{"id":19785,"date":"2017-08-07T09:43:18","date_gmt":"2017-08-07T13:43:18","guid":{"rendered":"https:\/\/participatorymedicine.org\/epatients\/?p=19785"},"modified":"2017-08-10T16:02:50","modified_gmt":"2017-08-10T20:02:50","slug":"wikiproject-medicine-three-years-on-converting-clinicians-to-active-digital-contributors","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2017\/08\/wikiproject-medicine-three-years-on-converting-clinicians-to-active-digital-contributors.html","title":{"rendered":"WikiProject Medicine three years on: &#8220;converting clinicians to active digital contributors&#8221;"},"content":{"rendered":"<h2>&#8220;To help inform patients of the best scientific knowledge&#8230;&#8221;<\/h2>\n<blockquote><p><i><span style=\"font-weight: 400\">\u201c&#8230;as future physicians, they realize that part of their contract with society is to meet patients where they are and to help inform patients of the best of scientific knowledge about the conditions that patients or their loved ones are reading about on Wikipedia.\u201d<\/span><\/i><\/p>\n<p style=\"text-align: right\"><i><span style=\"font-weight: 400\">&#8212; from the interview below<\/span><\/i><\/p>\n<\/blockquote>\n<div id=\"attachment_19803\" style=\"width: 452px\" class=\"wp-caption alignright\"><a href=\"https:\/\/en.wikipedia.org\/wiki\/Wikipedia:WikiProject_Medicine\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-19803\" class=\"size-full wp-image-19803\" style=\"border: 1px solid black\" src=\"https:\/\/participatorymedicine.org\/epatients\/wp-content\/uploads\/sites\/3\/2017\/08\/wikiproject-medicine.jpg\" alt=\"\" width=\"442\" height=\"208\" srcset=\"https:\/\/participatorymedicine.org\/epatients\/wp-content\/uploads\/sites\/3\/2017\/08\/wikiproject-medicine.jpg 442w, https:\/\/participatorymedicine.org\/epatients\/wp-content\/uploads\/sites\/3\/2017\/08\/wikiproject-medicine-300x141.jpg 300w\" sizes=\"auto, (max-width: 442px) 100vw, 442px\" \/><\/a><p id=\"caption-attachment-19803\" class=\"wp-caption-text\">Source: WikiProject Medicine<\/p><\/div>\n<p><span style=\"font-weight: 400\">This Thursday in Montreal, <\/span><a href=\"https:\/\/wikimania2017.wikimedia.org\/wiki\/Programme\/Wiki_Project_Med\"><span style=\"font-weight: 400\">Medicine Day<\/span><\/a><span style=\"font-weight: 400\"> at the big<\/span><a href=\"https:\/\/wikimania2017.wikimedia.org\/wiki\/Wikimania\"> <span style=\"font-weight: 400\">WikiMania<\/span><\/a><span style=\"font-weight: 400\"> conference will include an important update on a radical, wonderful, disruptive project that\u2019s bearing fruit big-time: <\/span><a href=\"https:\/\/en.wikipedia.org\/wiki\/Wikipedia:WikiProject_Medicine\"><span style=\"font-weight: 400\">WikiProject Medicine<\/span><\/a><span style=\"font-weight: 400\">, <\/span><\/p>\n<p><span style=\"font-weight: 400\">Three years ago we<\/span><a href=\"https:\/\/participatorymedicine.org\/epatients\/2014\/03\/wikiproject-medicine-med-students-producing-high-quality-wikipedia-articles.html\"> <span style=\"font-weight: 400\">reported here<\/span><\/a><span style=\"font-weight: 400\"> on an intriguing and culturally significant development: fourth year medical students being coached on how to upgrade Wikipedia articles on medical subjects. If this subject interests you I encourage you to read that full post, and others linked here, especially the meaty comments on some posts. <\/span><\/p>\n<p><span style=\"font-weight: 400\">In the three years since, important progress has been made &#8211; it&#8217;s now clear that this model is <\/span><i><span style=\"font-weight: 400\">really <\/span><\/i><span style=\"font-weight: 400\">working. This month the two principals of that post sat down again for another video interview: <a href=\"https:\/\/www.linkedin.com\/in\/peterfrishauf\">Peter Frishauf<\/a> and <a href=\"http:\/\/profiles.ucsf.edu\/amin.azzam\">Amin Azzam MD<\/a>\u00a0of UCSF (University of California at San Francisco)<i>.<\/i>\u00a0<a href=\"https:\/\/docs.google.com\/document\/d\/165fFpHHwyonxbp78umrUO_wkOPo9CK_6BdvTcdftE1c\/edit?ts=598462e3#\">Here<\/a> is a link to a transcript (4000 words), heavily annotated with links by Frishauf, below is our discussion of how important we think this is and why, and here&#8217;s the video of the interview:<\/span><br \/>\n<!