Networked Social Media in
Learning, Teaching and Research
Maged N. Kamel Boulos, MBBCh, MSc, PhD, FHEA, SMIEEE
Associate Professor in Health Informatics
University of Plymouth, UK
mnkamelboulos@plymouth.ac.uk
mnkboulos@ieee.org

Founder
&

Workshop Themes
• Networked Social Media in Learning and Teaching
(contexts: higher education; medicine and healthcare,
including patient education and clinicians’ collaboration
and CPD—Continuing Professional Development).
• Networked Social Media in Research (both as a primary
focus for research and as tools/enablers in research).
• The above two themes are interrelated and frequently
overlap in research-led higher education institutions
(research-informed teaching and practice).
Format: Slides and videos (7 video clips - 30 min. total): include practical and
how-to examples/demos; Audience interactivity: Q&A opportunities
throughout the day and small-group reflective activity/discussions.

General Agenda
• Overview of Networked Social Media in health/healthcare
education and research, including a research agenda for the
coming years.
• Social Web tools for virtual collaborative practice and
learning/CPD in medicine and health (covers Wikis, blogs,
micro-blogs, podcasts, YouTube and SlideShare).
• Introduction to 3-D Virtual Worlds.
• Research example: UOP Sexual Health SIM in Second Life®
(2007-2009)—covers the use of Virtual Patients and of Social
Media Marketing and Captology techniques in Virtual Worlds.
• Research example: Novel emergency/public health situation
rooms using 4-D GIS (incorporating 3-D Virtual Worlds, Virtual
Globes and other NSM tools).
• Small-group activity/reflection exercise.

Logos of City of Plymouth and University of Plymouth (inset, red), Plymouth, UK
Photo © MNK Boulos

Overview of Networked Social
Media in Health/Healthcare
Education and Research
A Research Agenda

Agenda
• What are Networked Social Media (NSM)? (Includes a brief
critique of the term “Web 2.0”)
• NSM as enablers of positive change in education and health,
including self-help and peer-to-peer support, and the
challenges that need to be addressed.
• A research agenda:
– Establishing the evidence regarding the use of NSM in higher education,
health/healthcare and social care, and establishing and informing best
practices;
– Identifying and researching associated barriers/ problems and
workarounds;
– Looking into how various disciplines, technologies and applications have
been affected by, and are affecting, NSM;
• Social Web mining
– Virtual worlds and social networks as large social research labs like never
before; and
– Select highlights from PubMed (Mar-Jun 2010).

Aug 2006/Jan 2007

Popular PowerPoint [MN Kamel
Boulos - April 2007 - 32 slides -
PDF - 2.7MB:
http://healthcybermap.org/MNKB_W
eb2_3DWeb_SecondLife.pdf - also
available on SlideShare (6779 views
as at 23/5/2010)]

Social Web / Networked Social Media
• Social Web or Networked Social Media (NSM) are
mediated environments where people (including
students and faculty in higher education) can use their
computer or mobile phone to connect with others, share
information, and generate content, among other things.
• Example tools include wikis, e.g., Wikipedia, social
network sites, e.g., MySpace, Facebook, LinkedIn,
Sermo; media sharing platforms, e.g., YouTube, Flickr,
SlideShare; blogging and micro-blogging, e.g., Twitter
and identi.ca; social bookmarking, e.g., Delicious; 3-D
virtual worlds, e.g., Second Life®; and 3-D virtual globes,
e.g., Google Earth™.

http://www.google.com/moderator/
http://www.google.com/buzz
http://wave.google.com/

http://www.sermo.com/

Social Web / Networked Social Media
• Practices involved in NSM include tagging (using loose,
user-created vocabularies or folksonomies), user
generated content, copy/paste code creation, and code
and content remixing (mashups).
• Many universities, as well as health and social care
providers, particularly in the US, are already using NSM
extensively, e.g., the US CDC—Centers for Disease
Control and Prevention (http://www.cdc.gov/socialmedia/),
as well as a good number of hospitals (e.g., US list at
http://ebennett.org/hsnl/).
• Even those organisations with the strictest and most
conservative Internet access/use policies and regulations
in place could not evade the latest NSM wave, e.g., the
US DoD—Department of Defense
(http://socialmedia.defense.gov/).

http://www.cdc.gov/socialmedia/

http://socialmedia.defense.gov/

Web 2.0?
• NSM are sometimes inaccurately referred to as “Web
2.0”. Such versioning of the Web is better avoided (I
must admit I have used the term in some of my papers
including in the title of one of my early papers on the
subject back in Dec 2006 and in some of my early
presentations).
• Confusion regarding “Web 3.0”: Is it the Semantic Web?
3-D virtual worlds?
• As Sir Tim Berners-Lee, the inventor of the Web, would
say, the Web has been conceived as a social medium
and a sharing and communication platform from the
very start (see
http://www.ibm.com/developerworks/podcast/dwi/cm-int082206.txt).

Web 2.0?
• The Web (b 1990) just grew more popular (= deeper
and much more branching social networks and links
over time), and more affordable and usable over the
past two decades, to become what we have today
and what we currently observe as the prominent
social aspects and opportunities of the Web.
• But the core principles and concepts of online
communities and users’ sharing, repackaging and
repurposing of online content have always been
there in one form or another since the very early days
of the Web (e.g., the first wiki, WikiWikiWeb,
appeared 16 years ago, in 1994), and even predate
the Web (e.g., could be recognised in the 1980s
CompuServe dialup service).

Fast Technology Evolution Not Concept Revolution
• HTML5
http://www.youtube.com/html5

Video Station: But Some Would
Still Argue It’s a Revolution…
• Social Media Revolution 2 (Refresh) – 4 min : 25 sec
Hardcover: 288 pages
Publisher: Wiley; 1 edition (August 24, 2009)
Language: English
ISBN-10: 0470477237
ISBN-13: 978-0470477236
Product Dimensions: 9.1 x 5.9 x 1.1 inches

NSM as Enablers of Positive Change in
Education and Health
• The technologies that enable NSM are rapidly
changing the way we interact with others, get
information, and do business in the higher
education and health and social care sectors.
• NSM are enablers of participatory learning and
learners-centred education, and of participatory
healthcare and patient-centred care, in which
students’ and patients’ engagement and
empowerment are keys to improving educational
(in case of students) and clinical (in case of
patients) outcomes.

Self-help and Peer-to-peer Support
• Learners’ self-help and mutual help in online learners’
communities (these are not costly to realise) can play a
key role in improving the overall quality of education
and relieving some of the existing burden on higher
education institutions in developing countries, where
human and financial resources are constrained and
facilities (e.g., labs and classrooms) are overpopulated.
• Patients’ self-help also has a strategic importance in
that it can help relieve some of the increasing burden
on the already constrained conventional healthcare
systems (e.g., acute care hospitals) in developing as
well as developed countries.

An Online Journal Club
 Users (clinicians and
clinical students) can rate
and discuss medical
literature, and critically
appraise and share their
thoughts on any paper
instantly online.
 This has the potential
of improving
communication amongst
physicians and leading to
better understanding
and interpretation of
medical literature.

http://www.patientslikeme.com/

But…
http://www.ashp.org/import/news/HealthSystem
PharmacyNews/newsarticle.aspx?id=3308
http://e-patients.net/archives/2010/03/why-is-
participatory-medicine-such-a-tough-sell.html

Engaging Patients in Care Poses Many
Challenges
• The least difficult of these challenges is related to access
(digital divide). A recent study by the Pew Internet and
American Life Project and the California HealthCare
Foundation found that people fighting chronic illnesses
are less likely than others to have Internet access, but
once online they are more likely to blog or participate in
online discussions about health problems
(http://www.pewinternet.org/Reports/2010/Chronic-Disease.aspx).
• Other much-tougher-to-address challenges include the
potential of NSM to spread misinformation (Scanfeld et
al., 2010)* and the related difficulties in controlling the
quality of the very vast amounts of user generated
content.
* Scanfeld D, Scanfeld V, Larson EL. Dissemination of health information through social
networks: twitter and antibiotics. Am J Infect Control. 2010 Apr;38(3):182-8.

