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Electronic Journal in Communication,
                                                         Information and Innovation in Health

                                                     [www.reciis.cict.fiocruz.br]
                                                         ISSN 1981-6286




                                                         Original Articles


             Mashing, Burning, Mixing
      and the Destructive Creativity of Web 2.0:
         Applications for Medical Education


                               Steven                                                           Maged Kamel
                               Wheeler                                                          Boulos
                               Faculty of Education,                                            Faculty of Health & Social
                               University of Plymouth,                                          Work, University of Plymouth,
                               Plymouth,                                                        Plymouth,
                               United Kingdom.                                                  United Kingdom.
                               S.Wheeler@plymouth.ac.uk                                         maged.kamelboulos@plymouth.ac.uk



Abstract
We examine the recent growth of social software (Web 2.0) and its initial impact on education, and offer a review
of some of the recent research conducted in the evaluation of its pedagogical applications. We highlight the
propensity of students to be both creative and destructive in their use of social software, particularly with wikis,
web logs (blogs) and other text based environments. Student activities within these social software environments
can cause tension and conflict, and reactions vary, but outcomes have been generally positive. Some medical
education examples are reviewed, providing the reader with worked examples of the use of social software in
action in clinical education contexts.

Keywords
Interactive software, Web 2.0, collaborative learning, wiki spaces, blogs.




1. Introduction                                                        popularity of these applications is rising rapidly, as
     The emergence of social (or so-called ‘Web 2.0’)                  students see the opportunities to free up time and space
software provides new and exciting opportunities for                   so that learning can be fitted into busy lifestyles.
teachers to create dynamic, collaborative and sociable                      However, a dilemma has arisen. Although, by its
learning environments for their students. This                         very nature, social software attracts activities which
incarnation of the world wide web holds                                have democracy and freedom from institutional
transformational potential for teachers and students                   influence at their heart (RICHARDSON, 2006), such
alike (RICHARDSON, 2006). Mashups, mixes and                           freedom may have the effect of opening the door to
aggregations of digital artefacts form the basis for a                 abuse or misuse of technologies. Seemingly destructive
dynamic and creative emerging environment within                       elements may emerge where the right to participate is
which students can learn through collaborative working                 exploited. Institutional rules may be infringed, causing
and community based enquiry. Feed burning software                     a detrimental effect upon the traditional organisation
enables users to receive alerts of web page updates direct             through subversion of previously accepted practices.
to their desktop computers or mobile devices. The                      In this paper we explore the creative and destructive



RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33                                                           27
nature of Web 2.0 participation and its implications         architecture of participation that encourages students
for education.                                               to engage in non-hierarchical communities of learning.
                                                             Perhaps the new term ‘unmanaged learning
2. Autonomous learning                                       environment’ should be applied to the use of Web 2.0
                                                             software in distance education. Certainly, the days of
     Students using Wikis and ‘blogs generally work
                                                             the managed learning environment appear to be
autonomously and independently, beyond the reach of
                                                             numbered.
any recognised authority, so it is debatable to what
extent educational institutions can, and should attempt           More commonly, the term ‘personalised learning
to ‘manage’ such learning technology. It follows that        environments’ or PLE has been coined to describe open
some universities may see a need to control the use of       architecture systems in which users create, mix and
such software in formalised learning contexts, but lack      edit their own content. Content can be ‘tagged’ using
the surveillance power necessary to facilitate it. Younger   keywords so that other users, both within and outside
students in particular often engage in the use of social     the user group can find pages and if permitted, also
software to share bookmarks, images and videos, and          participate in the editing. One popular tag organisation
other media outside of the auspices or control of their      site, Del.icio.us.com, enables such processes to be
parent institution. Popular sites include Bebo,              managed by individuals and groups in a highly visible
FaceBook, YouTube and MySpace, all of which are used         and accessible manner. Whichever way such openly
by millions of subscribers each day. Regulation of such      editable software is viewed, it is clear that this parti-
activities, even if desirable, would be impractical for      cular role of the teacher/instructor is being radically
most organisations.                                          re-engineered, with teachers becoming resources whilst
                                                             students take a more active role in the generation and
                                                             representation of knowledge.
3. Wikis
     There is an obvious attraction to such freely
                                                             5. Social presence
available webspace tools, but the question is whether
educational authorities should attempt to harness the              Encouraging students to immerse themselves in
power of such applications, or leave them to evolve in       richly collaborative learning environments in which they
an uncontrolled and ‘viral’ manner. The notion of na-        are able to create, mix, modify and extend their own
tural selection – ‘Darwikianism’ is a term applied to        knowledge artefacts using social software as personal
the lifecycle of wikis – can be applied as a yardstick to    ‘cognitive tools’, is not merely desirable (JONASSEN
test the longevity and utility of social software.           et al, 1999). It should also be a clear goal for all those
                                                             who wish to create social presence in distance
     Wikis quickly evolve into shared knowledge
                                                             education. Socially isolated individuals may be generally
repositories as communities aggregate their
                                                             less healthy than those connected to a richly social
contributions over time (GODWIN-JONES, 2003) and
                                                             environment. PUTNAM (2000) suggests that social
the ‘wisdom of the masses’ can be applied to the creation
                                                             capital enables individuals to widen their awareness of
of the ‘knowledge artefacts’. The social web promotes
                                                             the ways in which their fate is linked to community.
a stimulating and creative environment where readers
                                                             “The networks that constitute social capital also serve
become writers, and consumers become contributors
                                                             as conduits for the flow of helpful information that
(BOULOS et al, 2006). It is literally, the ‘read/write’
                                                             facilitates achieving our goals.” (PUTNAM, 2000). If
web.
                                                             used cor rectly, social software provides such a
                                                             networked environment, providing students with
4. ‘Unmanaged’ learning environments                         communication tools and virtual contact that emulates
     Regardless of a natural orientation toward              co-presence.
unmanaged independence, tutors who manage                         There is a perceived ‘coldness’ reported by many
educational provision from a distance may be uniquely        students whose learning is mediated largely through
placed to tap into the power and potential of social         technology (WALLACE, 1999; RICE, 1993). The notion
software. Teachers may attempt for example, to create        that one is not merely interacting with a technology,
student centred activities that engage and challenge         but that warmth of human contact exists at the ‘other
through the platform of social software. Such activities     end’ is vital for the success of most remote learners
might need to be managed loosely in keeping with the         (WALLACE, 1999). Social presence reflects the
autonomous nature of social spaces.                          student’s perception that s/he is communicating with
     There has been a long running debate about the          people through the technology (SHORT et al, 1976).
effectiveness of media and technology to influence           Achieving an effect of social presence is therefore
learning (KOZMA, 1994; CLARK, 1994), but choice              important in distance education, for without it,
of delivery technology is crucial to the success of a        students can feel isolated. With a sense of social
programme. Web 2.0 software goes beyond the                  presence through direct tutorial intervention however,
somewhat stilted and linear ‘managed learning                students feel that they are not alone in their long
environment’ or MLE approach established throughout          distance journey and often raise their game
much of higher and further education, providing an           (BELAWATI, 2005) and similar responses are observed


