Hughes, B. et al.: To 2.0 or not to 2.0 – have junior doctors already answered the question? <ul><li>This slideshow, prese...
To 2.0 or not 2.0:  Have Junior Doctors Already Answered the Question? Dr Indra Joshi, West Hertfordshire Hospitals NHS Tr...
<ul><li>Multiple studies have looked at Doctor’s internet use  (Masters, 2008) </li></ul><ul><ul><li>Three main types of u...
… this Study focuses on the use of Medicine 2.0 via a multi-method approach. <ul><ul><li>Up to 250,000 physicians are alre...
Today we will focus on patterns of Web 2.0 use identified in the study (RQ1) RQ1:   What is the pattern of use of Web 2.0 ...
Methods <ul><li>Sample: </li></ul><ul><ul><li>70 junior doctors invited to participate </li></ul></ul><ul><ul><li>Selected...
Use of Web 2.0  tools  on a weekly basis N=35 doctors
Use of Web 2.0  sites  on a weekly basis N=35 doctors Key   Hybrid site Web 2.0 site Traditional online content
Highlights of results <ul><li>High use of web 2.0 tools for professional development: </li></ul><ul><ul><li>89% of reveale...
Use of Web 2.0  sites  on a daily basis N=318 days Key   Hybrid site Web 2.0 site Traditional online content
Discussion and future implications <ul><li>Difficulties in tools based view and site based view as it tells little about t...
References   <ul><li>Tapscott D, Williams A. Wikinomics. New York, NY: Penguin Group: 2006.  </li></ul><ul><li>von Hippel ...
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To 2.0 or not to 2.0 – have junior doctors already answered the question? [5 Cr3 1330 Hughes]

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  • To 2.0 or not to 2.0 – have junior doctors already answered the question? [5 Cr3 1330 Hughes]

    1. 1. Hughes, B. et al.: To 2.0 or not to 2.0 – have junior doctors already answered the question? <ul><li>This slideshow, presented at Medicine 2.0’08 , Sept 4/5 th , 2008, in Toronto, was uploaded on behalf of the presenter by the Medicine 2.0 team </li></ul><ul><li>Do not miss the next Medicine 2.0 congress on 17/18th Sept 2009 ( www.medicine20congress.com ) </li></ul><ul><li>Order Audio Recordings (mp3) of Medicine 2.0’08 presentations at http://www.medicine20congress.com/mp3.php </li></ul>
    2. 2. To 2.0 or not 2.0: Have Junior Doctors Already Answered the Question? Dr Indra Joshi, West Hertfordshire Hospitals NHS Trust, UK Benjamin Hughes, Department of Information Systems, ESADE September, 2008
    3. 3. <ul><li>Multiple studies have looked at Doctor’s internet use (Masters, 2008) </li></ul><ul><ul><li>Three main types of use: looking for medical information, professional development and administrative use </li></ul></ul><ul><ul><li>While the internet is growing in importance in the clinical setting , when unsure about diagnostic and management issues for a complex case, 41.3% doctors still chose to consult with a colleague or 22.8% read from a text rather than consult the internet (Bennett, Casebeer, Zheng & Kristofco , 2006) </li></ul></ul><ul><li>Require further research for many reasons </li></ul><ul><ul><li>Need to go beyond the US focus and predominant use of Surveys as data collection. In comparisons to patients´ views, physicians' perspective on evolving internet environment is lacking (Podichetty, Booher, Whitfield & Biscup, 2006) </li></ul></ul><ul><ul><li>Literature is inconsistent about how an internet search is made, by knowing preferred sites facilitated by the use of Google (Sim, Khong & Jiwa, 2008) or without Google (De Leo, LeRouge, Ceriani & Niederman , 2006) </li></ul></ul><ul><ul><li>Need to isolate the use of Web 2.0…. </li></ul></ul>Research needs to go further to understand Doctor’s internet use…