What About Higher Education?
• Similarly, engaging students in participatory learning
using NSM tools has got its own challenges.
• Access/digital divide is one of those challenges,
especially in developing countries.
• But the biggest challenge is ‘How do we make proper
and best use of NSM to enhance our learning and
teaching?’ ‘How do we foster vibrant online social
learning communities of learners and practitioners?’
• We always need to remember that pedagogy rather
than technology should always be the main driver
and formulator for change.

Tinside Pool—Seafront, Plymouth, UK – Photo © MNK Boulos

A Research Agenda
• Research is still needed to answer many
questions and address various issues associated
with the use of NSM in medical and health
education (clinical students/professionals and
patients/members of general public) and health
and social care in general.
• The following slides will provide some examples
of research areas and topics that can be further
explored in this respect (not an exhaustive list).

A Research Agenda
• Establishing the evidence regarding the use of NSM in
higher education, health/healthcare and social care,
and establishing and informing best practices in this
respect:
– Measuring and tracking the uptake of NSM in the higher
education and health and social care sectors. How many
universities (medical and nursing schools) and healthcare
providers are using social media, and what are the
motivations behind getting started, etc.
– Exploring how NSM may be used in online learning
communities and properly integrated into existing e-
learning tools; and
– Information/Misinformation: Finding how NSM may
provide a venue to identify misuse or misunderstanding of
health/clinical information, promote positive behaviour
change, disseminate valid information, and exploring how
such tools can be used to gather real-time health data for
surveillance purposes (we will revisit this last point later).

A Research Agenda
• Identifying and researching associated barriers/
problems and workarounds; for example:
– Technology and tools issues, e.g., NSM standards and
interoperability, as well as user interface issues with the
transition from the PC era (desktops and full-size notebooks) to
the mobile era (small form factor Internet devices), which
together with the very heterogeneous spectrum of NSM
modalities, have direct implications on how Social Web
applications and experiences should be designed and
prescribed, so that students (m-learning or mobile learning),
members of the general public, patients, and clinicians,
including users with special accessibility needs, such as older
people/people with disabilities and students with special
learning needs, can all participate, make best use of social
media in their health/social care and their education (for
students), and no one is excluded (eInclusion); and

A Research Agenda
(Identifying and researching associated barriers/
problems and workarounds – Cont’d)
– Knowledge management/Semantic
Web issues (e.g., how to make
folksonomies more reliable and
consistent to improve NSM resource
discovery and retrieval, and semantic
wikis*), among other issues; and
– Legal** and ethical issues (copyrights/ http://creativecommons.org/education
licensing, privacy, provider’s liability,
cyber-harassment, protecting
vulnerable groups, etc.).
* Kamel Boulos MN. Semantic Wikis: A Comprehensible Introduction with
Examples from the Health Sciences. Journal of Emerging Technologies in Web
Intelligence. 2009; 1(1):94-96. http://dx.doi.org/10.4304/jetwi.1.1.94-96
** Setback for scientists conducting Social Web mining research:
http://tinyurl.com/ye3ab5b

While tags allow users to freely describe
resources by subject using their own words,
barriers remain to their effectiveness as tools
for resource discovery and retrieval. The lack
of a controlled vocabulary means that the
relationship between concepts and the
words used to describe them may not be
consistent.
http://www.citeulike.org/ ^ Explore bookmarks of like-minded people

A Research Agenda
• How various disciplines, technologies
and applications have been affected
by, and are affecting, NSM; for
example:
– GIS (Geographic Information Systems),
once the exclusive domain of highly
specialised/skilled scientists and
professionals have been “wikified” for
the masses (neogography and
volunteered geographic information
(VGI) and annotations/information
layers contributed by the general
public), paving the way for many
participatory GIS applications, location-
aware services, and geo-mashups in
education, health and public health;*
* Kamel Boulos MN, Scotch M, Cheung KH, Burden D. Web GIS in practice VI: a demo
playlist of geo-mashups for public health neogeographers. Int J Health Geogr. 2008 Jul
18;7:38. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2491600/

A Research Agenda
(How various disciplines, technologies and applications have
been affected by, and are affecting, NSM – Cont’d)
– Other domains that have been reshaped by NSM include
cybermedicine/cyberhealth (mass health education of the
public, including members of the public educating and
supporting each other), e.g., our sexual health education
project in virtual worlds (http://healthcybermap.org/slsexualhealth/),*
and higher education/e-learning, e.g., novel teaching
methods with Twitter.
* Kamel Boulos MN, Toth-Cohen S. The University of Plymouth Sexual Health SIM
experience in Second Life®: evaluation and reflections after one year. Health
Information and Libraries Journal. 2009; 26(4): 279-288 - http://dx.doi.org/10.1111/j.1471-1842.2008.00831.x

A Research Agenda
(How various disciplines, technologies and applications have
been affected by, and are affecting, NSM – Cont’d)
– Public health and environmental surveillance have also been
significantly affected by NSM, forming the new emerging fields of
infodemiology/infosurveillance and technosocial predictive
analytics that use aggregated, real-time NSM feeds (e.g., blog
posts and Twitter tweets from whole populations), NSM mining
methods, and 3-D virtual worlds (serious gaming)/4-D (3-D +
Temporal dimension) participatory GIS, among other methods, to
perform various public health, environmental health and national
security surveillance and response tasks (e.g., monitoring
population health trends based on Social Web activity: early
detection of bioterrorist attacks and of disease outbreaks;
disaster/emergency modelling and real-time management
applications in immersive environments; etc.).*
* Kamel Boulos MN, Sanfilippo AP, Corley CD, Wheeler S. Social Web mining and exploitation
for serious applications: Technosocial Predictive Analytics and related technologies for
public health, environmental and national security surveillance. Comput Methods
Programs Biomed. 2010 Mar 15. [Epub ahead of print] http://dx.doi.org/10.1016/j.cmpb.2010.02.007

Social Web Mining
Kamel Boulos MN,
Sanfilippo AP, Corley CD,
Wheeler S. Social Web
mining and exploitation
for serious applications:
Technosocial Predictive
Analytics and related
technologies for public
health, environmental and
national security
surveillance. Comput
Methods Programs
Biomed. 2010 Mar 15.
[Epub ahead of print]
http://dx.doi.org/10.1016/j.cmpb.
2010.02.007

Social Web Mining
• Analysing Social Web (e.g., blogs, Twitter, etc.) post
aggregates in real or near-real-time can give us a good
indication of the prevailing public opinion(s) of corresponding
communities regarding different matters of interest. It can tell
us about the general public mood and where ‘the wisdom of
the (online) crowds’ is pointing, acting like a measure of the
psychosocial “pulse” and beat of online societies.
• As more and more people are getting connected these days to
the Internet all over the world, online societies are rapidly
becoming a good mirror of offline, conventional societies, and
the Social Web is quickly becoming a strategic place of choice
to reach out to them and influence them on a large scale in
ways that were never possible a few decades ago, e.g., using
‘viral’ (rapidly spreading) videos and other forms of ‘viral’
social marketing techniques.*
* Gosselin P, Poitras P. Use of an Internet “viral” marketing software platform in
health promotion. J Med Internet Res. 2008 Nov 26;10(4):e47.

• Moreover, by tracking the change in Social Web post aggregates
over time after some Social Web opinion, attitude, and/or
behaviour-shaping intervention has been made, one can monitor
and assess the effectiveness of such an intervention and tweak or
retarget it as necessary.
• To achieve this vision, technologies for immersive multimedia
collaborative environments for distributed teams,* as well as
techniques for automated or semi-automated, reliable harvesting,
filtering and aggregation of social media feeds, and for analysing
and visualising the aggregates (in real time/near real time and/or
periodically) have to be developed to provide meaningful insights,
e.g., dashboards identifying: disease trends/unfolding outbreaks,
the spread of misinformation about drugs or other health-related
issues in NSM, information gaps and
needs on the Social Web, etc.
* Kamel Boulos MN. Novel emergency/public health situation
rooms and more using 4-D GIS. Presented at: ISPRS WG IV/4
International Workshop on Virtual Changing Globe for
Visualisation & Analysis (VCGVA2009), Wuhan University, Wuhan,
Hubei, China, 27–28 October, 2009 (Published in ISPRS Archives,
vol. XXXVIII ISSN No: 1682-1777 PART 4/W10).
http://www.isprs.org/proceedings/XXXVIII/4-10/papers/VCGVA2009_03608_Boulos.pdf

Left: An early (quite
primitive) live Twitter
dashboard:
http://www.casa.ucl.ac.uk/tom/
Below: Google Flu Trends:
http://www.google.org/flutrends/

Social Web Mining
Computational Social Network Analysis
“This US NIH FOA (Funding Opportunity Announcement)
encourages basic research that will: generate new theories
that can further social network analysis; address fundamental
questions about the relationship between social networks and
health; and develop methodological and technological
innovations to facilitate and extend social network analyses.”