28                                                            RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33
in children’s learning (TUNG et al, 2006). Personal                 revolution. Ultimately, professionals are beginning to
communication, immediacy of responses from tutor                    realise that they are no longer the arbiters of all
and peer group, and a common sense of purpose within                knowledge, but that through the use of information
a community of learning are all features that contribute            and communication technologies, all can contribute
significantly toward stronger perceptions of social                 within the ‘architecture of participation’ (O’REILLY,
presence (WHEELER, 2006). The social web has the                    2004).
potential to deliver these features.                                      Some students have expressed unease about the
                                                                    ease at which previous ‘hard work’ is deleted or
6. Division of labour                                               modified beyond recognition. They sometimes hold the
     One of the features of wikis and other community               belief that the ideas are ‘theirs’ which indeed, in many
based authoring software such as Google Docs and                    cases, they are. This is until the ‘Send’ button is clicked,
Spreadsheets, is that all members of a community or                 and from this point onwards, the content has become
user group are able to modify, expand or delete previous            ‘public property’ and can then be subject to any amount
entries with alacrity (RICHARDSON, 2006). Such                      of destruction. We have already indicated that conflict
activities, although apparently destructive, tend to                can occur, and disagreements have been observed
result in greater clarity of thought, more judicious                between our own students during wiki editing and
correction of errors, and clearer elaboration of previously         content generation. In this context, the notion of
posted content and ideas. The division of labour                    intellectual property becomes problematic, and unless
required to engage an entire group of students in                   wiki group members agree on the content, an endless
content generation can be explained within an activity              series of ‘modification wars’ can ensue. Overall, wiki
theory framework (ENGESTRÖM, 1993). Division of                     users must realise that the editing space is open and
labour in this context refers to the horizontal                     free for all to use and contribute toward, and that the
relationship between members of the learning                        creative/destructive process is ever ongoing.
community as a result of their mutual actions and
interactions. Wikis can subvert traditional values such             8. Blogging and creative writing
as personal ownership and intellectual property                           Writing to the web has never been easier, as many
(RICHARDSON, 2006), whilst community ownership                      students are discovering. Web logs, or ‘blogs take the
of the content becomes an equalising factor. A vertical             form of online reflective diaries and are predominantly
division of ‘power and status’ may also be present which            web pages produced by individuals, although groups
exemplifies this differential (THORNE, 2000). If such               and corporations can also be involved. There is also a
a division is not resolved within the community of                  facility for readers, often bloggers themselves, to enter
learners, conflict results.                                         into dialogue with the blogger, and to generate
      Thereby, editors and organisers of open                       discussion over a period of time.
architecture spaces carefully regulate content                             Many bloggers report that regular ‘blog writing
generation by wielding the power to remove offending                enables them to discover a more creative side to
or inappropriate posting of content. This is achieved               themselves (NÜCKLES et al, 2004). Some declare that
by simply ‘rolling back’ to a previously more acceptable            ‘blogging has made them better writers and ultimately,
version of the wiki page through the wiki ‘page history’            better communicators (WILLIAMS et al, 2004). There
facility. In an education setting, wiki development is              is also a strangely addictive quality to blog writing,
wisely left as the purview of the student group. Any                particularly if the blogger is aware of an audience.
vertical power differential or status division can be               Students generally write blogs about what affects them
ameliorated by the teacher adopting the role of observer            during their studies, and relish the facility to share
within the creative/destructive process.                            their thoughts with others. They enjoy receiving
                                                                    comments back from readers, thereby indicating that
7. Ownership and agreement                                          the postings are being read and valued. Membership of
     There is little doubt that the boundaries between              a social tagging utility such as Del.icio.us or Technorati
that of the professions and the general public are being            can also increase traffic to a blog, and when other
gradually eroded by the proliferation and widespread                bloggers link their sites, blog listings rise in the
adoption of social software. A cursory examination of               ‘popularity’ rankings. Some star bloggers already enjoy
medical or legal wiki sites will confirm this. New                  regular readerships numbering thousands (WILLIAM
partnerships are opening up where lay-people and                    et al, 2004; BOULOS et al, 2006).
professionals coalesce their ideas, connections and                      Encouraging students to create a group blog, where
transactions to create repositories of knowledge that               each member of the group has responsibility to
transcend the traditional resources previously available.           contribute to the regular postings, is a valuable means
There is a sort of ‘swarm mentality’ emerging from                  to engage quieter students and a fair equaliser in the
virtual interactions, probably first pointed out by                 quest to engage all students in active, discursive learning.
RHEINGOLD (1998) and others. The swarm software                     Research indicates that writing learning diaries can
such as wikis, folksonomies and application sharing                 foster a deeper cognitive engagement with course
are merely the tools that are facilitating this social              content (NÜCKLES et al, 2004) and encourages critical


RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33                                                            29
reflection (KUHN, 1991). Further, if couched within a
learning context the dialogue between bloggers can
generate rich and meaningful engagement with course
materials, experiences and new ideas (WILLIAMS et
al, 2004).


