of professionalism in a wider sense.One theme that emerged in relation to students’ use of wikis was how wikis could promotestudents’ development as reflective practitioners, i.e. by having to think about the quality ofresources that they contribute to the shared wiki space. Linked to this theme, another importantfinding indicated that by students separating their online social and academic spaces, they becomeconcerned with how they act as individuals in both spheres, as a ‘student’ in the former, and as a‘professional’ in the latter. This reflection, in turn, then has the benefit of creating an online identity,which promotes students’ sense of developing professionalism. Figure 7 summarises these two mainbenefits as they emerged during the research. The following two sections take each benefit in turn,to discuss them in detail. 21
  • 20. Using wikis to promote the personal and professional development of UG medical studentsFigure 7 The two main benefits of using wikis to enhance medical students learning aboutprofessionalismKey points – Benefits of wikis: The two main areas of using wikis in student learning on professionalism were shown to be: o Wikis can act as a shared resource and knowledge-base. They allow students to share their identified learning resources with one another in –between their face-to- face sessions. o Wikis can act as online spaces for developing students’ identity as a professional and their development as reflective professionals.5. 1 Wikis as a shared resource and knowledge-baseOne of the main benefits that students reported concerned their ability to share resources on theiridentified learning objectives in-between their PBL sessions. When other students found a relevantresource on the area of personal and professional development and posted it to the wiki, the wholegroup was able to see it online. Sharing links in this way helped students study the relevant learningobjectives. Some students found these links especially useful when they had seemed to waste a lotof time and effort on identifying resources for the given learning objective. This benefit was all themore welcome as students found personal and professional development to be the least wellprovided for out of the four strands associated with their problem-based learning scenarios: 22
  • 21. Using wikis to promote the personal and professional development of UG medical students “Professionalism is hard to find resources on, so ... it’s quite useful to share them.” (Focus Group 3)The small-scale survey responses also signalled a positive attitude from students who accessed orcontributed to the wiki. They reported an enhanced understanding of personal and professionaldevelopment, they said that they shared more resources as a result of the wiki and that it improvedcollaboration within the group. To a lesser extent, these students also agreed that wikis contributedto their professional development and enhanced the PBL process. This was confirmed in the focusgroups with one student suggesting that resources put up in the wiki by other students helped clarifytheir problem-based learning discussions: “*X+ put references on for certain pieces of information, which made it a lot easier to understand what she was talking about in PBL.” (Focus Group 1)Another student commented that if they were unable to find a resource on professional learning toput in the wiki then it may be an indicator that their learning objective needed amending, whichthey could do in the wiki without waiting until the next problem-based learning session. Somestudents also found this method of sharing better than their previous methods which were emailingand texting one another. In another student’s view, wikis had the potential to display differentperspectives on the same issue, which they saw as a useful characteristic, especially when it came todiscussing more complex professional issues: “If there is a very difficult question, or one that you can only see one way, you can put it up to see how other people approach it in different perspectives” (Focus Group 2)In Chapter 4, the importance of the PBL group in creating a positive peer environment for students’learning was highlighted. Wikis were seen to benefit students in this sense too. Students consideredthe use of the wiki as a potential medium which, being located in their PBL group, strengthenedgroup cohesion and opportunities for positive peer feedback. This was due to being able to see howothers progress in searching for and thinking about the identified learning objectives online in-between sessions. Students commented on feeling a lack of confidence especially in the early periodof their arrival to university. They saw these wiki interactions in-between sessions as potentiallybeneficial in increasing their confidence in their own ability to achieve their set learning objectives.Key points – Benefits of wikis when acting as a shared resource and knowledge-base Wikis helped students to share resources with one another in-between their face-to-face sessions. This is particularly useful as professionalism seemed to be an area where resources were difficult to locate. Wikis helped clarify PBL discussions. By being able to check one another’s wiki contributions online, students felt more confident about their learning. 23
  • 22. Using wikis to promote the personal and professional development of UG medical students5.2 Wikis as online spaces for developing identity as a professionalThe previous section demonstrated the benefits of using wikis in relation to the particular learningobjectives. Before describing another major area of benefits arising from the use of wikis, it isnecessary to highlight two aspects of professionalism, at least as the concept was interpreted by theauthor of this research study. This interpretation viewed the essential characteristic of a‘professional’ as their ability to reflect on their own learning, attitudes and behaviour. Further, thatthe development into a ‘professional’ was very much concerned with a reflection on what it meantto be a professional, i.e. a sense of emerging professional identity. What emerged from this studywas that wikis were seen as beneficial related to both of these aspects. Thus, the fact that wikispromoted students’ reflection and sense of identity-formation demonstrated their potential forstudents’ development of professionalism. How these benefits materialised are discussed below.Towards becoming reflectiveUsing wikis helped students reflect on their learning. When talking about the problem-basedlearning objectives in personal and professional development, students’ reported their main sourceof information to be the internet. They cited websites – such as the General Medical Council, theNational Health Service and the Department of Health – as useful sources for finding out informationto complete their learning objectives. Some drew on family and friends for information. However,because students engaged in locating resources via the internet, the issue of the difficulty in judgingthe quality of internet resources emerged: “Things like group discussion I think help to tie in everything we have been learning ‘cos on the internet you get so many different resources give slightly different opinions on professionalism.” (Focus Group 3)Students found it hard to evaluate whether the internet resource was good quality and reliable. As aresult of these expressed uncertainties, some students were more hesitant to contribute theresource they found to the group wiki. Students did not want to be seen to ‘be wrong’ in front ofothers by posting up an unreliable web resource.3 As opposed to the informal social networkingspace where these fears were not present, the fact that students felt faculty members could seewhat they had posted, meant that they were less confident in contributing to the wiki space in casethe resource was not of high quality. These comments demonstrated a developing sense ofprofessionalism, exactly because students realised the importance of the quality and reliability ofresources in their learning as trainee medical professionals. These tentative attitudes expressed bystudents when consulting the internet for resources on professionalism therefore at the same timeindicated that they were becoming more reflective. McGee and Begg (2008) similarly argue that inthe current technological environment, information literacy skills are requisite skills in highereducation where “future physicians need to be adept at locating and synthesising info from a varietyof sources”. The project then demonstrated how these information literacy skills could be promotedthrough the use of wikis, and how these contributions could promote students’ becoming morereflective professionals.3 Students also listed a range of other sources which they draw on to develop their professionalism duringtheir course such as their communication skills module or clinical practice; and the importance of interactionand real-life settings – however, the discussion of these is outside the remit for now. 24