A Research Agenda
• Virtual worlds and social networks can act as large social
research lab like never before: They offer social scientists,
psychologists and educationalists an unparalleled opportunity to
study and model human (including student) behaviour in both the
physical and online worlds.
– Issues that can be investigated here include: how learning
happens in NSM, society and identity in NSM, NSM avatars as Life®
VSecond
forms of self-representation,
how we perceive other people online,
what a virtual crowd looks like, how
social conventions develop in NSM
(various NSM modalities will yield different answers), what are
people’s incentives for spreading information and how and
why do they distribute content (e.g., “viral” videos on
YouTube), how (and how fast) misinformation gets rectified in
NSM channels (“Darwikinism”), and how can we understand
and harness the flows of content in the context of everyday
health and social care practices and needs.

http://www.utdallas.edu/worlds/research-projects.html

Select Highlights from PubMed (Mar-Jun 2010)
1963
2006

Select Highlights
from PubMed
(Mar-Jun 2010)

The Barbican, Plymouth, UK – Photo © MNK Boulos

Social Web Tools for Virtual
Collaborative Practice and Learning/CPD
in Medicine and Health
Wikis, blogs, micro-blogs, podcasts, YouTube and
SlideShare

Agenda
• Introduction
• Wikis
• Blogs
• General Advantages (Ease of Use, Free/Open Source
Software/Hosting Options), Disadvantages (Vandalism and
Quality Issues, Content Copyrights) and Remedies
(Monitoring and Moderation, ‘Closed Environment’ Scenario)
• Micro-blogs (Twitter)
• Podcasts and m-Learning (Mobile Learning)
• YouTube and SlideShare
• What’s Next?

Introduction
• The current generation of collaborative Web-based tools,
namely wikis, blogs/micro-blogs/photoblogs,
podcasts/vodcasts and SlideShare/YouTube, offer many
unique and powerful information sharing and collaboration
features.
• They also have the added advantage of taking the technical
skill out of these features, allowing users to focus on the
information and collaborative tasks themselves—minus
delivery obstacles.
• These tools carry the potential of complementing, improving
and adding new social and collaborative dimensions to the
many Web-based medical/health education, CPD*, and
research services we have today.
* CPD = Continuing Professional Development

Wikis
• A wiki (from Hawaiian wiki, to
hurry, swift) is a collaborative
Web site whose content can be
edited by anyone who has access
to it.*
• Perhaps the best example of a
wiki in action today is ‘Wikipedia
– The Free Encyclopedia’
http://wikipedia.org/.
• Special conferences have been
and are being organised to discuss
wikis; for example, the Wikimania
conference series
http://wikimania.wikimedia.org/wiki/Main_
Page, and the ACM (Association for
Computing Machinery)-sponsored
WikiSym conference series
http://www.wikisym.org/.
______________
* http://www.answers.com/topic/wiki

Health/Medical Wiki Examples
http://ganfyd.org/

Health/Medical Wiki Examples
The purpose of the Flu
Wiki is to help local
communities prepare
for, and perhaps cope
with, a possible
influenza pandemic. If
we can pool and share
our knowledge, we can
advance preparation
for, and the ability to
cope with, events. This
is not meant to be a
substitute for planning,
preparation and
implementation by civil
authorities, but a
parallel effort that
complements, supports
and extends those
efforts.
http://www.fluwiki.info/

RSS Feeds
Wikis, blogs and
podcasts all use RSS*,
which is now natively
supported by/built into
Web browsers such as
Windows Internet
Explorer 7/8 and later.
Users can easily set up
‘feeds’ to automatically
receive updates from
their favourite services.
* RSS = Really Simple
Syndication

Health/Medical Wiki Examples
http://commons.wikimedia.org/

Wikis: Easy Editing
(except where protected)

Wikis: Versioning Capability
• All past changes
to the page in
question are
listed in reverse-
chronological
order.
• To view a specific
version, click a
date.

Wikis: Versioning Capability
Tip: Citing a wiki page in your work can be very tricky (unless one uses the
‘permanent link’ feature in MediaWiki to point to a specific revision of
that page). Because of the dynamic editable nature of wikis, a page might
significantly change and become a totally different article than the one
you were originally referring to (while still maintaining the same URL).

Wikis: Comparing Versions

Wikis: Article Discussions

Wikis in Education
• Wikis are democratic and promote negotiation.
• Wikis work in real time, permitting public document construction,
i.e., distributed authorship.
• Wiki policies can be set to endorse particular ways of writing (e.g.,
NPOV—see http://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_view).
• Some possible uses:
– Easily create and update simple Web sites with added content
organisation and navigation features, e.g., interlinked pages, content
categories and templates (http://en.wikipedia.org/wiki/Help:Template).
– Group authoring, e.g., for instructors: collaborative curriculum
design/course content authoring.
– Project development with peer review.
– Data collection.
– Track a (research/student) group project.
• Wikis can pose some difficulties when assessing (grading)
individual student work (within a group); the collective assessment
of group work, however, should be straightforward.
A free wiki engine that you can install
on your own server (same engine
running Wikipedia) >

Semantic Wikis
Kamel Boulos MN. Semantic Wikis: A
Comprehensible Introduction with
Examples from the Health Sciences.
JETWI - Journal of Emerging Technologies
in Web Intelligence. 2009 Aug; 1(1):94-96.
http://dx.doi.org/10.4304/jetwi.1.1.94-96
http://semantic-mediawiki.org/

Blogs
• A related Web information sharing technology is the ‘blog’. A
blog (WeBLOG) is a Web site that contains dated entries in
reverse chronological order (most recent first) about a
particular topic area.*
• Functioning as an online journal, blogs can be written by one
person or a single group of contributors.
• Entries contain commentary and links to other Web sites;
images and embedded videos (e.g., from YouTube), as well as
a search facility may also be included.
• Readers may post comments on blog entries (where allowed
by the blog owner).
* http://www.answers.com/topic/blog

Health/Medical
Blog Examples
http://casesblog.blogspot.com
http://clinicalcases.org/

Health/Medical Blog
Examples
http://vgrd.blogspot.com/

Basic Blog Features
Each post to the blog is also a standalone Web page with a unique URL. This facilitates
linking to, and organising content within the same blog and from external sites.
On blogs where feeds are enabled by owner
Automatic feed
detection in
Internet Explorer
and Firefox.

Basic Blog Features: Easy Posting
Posting a clinical photo from your digital
camera directly to your blog after
optimisation and adding your comments
can also be made at the touch of a button
using, for example, the free Google Picasa
application.
This screenshot is from Google Blogger
https://www.blogger.com/. Another blog
engine, WordPress http://wordpress.org/, is
equally easy to use.

Blog Features: Posting Photos
http://picasa.google.com/
Also these days
mobile phones
with 2+
megapixel
cameras can
instantly post
good resolution
clinical photos
to photoblogs/
moblogs on the
Web.

Blog Features: Easy Posting – Blog Editing in Microsoft Word 2010

Basic Blog Features: Labels and Readers’ Comments
Only on blogs where readers’ comments
are enabled by owner.
A blog owner can also choose to enable
comment moderation and to turn off
comment posting by Anonymous users.
Blog posts can be tagged and
categorised by labels or tags.