9. Virtual worlds and second lives
     A virtual world is a computer-based, simulated
multimedia environment, usually running over the Web,
and designed so that users can ‘inhabit’ and interact
via their own graphical self-representations known as
avatars.      Virtual    Worlds       Review       (http://    Figure 1 – Screenshot from the ‘Heart Murmur Sim - Cardiac Auscultation
www.virtualworldsreview.com/) provides a useful list of        Training Concept’ educational virtual world created in Second Life that
persistent online two-dimensional (2D) and three-              allows visitors (clinical students) to tour a virtual clinic and test
                                                               their skills at identifying the sounds of different types of heart
dimensional (3D) virtual worlds that emphasise social          murmurs, based on sound files from McGill University’s Virtual
interaction. Of these, Second Life (http://                    Stethoscope (http://sprojects.mmi.mcgill.ca/mvs/mvsteth.htm).
secondlife.com/ - Figure 1) is perhaps the most popu-
lar today, which in mid-February 2007 boasted more
                                                               educational blog posts (e.g., http://steve-
than 3.5 million virtual citizens or ‘Lifers’ all with their
                                                               wheeler.blogspot.com/search/label/Second%20Life).
own fully textured high-resolution avatar that can be
finely customised. (http://www.virtualworldsreview.com/             ANTONACCI et al (2005) have explored the
secondlife/).                                                  nature of Second Life in an online paper complete with
                                                               video presentations. More recently, YELLOWLEES et
      Virtual worlds like Second Life are not mere 3D
                                                               al (2006) evaluated Second Life as a medical education
multiplayer games. The immersive experience that such
                                                               tool for learning about psychotic hallucinations, and
environments offer combines many of the features of
                                                               concluded that ‘the use of Internet-connected graphics
Web 2.0 like instant messaging, profiles, users’ ratings
                                                               environments holds promise for public education about
and social networking, and a unique form of online
                                                               mental illness’.
social interaction that involves sharing various objects
and creative collaboration on building and running                  Results from a recent survey by the US-based
places and services in the virtual world (user-generated       ‘Center for the Digital Future’ of 2,000 individuals (part
content). SLurl (http://slurl.com/), a Web-based service       of a six-year study into attitudes to the Web) found
allowing external location-based linking or teleporting’       that many members of online communities believe vir-
to places in Second Life (bookmarked by users), has            tual communities are as important as their real-world
also been launched. Some financial experts even see            counterparts (BBC NEWS ONLINE, 2006). 3D virtu-
unique business and marketing opportunities in Second          al worlds then, appear to have much creative collateral
Life (e.g., http://money.cnn.com/2006/11/09/technology/        to offer to education as social spaces for learning, but
fastforward_secondlife.fortune/index.htm and FT                as with all applications, there are caveats.
articles: http://www.ft.com/cms/s/cf9b81c2-753a-11db-
aea1-0000779e2340.html and http://www.ft.com/cms/              10. Main disadvantages
s/3e21a6ca-7a37-11db-8838-0000779e2340.html). The                   Despite the fact that Second Life has two separate
potential of such a rich experience in education must          worlds or grids, one for teens and one for adults, and
also be great.                                                 a wealth of useful user-generated content (e.g., http:/
     In a virtual world, educators can create online           /orthodoxwiki.org/Virtual_Chapel), undesirable
communities that students can log into and interact            elements such as gambling/Internet addiction,
in. Within these educational virtual worlds, students          pornography and online child (and adult) sex
will use their avatar to learn about new assignments           exploitation remain big problems in Second Life. The
and to create projects that are viewable within the            same is true in many other Web 2.0 social networking
virtual    world      (http://en.wikipedia.org/wiki/           services such as MySpace. Even after a ‘Lifer’ deselects
Virtual_world#In_the_classroom). Indeed, Second Life           ‘Show/Search Mature Places and Events’ in Second
features a dedicated education-oriented section or             Life, there is still a strong possibility that they may
community, and several educational institutions in the         encounter unsolicited objectionable content
USA are already making use of it (see ‘ Top 20                 (TERDIMAN, 2006; REUTERS, 2007).
Educational Locations in Second Life’ (with teleport                Another minor shortcoming is the need for a fast
links using SLurl): http://www.simteach.com/wiki/              broadband Internet connection and high-end computer
index.php?title=Main_Page).                                    and graphics card to be able to smoothly run the Second
     Educause has pages dedicated to Second Life (e.g.,        Life software client, which must be installed on user’s
http://connect.educause.edu/taxonomy/term/2174/0),             machine and communicates in real time with Second
which has also been the focus of many recent                   Life servers and other online Lifers in the virtual world.



30                                                              RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33
11. Mashups and other contrivances                                  Maps’ (for a medical geography example of the latter,
      The increasingly sophisticated array of software              see the ‘Places mentioned in this book’ section at http:/
made available to the connected community brings with               /books.google.com/books?vid=ISBN159385160X).
it the ability to destroy and recreate previously                        Mapping mashups are thus an excellent example
generated digital artefacts. Known as ‘mashups’, many               of remixing (sharing, reusing and repurposing)
of the modified images, sounds and textual landscapes               information in Web 2.0 to produce value-added content.
found in Web 2.0 bear little or no resemblance to their             The global distribution of ‘free’ geospatial tools, imagery,
initial incarnations. Such repurposing is a increasingly            and maps by Google and other providers is to be
common feature on Web 2.0. One notable mashup is                    commended as a significant step towards the ultimate
an amalgamation of mapping resources.                               ‘wikification’ of maps and GIS or Geographic
     Online mapping services like Google Maps (http:/               Information Systems (BOULOS, 2005)
/maps.google.com/) allow users to navigate most of the                    SYM-SMITH (2007) describes how Web 2.0 and
globe (and even the moon - http://moon.google.com/)                 social-computing concepts - in which the technology
through an interactive Web interface, viewing varying               puts the power in the hands of the users, not
levels of resolution through maps, satellite imagery, or            institutions - are rewriting the rules in the area of Earth
a combination. Mapping mashups can overlay one or                   navigation. Educause has published two interesting two-
more data feeds from other online sources on those                  page sheets on the uses of mapping mashups (Educause.
maps, resulting in new user-generated interactive maps
that can have clickable markers showing specific points
of interest. Mapping mashups can even show links to
additional Web information about those points
(definition adapted from: Educause. Seven things you
should know about... Mapping Mashups. http://
www.educause.edu/ir/library/pdf/ELI7016.pdf).
     As RSS (Really Simple Syndication/Rich Site
Summary) is becoming more and more prevalent as a
means of publishing and sharing information online, it
has become increasingly important to extend it to allow
location to be described in an interoperable manner.
This move enables users to request, aggregate, share
and map geographically tagged feeds (SCHUTZBERG,
2006). Daden’s Avian flu feed for Google Maps is a
practical example of a health-related ‘geofeed’ (http://            Figure 2 – Screenshot of HEALTHmap (http://healthmap.org/), a
www.daden.co.uk/pages/000208.html). Another                         mapping mashup service that overlays health-related news links
                                                                    from multiple sources on maps sourced from Google Maps, using
example, HEALTHmap (http://healthmap.org/), a Glo-
                                                                    the API (Application Programming Interface) that Google Maps is
bal disease alert mapping system, is also based on                  providing for this purpose (http://www.google.com/apis/maps/).
Google Maps and news feeds (Figure 2).
      Moreover, courtesy of free or inexpensive software
like GooPs (http://sites.onlinenw.com/goops/goops.php)              7 things you should know about... Mapping Mashups.
and GpsGate (http://franson.com/gpsgate/), users can                http://www.educause.edu/ir/library/pdf/ELI7016.pdf) and
overlay their own position on the same maps and also                Google Earth (Educause. 7 things you should know
view the position of their friends in real time over the            about... Google Earth. http://www.educause.edu/ir/
Web, if they have a simple GPS device (a position                   librar y/pdf/ELI7019.pdf) in education and their
tracking device based on the Global Positioning System)             implications for teaching and learning. Mapping
like an inexpensive USB GPS mouse receiver connected                mashups certainly have a great potential in education
to their laptop or PC.                                              and some educators are already using them (see the
                                                                    above Educause sheets).
     Photography enthusiasts can use cameras with
built-in GPS to enable them to attach exact Earth                        Mapping mashups offer many possibilities to
location coordinates to each photograph at the spot it              creative educators, but these possibilities will need to
was taken. However, even without such devices, people               be identified, explored in various settings/scenarios, and
are still able to ‘geotag’ their photos and utilise existing        carefully researched and evaluated to document best
Web 2.0 services such as Flickr (http://www.flickr.com/             practices before they can be used confidently in daily
groups/mappr/), Mappr (http://www.mappr.com/), and                  teaching and learning activities.
Google earth (http://earth.google.com/) in many novel
and exciting ways (TORRONE, 2005).                                  12. Conclusion
      More recent examples of mapping mashups include                    Within this short paper we have shown that many
Jotle, a Google Maps-Flickr (photos)-YouTube (videos)               opportunities exist for students to engage in social
Mashup (http://www.jotle.com/) and ‘Google Books and                interaction and learning through Web 2.0 enabled



RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33                                                               31
software. Sharing, aggregating and mixing of digital         JONASSEN, D. H.; PECK, K. L.; WILSON, B. G.
objects can be both creative and destructive, but               Learning with Technology: a constructivist
generally result in more rounded and accurate                   perspective. Upper Saddle River, NJ: Merrill. 1999.
outcomes. Ultimately, wikis, blogs, mashups, 3D virtu-
                                                             KOZMA , R . B. Will media influence learning?
al worlds and other sociable applications can create
                                                                Reframing the debate. Education Technology
for students a vibrant, dynamic and challenging infor-
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                                                                1994.
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to be fully explored, raising interesting questions for         Cambridge University Press. 1991.
teachers to address. One thing is certain – the popularity
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  acquisition. Oxford: Oxford University Press,                        Environments, v.14, n.3, p.251-264, 2006.
  p.219-244, 2000.
                                                                    WALLACE, P. The Psychology of the Internet.
TERDIMAN, D. Phoney kids, virtual sex. 12 Apr. 2006.                   Cambridge: Cambridge University Press, 1999.
   At: http://news.com.com/Phony+kids,+virtual+
   sex/2100-1043_3-6060132.html. Accessed: 24 Jan.                  WHEELER, S. Learner support needs in online problem
   2007.                                                              based learning. Quarterly Review of Distance
                                                                      Education, v.7, n.2, p.175-184, 2006.
SCHUTZBERG, A. Fun with GeoRSS. Directions
   Magazine. At: http://www.directionsmag.com/                      WILLIAMS, J. B.; JACOBS, J. Exploring the use of blogs
   article.php?article_id=2197&trv=1. Accessed: 09                     as learning spaces in the higher education sector.
   jun. 2006                                                           Australian Journal of Educational Technology,
TORRONE, P. How to GPS Tag Photos: Flickr, Mappr,                      v.20, n.2, p.232-247, 2004. At: http://
   Google Earth. 2005. At: http://www.makezine.com/                    www.ascilite.org.au/ajet/ajet20/williams.html.
   blog/archive/2005/07/how_to_gps_tag.html.                           Accessed: 14 Feb. 2007.
   Accessed: 10 Feb. 2007.                                          YELLOWLEES, P. M.; COOK, J. N. Education about
TU, C. The measurement of social presence in an online                 hallucinations using an internet virtual reality
    learning environment. International Journal of                     system: A qualitative survey. Academic Psychiatry,
    E-Learning, v.1 n.2, p.34-45, 2002.                                v.30, n.6, p.534-539, 2006.




About the authors
Steve Wheeler
Steve Wheeler is Senior Lecturer in Education and ICT in the Faculty of Education at the University of Plymouth. He
has worked with educational media and technology since 1976, and has worked as a consultant on several
groundbreaking e-learning projects, including the RATIO project (UK) and South Dakota's state wide broadband
network (USA). He is a visiting lecturer/professor at several universities in the US and Czech Republic and is regularly
invited to speak at international conferences worldwide. His research interests include learner perception and e-
learning, and he serves on the editorial boards of six international academic journals, including ALT-J, Interactive
Learning Environments and IRRODL . His most recent book is entitled 'Transforming Primary ICT'.


Maged N. Kamel Boulos
Maged N Kamel Boulos is Senior Lecturer in Health Informatics at the University of Plymouth, Devon, UK. He
previously worked as Lecturer in Health Informatics at the University of Bath, and worked before that at City
University, London, both in UK. As well as his medical degree and Master in Dermatology, he holds an Master in
quot;Medical Informaticsquot; from King's College, University of London, and a PhD in quot;Measurement and Information in
Medicinequot; from City University, London, both in UK. He is well published on the topics of Web 2.0/social software,
the Semantic Web and geographic information systems, including Internet/Web GIS, in health and healthcare. He is
also the Editor-in-Chief of the Open Access International Journal of Health Geographics http://www.ij-
healthgeographics.com, and one of the Principal Investigators of the CAALYX EU FP6 e-health project http://caalyx.eu.




RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33                                                      33

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Mashing Burning Mixing and the Destructive Creativity of Web 2.0