  • 23. Using wikis to promote the personal and professional development of UG medical studentsDeveloping identity through online wiki spacesAs one student commented, this web2.0 type technology “introduced *her+ to a new way oflearning”. Although she also commented that due to the short time-scale of the pilot, its full benefitswere not yet explored or were not evident to her, this student saw that through the use of wikis,trainee students could learn how to interact online. What emerged from this and other students’views was a way in which online wiki spaces could contribute to the promotion of professionalidentity. How this may take place is discussed below.As Wagner asserts, part of medical education is about acquiring a new identity as a doctor andmedical professional (Wagner et al 2007). Whilst Hilton and Slotnick (2005) describe thisdevelopment in relation to the communities of practice model in which the young trainee attemptsto copy the behaviour of their more experienced and senior professional with whom they come incontact. These stages of identity-forming were observable during the wiki pilot as well. That somestudents expressed a need for a staff member to offer their expertise in helping them to monitor thequality of wiki contributions suggested exactly this: they wanted to rely on and copy their behaviouruntil they were confident enough in their own. Similarly, not wanting to be seen to ‘be wrong’ infront of staff members – when students were aware that faculty members may have monitored theirwiki contributions, even if they did not, – also suggested a sense of forming professional identity,manifested online.The role of technologies, especially that of web2.0, in developing students’ identity has beendiscussed by others too. Sefton-Green (2004) for instance describes how through their participationin online social networks, students become used to negotiating a range of identities, which thenhelps them to explore their identity. Similarly to this, Collis and Moonen argue that: “the many different kinds of communication, representation and collaboration tools collectively referred to as web2.0 that are now being used by learners of all ages and levels outside formal education requirements are making fast inroads because they offer effective ways to be heard, to connect, to find and share, and to build identity” (quoted in Trinder et al 2008)With particular reference to medical students, the stage of students presenting themselves to theirpeers and receiving feedback is an important part of their professional development (Niemi 1997).The various technologies offer a platform for students to develop their self-identity (Sandars 2008quoting Livingstone 2002). As was seen in Section 4 on learning context, the pilot’s students didmake extensive use of informal, online social networking to interact with one another in, andbeyond, their peer group. These interactions took place in a trusted, informal environment wherestudents could be themselves: ‘students’. They talked about the freedom of making mistakes and noone observing them or making judgements as to their competence. As soon as they entered therealm of the wikis, which were seen to be set up by their course instructors, and to which facilitatorsalso had access, their behaviour changed, they took on a different, ‘professional’ identity. This wasan identity which they identified as ‘work’ and with being a professional medical trainee. In thissphere, rules of engagement changed and students were keen to be seen acting as ‘professionals’when it came to their wiki contributions: “When you are online, you tend to be a lot more informal than face to face. Basically you like have to develop to [do] communication in a professional way. I guess that kind 25
  • 24. Using wikis to promote the personal and professional development of UG medical students of makes me reluctant to use this wiki thing, because we are just used to informal chatting. I wouldn’t be [acting] professional with these people [referring to PBL group]. I am not saying that [group laughs], but I wouldn’t like to try to give up that kind demeanour, just like a friend to a friend. “ Focus Group 1That both the informal social networking and the wiki contributions were acted out in the same peergroup has caused some tension in relation to this identity: “Why would we be writing professionally as like really formal to [one another]? We are not like esteemed colleagues [laughs- all participants laugh+.” Focus Group 1The above perception demonstrates that students were aware of an innate need to actprofessionally in the wiki. However, they found it difficult to adjust and act professionally in thesame peer group with which they interacted informally in their private online spaces. The aboveperception also highlighted some lack of awareness as to the benefits of ‘being professional’ online,i.e. that these online interactions may have another aspect of developing skills which the studentwould be able to employ in their future career as a medical professional. Thus, although the benefitof using wikis demonstrated a potential in students’ identity-formation as professionals, by way ofcontrasting their informal and formal online learning spaces, this potential may need furtherhighlighting to students.Key points – Benefits of wikis when acting as online spaces for identity development Wikis can help students become more reflective practitioners as they are ‘forced’ to evaluate the resources before they share them. Students identified the wiki spaces (as provided by the institution) with ‘work’ which also meant that they interacted differently in their informal, private online spaces as opposed to the wikis. Students wanted to appear ‘professional’ when contributing to the wiki and were concerned with the quality of their contributions and not wanting to be seen ‘wrong’ or ‘stupid’. These different interactions showed how online wiki spaces can help develop students’ professional identity. The merits of acting professionally online were not always evident to students, suggesting that these need to be explicitly highlighted to them.The fact that not all students experienced these above benefits to the same extent draws attentionto the various issues that influenced student engagement as well as the outcomes of the wiki pilot.These issues are discussed in the next chapter. 26
