UCSF’s Wikipedia Experiment: Should Med Students Get Credit For Curating Medical Information Online?

You’re a loyal THCB reader. You have a symptom. You Google it. One of the first three hits will be an entry about the symptom or an associated condition on Wikipedia.

As an informed lay person, you wonder, “How accurate is Wikipedia for medical information?”

You’ve always been a little skeptical of Wikipedia, but over the years you’ve found it more and more reliable for celebrity tidbits (e.g. “How old is Jane Lynch?” or “What was the name of that guy in “Crash?”) and sports trivia (“How many Super Bowls have the Minnesota Vikings lost?”).

In fact, it’s become quite useful for understanding geopolitics, ancient and recent history, and helping explain science topics (Higgs Boson, anyone?).

So why not medicine?

We in academic medicine look down our noses at Wikipedia. “Show us original texts,” we harrumph. “Where does the original data come from?” we ask our residents and students.

Just like high schoolers and college kids are warned NOT to use Wikipedia as a research tool, medical professors hold the site lowly in regard to seriousness of purpose.

Well, it’s time to accept reality.

We all use it, whether we admit it or not. Some of us a lot. The good news is, Wikipedia’s going to get even better in the medical realm.

In a smart win-win, an enterprising clinical teacher at the University of California @ San Francisco Medical School will offer course credit to senior (4th year) medical students for updating and improving Wikipedia articles on medical topics.

“We as a profession have our corpus of knowledge, and we owe it as a profession to educate the lay public,” said Dr. Amin Azzam, a health sciences associate clinical professor at the U.C.S.F. School of Medicine who will teach the monthlong elective course in December.

I like what Dr. Azzam says–we owe it as a profession to educate the lay public. In the ultimate academic bargain, these students are going to make their work count twice-and many times over. Classwork for course credit, that goes out into the cloud and is useful to many other people. With an emphasis on lay people being able to read and understand it.

All medical information should be conveyed that way.

John H. Schumann, MD (@GlassHospital) is a general internist and medical educator at the University of Oklahoma School of Community Medicine in Tulsa, OK . He is also author of the blog, GlassHospital , where this post originally appeared.

11 replies »

  1. It will definitely be a plus for the average Wikipedia user if professionals (or future professionals) with solid knowledge will curate medical related topics. The medical information is in high demand on Internet and somehow underserved when it comes to reliability.
    Nice to think that the community will directly benefit from the work of those students.

  2. It’s nice to have a resource for self diagnosis/reference, but in the end what does it get you? Wikipedia says “don’t worry, take this OTC” (do you trust them) or it says “run to your doctor”.

    If it says “see doctor” do you print out the symptom/cause page to show your doc – or do you see if he gets it right on his own? Great resource for hypochondriacs.

    Will the ACA recognize Wikipedia as my health care provider?

  3. I’ve looked at lots of online health information resources over the years, and used to write for a website for the caregivers of older adults. (Site gave me an editor/writer to work with, which was a huge help though they did say I needed less help than most docs.)

    I never recommend people look at Wikipedia’s pages on medical topics, because frankly, they already look like something written by med students. Which is to say, heavy on technical detail. And relatively little sense as to how the information relates to real-world clinical situations, or patient’s real world questions, for that matter.

    For health information to be most useful to the public, I think it’s better to ground it in some practical experience. Med students don’t have enough of this. Next, the information has to be presented in a clear, readable format; it’s not enough to avoid jargon. Most med students have no experience writing clearly for a lay audience.

    Does it matter? Maybe not; people will go to Wikipedia regardless of whether the content offers practical and useful help, because it’s available. I myself like Wikipedia for a lot of things, but not for medical info.

    Instead, I much prefer the Mayo Clinic’s site for health information.

    I’d love for there to be more information on health and health problems available to the public. But putting med students to work on Wikipedia is not the way I’d go about it.

  4. “The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license.”

    THAT just went into my Quotes column on my REC Blog.

    RegionalExtensionCenter [dot] blogspot [dot] com

    (They won’t let me post my link. here on THCB)

  5. Wikipedia is just the beginning. Medicine has always been taught and practiced in the open and that remains essential for safety and fairness as we move into the networked digital era.

    The transition from books to software as substrate of medical knowledge is not going smoothly. An article from today’s news http://www.ihealthbeat.org/articles/2013/11/8/himss-ehr-association-weigh-in-on-ehr-regulatory-framework has our clinical software vendors worried about regulation.

    The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license. EHRs that embed medical practice into secret code that is not subject to peer review and distribute that medical knowledge for paid-up license will need some other form of regulation.

    Who would prefer FDA-regulated secret software to peer-reviewed open source software?

    Medical societies, schools and patients are slow to catch on to this issue. It’s good to see UCSF take a small step for keeping medicine open.

  6. I would concur with previous statement that we OVERVALUE many sources. Had the privilege of listening to Dr. Lawrence Weed speak recently and have to agree with his observation that we must figure out how to imbed the system with knowledge, rather than isolate it to that of physicians’ brains. If we are to affect outcomes with evidence based practices and patient engagement, we all need to find some common ground. New technologies like EHR, HIE, PHR have an opportunity to coalesce appropriate and accurate information prompting all participants toward common goals. We try to have each staff member practice to the full extent of their license, we should do they same of the patient’s capabilities.

  7. One of my colleagues the other day said to me, “I don’t think the public is using the same definition of healthcare provider as we healthcare professionals.” What he meant was that Google in many ways plays a role in society that used to be played by the family physician, your aunt the nurse or the local pharmacist.
    I think that is one of the fascinating things about the Internet in general. It is decidedly anti-establishment and anti-institutional. Organizations, institutions erect walls around information. The Internet tears them down. Consider several examples: Napster, Netflix, and news blogs. Who or what is next, medical schools? Oh and what is the consequence?

  8. A big rethink is needed. The problem isn’t just that we undervalue Wikipedia. The problem is that we vastly OVERVALUE other sources.

  9. “as long as you take the time to triangulate what learn in a Wiki piece, it is a very useful, user-friendly free resource”

    Yep. Second that.

  10. I love this post. I use Wikipedia frequently for all manner of research, and, in my view, as long as you take the time to triangulate what learn in a Wiki piece, it is a very useful, user-friendly free resource. Teaching medical students and other professionals to engage with it and update resources is a brilliant way to further democratize medical information.

    I am clearly not the only person thinking along these lines about Wiki. The Isabel Symptom Checker (http://symptomchecker.isabelhealthcare.com/), which used to be available only to physicians now has a consumer arm. You select your global region, input symptoms, and it disgorges a differential diagnosis with links. Many of the links are to Wiki pages. I used it for an annoying GI problem last month, and it was dead on, referring me to multiple Wiki pages, as well as the Mayo Clinic and NIH. I used the latter two to validate the former. Diagnosis made. Treatment plan initiated. Problem solved.

    When and if I choose to see my physician (who I like and respect a great deal) should be for those times when I really cannot resolve something on my own. And, even in those cases, I know it will help him help me if I show up ready to engage in a dialogue instead of just waiting for him to descend the mountain in his white coat and grace me with his advice. That’s so old school and so increasingly and deservedly irrelevant. Any physician that falls into that group has much, much company. They’re called fossils.

  11. I think the traditionalists in medicine will snort when they hear this one. I understand the mindset, but that’s exactly wrong attitude to have. Wikipedia has credibility problems? Sure. But so does most medical information online. You want to cite peer reviewed research? Take a look at Retractionwatch. Not sure this is the answer, but a good experiment worth watching …