--more--><\/p>\n<div class=\"embed-vimeo\" style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/227069906\" width=\"640\" height=\"360\" frameborder=\"0\" webkitallowfullscreen mozallowfullscreen allowfullscreen><\/iframe><\/div>\n<p><a href=\"https:\/\/vimeo.com\/227069906\">WikiProject Medicine update interview, July 2017<\/a><\/p>\n<h2><span style=\"font-weight: 400\">Highlights of the medical student training program\u00a0<\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400\">\n<div id=\"attachment_19801\" style=\"width: 412px\" class=\"wp-caption alignright\"><a href=\"https:\/\/wikiedu.org\/blog\/2016\/04\/05\/medical-students-wikipedia\/\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-19801\" class=\"size-full wp-image-19801\" src=\"https:\/\/participatorymedicine.org\/epatients\/wp-content\/uploads\/sites\/3\/2017\/08\/Wiki_Ed_at_UCSF_09-shrunk.jpg\" alt=\"\" width=\"402\" height=\"292\" srcset=\"https:\/\/participatorymedicine.org\/epatients\/wp-content\/uploads\/sites\/3\/2017\/08\/Wiki_Ed_at_UCSF_09-shrunk.jpg 402w, https:\/\/participatorymedicine.org\/epatients\/wp-content\/uploads\/sites\/3\/2017\/08\/Wiki_Ed_at_UCSF_09-shrunk-300x218.jpg 300w, https:\/\/participatorymedicine.org\/epatients\/wp-content\/uploads\/sites\/3\/2017\/08\/Wiki_Ed_at_UCSF_09-shrunk-400x292.jpg 400w\" sizes=\"auto, (max-width: 402px) 100vw, 402px\" \/><\/a><p id=\"caption-attachment-19801\" class=\"wp-caption-text\">Dr. Azzam teaching the class, 2015. Source: https:\/\/wikiedu.org\/blog\/2016\/04\/05\/medical-students-wikipedia\/<\/p><\/div>\n<p><span style=\"font-weight: 400\">Students are taught about WIkipedia\u2019s system of grading article quality.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">They\u2019re also taught about the culture and methods of editing Wikipedia, including the back room \u201cTalk\u201d pages where things sometimes get argued out &#8212; in effect a form of peer review. In other words, they\u2019re taught to become real \u201cWikipedians\u201d <\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">They select Wikipedia articles that interest them, have lots of pageviews, and don\u2019t have a great quality rating. In other words, the focus is on articles where improvement will make a difference to a lot of people.<\/span><\/li>\n<\/ul>\n<p>(I discovered you can learn a ton more about it by browsing through a <a href=\"https:\/\/www.google.com\/search?q=&quot;amin+azzam&quot;+ucsf+wikipedia&amp;source=lnms&amp;tbm=isch\" target=\"_blank\" rel=\"noopener\">Google Image Search for Amin Azzam Wikipedia<\/a>!)<\/p>\n<h2><span style=\"font-weight: 400\">Highlights of project results discussed in the video<\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400\">\n<div id=\"attachment_19802\" style=\"width: 329px\" class=\"wp-caption alignright\"><a href=\"Wiki_medicine_presentation_-_UCSF_medical_education_-_2014_Western_Group_on_Educational_Affairs_-_slides.pdf&amp;page=5\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-19802\" class=\"size-full wp-image-19802\" src=\"https:\/\/participatorymedicine.org\/epatients\/wp-content\/uploads\/sites\/3\/2017\/08\/Wiki_medicine_presentation_-_UCSF_medical_education_-_2014_Western_Group_on_Educational_Affairs_-_slides.pdf.jpg\" alt=\"\" width=\"319\" height=\"240\" srcset=\"https:\/\/participatorymedicine.org\/epatients\/wp-content\/uploads\/sites\/3\/2017\/08\/Wiki_medicine_presentation_-_UCSF_medical_education_-_2014_Western_Group_on_Educational_Affairs_-_slides.pdf.jpg 319w, https:\/\/participatorymedicine.org\/epatients\/wp-content\/uploads\/sites\/3\/2017\/08\/Wiki_medicine_presentation_-_UCSF_medical_education_-_2014_Western_Group_on_Educational_Affairs_-_slides.pdf-300x226.jpg 300w\" sizes=\"auto, (max-width: 319px) 100vw, 319px\" \/><\/a><p id=\"caption-attachment-19802\" class=\"wp-caption-text\">Source: Wikimedia Commons https:\/\/commons.wikimedia.org\/w\/index.php?title=File:Wiki_medicine_presentation_-_UCSF_medical_education_-_2014_Western_Group_on_Educational_Affairs_-_slides.pdf&amp;page=5<\/p><\/div>\n<p><span style=\"font-weight: 400\">80 students have participated so far in the UCSF course.