  • 25. Using wikis to promote the personal and professional development of UG medical students 6. Teaching & learning, technical and managerial issues of using wikisThis chapter describes the various teaching & learning, technical and managerial issueswhich influenced students’ engagement with wikis. The main identified teaching andlearning issues included wiki awareness, privacy, group work and sharing, the‘populatedness’ of the wiki, reliability, motivation and professional identity. Whilstmanagerial issues predominantly concerned the scalability of the pilot.The previous chapter highlighted the main benefits of using wikis as evidenced from this research.The student survey, the focus group discussions together with the observation of online wikiinteractions gathered a number of issues related to student engagement. Some of these issues weregeneral teaching and learning issues, some of these were related to the use of wikis as a web2.0technology or specific to the particular wiki tool (TeamsLX) used in the pilot and finally, someconcerned the way wikis were set up and managed. These issues are grouped and discussed in thenext three sections: teaching and learning, technical and managerial.6.1 Teaching and learning issuesFirst, the teaching and learning issues are considered, including those educational issues thatinfluenced the perceived effects of learning benefits of wiki use either from the instructors’ orstudents’ points of view. These included awareness of the wiki technology, privacy, group work andsharing, the ‘populatedness’ of the wiki, concerns of reliability, gains in professional identity and lackof student motivation. These will be explored below.Wiki awarenessStudies concerned with today’s generation of young students have claimed that there is awidespread awareness between students of new types of technologies such as social networking,blogging and wikis (see Prensky 2001). Recent studies, however, found that students’ degree offamiliarity differed when it came to the different types of web2.0 technologies. Whilst studentsextensively used online social networking (e.g. 91%), they were both less familiar with andcomfortable using wikis and blogs for instance (52%) (JISC/IPSOS MORI 2008). It is interesting to notethat while many students use Wikipedia for researching their studies, a high proportion of them arenot aware of what a wiki is or how to use it (JISC/IPSOS MORI 2008). This finding was confirmed bythe current study. It appeared during focus group discussions that before the pilot started, studentshad not been aware of what wikis were or had not used them before. One student, when promptedabout Wikipedia being similar to the wiki, exclaimed with surprise: “Is that a form of the wiki?” Oncestudents were equipped with the knowledge as to the purpose of the group wikis (whether it wasresource sharing or discussions around the learning objectives) and how they could be used for theirlearning, they seemed to value wikis more. This confirmed another finding from related e-learningstudies, i.e. that students, although familiar with web2.0 technologies for their social purposes, donot necessarily see the educational value in them without further structure and guidance from theireducator (Trinder et al 2008). The findings of this research study confirmed that students were lessaware of the wikis than the abovementioned studies suggested. Students’ learning curve wasgreater than with other, more familiar types of web2.0 technologies, such as social networking toolsor even blogs. These point to the need for careful scaffolding when introducing students to this 27
  • 26. Using wikis to promote the personal and professional development of UG medical studentstechnology, both in terms of an introduction to the tool as well as how they will be used in theirstudies.As mentioned above, those students who took part in a discussion at one of the focus groups as tothe nature and structure of wikis, did show an increased engagement with the tool after the focusgroup session.Key points – Wiki awareness Students demonstrated less awareness of wikis as a technology than expected on the basis of previous studies. The more students were aware of what wikis were, the more likely they were to be engaged with them.PrivacyMany students contrasted their interactions in the institutionally provided group wikis with that oftheir own private social networking tools. As mentioned before in Chapter 4 on learning context,students predominantly used Facebook for their own social purposes, although also commentedthat in Facebook they discussed their learning or sharing resources on an ad-hoc basis. Theyassociated this online social networking space with safety and comfort where they did not have toworry about having to appear professional, they could be themselves, students: “you feel more free to express yourself” (Focus Group 1)Because the institutional wiki was set up for the students by the medical faculty, they associated thisspace as one that was being ‘monitored’ and therefore not private; even though only their groupsand their facilitator could access it and there was no intention of the faculty monitoring theircontributions. Purely because of where the wiki space was located (i.e. within the institutional VLE),students felt that they were in a different environment over which they had no control. The effect ofthis perception was that students were less motivated to contribute to the wiki, or at least that theyhad to make more purposeful judgments as to when to contribute or not, more so than they wouldhave made in their private social networks.If students identified their online Facebook networks with privacy and their wiki space with a ‘public’space, there was another dimension of this dichotomy: the separation of social and work spheres,respectively: “Facebook is primarily a way of communicating with friends. Whereas the Wiki is a way of communicating things that you’ve found that are relevant to work. So *pause+ it’s seen as something that’s work not something that’s social so you’re less tempted to use it.” (Focus Group 3)The fact that students saw the wiki space as “work” did tend to affect their engagement with wikis;though this occurred differently in the case of different students. Some appreciated the separatework space and preferred working in the wiki, whilst others preferred to stay in their social Facebookspace. This polarised behaviour was also observed in the JISC/IPSOS MORI study concerning the use 28
  • 27. Using wikis to promote the personal and professional development of UG medical studentsof wikis (2008). In line with other studies (Sandars et al 2008), students also highlighted that it wouldnot be a solution to move the institutional web space to their preferred online networking space asthey would not use it: “I think if you do add it [wiki] to a social site then no one will use the social thing because they will think the faculty are watching or checking all what they are all doing.” (Focus Group 1)The characteristics of the wiki space then, in which students shared their learning within their peergroup, whether it was seen as an informal/social/private place or whether a formal/work/publicspace affected students’ interactions. The solution, on the basis of student comments and asSandars et al (2008) also suggested, was not necessarily moving one space into the other, butlooking at managing control and ownership within the institutionally set-up wiki space. Manystudents commented that they preferred small-group based wikis, in which access was restricted totheir eight-person PBL group. This offered them a trusted and safe environment in which they feltconfident making contributions, as opposed to having to contribute to large wikis to which thewhole year group had access.Key points – Privacy Students who liked the separation between their online work and social spaces, tended to appreciate and use the wiki space more for their learning. When students found the wiki space too ‘public’ for their interactions, they were less likely to see the benefits of this space for their learning and so, they preferred to keep their discussions about the problem-based learning objectives within their own private (online/offline spaces). Private, small-group based wikis were welcomed by students. This was because their known problem-based group ensured a trusted, safe environment where they did not need to worry about the quality of their contributions and how they were seen by other group members.Group work and sharingGroup work and willingness to share resources with others were issues which emerged during theintroduction of wikis. As seen in Chapter 4, different PBL groups engaged with the wiki at varyinglevels, some being more active than others. In one instance, although students accessed the wiki,the group did not contribute to it at all. Facilitators suggested that some groups worked bettertogether as a group than others, with the more cohesive groups being more active online as well.Reticence to share resources, albeit on a small scale, was also a reason why those less willing toengage in the wikis did not contribute to it. Cultural differences went some way to explain thisstudent attitude, though as students themselves said, it only characterised a small proportion ofstudents. These issues related to group dynamics though not specifically relevant to the use ofweb2.0 technologies per se, were nevertheless important pedagogical aspects of the learningcontext which influenced student engagement. 29