  • 1. Electronic Journal in Communication, Information and Innovation in Health [www.reciis.cict.fiocruz.br] ISSN 1981-6286 Original Articles Mashing, Burning, Mixing and the Destructive Creativity of Web 2.0: Applications for Medical Education Steven Maged Kamel Wheeler Boulos Faculty of Education, Faculty of Health & Social University of Plymouth, Work, University of Plymouth, Plymouth, Plymouth, United Kingdom. United Kingdom. S.Wheeler@plymouth.ac.uk maged.kamelboulos@plymouth.ac.uk Abstract We examine the recent growth of social software (Web 2.0) and its initial impact on education, and offer a review of some of the recent research conducted in the evaluation of its pedagogical applications. We highlight the propensity of students to be both creative and destructive in their use of social software, particularly with wikis, web logs (blogs) and other text based environments. Student activities within these social software environments can cause tension and conflict, and reactions vary, but outcomes have been generally positive. Some medical education examples are reviewed, providing the reader with worked examples of the use of social software in action in clinical education contexts. Keywords Interactive software, Web 2.0, collaborative learning, wiki spaces, blogs. 1. Introduction popularity of these applications is rising rapidly, as The emergence of social (or so-called ‘Web 2.0’) students see the opportunities to free up time and space software provides new and exciting opportunities for so that learning can be fitted into busy lifestyles. teachers to create dynamic, collaborative and sociable However, a dilemma has arisen. Although, by its learning environments for their students. This very nature, social software attracts activities which incarnation of the world wide web holds have democracy and freedom from institutional transformational potential for teachers and students influence at their heart (RICHARDSON, 2006), such alike (RICHARDSON, 2006). Mashups, mixes and freedom may have the effect of opening the door to aggregations of digital artefacts form the basis for a abuse or misuse of technologies. Seemingly destructive dynamic and creative emerging environment within elements may emerge where the right to participate is which students can learn through collaborative working exploited. Institutional rules may be infringed, causing and community based enquiry. Feed burning software a detrimental effect upon the traditional organisation enables users to receive alerts of web page updates direct through subversion of previously accepted practices. to their desktop computers or mobile devices. The In this paper we explore the creative and destructive RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33 27
  • 2. nature of Web 2.0 participation and its implications architecture of participation that encourages students for education. to engage in non-hierarchical communities of learning. Perhaps the new term ‘unmanaged learning 2. Autonomous learning environment’ should be applied to the use of Web 2.0 software in distance education. Certainly, the days of Students using Wikis and ‘blogs generally work the managed learning environment appear to be autonomously and independently, beyond the reach of numbered. any recognised authority, so it is debatable to what extent educational institutions can, and should attempt More commonly, the term ‘personalised learning to ‘manage’ such learning technology. It follows that environments’ or PLE has been coined to describe open some universities may see a need to control the use of architecture systems in which users create, mix and such software in formalised learning contexts, but lack edit their own content. Content can be ‘tagged’ using the surveillance power necessary to facilitate it. Younger keywords so that other users, both within and outside students in particular often engage in the use of social the user group can find pages and if permitted, also software to share bookmarks, images and videos, and participate in the editing. One popular tag organisation other media outside of the auspices or control of their site, Del.icio.us.com, enables such processes to be parent institution. Popular sites include Bebo, managed by individuals and groups in a highly visible FaceBook, YouTube and MySpace, all of which are used and accessible manner. Whichever way such openly by millions of subscribers each day. Regulation of such editable software is viewed, it is clear that this parti- activities, even if desirable, would be impractical for cular role of the teacher/instructor is being radically most organisations. re-engineered, with teachers becoming resources whilst students take a more active role in the generation and representation of knowledge. 3. Wikis There is an obvious attraction to such freely 5. Social presence available webspace tools, but the question is whether educational authorities should attempt to harness the Encouraging students to immerse themselves in power of such applications, or leave them to evolve in richly collaborative learning environments in which they an uncontrolled and ‘viral’ manner. The notion of na- are able to create, mix, modify and extend their own tural selection – ‘Darwikianism’ is a term applied to knowledge artefacts using social software as personal the lifecycle of wikis – can be applied as a yardstick to ‘cognitive tools’, is not merely desirable (JONASSEN test the longevity and utility of social software. et al, 1999). It should also be a clear goal for all those who wish to create social presence in distance Wikis quickly evolve into shared knowledge education. Socially isolated individuals may be generally repositories as communities aggregate their less healthy than those connected to a richly social contributions over time (GODWIN-JONES, 2003) and environment. PUTNAM (2000) suggests that social the ‘wisdom of the masses’ can be applied to the creation capital enables individuals to widen their awareness of of the ‘knowledge artefacts’. The social web promotes the ways in which their fate is linked to community. a stimulating and creative environment where readers “The networks that constitute social capital also serve become writers, and consumers become contributors as conduits for the flow of helpful information that (BOULOS et al, 2006). It is literally, the ‘read/write’ facilitates achieving our goals.” (PUTNAM, 2000). If web. used cor rectly, social software provides such a networked environment, providing students with 4. ‘Unmanaged’ learning environments communication tools and virtual contact that emulates Regardless of a natural orientation toward co-presence. unmanaged independence, tutors who manage There is a perceived ‘coldness’ reported by many educational provision from a distance may be uniquely students whose learning is mediated largely through placed to tap into the power and potential of social technology (WALLACE, 1999; RICE, 1993). The notion software. Teachers may attempt for example, to create that one is not merely interacting with a technology, student centred activities that engage and challenge but that warmth of human contact exists at the ‘other through the platform of social software. Such activities end’ is vital for the success of most remote learners might need to be managed loosely in keeping with the (WALLACE, 1999). Social presence reflects the autonomous nature of social spaces. student’s perception that s/he is communicating with There has been a long running debate about the people through the technology (SHORT et al, 1976). effectiveness of media and technology to influence Achieving an effect of social presence is therefore learning (KOZMA, 1994; CLARK, 1994), but choice important in distance education, for without it, of delivery technology is crucial to the success of a students can feel isolated. With a sense of social programme. Web 2.0 software goes beyond the presence through direct tutorial intervention however, somewhat stilted and linear ‘managed learning students feel that they are not alone in their long environment’ or MLE approach established throughout distance journey and often raise their game much of higher and further education, providing an (BELAWATI, 2005) and similar responses are observed 28 RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33