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The idea of a course like this has spread. <\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">150 students have participated in a similar course at the UCSF school of pharmacy, editing pages on the most heavily prescribed drugs<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Similar projects have begun in Tel Aviv and in Fremantle, Western Australia<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Students learn to peer review each other, and then (as with all Wikipedia) the discussion is posted on the article\u2019s Talk Page &#8211; which is in fact fully open peer review.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Wikipedia edit-a-thons are happening in medical schools now &#8211; student-driven self-directed projects<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The Hewlett Foundation has awarded a grant to Dr. Azzam and <\/span><a href=\"http:\/\/osmosis.org\"><span style=\"font-weight: 400\">Osmosis<\/span><\/a><span style=\"font-weight: 400\"> to spread the project to other medical schools, starting with five this year.<\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The video content produced by Osmosis is a natural fit for this project.<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The project\u2019s results have just been <\/span><a href=\"http:\/\/journals.lww.com\/academicmedicine\/Citation\/2017\/02000\/Why_Medical_Schools_Should_Embrace_Wikipedia__.22.aspx\"><span style=\"font-weight: 400\">published<\/span><\/a><span style=\"font-weight: 400\"> in the top-tier journal <\/span><i><span style=\"font-weight: 400\">Academic Medicine<\/span><\/i><span style=\"font-weight: 400\">:<\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The 80 students have edited 65 Wikipedia pages, adding 93,000 words and 605 references.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Those pages had 1.8 million views during the 30 days of active editing.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Then, through March 23 those 65 pages had 34 million page views.<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">360 pharmacy students edited 177 pages, which were viewed 2.3 million times during the editing.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Article quality has been assessed by two physicians. (See tables in the article and in the video.) <\/span>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">As noted in our 2014 post, it\u2019s harder to upgrade your quality rating on Wikipedia than it is to get doctors to say you improved it. Yes, WIkipedia has tougher quality standards,<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">\u201cWe &#8230; tend to defer to expertise without questioning the validity of statements that people who have initials after their name like me say.\u201d [More on this below.]<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The Wiki Education Foundation is doing similar work in non-medical fields.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">As you\u2019ll see, there are certainly challenges. But what\u2019s exciting is the clear signs that this approach of editing medical content to make it more reliable and understandable is working: it\u2019s producing results, it\u2019s bearing fruit, and it\u2019s scaling.<\/span><\/p>\n<h2><span style=\"font-weight: 400\">Dimensions of the social, cultural, and intellectual changes embodied in WikiProject Medicine<\/span><\/h2>\n<p><span style=\"font-weight: 400\">It\u2019s hard to know where to start in saying how profound it is that this is working. So many assumptions about authority and reliability are called into question, all of which is foundational to the culture shift this Society is helping bring about. How can we articulate what\u2019s happening here, what specifically it\u2019s changing, and what it means for the arriving future of participatory medicine?<\/span><\/p>\n<p>Our 2014 post listed these earthshaking innovations compared to traditional peer review:<\/p>\n<ul>\n<li>A major advantage: transparency on who edited what, with public discussion<\/li>\n<li>Another big deal: the patient perspective is welcome.