  • 28. Using wikis to promote the personal and professional development of UG medical studentsKey points – Group work and sharing Positive group dynamics were an important indicator for students’ engagement. Groups which worked well together in face-to-face sessions were more likely to share resources with one another online. Cultural issues related to sharing, i.e. students being reticent to share their learning with others, were also found to act as a barrier to engagement, though this concerned only a few individuals.‘Populatedness’One optimal condition that students saw for using wiki in their PBL context was when the wiki wasalready populated with items such as web or other resources. An empty wiki was daunting for them.They did not want to be the first to contribute: “I think everyone hesitates to put something in it at the moment. You don’t want to be the first person that starts …” (Focus Group 1)The ‘populatedness’ of the wiki was linked to levels of sharing and access. Students appreciated thatwhilst a small, peer-group based wiki had advantages in terms of privacy, it also meant a limitedamount in terms of the volume of postings (with a maximum of eight members being able to post tothe wiki). Students felt that a wiki available to the wider student group – for instance to the wholeyear – though losing in privacy, would allow a greater number of contributions to the benefit of allmember students.‘Populatedness’ of the wiki was not just a quantitative issue. Students also expressed the view thatthey would have liked to have access to a wiki which was already populated by resources related toprofessionalism and checked by staff members. This would not only have initialised theircontributions but would have offered them a guide as to what they should be learning and guidingthem in terms of selecting the ‘right’ kind of information for their study. This finding coincided withthat of Cruess and Cruess (2006) who also identified institutional support including adequateresources important for students’ development of professionalism. That said it also signals a tensionbetween the problem-based learning approach where part of the learning is to find, evaluate anduse information and resources.To summarise, whether resources already existed in the wiki, either by peer members or facultystaff, influenced students’ confidence in posting contributions to the wiki. A tension between thepreference for a private, trusted wiki space between the issue of ‘populatedness’ was alsodiscovered during the pilot, which was linked to the extent of member access (small group versuslarge group).Key points – ‘Populatedness’ The lack of pre-existing resources in the wiki, the lack of ‘populatedness’, was daunting for students. Many did not want to be the first to contribute. Students welcomed the idea of contributing to wikis which were already populated by resources on professionalism and which were quality assured by staff. 30
  • 29. Using wikis to promote the personal and professional development of UG medical students Students saw whole year-group wikis as having advantages as these large wikis would have potentially contained more resources to choose from for their learning about professionalism. However, this caused a tension between their previously expressed preference for private, small-group based wikis.ReliabilityAs already discussed in relation to the benefits of wikis to student learning in chapter 5, students intheir reflections about their wiki engagement expressed a concern as to the quality of postings oftheir wiki contributions. A number of students commented that they did not want to be seen to beposting ‘wrong’ or irrelevant content. Apart from the reliability of resources being linked to issues ofprofessionalism such as identity and confidence, this student concern had a pedagogical impact aswell. These comments brought up the issue of the need for monitoring and editorship in the wiki.Some students conveyed the view that they would have liked staff members to act as monitors overtheir own and their peers’ contributions, as they were better judges of the quality of resources. Theyfound the lack of quality-assured materials, especially in the area of personal and professionaldevelopment a difficulty, given that this area was the most difficult to find resources on. There wasalso some discussion about what should happen to the postings that were deemed not to be right –whether they were to be deleted or to be commented upon and evaluated. One student observedthat as different groups had defined different learning objectives for the same learning scenario, oneresource may be relevant for one group and not to the other.Key points – Reliability In their reflections on wiki engagement, students expressed a concern as to the reliability of the resources contributed to the wiki. Students did not want to be seen ‘wrong’ when posting to the wiki. Where students had more confidence in their information literacy skills, they were more likely to share resources within the wiki. Students found the lack of quality-assured materials by staff members and professionals a difficulty in their learning about personal and professional development. They welcomed the idea of having a staff member who would monitor the quality of contributions.Professional identityChapter 5 highlighted that the use of wikis promoted students’ development of professionalism bymaking them reflect on the way they interacted in different online spaces. This was achieved byjuxtaposing their interactions in the formal wiki and informal social networking spaces. However,not all students were aware of this indirect benefit, i.e. that interacting online and discussingprofessional issues with their peers through wikis could lead to an appreciation of what role similaronline spaces may play in their future career. For instance, they did not draw a connection betweentheir own wiki use and that medical professionals may draw on similar online communities ofpractice in their careers for their own personal and professional development. 31
  • 30. Using wikis to promote the personal and professional development of UG medical studentsKey points – Professional identity Not all students appreciated, or were aware of, the benefits that interacting in more formal online spaces, such as wikis, could bring to their future professional career and development.MotivationAs far as student motivation was concerned, there were a number of students who did not engage inusing wikis for their problem-based learning studies. There were a number of possible reasons forthis. Some students stated that their “current methods are good enough”, meaning that the waythey discussed their learning and shared resources between sessions, e.g. via email, text and face-to-face, were suitable methods. The other main educational reason for being less engaged was due tostudents being strategic learners. If students did not see the immediate benefits of wikis for theirexams, they did not feel the need to be engaged (McGee and Begg 2008). What transpired from thefocus group discussions was that the majority of students still favoured making their own paper-based notes (though some students did some of this on their laptops) which they brought to thenext session. This meant that students who did engage in the wiki were more motivated to sharelinks with one another rather than typing up content for others to see.Key points – Motivation Some students found their current methods of learning about professionalism ‘good enough’ (which could be either offline or online, individual or peer methods); they lacked motivation for using the institutionally provided wikis. This was linked to the voluntary nature of wikis - their use was not aligned to any assessment tasks; students being strategic learners did not feel compelled to use the wikis for their learning.Motivation to use wikis for their studies was also linked to technical issues, which are discussed inthe next section.6.2 Technical issuesThe technical issues that influenced students’ perceptions as to the benefits of using wikis for theirlearning included two main aspects: issues of usability (such as the interface and functions of thewiki tool) and training & support needs.UsabilityAs for usability, where students expressed more negative views of the wiki, these tended to relate toits interface (the chosen tool was the the TeamsLX wiki in the institutional learning environment,Blackboard). These comments were typically like: the wiki was “too boring”, “plain” and“uninteresting”. In many instances students compared the wiki tool to that of Facebook, with thelatter being the preferred option for its user-friendly, colourful and engaging interface. This was truefor the functionalities that both offered. Students liked the fact that Facebook was activity-centricand that it notified them of recent activities. Similar alerts were not available in the TeamsLX wiki, 32