  • 3. in children’s learning (TUNG et al, 2006). Personal revolution. Ultimately, professionals are beginning to communication, immediacy of responses from tutor realise that they are no longer the arbiters of all and peer group, and a common sense of purpose within knowledge, but that through the use of information a community of learning are all features that contribute and communication technologies, all can contribute significantly toward stronger perceptions of social within the ‘architecture of participation’ (O’REILLY, presence (WHEELER, 2006). The social web has the 2004). potential to deliver these features. Some students have expressed unease about the ease at which previous ‘hard work’ is deleted or 6. Division of labour modified beyond recognition. They sometimes hold the One of the features of wikis and other community belief that the ideas are ‘theirs’ which indeed, in many based authoring software such as Google Docs and cases, they are. This is until the ‘Send’ button is clicked, Spreadsheets, is that all members of a community or and from this point onwards, the content has become user group are able to modify, expand or delete previous ‘public property’ and can then be subject to any amount entries with alacrity (RICHARDSON, 2006). Such of destruction. We have already indicated that conflict activities, although apparently destructive, tend to can occur, and disagreements have been observed result in greater clarity of thought, more judicious between our own students during wiki editing and correction of errors, and clearer elaboration of previously content generation. In this context, the notion of posted content and ideas. The division of labour intellectual property becomes problematic, and unless required to engage an entire group of students in wiki group members agree on the content, an endless content generation can be explained within an activity series of ‘modification wars’ can ensue. Overall, wiki theory framework (ENGESTRÖM, 1993). Division of users must realise that the editing space is open and labour in this context refers to the horizontal free for all to use and contribute toward, and that the relationship between members of the learning creative/destructive process is ever ongoing. community as a result of their mutual actions and interactions. Wikis can subvert traditional values such 8. Blogging and creative writing as personal ownership and intellectual property Writing to the web has never been easier, as many (RICHARDSON, 2006), whilst community ownership students are discovering. Web logs, or ‘blogs take the of the content becomes an equalising factor. A vertical form of online reflective diaries and are predominantly division of ‘power and status’ may also be present which web pages produced by individuals, although groups exemplifies this differential (THORNE, 2000). If such and corporations can also be involved. There is also a a division is not resolved within the community of facility for readers, often bloggers themselves, to enter learners, conflict results. into dialogue with the blogger, and to generate Thereby, editors and organisers of open discussion over a period of time. architecture spaces carefully regulate content Many bloggers report that regular ‘blog writing generation by wielding the power to remove offending enables them to discover a more creative side to or inappropriate posting of content. This is achieved themselves (NÜCKLES et al, 2004). Some declare that by simply ‘rolling back’ to a previously more acceptable ‘blogging has made them better writers and ultimately, version of the wiki page through the wiki ‘page history’ better communicators (WILLIAMS et al, 2004). There facility. In an education setting, wiki development is is also a strangely addictive quality to blog writing, wisely left as the purview of the student group. Any particularly if the blogger is aware of an audience. vertical power differential or status division can be Students generally write blogs about what affects them ameliorated by the teacher adopting the role of observer during their studies, and relish the facility to share within the creative/destructive process. their thoughts with others. They enjoy receiving comments back from readers, thereby indicating that 7. Ownership and agreement the postings are being read and valued. Membership of There is little doubt that the boundaries between a social tagging utility such as Del.icio.us or Technorati that of the professions and the general public are being can also increase traffic to a blog, and when other gradually eroded by the proliferation and widespread bloggers link their sites, blog listings rise in the adoption of social software. A cursory examination of ‘popularity’ rankings. Some star bloggers already enjoy medical or legal wiki sites will confirm this. New regular readerships numbering thousands (WILLIAM partnerships are opening up where lay-people and et al, 2004; BOULOS et al, 2006). professionals coalesce their ideas, connections and Encouraging students to create a group blog, where transactions to create repositories of knowledge that each member of the group has responsibility to transcend the traditional resources previously available. contribute to the regular postings, is a valuable means There is a sort of ‘swarm mentality’ emerging from to engage quieter students and a fair equaliser in the virtual interactions, probably first pointed out by quest to engage all students in active, discursive learning. RHEINGOLD (1998) and others. The swarm software Research indicates that writing learning diaries can such as wikis, folksonomies and application sharing foster a deeper cognitive engagement with course are merely the tools that are facilitating this social content (NÜCKLES et al, 2004) and encourages critical RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33 29
  • 4. reflection (KUHN, 1991). Further, if couched within a learning context the dialogue between bloggers can generate rich and meaningful engagement with course materials, experiences and new ideas (WILLIAMS et al, 2004). 9. Virtual worlds and second lives A virtual world is a computer-based, simulated multimedia environment, usually running over the Web, and designed so that users can ‘inhabit’ and interact via their own graphical self-representations known as avatars. Virtual Worlds Review (http:// Figure 1 – Screenshot from the ‘Heart Murmur Sim - Cardiac Auscultation www.virtualworldsreview.com/) provides a useful list of Training Concept’ educational virtual world created in Second Life that persistent online two-dimensional (2D) and three- allows visitors (clinical students) to tour a virtual clinic and test their skills at identifying the sounds of different types of heart dimensional (3D) virtual worlds that emphasise social murmurs, based on sound files from McGill University’s Virtual interaction. Of these, Second Life (http:// Stethoscope (http://sprojects.mmi.mcgill.ca/mvs/mvsteth.htm). secondlife.com/ - Figure 1) is perhaps the most popu- lar today, which in mid-February 2007 boasted more educational blog posts (e.g., http://steve- than 3.5 million virtual citizens or ‘Lifers’ all with their wheeler.blogspot.com/search/label/Second%20Life). own fully textured high-resolution avatar that can be finely customised. (http://www.virtualworldsreview.com/ ANTONACCI et al (2005) have explored the secondlife/). nature of Second Life in an online paper complete with video presentations. More recently, YELLOWLEES et Virtual worlds like Second Life are not mere 3D al (2006) evaluated Second Life as a medical education multiplayer games. The immersive experience that such tool for learning about psychotic hallucinations, and environments offer combines many of the features of concluded that ‘the use of Internet-connected graphics Web 2.0 like instant messaging, profiles, users’ ratings environments holds promise for public education about and social networking, and a unique form of online mental illness’. social interaction that involves sharing various objects and creative collaboration on building and running Results from a recent survey by the US-based places and services in the virtual world (user-generated ‘Center for the Digital Future’ of 2,000 individuals (part content). SLurl (http://slurl.com/), a Web-based service of a six-year study into attitudes to the Web) found allowing external location-based linking or teleporting’ that many members of online communities believe vir- to places in Second Life (bookmarked by users), has tual communities are as important as their real-world also been launched. Some financial experts even see counterparts (BBC NEWS ONLINE, 2006). 