<\/li>\n<li>Crowd vs credentials: Medpedia and Britannica<\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">For this year&#8217;s update, here are some additions &#8211; some key questions we can now say are being disrupted successfully:<\/span><\/p>\n<h3><i><span style=\"font-weight: 400\">1. Of course in medicine accuracy is important. What\u2019s the best path to reliable information?<\/span><\/i><\/h3>\n<p><span style=\"font-weight: 400\">Just 12 years ago (2005) the world was sure that the best source was experts with strong credentials. Then, as reported at <\/span><a href=\"https:\/\/participatorymedicine.org\/epatients\/2014\/03\/wikiproject-medicine-med-students-producing-high-quality-wikipedia-articles.html#crowd\"><span style=\"font-weight: 400\">\u201cCrowd vs Credentials\u201d<\/span><\/a><span style=\"font-weight: 400\"> in our previous post, <\/span><i><span style=\"font-weight: 400\">Nature <\/span><\/i><span style=\"font-weight: 400\">compared articles from Britannica (the &#8220;credentials&#8221; method) and Wikipedia (a self-governing &#8220;crowd&#8221; without a single source of authority) and found the two sources&#8217; accuracy comparable. <\/span><i><span style=\"font-weight: 400\">What the heck??? There\u2019s garbage on the internet &#8211; how could an ungoverned mob of unwashed nerds even come close to Britannica?<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400\">The answer to \u201chow\u201d is that when crowd is done right, it <\/span><i><span style=\"font-weight: 400\">corrects<\/span><\/i><span style=\"font-weight: 400\"> the garbage, faster than a printed publication can. That\u2019s a <\/span><i><span style=\"font-weight: 400\">radical <\/span><\/i><span style=\"font-weight: 400\">change in our mental model of how to home in on best advice. <\/span><\/p>\n<p><span style=\"font-weight: 400\">By the way, five years after the <\/span><i><span style=\"font-weight: 400\">Nature <\/span><\/i><span style=\"font-weight: 400\">article, Britannica produced its last print edition.<\/span><\/p>\n<p><span style=\"font-weight: 400\">In the same post we reported that a Silicon Valley startup called Medpedia had tried to solve the quality issue for medical information by hiring experts. At their founding in 2008 I\u2019d noted this, from their \u201cwho can contribute\u201d FAQ:<\/span><\/p>\n<blockquote><p><span style=\"font-weight: 400\">If you are an MD or PhD in the biomedical field, you can apply to become an Editor and make changes directly to Medpedia articles (See more below). If you are anyone else, you can use the \u201cMake a suggestion\u201d link &#8230;<\/span><\/p><\/blockquote>\n<p>There can be no clearer explicit declaration that people with credentials must know what they&#8217;re talking about, and the best anyone else is allowed to do is\u00a0<em>suggest\u00a0<\/em>things.<\/p>\n<p><span style=\"font-weight: 400\">In early 2009 they went into public beta. We posted<\/span> <a href=\"https:\/\/participatorymedicine.org\/epatients\/2009\/02\/medpedia-who-gets-to-say-what-info-is-reliable.html\"><b>Medpedia: Who gets to say what info is reliable?<\/b><\/a><span style=\"font-weight: 400\">, and SPM co-founder John Grohol of PsychCentral <\/span><a href=\"https:\/\/participatorymedicine.org\/epatients\/2009\/02\/medpedia-who-gets-to-say-what-info-is-reliable.html\/comment-page-1#comments\"><span style=\"font-weight: 400\">noted<\/span><\/a><span style=\"font-weight: 400\"> (scroll to his Feb 24 comment) \u201cI can\u2019t go into all the things wrong with the article on depression &#8230; \u201c and called one expert-approved statement \u201cstupidly simplistic.\u201d <\/span><\/p>\n<p><span style=\"font-weight: 400\">So much for reliability &#8211; our 2013 post noted that MedPedia had failed and gone out of business.<\/span><\/p>\n<h3><i><span style=\"font-weight: 400\">2. Who gets to decide which facts to include, which facts are important?<\/span><\/i><\/h3>\n<p><span style=\"font-weight: 400\">Again, the conventional wisdom has been \u201clearned authority.\u201d But in Wikiproject Medicine, the <\/span><i><span style=\"font-weight: 400\">users <\/span><\/i><span style=\"font-weight: 400\">of the information get to edit it &#8211; \u201cimprove\u201d it, in Wikipedia\u2019s terms. And if others say the edit was wrong, they can undo it. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Sound chaotic? That\u2019s why this news is so important: it <\/span><i><span style=\"font-weight: 400\">works<\/span><\/i><span style=\"font-weight: 400\">.<\/span><\/p>\n<h3><i><span style=\"font-weight: 400\">3. Who gets to say whether the writing is understandable and thus helpful?<\/span><\/i><\/h3>\n<p><span style=\"font-weight: 400\">Medicine <\/span><i><span style=\"font-weight: 400\">loves <\/span><\/i><span style=\"font-weight: 400\">to complain about the public\u2019s \u201chealth literacy.\u201d That\u2019s like the computer tech support joke about telling a customer they\u2019re too stupid to own a computer. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Note how the computer industry has since unfolded: users and buyers have migrated heavily toward usability, and vendors who had that attitude are generally out of business. (Remember when websites too often had forms and menus that were hard to understand? I personally sat in meetings where old-style experts complained that users were too stupid to appreciate how good our content was.)<\/span><\/p>\n<p><span style=\"font-weight: 400\">Note too that a driving factor in that decades-long change was &#8220;TCO&#8221; &#8211; total cost of ownership: companies learned that it wasn&#8217;t just the purchase price that mattered, it was all the long-term consequences of that choice, and bad usability caused big long-term problems. So it is with healthcare: people tend not to adopt changes and information that they can&#8217;t understand.<\/span><\/p>\n<p><span style=\"font-weight: 400\">That&#8217;s why for years I\u2019ve refused to discuss health literacy without discussing the <\/span><i><span style=\"font-weight: 400\">clarity<\/span><\/i><span style=\"font-weight: 400\"> of what we\u2019re supposed to understand. <\/span><span style=\"font-weight: 400\">See our 2011 post <\/span><a href=\"https:\/\/participatorymedicine.org\/epatients\/2011\/08\/health-literacy-missouri-clarity-is-power.html\"><b>Health Literacy Missouri: Clarity is Power.<\/b><\/a><\/p>\n<hr \/>\n<p>Do you see any other big shifts embodied in this project?<\/p>\n<h1>The times they are a-changin&#8217;.<\/h1>\n<p>At times like this it&#8217;s essential to put change into context. Without that, our thoughts about the future are likely to get whiplash as the far-out future suddenly whips past.<\/p>\n<p>Consider this brief timeline:<\/p>\n<ul>\n<li><strong>1994:<\/strong>\n<ul>\n<li>The first commercial browser, Mozilla, was born. Many consider this the birth of the Web.<\/li>\n<li>Our founder &#8220;Doc Tom&#8221; Ferguson was medical editor of the <a href=\"https:\/\/www.amazon.com\/Millennium-Whole-Earth-Catalog\/dp\/0062510592\" target=\"_blank\" rel=\"noopener\">Whole Earth Catalog&#8217;s millennium edition<\/a><\/li>\n<li>ACOR, the network of cancer patient listservs that I joined in 2007, was founded by SPM co-founder Gilles Frydman<\/li>\n<\/ul>\n<\/li>\n<li><strong>1995:<\/strong>\n<ul>\n<li>Doc Tom published his extraordinary &#8220;<a href=\"https:\/\/participatorymedicine.org\/epatients\/2008\/07\/steal-these-slides.html\" target=\"_blank\" rel=\"noopener\">triangle slides<\/a>&#8221; showing how healthcare would be turned on its head by the radical shift in access to information.<\/li>\n<li>Peter Frishauf launches Medscape at SCP Communications, Inc.\u00a0First trusted medical info site open to patients and MDs equally, a radical concept in its day (and a perfect companion to the inversion of power in Doc Tom&#8217;s slides).<\/li>\n<\/ul>\n<\/li>\n<li><strong>1996<\/strong>: Doc Tom published <a href=\"https:\/\/www.amazon.com\/Health-Online-Information-Communities-Cyberspace\/dp\/0201409895\/ref=sr_1_1?s=books&amp;ie=UTF8&amp;qid=1502075214&amp;sr=1-1&amp;keywords=health+online+ferguson\" target=\"_blank\" rel=\"noopener\"><em>Health Online: How To Find Health Information, Support Groups, And Self Help Communities In Cyberspace<\/em><\/a>, with chapters ranging from how to get an email account to lists of online health communities (most of them pre-Web)<\/li>\n<li><strong>1998:<\/strong> Google was founded.