24 Wikipedia medical page editing as a platform to teach evidence-based medicine

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Abstract

Objectives

Medical articles on Wikipedia are viewed over 10 million times a day and Wikipedia is arguably the most-read medical information platform on the internet. The quality and evidence-base of Wikipedia medical articles are improving but there is an ongoing need for refinement and updating. Editing and improving these articles represents a ‘whole task’ application of the steps in Evidence-Based Medicine (EBM) while simultaneously contributing to an altruistic mission of knowledge sharing and health advocacy. Involving medical students in Wikipedia-editing initiatives provides an opportunity for application of EBM skills while also improving medical articles on Wikipedia. We developed an embedded longitudinal Wikipedia editing project as part of a first year critical appraisal course in the School of Medicine at Queen’s University, Canada. Our goal was to evaluate the design and implementation of this project using student feedback in a structured survey.

Method

Students completed online training modules provided by Wikipedia and chose a medical article to improve. Students worked in small groups to assess their articles, made suggestions for improvement, and searched the literature for high-quality secondary sources containing suitable evidence. They posted suggested changes to the Wikipedia community for feedback and consulted with a faculty expert prior to making final page edits. All students completed a Wikipedia project evaluation form. Feedback was sought on the perceived strengths, weaknesses, struggles in project completion, and suggestions for improvement going forward. Using the Five-Dimensional Framework for Authentic Assessment (Gulikers, JTM et al., 2004), student feedback data was reviewed by two investigators (MW and LM) who independently identified barriers to/facilitators in project completion and assigned them into one of five dimensions relating to (1) the task (2) the physical/virtual context (3) the social context; (4) the result and (5) the criteria for evaluation.

Results

One hundred and one students made over 1000 edits to 16 articles, adding over 10 000 words to the pages, all with appropriate secondary source citations. Based on a preliminary review of the feedback data, students enjoyed applying the critical appraisal skills taught within the broader scope of the course (task), they liked making an improvement to a highly accessed public resource (result), they reported positive collaboration within their teams (social context), and they enjoyed learning about the process involved in forming and editing a Wikipedia medical page (task). Barriers to the project identified by the students included a lack of clarity regarding assignment expectations (task), frustration with Wikipedia coding (task), difficulty engaging with the Wikipedia editors/community (social context), distrust of Wikipedia editors as content experts (social context), and a perceived mismatch in efforts dedicated to the assignment and the resulting change/impact on their Wikipedia medical page (result).

Conclusions

Initial results highlight important barriers and facilitators identified by medical students in engaging with and completing the longitudinal Wikipedia assignment as part of their first-year critical appraisal, research and life long learning course. These results will inform the future delivery and assessment of this assignment in an effort to increase engagement among first-year medical students in improving one of the leading sources of online health information worldwide.

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