Blogs in Education
• Quoting http://weblogg-ed.com/why-weblogs/:
– Blogs are a personal writing space. Easy, sharable,
automatically archived.
– Blogs are easily linked and cross-linked to form learning
communities.
– Blogs can become digital portfolios of students’
assignments and achievements.
– Blogs are a novice’s Web authoring tool.
– Way to improve own writing.
http://technorati.com/

Source: http://www.edtechpost.ca/gems/matrix2.gif

Blogs in Education
• For instructors/researchers:
– Networking and personal knowledge sharing.
– Reflective practice logbook (gathering and filing evidence from own
practice, plus reflections).
– Instructional tips, course announcements, annotated links and
readings for students.
– Posting research project updates.
• For students:
– Assignment submission and review (tutor can use the comments
function to comment on student work).
– Share course-related resources with fellow students and tutors.
– Reflective learning and writing journals.
– e-portfolios, e.g., for Keys Skills’ development, evidence-filing/
documentation and assessment.
– Posting student group project updates.
• Blogs can be run on university intranets/as a protected and
closed (access-controlled) environment, where necessary.

Wikis vs. blogs
• There are similarities and areas of overlap between wikis and blogs,
but, by design, wikis are more suited than blogs for
collaborative/group writing and editing, and also as content
management tools, while blogs could be thought of as two-way
conversations between an individual author (or team) and
his/her/their audience.
• Quoting Blogs and Wikis in Teaching at QUT –Update (5/5/2006)
http://snurb.info/index.php?q=node/472, “Both technologies can be
useful tools in different teaching contexts, and it is simply important
to make an informed choice as to which may be more appropriate for
any one case. The key difference between them is usually the
underlying organisation of information (temporal in blogs, spatial in
wikis), and the answer to which one should be used can often be
found right there already. So, blogs can be useful for ongoing
personal/group reflection, or for the incremental development of
skills/gathering of information/provision of feedback; wikis can be
useful for compiling information and ideas in an ad hoc form, with
informational structures emerging as information is being compiled.”

Wikis vs. blogs
• However, this suggested “spatial” Combining the concepts of
(hierarchical categorisation of content)/ both blogs and wikis, a bliki is
temporal differentiation between wikis and a blog with wiki support.
blogs might not be very accurate. For
example, wikis (and their discussion or ‘talk
pages’) have powerful date-and-time-
stamped versioning capabilities, with many
potential uses in a teaching and learning
context. Wikis also feature RSS/Atom-feed-
enabled special pages for ‘Recent changes’,
where changes/edits/posts to the wiki are
listed chronologically. And in wiki pages
powered by MediaWiki, editors can easily
request the system to add a date-time
stamp to whatever material they post (just
type: ~~~~).
• IBM wiki history flow is another (visual)
evidence for the temporal and evolving
nature/aspects of wikis.
http://www.research.ibm.com/history/

General Advantages, Disadvantages and
Remedies
• Two main big advantages: Ease of
use and availability of many Open
Source/free/low-cost software and
hosting options.
• Examples of the latter include
MediaWiki
http://www.mediawiki.org/wiki/MediaWiki
(Open Sourcethe same software package
that runs Wikipedia), Google Blogger
(free) http://www.blogger.com/start and
WordPress (free) http://wordpress.org/

Disadvantages
• Wikis and blogs are sometimes prone to vandalism
and, as a result, serious quality issues, because of
their free form nature and the (relative/potential)
lack of control over their content (though this can be
the very strength of wikis and blogs—see
http://meta.wikimedia.org/wiki/Darwikinism).
• In an open collaborative Web environment, anyone
can very easily post copyrighted material without
the permission of copyright holders, post otherwise
unsuitable or misleading content, edit existing
content in a way that reduces its quality/accuracy, or
even delete/blank a good wiki entry.

Wiki Vandalism
• There are two main types of vandalism—manual
and automated (see
http://www.orthodoxwiki.org/OrthodoxWiki:Vandalism).
The latter is carried out using vandalbots (see
http://meta.wikimedia.org/wiki/Vandalbot).
• A famous example of manual vandalism is the case
of Wikipedia’s false ‘biography’ of John Seigenthaler
Sr. (May 2005):
http://en.wikipedia.org/wiki/John_Seigenthaler_Sr._Wikipedia_biography_controversy
http://www.usatoday.com/news/opinion/editorials/2005-11-29-wikipedia-edit_x.htm
http://news.bbc.co.uk/2/hi/technology/4502846.stm
• Wikipedia:Counter-Vandalism Unit
http://en.wikipedia.org/wiki/Wikipedia:Counter-
Vandalism_Unit
http://en.wikipedia.org/wiki/Wikipedia:Cleaning_up_vandalism

Wikis and Plagiarism/Copyright Violation
See Wikipedia:Spotting
possible copyright violations
http://en.wikipedia.org/wiki/
Wikipedia:Spotting_possible_
copyright_violations
< Template:Copyvio
(http://en.wikipedia.org/wiki/
Template:Copyvio)

Quality Issues
Lack of vital article meta-
information
• All what one finds in wikis
are IP addresses and
nicknames.
• The lack of clear and
complete authorship/
editorship information
attached to each wiki
entry, including
authors’/editors’
affiliations and
credentials, is a very
serious quality issue
encountered in most wiki-
based encyclopaedias
these days.

As at 29 May 2010
Links on this slide:
• http://www.theregister.co.uk/2005/10/18/wikipedia_quality_problem/
• http://wikimediafoundation.org/wiki/Press_releases/May_2010_Wikimedia_Foundation_will
_engage_academic_experts_and_students_to_improve_public_policy_information
• http://en.wikipedia.org/wiki/Wikipedia:Featured_articles
• http://en.wikipedia.org/wiki/Wikipedia:Good_Articles

Giles J. Internet encyclopaedias go head to head.
Nature. 2005 Dec 15;438(7070):900-1.

Clauson KA, Polen HH, Kamel
Boulos MN, Dzenowagis JH.
Scope, completeness, and
accuracy of drug information
in Wikipedia. Ann
Pharmacother. 2008
Dec;42(12):1814-21.
No factual errors were
found in our sample of
drug information entries
from Wikipedia, BUT
Wikipedia has a more
narrow scope, is less
complete, and has more
errors of omission than
the comparator database
(Medscape). Wikipedia
may be a useful point of
engagement for
consumers, but is not
authoritative and should
only be a supplemental
source of drug
information.

Encyclopedia
Britannica now
tapping into
the ‘wisdom of
crowds’!

Remedies: Monitoring and Moderation of
Open Wikis and Blogs
• Options include:
– Monitoring and moderating posts, and deleting/reverting
(rollback) edits as necessary;
– Protecting (rendering ‘read-only’) key/stable content (there
are actually multiple types and levels of protection that can
be applied—see http://en.wikipedia.org/wiki/Wikipedia:Protection_policy
for full details);
– Controlling who can post; and
– Blocking specific (problematic) users/IP addresses.
• Wiki and blog software packages have built-in
Administrator’s functionalities to support these tasks.
• Can become very time-consuming/human resource
intensive.

Remedies: ‘Closed Environment’ Scenario
• Enforce, check, and limit wiki and blog registration and editing
privileges to select, well-defined, and verifiable special interest
groups or communities of users.
• Posting/editing articles on these wikis and blogs will thus be limited
to select, well-known and trustworthy people.
• Everyone else would still be able to access/read the wiki or blog
and, if required, also post limited (moderated) comments (to build a
community).
(Read-only access and posting limited moderated comments/discussion topics
can also be blocked by the Administrator, if deemed necessary.)
• Once a trustworthy expert is identified among external readers
(based on the quality of his/her posted comments and further
private communication with them), they can also be granted
posting/editing privileges (and in this way the (closed) pool of
editors will keep growing).