    4. 4. … this Study focuses on the use of Medicine 2.0 via a multi-method approach. <ul><ul><li>Up to 250,000 physicians are already using Web 2.0 in the US, with 60,000 “uploaders” (Manhattan Research, 2007) </li></ul></ul><ul><ul><li>[we need]….an understanding of how this group currently uses Web 2.0 technologies and the barriers to effective use (Sandars & Schroter 2007) </li></ul></ul><ul><ul><li>Careful thinking, testing and evaluation research are still needed in order to establish “best practice models” (McLean , 2008) </li></ul></ul><ul><ul><li>Concerns have arisen with the emergence of Web 2.0 in medicine (Eysenbach, 2008) with the difficulties for doctors working with patients mislead by the internet, concerns of information inaccuracy and issues of online privacy (Hughes, Joshi & Wareham, 2008) </li></ul></ul><ul><ul><li>Determine impact of Web 2.0 tools in daily clinical practice in the UK amongst junior doctors – with focus on the used of Web 2.0’s user generated content </li></ul></ul><ul><ul><li>Highlight its frequency of use, both for the internet and Web 2.0, but also to understand how the information is both sought and applied in the clinical context </li></ul></ul><ul><ul><li>Overcome strong criticisms of the predominantly used survey method in investigating internet use behaviors (Hargittai, 2002) by the use of multiple data collection methods (surveys, diaries and interviews) </li></ul></ul>Contributions and approach… Web 2.0 and Medicine 2.0…
    5. 5. Today we will focus on patterns of Web 2.0 use identified in the study (RQ1) RQ1: What is the pattern of use of Web 2.0 by junior doctors (JDs) in clinical practice? (e.g., frequent and favored sites)? RQ4: How are internet/web 2.0 tools incorporated into patient consultation and overall case management? RQ2a: What skills have JDs learnt and are employing in using Web 2.0? RQ2b: What are the limitations of web 2.0 that JDs have been unable to overcome? RQ5: What are the implications of the emergence of web2.0 tools for policy makers and medical training (as viewed by JDs)? RQ3: What are the triggers and motivations for using the internet and web 2.0 tools for JDs? (regarding a presenting complaint) Focus of today’s discussion
    6. 6. Methods <ul><li>Sample: </li></ul><ul><ul><li>70 junior doctors invited to participate </li></ul></ul><ul><ul><li>Selected at random from cohort of London Medical Schools </li></ul></ul><ul><ul><li>Level of FY2 – ST1 (2-3 years post graduation) deliberately chosen to target early Web 2.0 adopters </li></ul></ul><ul><li>Data collection: </li></ul><ul><ul><li>Web 2.0 survey showing overall use by tool type </li></ul></ul><ul><ul><li>Internet diary (5 days per doctor) focusing on web 2.0 site use </li></ul></ul><ul><ul><li>Face to face interviews </li></ul></ul><ul><li>Analysis methods: </li></ul><ul><ul><li>Content analysis or grounded theory (Strauss & Corbin) </li></ul></ul>
    7. 7. Use of Web 2.0 tools on a weekly basis N=35 doctors
    8. 8. Use of Web 2.0 sites on a weekly basis N=35 doctors Key Hybrid site Web 2.0 site Traditional online content
    9. 9. Highlights of results <ul><li>High use of web 2.0 tools for professional development: </li></ul><ul><ul><li>89% of revealed the use of at least one Web 2.0 tool with 80% of reported using wikis, and 20% used podcasts and social networking </li></ul></ul><ul><ul><li>Google the most commonly used site, followed by wikipedia </li></ul></ul><ul><ul><li>Doctors looked for online information on average 1.2 times a day </li></ul></ul><ul><ul><li>They perceived 61% of the content used to be open or Web 2.0 content – which they could have contributed to if they wanted </li></ul></ul><ul><li>Difficult to distinguish Medicine 2.0 tools and sites from traditional eHealth online content </li></ul><ul><li>Motivations and rationale for the Web 2.0 use (early interview results): </li></ul><ul><ul><li>Google can be used for effective searching even if only using sites with verified (or non-Web 2.0) content </li></ul></ul><ul><ul><li>Web 2.0 tools, such as Wikipedia, provide more information or are easier to use than standard sites </li></ul></ul><ul><ul><li>Rarely used for clinical management decisions, and when used are verified by checking secondary source (internet or other) </li></ul></ul>