3D virtu- unique business and marketing opportunities in Second al worlds then, appear to have much creative collateral Life (e.g., http://money.cnn.com/2006/11/09/technology/ to offer to education as social spaces for learning, but fastforward_secondlife.fortune/index.htm and FT as with all applications, there are caveats. articles: http://www.ft.com/cms/s/cf9b81c2-753a-11db- aea1-0000779e2340.html and http://www.ft.com/cms/ 10. Main disadvantages s/3e21a6ca-7a37-11db-8838-0000779e2340.html). The Despite the fact that Second Life has two separate potential of such a rich experience in education must worlds or grids, one for teens and one for adults, and also be great. a wealth of useful user-generated content (e.g., http:/ In a virtual world, educators can create online /orthodoxwiki.org/Virtual_Chapel), undesirable communities that students can log into and interact elements such as gambling/Internet addiction, in. Within these educational virtual worlds, students pornography and online child (and adult) sex will use their avatar to learn about new assignments exploitation remain big problems in Second Life. The and to create projects that are viewable within the same is true in many other Web 2.0 social networking virtual world (http://en.wikipedia.org/wiki/ services such as MySpace. Even after a ‘Lifer’ deselects Virtual_world#In_the_classroom). Indeed, Second Life ‘Show/Search Mature Places and Events’ in Second features a dedicated education-oriented section or Life, there is still a strong possibility that they may community, and several educational institutions in the encounter unsolicited objectionable content USA are already making use of it (see ‘ Top 20 (TERDIMAN, 2006; REUTERS, 2007). Educational Locations in Second Life’ (with teleport Another minor shortcoming is the need for a fast links using SLurl): http://www.simteach.com/wiki/ broadband Internet connection and high-end computer index.php?title=Main_Page). and graphics card to be able to smoothly run the Second Educause has pages dedicated to Second Life (e.g., Life software client, which must be installed on user’s http://connect.educause.edu/taxonomy/term/2174/0), machine and communicates in real time with Second which has also been the focus of many recent Life servers and other online Lifers in the virtual world. 30 RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33
  • 5. 11. Mashups and other contrivances Maps’ (for a medical geography example of the latter, The increasingly sophisticated array of software see the ‘Places mentioned in this book’ section at http:/ made available to the connected community brings with /books.google.com/books?vid=ISBN159385160X). it the ability to destroy and recreate previously Mapping mashups are thus an excellent example generated digital artefacts. Known as ‘mashups’, many of remixing (sharing, reusing and repurposing) of the modified images, sounds and textual landscapes information in Web 2.0 to produce value-added content. found in Web 2.0 bear little or no resemblance to their The global distribution of ‘free’ geospatial tools, imagery, initial incarnations. Such repurposing is a increasingly and maps by Google and other providers is to be common feature on Web 2.0. One notable mashup is commended as a significant step towards the ultimate an amalgamation of mapping resources. ‘wikification’ of maps and GIS or Geographic Online mapping services like Google Maps (http:/ Information Systems (BOULOS, 2005) /maps.google.com/) allow users to navigate most of the SYM-SMITH (2007) describes how Web 2.0 and globe (and even the moon - http://moon.google.com/) social-computing concepts - in which the technology through an interactive Web interface, viewing varying puts the power in the hands of the users, not levels of resolution through maps, satellite imagery, or institutions - are rewriting the rules in the area of Earth a combination. Mapping mashups can overlay one or navigation. Educause has published two interesting two- more data feeds from other online sources on those page sheets on the uses of mapping mashups (Educause. maps, resulting in new user-generated interactive maps that can have clickable markers showing specific points of interest. Mapping mashups can even show links to additional Web information about those points (definition adapted from: Educause. Seven things you should know about... Mapping Mashups. http:// www.educause.edu/ir/library/pdf/ELI7016.pdf). As RSS (Really Simple Syndication/Rich Site Summary) is becoming more and more prevalent as a means of publishing and sharing information online, it has become increasingly important to extend it to allow location to be described in an interoperable manner. This move enables users to request, aggregate, share and map geographically tagged feeds (SCHUTZBERG, 2006). Daden’s Avian flu feed for Google Maps is a practical example of a health-related ‘geofeed’ (http:// Figure 2 – Screenshot of HEALTHmap (http://healthmap.org/), a www.daden.co.uk/pages/000208.html). Another mapping mashup service that overlays health-related news links from multiple sources on maps sourced from Google Maps, using example, HEALTHmap (http://healthmap.org/), a Glo- the API (Application Programming Interface) that Google Maps is bal disease alert mapping system, is also based on providing for this purpose (http://www.google.com/apis/maps/). Google Maps and news feeds (Figure 2). Moreover, courtesy of free or inexpensive software like GooPs (http://sites.onlinenw.com/goops/goops.php) 7 things you should know about... Mapping Mashups. and GpsGate (http://franson.com/gpsgate/), users can http://www.educause.edu/ir/library/pdf/ELI7016.pdf) and overlay their own position on the same maps and also Google Earth (Educause. 7 things you should know view the position of their friends in real time over the about... Google Earth. http://www.educause.edu/ir/ Web, if they have a simple GPS device (a position librar y/pdf/ELI7019.pdf) in education and their tracking device based on the Global Positioning System) implications for teaching and learning. Mapping like an inexpensive USB GPS mouse receiver connected mashups certainly have a great potential in education to their laptop or PC. and some educators are already using them (see the above Educause sheets). Photography enthusiasts can use cameras with built-in GPS to enable them to attach exact Earth Mapping mashups offer many possibilities to location coordinates to each photograph at the spot it creative educators, but these possibilities will need to was taken. However, even without such devices, people be identified, explored in various settings/scenarios, and are still able to ‘geotag’ their photos and utilise existing carefully researched and evaluated to document best Web 2.0 services such as Flickr (http://www.flickr.com/ practices before they can be used confidently in daily groups/mappr/), Mappr (http://www.mappr.com/), and teaching and learning activities. Google earth (http://earth.google.com/) in many novel and exciting ways (TORRONE, 2005). 12. Conclusion More recent examples of mapping mashups include Within this short paper we have shown that many Jotle, a Google Maps-Flickr (photos)-YouTube (videos) opportunities exist for students to engage in social Mashup (http://www.jotle.com/) and ‘Google Books and interaction and learning through Web 2.0 enabled RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33 31