“A wiki on gene
function, which
utilises the collective
brain power of
biologists around
the world, would be
an invaluable tool
for biological
sciences.”
Wang K. Gene-function wiki would let biologists pool worldwide
resources. Nature. 2006 Feb 2;439(7076):534.
http://www.nature.com/nature/journal/v439/n7076/full/439534a.html

The Barbican, Plymouth, UK – Photo © MNK Boulos

Micro-blogs

How-to
A 2009 study based on >11 million
users revealed that 10% of Twitter
users contribute 86% of all activity!
http://www.sysomos.com/insidetwitter/
This slide and the next one have been adapted with modifications from: http://www.slideshare.net/hopkinsdavid/twitter-in-education

Uses
‘Real life’ happens between blogs and e-mails (small
events or pieces of information/updates that do not
warrant writing a full blog post or sending an e-mail
about them). http://www.youtube.com/watch?v=ddO9idmax0o
Research:
mining
Twitter
aggregates.

Other Micro-blogging
Services (Twitter Alts)

Podcasts and m-Learning (Mobile Learning)
• Podcasting’s essence is about creating content
(audio or video—vodcasts) for an audience
that wants to listen when they want, where
they want, and how they want.
• Origin of the term:*
– The term ‘podcasting’ was first mentioned by Ben
Hammersley in The Guardian newspaper in a
February 2004 article, (although the article did not
detail the use of the RSS protocol or automatic
synchronisation, which are central to podcasting).
– It is a portmanteau of the words ‘pod’, derived from
iPod, a brand of portable media player produced by
Apple, and ‘broadcasting’.
– The name may be misleading, as it has never been
necessary to have an iPod, or, indeed, any other form
of portable media player, to use podcasts; the
content can be accessed using any computer that can __________
* Source:
play media files. http://en.wikipedia.org/w/index.php?title=Podcast
– Use of the term ‘podcast’ predates the addition of &oldid=363668311
native support for podcasting to the iPod or to
Apple’s iTunes software.

Podcasts and m-Learning (Mobile Learning)
• Advantages:
– Listen on your computer or download to portable
MP3/MP4 players and listen on the move/anywhere,
e.g., while commuting to work (perfect for the busy
health professional and mature, part-time students).
• But audio and video files can be large in size; users must have
sufficient bandwidth to download them, especially over mobile
Internet connections.
– Support for auditory learners (it is claimed that the
primary learning style in at least 30% of
learners is auditory).
A Nokia N76 Mobile Phone with Built-in MP3/MP4 Player (2007)

Source: Meng P. Podcasting and Vodcasting: A White Paper. University of Missouri, 2005
http://web.archive.org/web/20051130023111/http://edmarketing.apple.com/adcinstitute/wp-content/Missouri_Podcasting_White_Paper.pdf
The above ‘white paper’ by Peter Meng of the University of Missouri contains excellent How
to Podcast and How to VODcast sections. Meng also describes many educational applications
of podcasting and vodcasting, including:
Recordings of lectures for those students unable to attend the lecture in person;
Audio recordings of textbook text by chapter, would allow students to “read” or review texts while walking or
driving to class (significant aid to auditory learners); and
Downloadable libraries of high resolution heart and respiratory sounds for medical students.

Health/Medical Podcast Examples
 ASCRS (American Society of Cataract
and Refractive Surgery) ophthalmology
CME programmes via podcast.
 Users can subscribe to the RSS feed
to automatically receive updates.
 They can use Windows Media Player
to listen to the MP3 files.

Listeners’ questions can be played
back and answered in forthcoming
episodes.

Health/Medical Podcast Examples

Health/Medical Podcast Examples

Health/Medical Podcast Examples
http://books.mcgraw-hill.com/podcast/acm/

You don’t need a dedicated
‘podcatcher program’ if you
are running a recent version
of any of the popular Web
browsers these days, e.g.,
Internet Explorer 7/8 or
Firefox 3.5/3.6 or later.
Podcasts use RSS, which is
now natively supported
by/built into these browsers,
among others.

Health/Medical Podcast/Vodcast Examples
http://www.cdc.gov/podcasts/

Health/Medical Podcast Examples
http://www.cdc.gov/podcasts/

Health/Medical Podcast Examples
Podcasts are
already
being used
in medical
school
curricula.
http://webweekly.hms.harvard.edu/archive/2006/0130/student_scene.html

Health/Medical Podcast Directory
http://hsclibrary.uchsc.edu/podcasts/

Pedagogical Podcasting or Podagogy
Excerpts from:
http://web.archive.org/web/20070222005153/http://engage.doit.wisc.edu/podcasting/teachAndLearn/
• Avoid overly complex and dense content material that
includes lots of facts and figures—this is because most
students listen to podcasts as they perform other tasks,
e.g., riding a bus, driving, exercising, walking to class, etc.
In most cases they won’t be taking notes as they listen.
• Recordings of classroom lectures (unmodified) may not
be the best use of podcasting—only use lectures as
podcasts when you have a strong
pedagogical rationale for doing so.
• Narrow the focus of a podcast.

Requirements for Successful Podcasts
in Education
Excerpts from:
http://web.archive.org/web/20070322004807/http://www.xplanazine.com/
xplanaradio/archives/2005/07/pedagogy_for_po.html
• Appropriate length.
• Informal tone and high energy—to make students feel that they are
part of something rather than merely the recipients of a boring
presentation.
• Context and review—educational podcasts should always begin with
a clear context for the information being presented, and end with a
review of the most important things to remember.
• Options for different learning style preferences—effective podcasts
should offer optional transcripts and/or images (or video) to address
different learning styles as well as accessibility issues. Podcasts
accessed on the Web can make use of all these media types.
• Flexible/multiple delivery options—to accommodate different
students’ preferences for subscribing and downloading.

MIT Channel on YouTube
http://www.youtube.com/user/MIT
YouTube “Alts”:
http://www.dailymotion.com/
http://www.vimeo.com/
among others.

US National Library of Medicine Presentations
Channel on SlideShare
http://www.slideshare.net/NLM_SIS
Related:
http://www.scribd.com/

Full control over the distribution of
your presentations (who can
access them and how they can
access them).
You can also embed YouTube
videos in SlideShare presentations.

2010
http://ondemand.blackboard.com/r91/movies/bb91_
course_content_creating_a_mashup.swf
Flash Tutorial (3 min.)

What’s Next?
• Careful thinking is needed in order to find the best ways
to use these social and collaborative tools to boost our
productivity, foster better communities of learning an
practice, and support our continuing professional
development (CPD).
• Stakeholders’/prospective users’ representatives
(healthcare professionals and students) must be
adequately involved in this process.
• The key to successful use of Networked Social Media in
learning, teaching and research is to identify the unique
affordances/‘raison(s) d’être’ of each of the different
tools/tool classes on offer, what each option can do
better or best, and what it cannot do at all or well.

Capitalise on the Unique Affordances /
Affordances Profile of Each Tool
• Comparing the different Social Web tool classes can
be tricky, and some might consider it like comparing apples
with oranges. The affordances (profile) of each medium are
different; each option or modality will usually have its own
advantages and disadvantages vis-à-vis a given use scenario,
and tool options are also not necessarily always mutually
exclusive or a substitute for one another, but could rather be
very complementary and synergistic in many ways. Moreover,
people have different tastes/preferences and the audiences of
various modalities can be overlapping.
• We need to especially identify and focus/capitalise on what a
given tool or modality is best at–those (useful) things/scenarios
that can only be effectively carried out using that tool option
and not via any other ‘e’ medium (as effectively), and also
determine the optimal formulae for blended approaches that
combine various Social Web tools and modalities.

Useful Resources
• http://www.educause.edu/ir/library/pdf/ELI7004.pdf
• Renée Fountain, Wiki Pedagogy (2005):
http://www.profetic.org:16080/dossiers/dossier_imprimer.php3?id_rubrique=110

Useful Resources
• http://www.educause.edu/ir/library/pdf/ELI7006.pdf
“Because blogs engage people in knowledge sharing, reflection,
and debate, they often attract a large and dedicated readership.”
• http://www.educause.edu/ir/library/pdf/ELI7027.pdf

Useful Resources
• http://www.educause.edu/ir/library/pdf/ELI7003.pdf
• Audacity: free, open source audio recording and editing
software for Microsoft Windows, Mac OS X and Linux:
http://audacity.sourceforge.net/

Seafront, Plymouth, UK – Photo © MNK Boulos

Introduction to
3-D Virtual Worlds

Agenda
• What are 3-D Virtual Worlds?
• Possible uses.
• Application example.
• A quick demo of Second Life®.
• Some emerging trends.
• Resources and further reading.