  • 31. Using wikis to promote the personal and professional development of UG medical studentsi.e. if the wiki was updated, students were not notified of this. They actively had to log in and scrollthrough each page to see whether there were any new changes. Some students also struggled withnavigating round the wiki.Training and support needsThe importance of hands-on learning and getting familiar with the structure of the wiki in face-to-face sessions was also confirmed. Due to the short lead-in time available for the set-up of the pilot, itwas not possible to conduct a face-to-face training session and this was commented on by students.The written guide, although helpful in some cases, was not satisfactory in guiding them as to whatthey could do in the wiki. This was because those more confident with ICT were happy to experimentwith the wiki on a trial-and-error basis, whilst those less confident did not draw on the guide either.Students were not too aware of the history function of the wiki; this was shown by their concern ofpotentially making mistakes in the wiki or posting something wrong, not realising that the option ofdeleting or amending contributions was one of the main aspects of wikis. Had they been aware ofthis functionality, the knowledge that their posting could be reverted could have helped theirconfidence in making contributions to the wiki.What these technical issues pointed to was the importance of alerts when using wikis in similargroup contexts as well as the value of making the wiki appealing, perhaps through the use of imagesand colours. Having the need for a face-to-face training session in which the purpose, structure andnavigation of wikis were explained to and discussed with students was in strong evidence on thebasis of student accounts.Key points – Technical issuesUsability Students’ engagement was negatively influenced by the design and interface of the wiki tool. Students preferred the interface of Facebook to that of the wiki tool piloted (Teams LX) as they found it easier to use and more friendly and colourful. Students had to actively log in to the wiki and check each page one-by-one to see whether anything has been added. This lack of functionality with regards to alerts, otherwise a central function of web2.0 tools such as Facebook, was also a major impediment for student engagement.Training and support needs Not having a dedicated face-to-face session had the effect of some students not logging on at all, due to a lack of ICT confidence. Students preferred a hands-on introduction to the wikis as opposed to reading a written guide. The history function of the wiki was less well known to students.6.3 Managerial issuesThere were a number of considerations which pointed beyond the technical capabilities of thechosen wiki tool. These concerned the set-up and management of the wikis. This section thereforediscusses how these managerial decisions impacted on the achieved learning benefits of wikis. Given 33
  • 32. Using wikis to promote the personal and professional development of UG medical studentsthe pilot, small-scale nature of the study, it was important to consider any issues within the researchwith a view of what would happen when the pilot is scaled up, in this instance, with the introductionof wikis to the whole first-year group. Therefore this section first discusses any managerial issuesthat the introduction of wikis brought about during the pilot, which were access, privacy, remit andnavigation.As the pilot was conducted in the context of problem-based learning groups, it was decided torestrict access to the wikis to the eight-member PBL group. The group’s facilitator and theresearchers on the project also had access to the wiki. Students liked this privacy: “One thing about that PPD thing [wiki] which was good was the fact that it is private and other groups can’t see what we have written.” Focus Group 1Although students also commented that in this privacy set-up they could be losing out due to notseeing other groups’ contributions: “But I also think it’s a disadvantage as well because sometimes being able to see with the PBL learning objectives, being able to see what other people have written is beneficial as well.” Focus Group 1Further, it was decided that for each problem-based learning scenario a new wiki would be created;this meant to make it easier for students to relate resources to their identified learning objectivesfor that module (as opposed to creating an overall wiki for instance for the duration of the pilot). Inthis set-up however, the potential for the wiki’s remit to act as a cumulative resource over thelifetime of the student, or even just the year, was muted.To match this remit at the module level (the two weekly-learning scenario), the wiki was linked tothe relevant module in Blackboard, i.e. students had to click at least four clicks to access it within thehierarchical navigation.All these managerial decisions (small group vs large group access; privacy; remit; and location interms of navigation – see Table 1) influenced student contributions to the wiki.Table 1 Managerial considerations of the wiki setup Managerial Details considerations Access Who has access to the wiki? Small or large group? Privacy Is the wiki open to others Private (members-only) or public (non- who are not members? members have read access) wiki? Remit What is the remit of the Is it linked to the module or wiki? cumulatively to more modules over the years? Location/Navigation Where is the wiki located? Can students click into it at the top level or do they need to navigate through various levels of hierarchy to access it? 34
  • 33. Using wikis to promote the personal and professional development of UG medical studentsIt is not yet clear without further researching other wiki tools whether these managerial decisionscould be consolidated in other wiki tools by enhanced functionality or whether they are decisionsthat need to be made on the basis of weighing up the advantages and disadvantages of each option.Issues for scalability of the pilotThe small-scale pilot also offered an opportunity to consider the managerial issues with regards toits scalability, i.e. implementing the use of wikis in PBL groups across a whole year (with some 300medical students). These need to be taken into account alongside the above mentioned managerialconsiderations. The identified issues mainly concern: access to the wiki - whether only a small (e.g. problem-based learning group) or the whole- year group has access to it and whether non-members can read wiki contributions or not; its setup in relation to the remit of the wiki - i.e. what is the boundary of the wiki– is it just for discussing the relevant problem-based learning scenario or does it follow a broader purpose to record students’ learning; the lifecycle of the wiki - whether and how students access/interact with it in subsequent years;Some of the solutions to the issues may be directly determined by the available functions of thechosen wiki tool. Whether or not both institutionally or externally available tools can be chosen willbe determined by the institution. So what follows is a consideration of these various managerialissues as mentioned above, highlighting what potential solutions would need to be taken intoaccount for the success of up-scaling the pilot to a whole medical year-group.Issue 1: Access and privacy: who has read/write access to the wiki?Issue description: On the one hand, students preferred to share their learning online in their familiarpeer groups. This meant that they liked the fact that the wikis were only accessible to their owngroup. Another