<\/li>\n<li><strong>2000<\/strong>: Ferguson&#8217;s first BMJ article: &#8220;<a href=\"http:\/\/www.bmj.com\/content\/321\/7269\/1129\" target=\"_blank\" rel=\"noopener\">Online patient-helpers and physicians working together: a new partnership for high quality health care<\/a>&#8221; includes this:\n<ul>\n<li>\u201cThe whole structure of medicine has been based on the assumption that physicians have the current information and patients do not. The bottom line is, the consumer will have virtually all the information the professionals have. This is comparable to the way communism fell. Once people start getting in good communication you won&#8217;t be able to play the game in the same way.\u201d<\/li>\n<\/ul>\n<\/li>\n<li><strong>2001:<\/strong> Wikipedia was founded.<\/li>\n<li><strong>2002:<\/strong> Ferguson published the mind-challenging BMJ editorial &#8220;<a href=\"http:\/\/www.bmj.com\/content\/324\/7337\/555\" target=\"_blank\" rel=\"noopener\">From patients to end users<\/a>&#8220;, pointing to how when access to information changes, capabilities and thus roles will change.<\/li>\n<li><strong>2005:<\/strong>\u00a0<em>Nature\u00a0<\/em>published its comparison of Wikipedia and Britannica. (WIkipedia was only four years old.)<\/li>\n<\/ul>\n<p>From the birth of the Web to the young Wikipedia community overthrowing Britannica took 11 years. Wikipedia is now 12 years older and has developed tougher rules for article quality (according to this interview) than medicine itself has. Also during those years:<\/p>\n<ul>\n<li><strong>2008:<\/strong> Medpedia is founded to address &#8220;unreliability&#8221; of medical information online, modeled on traditional academic peer review.<\/li>\n<li><strong>2009:<\/strong> Ferguson&#8217;s friends organize the <a href=\"http:\/\/participatorymedicine.org\" target=\"_blank\" rel=\"noopener\">Society for Participatory Medicine<\/a> and its journal,\u00a0<a href=\"http:\/\/www.jopm.org\" target=\"_blank\" rel=\"noopener\">JoPM<\/a>\n<ul>\n<li>Editorial board member Frishauf authors\u00a0<a href=\"https:\/\/participatorymedicine.org\/journal\/opinion\/commentary\/2009\/10\/21\/reputation-systems-a-new-vision-for-publishing-and-peer-review\/\" target=\"_blank\" rel=\"noopener\">Reputation Systems: A New Vision for Publishing and Peer Review<\/a>: &#8220;Peer review as we know it today is broken. ,,, My thinking about peer review changed in 2002, when I discovered Wikipedia&#8230;.&#8221;<\/li>\n<\/ul>\n<\/li>\n<li><strong>2010:<\/strong> Britannica publishes its last print edition.<\/li>\n<li><strong>2013:<\/strong>\n<ul>\n<li>Medpedia folds<\/li>\n<li>In my <a href=\"http:\/\/dave.pt\/davebmj1\" target=\"_blank\" rel=\"noopener\">first essay in the BMJ<\/a>, my oncologist says he&#8217;s not sure I could have survived if it weren&#8217;t for the information I got from ACOR patients &#8230; information that doesn&#8217;t exist in any journal.<\/li>\n<\/ul>\n<\/li>\n<li><strong>2014:<\/strong>\n<ul>\n<li>This course starts at UCSF<\/li>\n<li>The BMJ announces its <a href=\"http:\/\/www.bmj.com\/campaign\/patient-partnership\" target=\"_blank\" rel=\"noopener\">Patient Partnership<\/a>, including a patient panel advising the BMJ&#8217;s editors. Several members of our society have been appointed to <a href=\"http:\/\/www.bmj.com\/about-bmj\/advisory-panels\/patient-panel-members\" target=\"_blank\" rel=\"noopener\">the panel<\/a>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>The results produced by Dr. Azzam and his collaborators demand that we look forward and ask: what will the\u00a0<em>next\u00a0<\/em>decade bring?? A hint: the medical students in that year will have never known a world without Google and Wikipedia, never mind the archaic era when people thought a <em>book<\/em> was the best place to look for the latest information.<\/p>\n<p>How should we prepare for this era?\u00a0How would you design knowledge systems &#8211; and train students, and patients &#8211; for such a world?<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#8220;To help inform patients of the best scientific knowledge&#8230;&#8221; \u201c&#8230;as future physicians, they realize that part of their contract with society is to meet patients where they are and to 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