<< Real Maged, Great Wall
of China, Beijing, October
2009 (while participating at
an ISPRS conference in China)
>>
Maged’s Alt/Avatar (MB
Chevalier) visiting the
Great Wall of China in
Second Life®, November
2009
(http://secondlife.com/)

What Are Virtual Worlds?
• Three-dimensional (3-D) virtual worlds like Second Life®
http://secondlife.com/ and Twinity http://twinity.com/ can be
considered as 3-D social networks, where people can
collaboratively create and edit objects in the virtual world
(think of it as a ‘3-D wiki’), besides meeting each other and
interacting with existing objects.
• Video (9m 44s)

A Flexible 3-D Wiki
• User-created 3-D objects in virtual worlds are not just
static replicas of familiar real-life artefacts.
• These objects can be programmed (scripted) to do
more “intelligent” things, e.g., move, react to different
events, etc.
• The objects can also interact with, and respond
realistically to, their environment, e.g., collisions, force
of gravity, etc. (‘physics’).
• Multi-user editing in real time and object persistence
across sessions.

Astonishingly Real!
Real Hope in a Virtual World
(Washington Post – 6 October 2007):
“Because the full-colour,
multifaceted nature of the
experience offers so much
more ‘emotional bandwidth’
than traditional Web sites,
e-mail lists and discussion
groups, users say the
experience can feel
astonishingly real.”

The Co-presence Power of a 3-D
Virtual World
See presentation by MN
Kamel Boulos entitled
‘Why visualize RL data in
SL? (or the co-presence
power of a 3-D virtual
world)’. Presented at the
‘Visualizing Real Data in a
Virtual World’ panel
organized by Linden Lab,
2 July 2008, Second Life -
http://healthcybermap.org/MNKB--
Why_visualize_RL_data_in_SL.zip
(July 2008 - two zipped PDFs - 881 KB)

Why 3-D for Collaboration? (Sun Microsystems)
“One question we are frequently asked is why use 3-D for a
collaboration environment? While it might be possible to build a 2-D
tool with functionality similar to MPK20 (Sun’s Virtual Workplace), the
spatial layout of the 3-D world coupled with the immersive audio
provides strong cognitive cues that enhance collaboration. For
example, the juxtaposition of avatars in the world coupled with the
volume and location of the voices allows people to intuit who they
can talk to at any given time. The 3-D space provides a natural way to
organize multiple, simultaneous conversations. Likewise, the
arrangement of the objects within the space provides conversational
context. If other avatars are gathering near the entrance to a virtual
conference room, it is a good guess that they are about to attend a
meeting in that space. It is then natural to talk to those people about
the content or timing of the meeting, just as you would if attending a
physical meeting. In terms of data sharing, looking at objects
together is a natural activity. With the 3-D spatial cues, each person
can get an immediate sense of what the other collaborators can and
cannot see.” http://labs.oracle.com/projects/mc/mpk20.html

Possible Uses
• The ‘Second Life in Education’ wiki
(http://wiki.jokaydia.com/page/Edu_SL) lists dozens of
educational and other uses of 3-D virtual worlds,
including:
1. Distance and flexible education
2. Presentations, panels and discussions
3. Training and skills (e.g., clinical and social
skills) development
4. Self-paced tutorials

Possible Uses
5. Displays and exhibits
6. Immersive exhibits
7. Roleplays and simulations
8. Data visualisations and simulations
9. Libraries, art galleries and museums
10. Multimedia and games design
11.Machinima (video clips produced entirely in
the virtual world)

An interactive genetics lab/museum and learning area,
The Gene Pool, in Second Life®:
http://slurl.com/secondlife/Genome/127/129/49

Possible Uses
12. Treasure hunts and quests
13. Virtual tourism, cultural immersion and
cultural exchange
14. Language teaching and practice, and
language immersion
15. Awareness/consciousness raising and even
fund raising (e.g., the American Cancer
Society in Second Life®)
16. Support and opportunities for people with
disabilities (stroke, autism, etc.)

Possible Uses
17. Business, commerce, financial practice and
modelling
18. Real estate practice (visit accurate property
replicas in the virtual world)
19. Product design, prototyping, user-testing
and market research
20. And much more…
Modelling healthcare logistics in virtual worlds
(University of Arkansas) - http://vw.ddns.uark.edu/

Application Example
• Video (5m 19s)

A Quick Live Demo of Second Life®
http://maps.secondlife.com/secondlife/HealthLands/94/169/26

Some Emerging Trends
• Virtual worlds and virtual globes (mirror worlds) such as
Google Earth™ will merge, opening up many new
possibilities and applications.
“You’ll be walking around in downtown London and be able to see
the shops, the stores, see what the traffic is like. Walk in a shop and
navigate the merchandise. Not in the flat, 2D interface that we
have on the Web today, but in a virtual (but real) walkthrough.”
–Microsoft’s Bill Gates, October 2005
It is noteworthy that Twinity uses COLLADA (COLLAborative Design
Activity - an interchange file format and standard for interactive 3-D
applications, also supported in Google Earth) as its 3-D model and
animation format, enabling 3-D content developers to easily re-use
COLLADA models created in popular 3-D modelling tools such as
Google SketchUp.
For an example application combining virtual worlds and virtual globes, see: Kamel Boulos MN.
Novel emergency/public health situation rooms and more using 4-D GIS. Presented at:
ISPRS WG IV/4 International Workshop on Virtual Changing Globe for Visualisation & Analysis
(VCGVA2009), Wuhan University, Wuhan, Hubei, China, 27–28 October, 2009 (Published in ISPRS
Archives, vol. XXXVIII ISSN No: 1682-1777 PART 4/W10).
http://www.isprs.org/proceedings/XXXVIII/4-10/papers/VCGVA2009_03608_Boulos.pdf

Some Emerging Trends
• Natural User Interfaces and more natural forms
of human-computer interaction and 3-D
navigation will replace the conventional mouse
and keyboard, e.g., multi-touch interfaces; using
face/voice recognition and motion sensors to allow
users to interact in 3-D virtual spaces; ubiquitous/
multi-device support; augmented reality; etc.
http://www.pranavmistry.com/projects/sixthsense/
http://www.xbox.com/en-US/live/projectnatal/
<< It is now possible to stream a 3-D
virtual world to a suitable mobile phone
Multi-touch/multi-user/hand interface >>

Games, virtual worlds on cellphones and TV
See http://blog.onlive.com/2010/05/13/onlive-coming-to-europe/

Some Emerging Trends
• Perfect realism and immersiveness.
• 3-D worlds standards for the Web/3-D Internet (e.g., ISO
MPEG-V http://mpeg.chiariglione.org/working_documents.htm#MPEG-V) and
seamless integration with flat Web content and browsers.
Image credit: Medusa Stereoscopic 3D Demo by NVIDIA®

Some Emerging Trends
• True 3-D/True stereoscopic vision (S3D) using readily
available technologies such as NVIDIA 3D Vision for
more realistic 3-D visualisation, with a better sense of
3-D depth and object relief.
• Glasses-free solutions, including
options for mobile device
displays such as the iPhone,
are already available today
(see:
Kamel Boulos MN, Robinson LR.
Web GIS in practice VII:
stereoscopic 3-D solutions
for online maps and virtual globes.
Int J Health Geogr. 2009; 8:59. URL:
http://www.ij-healthgeographics.com/content/pdf/1476-072X-8-59.pdf).
Sanyo S3D-ready Ultra Short-focus Projector for
Educational and Entertainment Usages >
< Asus G51J notebook with 120Hz LCD panel supporting NVIDIA 3D Vision

A low-quality (red/cyan anaglyph) S3D scene from the virtual world Twinity http://www.twinity.com/
S3D is the next ‘big thing’ after 1080p HD.