reason for this was the recognition that one group’s learning objectives would notnecessarily be the same for other groups and they would not have the same purpose/resources toidentify. On the other hand, students realised that wikis open to the whole year group would yieldmore contributions in terms of resources, purely because they would be coming from a significantlylarger group.The solution needs to consider: a wiki structure that offers different levels of access. This couldpotentially mean a two-level wiki, which a) has discrete private group areas for students to discusstheir own learning objectives and ask questions which they may not want to ask in front of thewhole group and b) a joint year-group area for the whole year. This latter could consist of resourceswhich were found to be of good quality by the small groups, as well as questions which the smallproblem-based groups are finding hard to answer or finding it difficult to find resources on.Issue 2: The remit of the wiki: what is the remit of contributions?Issue description = during the pilot, wikis were set up for each discrete learning scenario. This remitis not necessarily reflecting the iterative nature of the medical curriculum. Wikis could also be set upwhich would span a wider remit, beyond the learning scenarios. The first solution poses problems interms of searchability. Students at their later stages of their training would need find information ina potentially high number of wikis. The latter cumulative-wiki solution would present issues of 35
  • 34. Using wikis to promote the personal and professional development of UG medical studentsgrowth and structure, i.e. how information could be structured in the wiki so that students couldorganically and logically be able to grow their wikis during their training. One issue, and this may beparticular to the institution where wikis were piloted, was that the problem-based learning groupschange each semester so any group-related wikis would need to deal with this extra complexity.The solution needs to consider: whether wikis at the learning scenario level are useful for studentlearning (mini-wikis) or whether wikis would need to serve a wider cumulative purpose. Again, couldthis tool consolidate these opposing purposes?Issue 3: Wiki lifecycle: can future students use the wiki and its contributions?Issue description: the wiki pilot was conducted within a semester of students’ training for 2-5discrete learning scenarios. The question arises as to what would happen to wikis in theirsubsequent years of training as well as these wikis relationship to the new in-take of first yearstudents. If the wiki pilot continues, will students be able to easily access and find information intheir past wikis? Would the new first-year students be able to benefit from the contributions madeby previous first-year peers?The solution needs to consider: how this accumulation of knowledge is managed: whether it ismanaged in one wiki or across several wikis (linked to the previous issue of wiki remit). For instance,whether wiki contributions could be accessed and re-used by students in the following years. Theremay not be an easy solution. Different alternatives such as opening up wikis or perhaps exportingwiki pages may need to be considered.Issue 4: Wiki functionality: what functions does the tool have?Issue description: the chosen wiki tool for the pilot had various constraints in terms of itstechnological capabilities. One of the main limitations was that the tool did not have an alertfunction. Students also found the interface less engaging.The solution needs to consider: other wiki tools which may be external, third party tools.Institutional constraints may play a part in whether this choice is openly available. Given that themain purpose for students to use wikis was sharing links to resources rather than sharing content,other tools such as social bookmarking systems could also be considered.Issue 5: Support needs and resources: how to balance benefits versus support needs?Issue description: there are about 35 problem-based groups in a medical year at the pilot institution.If wikis were set up for each of these (or even if a joint group wiki was set up with different accessareas), the process of setting up these groups would require significant support and set-up time.The solution needs to consider: the large-scale nature of benefits of using wikis and measure themagainst these resource needs.It is true that with regards to scalability more questions than answers emerged as a result of thepilot. These questions are important in identifying the issues that would need to be considered whenscaling up the pilot to a whole year group. It was also possible however to make some practicalrecommendations as to future implementations for the use of wikis in medical education, especiallyrelating to the development of professionalism. These are expressed in the section 8. 36
  • 35. Using wikis to promote the personal and professional development of UG medical studentsKey points – Managerial issuesFive issues were identified which need to be considered when scaling up the pilot. These were: Access and privacy: wiki access, whether creating small or big group wikis influences student engagement with benefits and disadvantages in the case of both. A potential solution could be considered which offers different levels of access. Wiki remit: the implementation needs to consider whether wikis at the learning scenario level are useful for student learning (mini-wikis) or whether wikis would need to serve a wider cumulative purpose. Wiki lifecycle: the longevity of wiki usefulness surfaced as a managerial issue, i.e. whether wikis are created for a discreet learning period or whether they can provide a more cumulative resource base for students. Wiki functionality: given the functional restrictions of the wiki tool, future implementations need to consider other available tools, subject to institutional constraints. It could even be that other web2.0, such as social bookmarking, tools could also facilitate the sharing of resources on professionalism. Support needs vs benefits: implementation of the wiki project, if carried out similarly to the pilot, would require significant support and set-up time which needs to be measured against the expected benefits of using wikis for enhancing student learning. 37
  • 36. Using wikis to promote the personal and professional development of UG medical students 7. Project summary and outcomesThis chapter summarises the study and the outcomes of the project.7.1 Project summaryThe purpose of the study was to introduce wikis in a problem-based learning context and explorehow this web2.0 technology may be used to enhance first-year medical students’ learning in ablended environment, especially relating to their development of professionalism. Group-basedwikis were set up for the duration of the pilot associated with a particular learning scenario. Thismeant that students were able to share and discuss resources online related to their identifiedlearning objectives as a group.During the pilot phase, all four groups had the opportunity to access and use the wikis for theirstudy. Student interactions in the wiki, based on online observations as well as focus groupcomments, differed not just from group to group but also on an individual basis. Some groups, andsome individuals, were more active than others. Some students contributed to the wiki, whilstothers just viewed it, and again others did not log on at all. Students tended to experiment with thewikis on a trial-and-error basis rather than reading any support material.Data were collected in the form of a small scale survey and focus groups discussions. Through this, itwas possible to gather information about the learning context of the participating students as wellas to locate the benefits that students experienced when using wikis for their learning aboutprofessionalism.The learning context of these first-year students involved the importance of students’ peer group(both the immediate problem-based learning group and beyond) in their learning. These studentswere also at an important point of development as university students, formulating and developingtheir learning strategies appropriate to the university environment and