Doctors should be advocating against patients' digital exclusion, not scare-mongering.

This post in an edited version of my comment on KevinMD's post on "Patients using internet health information without physician guidance".
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I’m a doctor. I’m a GP (family doctor) in Wales, UK and I teach medical students. I work in a deprived area and I wish that many more of my patients, rather than less, accessed information that could help them be more healthy. But many of my patients do not have easy access to the internet. This impacts on their health in many ways. One that is less often considered is that digital exclusion leads to reduced income.

Recently there was a post on StoryTellERdoc about “Grim Google”. This related the story of a young, healthy man who presented in ER with bright, red rectal bleeding convinced he had bowel carcinoma because he had googled his symptoms and saw that this was a possibility. The story itself and most of the comments are quite scathing. But is this the appropriate response to this episode?

In the UK we know that despite universal access to healthcare we still have differences in cancer survival rates between areas, with patients in well-off areas living longer. This may partly be due to delay in diagnosis.

With regards to late-stage diagnosis of colorectal cancer, research in 1996 in the US showed that patients living in areas of low socio-economic status (SES) were significantly more likely to be diagnosed at a late stage compared to those living in areas of high SES. You may think that times have changed, but more recent research in Denmark- covering 1996-2004- shows that older, wealthier patients, and younger more highly educated patients are less likely to be diagnosed with rectal cancer at a late stage.

So a simple story that seems to illustrate the fallacy of patients trying to diagnose themselves online, may instead represent the awareness and health behaviours which mean that those with the know-how feel empowered to seek care for what could be life-threatening symptoms.

We should be encouraging more of our patients to access health information, especially those who will find access harder. In fact we should be advocating against digital exclusion because its influence as a cause of health inequalities may increase in coming years.

When are Influential Blog Posts published? And what makes one anyway?

I was really surprised when I noticed last month that Sarah Stewart had nominated me for an Edublog Award for Most Influential Blog Post. Actually, I was more than surprised I was shocked! The post in question was written a few weeks after I broke my wrist and was in response to an online BBC news article, with the title "Tech Addiction 'Harms Learning'". You can read the blog post here. It is about poor research and poor journalism. I'm not so sure how influential the article was, as none of the authors, the universities involved, or the publishers responded to my emails seeking clarification on the research.
I discovered later that the BBC were not the only people to publish the story. Most of the main UK newspapers had also picked up on it. So as google-sidewiki appeared at the same time I went around leaving links to my blog post anywhere that I could not leave a comment directly.
Paul Bradshaw did manage to get a response from the BBC after he picked the story up on his blog. Well done Paul! But not such a great response from the editor.

I am not so sure that the blog really was influential, or how anyone judges what an influential blog post is. But I am very happy that Sarah nominated me, and that the Edublog Awards team agreed it should be shortlisted.

Still, this post starts with a chart. There are 30 blog posts short listed in the Most Influential Blog Post category and I noticed that several of them, like mine seemed to be posted in the latter half of the year. So, why is September such a good month for blogs? Are we all well rested after the summer and keen to get back to blogging?  Or are memories just short, and when nominating posts we tend to remember best what we have read most recently?

What do you think?

Edublog awards 2009

My nominations for the Edublog awards 2009 are:

Best individual blog : Science of the Invisible
Best new blog : Dundee Chest
Best teacher blog : Dundee Chest 
Best librarian / library blog: Laika's MedLibLog
Best educational use of a social networking service ELESIG Ning

I'm sorry that I am not writing why I am nominating these (because it is later!) but if you have a look, it will be self-evident! A special mention has to go to Dundee Chest which is an outstanding example of going beyond the walls of the VLE to connect with medical students and the world.

UPDATE: I checked yesterday to see if my nominations had made the final list. It looked like they hadn't. And then I realised that I hadn't followed correct procedure by emailing in the nomination as well as just linking. Sorry to the great people I nominated. Next year!

What happens when you invite students to collaborate on a google doc....

Confused Sign
Originally uploaded by kudaker

..... and you use their university email address?

I've had a gmail account for years. I've used google documents with others for years. I've presumed that when I sent invites to universith colleagues to access a timetable in a google doc spreadsheet and fill in their availability etc, that this was quite an easy task to respond to. Although I had noticed that few people tended to actually add anything to the spreadsheet and emailed me back instead.

A few weeks ago, I invited the 7 students who I am working with on an audit project over the next year to collaborate on google documents. I used their university emails. Some of them could access the initial brainstorming document but they seemed to be denied access to to edit. Others couldn't even see the document. And a few 'asked permission' to edit, which I agreed to, although it seemed to be to the same email address which already had permission to edit! I was confused. They were confused.

So I decided to try it out for myself. I gave access to myself through my Cardiff Uni address to see how the process worked. This is what happened by way of my explanation to students:
"1. I received an email with a link which showed me the document and asked me to sign in with a google acount.
2. I didn't have a google account for Cardiff Uni address so I had to click to set one up.
3. I entered in Cardiff Uni email address and selected a password.
4. After a few minutes I received an email asking me to confirm that I had set up an account. When I clicked on this/logged in and clicked on docs, it looked as if the account was completely empty. There were no documents there.
5. I went back to the email with the link to the document. I clicked it and this time instead of being brought through to see the document I was told that I have been invited to share a document and I could click to accept or decline.
6. I accepted and was then able to go in and edit the document and invite others, and send all of you a mesage!
So if you are having trouble could you please follow these steps."

What have I learned? 1. If you invite someone to collaborate on a document and they don't already have a google account in that email address they might find the process more difficult that you think. It might be a good idea to instruct them to start by creating the google account.

2. I am so familiar with google accounts and documents that I assumed the process would be more striaghtforward to others than it was.

So, now for the question. What has been your experience of collaborating with students, or another group, who are unfamiliar with gdocs? What tips do you have?

Thanks!