Resources/Further Reading
• http://jvwresearch.org/index.php?_cms=default,4,4

Resources/Further Reading
http://healthcybermap.org/sl.htm

Kamel Boulos MN, Anastasiou A. A Complete Ambient Assisted Living eXperiment (CAALYX) in Second Life® .
In Proceedings of MedNet2008 - The 13th World Congress on the Internet in Medicine, 15-18 October 2008, St.
Petersburg State I.P. Pavlov Medical University, Saint Petersburg, Russia (pp.4-5) -
http://healthcybermap.org/CAALYXinSL/
Kamel Boulos MN, Burden D: Web GIS in practice V:
3-D interactive and real-time mapping in Second
Life. Int J Health Geogr 2007, 6:51.
< Google Maps in Second Life®

Related Online Presentations
3-D real-virtual worlds
for health and healthcare
(MN Kamel Boulos -
September 2008 - 57 slides
on SlideShare:
http://www.slideshare.net/sl.
medic/3d-realvirtual-worlds-
for-health-and-healthcare/)

Portland Square Building, University of Plymouth, Plymouth, UK – Photo © MNK Boulos

Research Example: UOP Sexual
Health SIM in Second Life®
(2007-2009)
Covers the Use of Virtual Patients
and of Social Media Marketing and
Captology Techniques in Virtual
Worlds

UOP Sexual Health SIM in Second Life®
(2007-2009)
• Designed to provide education about sexually transmitted
infections (STIs), prevention of unintended
pregnancy, and promotion of equalitarian
sexual relationships, the University of
Plymouth Sexual Health SIM in Second Life®
provided a wide variety of educational experiences, including
opportunities to test knowledge of sexual health through
quizzes and games, Web resources integrated within the
virtual context, and live in-world seminars on sexual health
topics.
See: Kamel Boulos MN, Toth-Cohen S. The University of Plymouth Sexual Health
SIM experience in Second Life®: evaluation and reflections after one year. Health
Information and Libraries Journal. 2009; 26(4): 279-288.
http://dx.doi.org/10.1111/j.1471-1842.2008.00831.x

UOP Sexual Health SIM in Second Life®
(2007-2009)
• Made possible thanks to a generous land grant
provided to us by Education UK.

3-D Scripted Objects
• The UOP Sexual Health SIM in Second Life®
(http://healthcybermap.org/slsexualhealth/)
provided its sexual health education in a
relaxing, playful setting alongside the (virtual) ocean, with giant
flowers and soaring butterflies.
• Visitors to the SIM were offered a wide range of 3-D scripted
objects and games to explore and interact with, including a virtual
condom-dispensing machine offering free (virtual) male condoms
and practical information. They could also chat with the resident
pseudo-intelligent chatterbot, ‘Alice’, to find
out simple facts about contraception and STIs.
• An interactive kiosk provided an atlas
illustrating STIs and ways to prevent them,
and enabled visitors to listen to associated
voice narration or access related Web media
such as a PowerPoint quiz game or Web page.

3-D Scripted Objects
• An interactive 3-D Earth globe offered
access to current STIs / HIV / AIDS
statistics and information from 53
European region countries. Visitors
could also access a selection of premier international Web-
based and in-world resources from leading organisations.
• Media formats included streaming video/audio, podcasts, in-
world custom search engines retrieving quality sexual health
results from the UK Intute database (http://www.intute.ac.uk/)
and Healia (http://www.healia.com/), and a newsstand that
refreshes every 10 minutes to display the top two sexual health
headlines on Yahoo! News.
• There was even an ‘AIDS-related Kaposi Sarcoma
Experience’ clothing dispenser (see next slides).
• The SIM also afforded opportunities to test knowledge of
sexual health by participating in quiz games and other fun
experiences.

Snapshots of the ‘Big Quiz Game’
obelisk at the UOP Sexual Health SIM in
Second Life. This is an interactive
graphical ‘Contraception and STIs’ quiz
with a prize to win if the player’s answer
is correct (the prize is delivered to the
player’s inventory in-world).
The goal of our SIM is to help young
adults make well informed choices of
their own. We provide strong messages
and education about sexually
transmitted infections and the dangers
of unprotected sex. Our in-world objects
provide information about both
condoms and abstinence, so our
presentation is not biased towards one
camp or the other, nor imposing any
particular direction/method on our
visitors.

Video
2 min. : 38 sec.

UOP Sexual Health SIM in Second Life®
(2007-2009)
• The SIM also fostered the development of a vibrant virtual
community around it.
• Our 2007/2008 in-world voice-enabled seminars covered the topics
of domestic violence; STIs, contraception and family planning; female
sexuality; sexual purity and healthy relationships from a Christian
Orthodox perspective; and ‘sex and disability’.
• A mini-evaluation of the project was conducted
in 2007/2008. Primary methods of evaluation
consisted of an in-world survey using a special,
scripted questionnaire administration object in
Second Life® and traffic statistics on the virtual
programme.
• Questionnaire evaluation results (n=135 unique avatars) indicated
that the Sexual Health SIM was positively viewed by its audience.
• The SIM received more than 4000 unique visitors between July 2007
and July 2008. Repeat visitors figures for the same period are much
higher.

Community  In-world seminars
 Sexual Health SIM Group in-world
Avatars attending a seminar at the
University of Plymouth Sexual Health
SIM in Second Life®

< In-world UOP Sexual Health
SIM Group (free to join)
Video
2:02 min.

Our AIDS-related Kaposi Sarcoma
Experience
• We developed an ‘AIDS-related Kaposi Sarcoma Experience’ skin
as part of our ‘UOP Sexual Health SIM’ project in Second Life®,
where users, through their avatars, are able to see and
experience how Kaposi sarcoma looks and feels to AIDS patients.
< Wear a special avatar clothing
layer to see and experience on
your own avatar how Kaposi
Sarcoma looks/feels to AIDS
patients. This example was created
by SL user:Bailey Yifu using Adobe
Photoshop and similar tools, and
then made freely available for
visiting avatars to get copies of it
via a scripted dispenser object at
the UOP Sexual Health SIM. (Once
the user receives a copy in their
Inventory, all they need to do is to
right-click the item and select ‘Wear’.)

Virtual Dermatology Patients
• The same principle can be expanded, refined and used to role-
play patients with various skin conditions and presentations at
different stages of a disease to show how progress, worsening or
healing might appear.
• Such ‘virtual patients’, controlled by real humans at their PCs, can
also be used to train clinicians—especially about rare conditions—
and for teaching undergraduate students.
• This virtual clinical experience provides trainees and clinicians
with the opportunity to ask virtual patients questions about their
disease history, to obtain intelligent answers from the patients in
real time by using voice or text or both, to conduct clinical
examinations, ask for further tests or investigations, receive
feedback, and access additional sensorial inputs such as
streaming audio, video, photographs and text, as well as
links to Web pages and other resources.

Virtual Dermatology Patients
• This can help to show the progress of a treatment; depending
on a trainee’s questions and prescriptions, the person role-
playing the patient can switch to the appropriate skin, so that
the trainee doctor is able to see the effect of his or her
diagnosis and treatment.
Described in: Huang ST, Kamel Boulos MN, Dellavalle RP. Scientific
Discourse 2.0. Will Your Next Poster Session Be in Second Life®? EMBO
Reports. 2008;9(6):496–499. Available at:
http://www.nature.com/embor/journal/v9/n6/pdf/embor200886.pdf

Using Social Media Marketing and
Captology Techniques
• Unlike when dealing with formal students who are usually pre-
motivated (at least to some extent, as evidenced by the fact
they are enrolled in a formal programme of study and are
usually willing to complete their course/achieve a pass mark or
better), this was not necessarily always the case with our
Sexual Health SIM audience (the general public).
• Our task was much more difficult: we wanted people not just
acquire some new knowledge, but also change their attitudes
and ultimately their real-life behaviour (with no relapse),
where applicable. The latter is particularly difficult to achieve
(and to measure); for example, it is easy to tell people about
the dangers of smoking (every pack of cigarettes has a
‘smoking kills’ label these days), but it is much more difficult to
make someone quit smoking (and not revert back again to
their smoking habit after some time).