requirements. Thesestrategies included the selection of online resources for their study. It was also a phase when theywere growing in confidence as learners, supported by the feedback of their facilitators and peers.The social bonds which they created were an important part of this, with an indication that some ofthis social interaction happened within their online social networking groups outside theinstitutional environment.As far as the development of professionalism was concerned, students demonstrated a range ofperceptions from the concrete ‘professionalism is about job roles’ to more complex views whichamalgamated professional attitudes with duty of care obligations through to associatingprofessionalism with ‘a lifestyle’. Most students used the internet for discovering resources forfulfilling their learning objectives related to professionalism. Students identified professionalism asan area that was least provided for by the institution as well as an area which was hard to findinformation about. All these perceptions pointed to the need for having access to resources,especially web resources, on professionalism. Students’ concern about not just trusting any resourcepointed to a sense of their developing identity as a reflective practitioner who was concerned withthe quality and relevance of the resources. Students identified that they needed the skills of beingable to search, evaluate and synthesise resources in order to be able to post to the wikis; skills whichthey associated with senior professionals and staff members. Indirectly then this was a stage in 38
  • 37. Using wikis to promote the personal and professional development of UG medical studentsprofessionalism to which students aspired to. This was evidenced by their ambition to be ‘right’when posting contributions to the wiki.The role of web2.0 technologies in helping students to experiment with and develop various (online)identities was evidenced in other studies. This pilot’s students were also very aware that they haddifferent identities when interacting in their private social networking groups and when theycontributed to the institutional, small-group wiki. These different platforms in some instancesexisted peacefully next to one another, whilst other students talked about the tension of the two(the private vs public space, the ‘social’ vs the ‘work’ space, the student vs the trainee medicalprofessional) with students being uncomfortable when having to act differently in front of the samegroup/ the same people that they would have talked to in their online social networks. What waslearnt during the study was that students were less aware of how their online interactions in the wikimay be relevant in their future career as medical professionals.Key points – Project study Wikis were introduced in a PBL context with a small number of first year undergraduates. Predominantly qualitative data were collected as part of this pilot study. Individual students as well as the PBL groups engaged with the wikis to differing extents.7.2 Project outcomesThe students who engaged with the wikis clearly experienced benefits in their studies. Thesebenefits fell into two main areas: wikis as a knowledge-base to share resources on professionalism,and wikis as online spaces for the development of identity as a reflective professional.Firstly, wikis offered a useful way for students to reference resources in the area of personal andprofessional development and share these with the whole problem-based learning group inbetween-sessions. This meant that students not only gained in time efficiency but were able toprepare better for their next session. Some students found that wiki contributions made by othershelped clarify their problem-based learning discussions. Sharing and discussing resources in wikisalso helped with their lack of confidence – a common issue in their first-year of study, when studentswere less sure both about the material to be learnt and the extent to which they needed to learn it.Students did not need to wait until the next session as they were able to see how others tackled thelearning objectives through the wiki contributions of others.Secondly, the more indirect learning benefits concerned the development of student identities asfuture professionals facilitated by the more formal learning space of the wiki. Although this couldalso cause tension, students recognised that they acted differently in the wikis than in their owninformal social networks. This recognition, coupled with their reflections on the quality control issueof wiki contributions, has moved students along their journey as trainee professionals, tacitlyintroducing them to the concept of online professional identity. A further outcome for thosestudents engaged in the wiki was that through their engagement in the searching, evaluating andsynthesising of information resources, their information literacy skills were enhanced; not directly,but because they were reflecting on the value of the resources in the first place. 39
  • 38. Using wikis to promote the personal and professional development of UG medical studentsThere were a number of facilitators and barriers which influenced these positive outcomes in termsof enhancing students’ learning about professionalism. These were teaching & learning, technicaland managerial factors.On the one hand, students’ awareness of the purpose and structure of wikis helped theirengagement. Similarly, private, small-group wikis were more conducive to student contributions asstudents were more confident posting in a small than a large group. Less effective group dynamicsand reticence to sharing, on the other hand, hindered student activity in the wikis. Students’information skills helped determine whether the resources they found were reliable. Students whowere more confident in their own ability to search, evaluate and synthesise information, also foundit easier to make contributions to the wiki, whereas those less confident, even if they found usefulresources were less likely to contribute. Students’ engagement in using wikis for sharing resourceswas also affected by their motivation. Some did not see a benefit in using wikis, and stated that theircurrent methods of learning were good enough, others appreciated that wikis introduced them to anew style of learning.With regards to technical barriers, the students who did not engage in the wikis, claimed that thiswas to some extent due to usability issues, such as the boring and uninspiring interface of the wikitool and its lack of alert function. Most of the students held their online social networking tools as agood example of what a motivating tool should look like. Most of the students claimed that theywere fairly ICT-literate. Despite the ease of use of the wiki tool, the importance of hands-onsessions, which were not possible to do within the pilot, was highlighted by the fact that studentspreferred to learn to use the tool by trial-and-error rather than through written guides.As far as scalability of the project was concerned, the pilot was important in highlighting thepotential managerial considerations for such a future implementation. These concerned levels ofaccess within the wiki (small or large group) linked to the potential in terms of the ‘populatedness’ ofthe wiki. ‘Populatedness’ of the wiki was an important aspect in students’ judgement of its use. Theyrecognised that wikis with higher volumes of contributions would be more useful for their learningabout professionalism. The remit of the wiki was another consideration which determined theirpotential use to students, i.e. whether it was restricted to a discreet learning scenario or whether itwas set-up for the accumulation of knowledge over a longer period of students’ learning. Therestrictions in terms of the functionality of the tool also acted as barriers for student engagement.One such example was that the lack of the alert function, meant extra work on the part of thestudent in having to check for updates by their peers by having to keep logging in to the wiki. Thishas naturally put off some students from making extensive use of the wiki. Further, the lack ofcertain functions also highlighted that one managerial consideration needs to be the evaluation ofother available wiki tools in comparison with the institutional wiki tool to discover whether theywould be more suitable tools to use for the purpose of the study and beyond. 40