  • 6. software. Sharing, aggregating and mixing of digital JONASSEN, D. H.; PECK, K. L.; WILSON, B. G. objects can be both creative and destructive, but Learning with Technology: a constructivist generally result in more rounded and accurate perspective. Upper Saddle River, NJ: Merrill. 1999. outcomes. Ultimately, wikis, blogs, mashups, 3D virtu- KOZMA , R . B. Will media influence learning? al worlds and other sociable applications can create Reframing the debate. Education Technology for students a vibrant, dynamic and challenging infor- Research and Development, v.42, n.1, p.7-19, mal environment in which to learn. Such environments 1994. go beyond the traditional boundaries of the educational establishment, and transgress into areas that are yet KUHN, D. The Skills of Argument. Cambridge: to be fully explored, raising interesting questions for Cambridge University Press. 1991. teachers to address. One thing is certain – the popularity NÜCKLES, M. et al. The use of public learning diaries of social software on the Internet will continue to grow, in blended learning. Journal of Educational Me- as more users begin to exploit the potential to generate dia, v.29, n.1, p.49-66, 2004. their own meaning and construct their own personalised learning experiences. O’REILLY, T. Open Source Paradigm Shift. 2004. At: h t t p : / / t i m . o r e i l l y. c o m / a r t i c l e s / paradigmshift_0504.html. Accessed: 15 Feb. 2007. Bibliographic references PARKER, A. A study of variables that predict dropout AANTONACCI, D. M.; MODARESS, N. ‘Second Life: from distance education. Cited in Levy, Y. (2007 The Educational Possibilities of a Massively in press) Comparing dropouts and persistence in Multiplayer Virtual World (MMVW)’, 2005. At: e-learning courses. Computers & Education, v.48, http://www2.kumc.edu/netlearning/ p.185-204, 1999. SLEDUCAUSESW2005/SLPresentation Outline.htm. Accessed: 21 Jan, 2007. PUTNAM, R. Bowling Alone: The Collapse and Revival of American Community. New York: Simon and BBC NEWS ONLINE. Virtual pals ‘soar in importance’. Schuster, 2000. 30 Nov. 2006. At: http://news.bbc.co.uk/1/hi/ technology/6158935.stm. Accessed: 24 Jan. 2007. REUTERS. Second Life: Interpol launches task force on child sex abuse, 17 Jan. 2007. At: http:// BELAWATI, T. The impact of online tutorials on course news.soft32.com/interpol-launches-task-force-on- completion rates and student achievement. Learning, child-sex-abuse_3268.html. Accessed: 2 Feb. 2007. Media and Technology, v.30, n.1, p.15-25, 2005. RHEINGOLD, H. The Virtual Community: BOULOS, M. N. Web GIS in practice III: creating a Homesteading on the Virtual Frontier. Boston Ma: simple interactive map of England’s Strategic MIT Press, 1998. At: http://www.rheingold.com/ Health Authorities using Google Maps API, Google vc/book/. Accessed: 14 Feb. 2007. Earth KML, and MSN Virtual Earth Map Control. International Journal of Health Geographics, v.22, RICE, R. E. Media Appropriateness: Using Social 2005. At:http://www.pubmedcentral.nih.gov/ Presence Theory to Compare Traditional and New articlerender.fcgi?artid=1242244. Accessed: 15 Organisational Media. Cited in Stacey, E. (2002) Feb. 2007. Social Presence Online: Networking Learners at a Distance. In: WATSON, D; ANDERSON, J. (Eds.) BOULOS, M. N.; MARAMBA, I.; WHEELER, S. Wikis, Networking the Learner: Computers in Education. blogs and podcasts: a new generation of Web-based Boston, MA: Kluwer Academic Press, 1993. tools for virtual collaborative clinical practice and education. BMC Medical Education, v.6, n.41, RICHARDSON, W. Blogs, Wikis, Podcasts and other 2005. At: http://www.biomedcentral.com/1472- Powerful Web Tools for Classrooms. Thousand 6920/6/41. Accessed: 12 Feb. 2007 Oaks, CA: Corwin Press, 2006. CLARK, R. E. Media will never influence learning. SCHUTZBERG, A. Fun with GeoRSS. Directions Education Technology Research and Magazine. At: http://www.directionsmag.com/ Development, v. 42, n.2, p.21-29, 1994. article.php?article_id=2197&trv=1. Accessed: 09 ENGESTRÖM, Y. Developmental studies of work as a jun. 2006 test-bench of activity theory: the case of primary SHORT, J.; WILLIAMS, E.; CHRISTIE, B, The Social care medical practice. In: LAVE, J.; CHAIKLIN, Psychology of Telecommunications. London: John S. (Eds.) Understanding Practice: perspectives Wiley and Sons, 1976. on activity and context. Cambridge: Cambridge University Press. 1993. SYM-SMITH, D. Navigation in 2007: It’s Much More Than Maps. Directions Magazine. At: http:// GODWIN-JONES, R. Emerging Technologies: Blogs and www.directionsmag.com/article.php?article_id= Wikis: Environments for On-line Collaboration. 2379&trv=1. Accessed: 24 Jan. 2007. Language Learning & Technology, v.7, n.2, p.12-16, 2003. 32 RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33
  • 7. THORNE, S. Second language acquisition and the TUNG, F.W.; DENG, Y.S. Designing Social Presence in truth(s) about relativity. In: LANTOLF, J. (Ed.) e-Learning Environments. Testing the effect of Sociocultural theor y and second language interactivity on children. Interactive Learning acquisition. Oxford: Oxford University Press, Environments, v.14, n.3, p.251-264, 2006. p.219-244, 2000. WALLACE, P. The Psychology of the Internet. TERDIMAN, D. Phoney kids, virtual sex. 12 Apr. 2006. Cambridge: Cambridge University Press, 1999. At: http://news.com.com/Phony+kids,+virtual+ sex/2100-1043_3-6060132.html. Accessed: 24 Jan. WHEELER, S. Learner support needs in online problem 2007. based learning. Quarterly Review of Distance Education, v.7, n.2, p.175-184, 2006. SCHUTZBERG, A. Fun with GeoRSS. Directions Magazine. At: http://www.directionsmag.com/ WILLIAMS, J. B.; JACOBS, J. Exploring the use of blogs article.php?article_id=2197&trv=1. Accessed: 09 as learning spaces in the higher education sector. jun. 2006 Australian Journal of Educational Technology, TORRONE, P. How to GPS Tag Photos: Flickr, Mappr, v.20, n.2, p.232-247, 2004. At: http:// Google Earth. 2005. At: http://www.makezine.com/ www.ascilite.org.au/ajet/ajet20/williams.html. blog/archive/2005/07/how_to_gps_tag.html. Accessed: 14 Feb. 2007. Accessed: 10 Feb. 2007. YELLOWLEES, P. M.; COOK, J. N. Education about TU, C. The measurement of social presence in an online hallucinations using an internet virtual reality learning environment. International Journal of system: A qualitative survey. Academic Psychiatry, E-Learning, v.1 n.2, p.34-45, 2002. v.30, n.6, p.534-539, 2006. About the authors Steve Wheeler Steve Wheeler is Senior Lecturer in Education and ICT in the Faculty of Education at the University of Plymouth. He has worked with educational media and technology since 1976, and has worked as a consultant on several groundbreaking e-learning projects, including the RATIO project (UK) and South Dakota's state wide broadband network (USA). He is a visiting lecturer/professor at several universities in the US and Czech Republic and is regularly invited to speak at international conferences worldwide. His research interests include learner perception and e- learning, and he serves on the editorial boards of six international academic journals, including ALT-J, Interactive Learning Environments and IRRODL . His most recent book is entitled 'Transforming Primary ICT'. Maged N. Kamel Boulos Maged N Kamel Boulos is Senior Lecturer in Health Informatics at the University of Plymouth, Devon, UK. He previously worked as Lecturer in Health Informatics at the University of Bath, and worked before that at City University, London, both in UK. As well as his medical degree and Master in Dermatology, he holds an Master in quot;Medical Informaticsquot; from King's College, University of London, and a PhD in quot;Measurement and Information in Medicinequot; from City University, London, both in UK. He is well published on the topics of Web 2.0/social software, the Semantic Web and geographic information systems, including Internet/Web GIS, in health and healthcare. He is also the Editor-in-Chief of the Open Access International Journal of Health Geographics http://www.ij- healthgeographics.com, and one of the Principal Investigators of the CAALYX EU FP6 e-health project http://caalyx.eu. RECIIS – Elect. J. Commun. Inf. Innov. Health, v.1, n.1, p. 27-33 33