Using Social Media Marketing and
Captology Techniques
“Captology is the study of computers as
persuasive technologies. This includes the
design, research, and analysis of
interactive computing products created
for the purpose of changing people's
attitudes or behaviours.
“As the graphic shows, captology
describes the area where computing
technology and persuasion overlap.
“This area continues to grow quickly. Each
week more computing products, including
websites, are designed to change what
people think and do.”
Quoted from: http://captology.stanford.edu/
http://www.ivyworldwide.com/

Using Social Media Marketing and
Captology Techniques
• To help us address this educational challenge, the UOP Sexual
Health SIM experience team employed principles of captology
(http://captology.stanford.edu/) and marketing/advertising
psychology in designing many of the SIM’s objects, e.g., the
Kaposi Sarcoma skin and our virtual condoms dispenser.
• Some commentators criticised our approach in develop-
ing the latter by arguing that one cannot use a Second
Life® virtual condom in real-life sex. In answering them, we
brought the examples of the various radio receivers that are used
by the Coca-Cola Company in marketing their carbonated soft
drinks and come in the forms of a Coke can, bottle or cup
(http://www.google.com/images?hl=en&q=coca-cola%20radios). One
cannot drink from such radio cans, bottles and cups, but it is the
message that matters in both our virtual condoms and the Coca-
Cola radio cases (‘remember to use a condom’; ‘drink Coca-Cola’)!

http://healthcybermap.org/slsexualhealth/

Conclusions
• Second Life® (as a popular example of virtual worlds
today) is a unique 3-D social networking experience. It
allows people from all over the world to meet, share
objects and collaborate in many novel ways, using a
comprehensive and well-integrated suite of
asynchronous and synchronous, multimodal
communication tools.
• Second Life can also be seen as a vast collaborative 3-
D “wiki” and an immersive audio-visual spatial multi-
user experience that people can experiment with, edit
(subject to permissions), and see the changes
together in real time (user-generated content)!

Conclusions
• 3-D virtual worlds are rapidly getting more and more
accessible and user friendly (even for people with
cognitive and/or physical disabilities). They are here to
stay, mature, and eventually become one with, and more
tightly and seamlessly integrated into, the flat (2-D) Web
and the ‘real world’/our daily lives over the coming
months and years (forming the 3-D Internet).

The Barbican Harbour, Plymouth, UK – Photo © MNK Boulos

Research Example:
Novel Emergency/Public Health Situation
Rooms (and more) Using 4-D GIS
Maged N Kamel Boulos, PhD, SMIEEE
mnkboulos@ieee.org
First Presented at:

The Current Situation
• Conventional situation rooms are routinely used to
oversee public health emergencies and disaster
management operations in real time.
• Nowadays, large amounts of emergency data are
increasingly coming from a wide range of sources in
real or near-real time and need to be cross-linked
and visualized where they spatially belong on maps
of the affected regions.
• Also, emergencies are usually managed by multi-
professional teams who, not uncommonly, are
distributed in multiple geographic locations.

The Current Situation
• Because of these reasons, we have started to see
physical situation rooms gradually being replaced (or
combined) with virtual situation rooms that use
online collaborative (and mostly 2-D –two-
dimensional) platforms such as Depiction
(http://www.depiction.com/), in addition to
conventional Web conferencing.
• These platforms, although usable and helpful, leave
much to be desired, as they are lacking the ‘third
dimension’, which is needed to create a proper
perception of the emergency space, as well as a
sense of co-presence of other virtual team
members.

Current flat Web collaboration tools
Like Depiction, Google Wave and
Microsoft Vine can be Used in virtual
public health emergency situation
room applications, but leave much to
be desired!

The Proposed Solution
• To overcome this limitation, we are proposing the
development of novel emergency and public health
virtual situation rooms in a suitable 3-D (three-
dimensional) virtual world (sometimes also called ‘3-
D serious gaming platform’), where avatars of
experts and professionals can collaborate together
and discuss incident data in real time in a simulated
3-D space representing the physical location where
the emergency/public health incident of interest is
unfolding and reflecting all changes taking place
there (again in real time).

The Proposed Solution
• The real-time link between the virtual world and the
physical world incident would be two-way and
multimodal involving geo-tagged physical/
environmental sensor data feeds, citizen-contributed
data (as found in Microsoft Vine and ‘Who Is Sick’
http://www.whoissick.org/), data gleaned via
automatic analysis of Social Web content (cf. Google
Flu Trends http://www.google.org/flutrends/), textual and
3-D spatialized audio/voice exchanges between virtual
team members, video feeds, 3-D simulations and
animations, various Web mashups, and shared
desktop applications, among other possibilities.

Emergency/Public Health Situation Rooms
(and more) Using 4-D GIS
• 4-D GIS = 3-D Geographic Information Systems, plus the
temporal/real-time dimension (= 4-D)—serve very well
the classic Person-Place-Time Triad.
• A collaborative and interactive platform that marries
virtual globes (such as Google Earth™) and 3-D virtual
worlds (such as Second Life®/OpenSim), and
complements/ tightly integrates them with other key
technologies, e.g., real-time, geo-tagged RSS feeds
(including data feeds from physical sensors) and geo-
mashups (using Web services like Yahoo! Pipes), etc.

Short Video
(2 min. : 45 sec.)

Emergency/Public Health Situation Rooms
(and more) Using 4-D GIS
• The platform weaves data and services in real-time from
different sources into a new rich ‘datascape’ that better
reflects the current situation (the ‘big picture’) in novel
ways that are easier to understand and manage (‘infoglut’
management).
• The platform is secure, enabling multiple distributed
persons to “see” each other, visualise relevant data
together in unique ways, conduct 3-D simulation scenarios/
‘what-if’ scenarios, and collaborate in real-time, each
according to their assigned role and access privileges.
• Much suited for emergency and disaster management in
real-time, e.g., managing an influenza pandemic and
coordinating actions at global, regional and local levels.

Other Platform Highlights
• Modular: The platform will offer a reusable toolbox of
programmable objects that can be easily (re)used in various
scenarios.
• Mobile: it is now possible to stream a 3-D virtual world to a
suitable mobile phone or other Internet-enabled, small form
factor mobile devices, making this vision end-user device and
platform-independent and thus
suitable for those members of
the emergency operations team
who are on the move.
• True stereoscopic vision can be added
using readily available technologies.
Stereoscopic 3-D virtual globes with more natural
multitouch navigation are already available today (described
in: Kamel Boulos and Robinson, 2009).

Further Reading
• Kamel Boulos MN, Scotch M, Cheung K-H, Burden D. Web GIS in practice VI: a
demo “playlist” of geo-mashups for public health neogeographers. Int J Health
Geogr. 2008; 7:38.
• Kamel Boulos MN, Burden D. Web GIS in practice V: 3-D interactive and real-time
mapping in Second Life. Int J Health Geogr. 2007; 6:51.
• Kamel Boulos MN, Robinson LR. Web GIS in practice VII: stereoscopic 3-D
solutions for online maps and virtual globes. Int J Health Geogr. 2009; 8:59.
• Welch GF, et al. 3D Medical Collaboration Technology to Enhance Emergency
Healthcare. J Biomed Discov Collab. 2009 Apr 19;4:4.

Inside Portland Square Building, University of Plymouth, Plymouth, UK – Photo © MNK Boulos

Small Group Activity (60 min. + 30 min.)
• Discuss together in 2 to 4 breakout groups (5-7 persons per
group – 60 min.) your views and proposals concerning possible
and potential applications of NSM in health and healthcare
(education and research), informed by and building on the
affordances of these tools and environments that you have just
been introduced to in this workshop.
• Focus on those applications and projects that you would like to
explore in your own, specific context (in the courses you teach
and your research).
• Share any NSM experiences in education and/or research that
you are currently or have been involved in.
• Groups reporting back/final wrapping up notes (30 minutes):
Report back at least two example applications per group.

Smeaton’s Tower, Plymouth, UK – Photo © MNK Boulos

Thank You
“The scholar must be a solitary, modest and charitable soul. He must embrace solitude as a
bride...that he may become acquainted with his thoughts.”
—Ralph Waldo Emerson (1803-82) - Author, poet and philosopher