  • 39. Using wikis to promote the personal and professional development of UG medical studentsKey points – Project outcomes Students experienced direct and indirect benefits of using wikis in their studies. Wikis were seen as a useful knowledge-base by students for sharing resources on professionalism. Wikis, albeit more indirectly, also contributed to the development of student identities as future professionals facilitated by the more formal learning space of the wiki. A well-populated wiki was seen as encouraging to student contributions. A number of facilitators and barriers have also been identified by the project, which influenced student engagement in the wikis. o Some of the facilitators included an awareness of what wikis were, small-group environments, confidence in one own’s information skills, positive group dynamics and individuals who were happy to share resources with one another. o Reticence to share, lack of motivation, lack of hands-on introduction, an unfriendly user-interface and the lack of alerts were all seen as barriers by students and so, hindered their engagement. Scalability efforts would need to consider a number of issues with regards to how the wikis are set up and managed, for instance in terms of wiki access, remit and life-cycle. 41
  • 40. Using wikis to promote the personal and professional development of UG medical students 42
  • 41. Using wikis to promote the personal and professional development of UG medical students 8. Conclusion and recommendationsFollowing on from the project summary and outcomes, this chapter offers some conclusionsand recommendations which have arisen from the study, based on the identified teaching &learning, technical and managerial issues detailed in chapter 6.This study demonstrated that the use of web2.0 technologies, in particular, wikis did enhancestudent learning in the area of professionalism both in direct and indirect ways. Arising from theabove outcomes and the accounts of students’ experiences, a set of recommendations areestablished with a view to the use of wikis in similar learning contexts. These recommendations aregrouped under two areas, the first in relation to professionalism, the second in relation to the use ofwikis in general. The final section of this chapter identifies future research areas which have arisenfrom this study.8.1 Recommendations for the development of professionalism Recommendations with regards to students’ development of professionalism Wikis can be used to enhance students’ learning especially as a medium to share resources linked to professionalism. When using wikis, consider making pre-loaded resources on professionalism, quality- assured by staff. Draw attention of students to how participation in online collaborative spaces may be relevant and beneficial in their future career. For instance, they can be introduced to other professional online spaces and shown examples of practitioners communicating online for professional ends. Recommendations in particular to the CETL in Professionalism: Suggest resources to students on professionalism which could be pre-loaded in the wiki (see suggestion above).8.2 Recommendations for the future implementation of wikisIf the use of wikis is to be implemented in the future, then various recommendations can be madewhich refer to each stage of their process of deployment. Although this pilot was carried out withmedical students, the recommendations will be of interest to other disciplines too. Therecommendations are made according to the various stages of the use of this technology: choosingthe wiki tool, setting wikis up for students, the introduction and training process, the managementand monitoring of wikis whilst students interact with it and, finally, areas for further research. Recommendations for the future implementation of wikis Choice of the wiki tool Consider, if possible within the given institutional constraints, other wiki tools which have an alert system, a user-friendly interface and flexible access-rights functionality. The set up of the wiki(s) Consider a two-level wiki which consists of small private group areas and a joint year- 43
  • 42. Using wikis to promote the personal and professional development of UG medical students group area. Consider the granularity of wikis, whether they serve a discrete or a wider, cumulative purpose. Consider pre-filling the wiki with resources to encourage student contributions. The introduction of wikis to students; training issues Introduce the use of wikis in the autumn semester of their first year when students are more receptive to new styles of learning. Introduce the various purposes of wikis to students (e.g. sharing resources, building up a collective body of learning, discussion/questions forum, or formative tool for feedback) and negotiate their use based on their preferences. Create a trusting, positive environment in the wiki group in order to overcome the issue of lack of confidence of students’ contributing in a group environment. Emphasise the history function of the wiki to highlight that entries can be deleted and amended if deemed unsuitable. Introduce students to the wikis in a hands-on session, showing them a live demonstration of its functions such as navigation and contributions, with a particular attention as to how students are expected to structure their contributions. Involve students in the introductory training who had already engaged in wikis before and found them useful. The management of wikis Consider how quality assurance is managed within wikis. These can take various forms, either peer-based or facilitated by staff. For instance, an appointed wiki moderator, either a staff member or a peer, could ensure the quality of contributions and alert faculty in case if inappropriate postings. Consider aligning wiki use to the assessment practices in the curriculum in order to motivate students in their use. Keep reminding students during the year about the presence of wikis. For instance, well- chosen and quality resources could be highlighted at different learning events (during the students’ problem-based sessions or at year-group sessions).8.3 Further researchThe study has also identified further areas of research. These include: what benefits and issues may arise when the small-scale pilot is scaled up to a whole year group of some 300 students; the benefits and issues that may arise when students use wikis over successive academic years in the form of a long-term study; the role of the moderator in the wiki and the role of quality assurance of wiki contributions; the appropriateness of other tools which may serve similar purposes to wikis (e.g. social bookmarking). 44
  • 43. Using wikis to promote the personal and professional development of UG medical students 9. Project impactThis study was strongly linked to the CETL in Professionalism goal “to enshrine within theundergraduate curriculum a system for personal development, career planning and reflection ofprofessionalism that allows a seamless progression to postgraduate practice.” The aim of the studywas to explore whether the use of wikis can enhance students’ development of professionalism. Theproject outcomes demonstrated that students who engaged in the wikis experienced benefits as aresult of the pilot. These benefits included more direct benefits, such as the ability to referenceresources in the area of personal and professional development and share these with the wholeproblem-based learning group in between-sessions. They also included more indirect gains, such asthe promotion of students’ becoming reflective practitioners by engaging in the evaluation andsynthesis of online resources to aid their medical studies. Wikis also offered a platform for thedevelopment of online professional identities.The study has contributed to the scarce evidence-base on the use of web2.0 technologies in medicaleducation and identified both practical issues for the future implementation of similar projects aswell as further areas for research. 45
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  • 46. Funded by the CETL in Developing Professionalism Liverpool: University of Liverpool, 2009. ISBN 978-0-906370-59-9