    10. 10. Use of Web 2.0 sites on a daily basis N=318 days Key Hybrid site Web 2.0 site Traditional online content
    11. 11. Discussion and future implications <ul><li>Difficulties in tools based view and site based view as it tells little about the nature of the information accessed. However, diaries revealed that doctors had clear idea what was open (Web 2.0) vs. normal content </li></ul><ul><li>Use of Web 2.0 conformed to what we already know on doctors internet use regarding i nformation seeking motivations and principle inconveniences </li></ul><ul><li>Combined with early interview analysis, diary study suggests: </li></ul><ul><ul><li>Cognitive models of the reliability of Web 2.0 and traditional eHealth sites’ usefulness  drives different search strategies including Google as Hub & Spoke or direct to site strategies </li></ul></ul><ul><ul><li>Building of these cognitive models by word-of-mouth recommendations and user experience (including new sites found via Google) </li></ul></ul><ul><ul><li>Clear acknowledgement of the risks of using Web 2.0 content : </li></ul></ul><ul><ul><ul><li>Different strategies to validate user generated content </li></ul></ul></ul><ul><ul><ul><li>Different use of this content (e.g., rarely for drug dosage etc.) </li></ul></ul></ul><ul><ul><li>Emerging skills to use internet content with patients (including Web 2.0 tools) </li></ul></ul>
    12. 12. References <ul><li>Tapscott D, Williams A. Wikinomics. New York, NY: Penguin Group: 2006. </li></ul><ul><li>von Hippel E. Democratizing Innovation. Cambridge, MA: MIT Press: 2005. </li></ul><ul><li>Giles, J. 2005. Internet encyclopedias go head to head. Nature , 438 (531). </li></ul><ul><li>Giustini D. How Web 2.0 is changing medicine. BMJ. 2006 Dec 23;333(7582):1283-4. PMID: 17185707 </li></ul><ul><li>Crespo R. Virtual community health promotion. Prev Chronic Dis. 2007 Jul;4(3):A75. PMID: 17572979 </li></ul><ul><li>Economist, The. 2007. Health 2.0 : Technology and society: Is the outbreak of cancer videos, bulimia blogs and other forms of “user generated” medical information a healthy trend? The Economist, September 6: 73-74 </li></ul><ul><li>Manhattan Research, LLC. White Paper: Physicians and Web 2.0: 5 Things You Should Know about the Evolving Online Landscape for Physicians. 2007. URL: http://www.manhattanresearch.com/TTPWhitePaper.aspx on 20/1/2008 </li></ul><ul><li>Masters, K. For what purpose and reasons do doctors use the Internet: A systematic review. international journal of medical informatics 77 ( 200 8) 4–16 </li></ul><ul><li>Eysenbach, G. Medicine 2.0: Social Networking, Collaboration, Participation, Apomediation, and Openness. J Med Internet Res 2008 (in press) http://dx.doi.org/10.2196/jmir.1030 </li></ul><ul><li>Hughes, B., Joshi, I., Wareham, J. Medicine 2.0: Tensions and controversies in the field. J Med Internet Res 2008). </li></ul><ul><li>www.jmir.org/2008/3/e23/ </li></ul><ul><li>Bolos MN, Wheeler S. The emerging Web 2.0 social software: an enabling suite of sociable technologies in health and health care education. Health Info Libr J. 2007 Mar;24(1):2-23. PMID: 17331140 </li></ul><ul><li>Sandars J, Haythornthwaite C. New horizons for e-learning in medical education: ecological and Web 2.0 perspectives.Med Teach. 2007 May;29(4):307-10. Review. PMID: 17786742 </li></ul><ul><li>McLean, R, Richards, B, Wardman, J. The effect of Web 2.0 on the future of medical practice and education: Darwikinian evolution or folksonomic revolution? MJA 2007; 187 (3): 174-177. PMID: 17680746 </li></ul><ul><li>Sandars, J., Schroter, S. Web 2.0 technologies for undergraduate and postgraduate medical education: an online survey. Postgrad. Med. J. 2007;83;759-762. doi:10.1136/pgmj.2007.063123. PMID: 18057175 </li></ul>

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