Wikis, education, and building better mousetraps

A few weeks ago I got a message from a resident with a scholarly interest in education who, in digging through some of my blog archives, discovered my 2014 post discussing my implementation of a wiki as part of our learning format for our surgical clerkship students. It highlighted a couple of things for me- first, that I never followed up on if it was a successful innovation, and how it might be relevant in today’s medical learning environment. The pandemic forced expansion of online learning for all groups of learners, and though I wasn’t in a teaching role this year I recognize that some of my “out there” ideas were probably ripe for resurrection. I also spent my year enrolled in a graduate program that was entirely on-line and saw both effective and ineffective virtual discussions…and have some new ideas based upon that experience.

In that initial post I acknowledged ways that I had desperately tried to foster asynchronous sharing of learning resources by our students, and that my efforts had been at best marginally successful. Because it was a required part of the grading rubric, participation in the board-style question discussions was somewhat more successful (and did achieve the intended goal of boosting scores on the NBME surgery shelf). However, my intent to use our online learning platform to facilitate social learning was never really achieved.

Recent scholarly work on wikis has complicated findings. While they have “great potential” as a learning tool, the absence of measurable outcomes following their use has remained a challenge. A concern raised by learners around wiki use for interprofessional education was simply that they felt it was valuable but required too much effort; this certainly aligns with the feedback that I received from our students in the surgical clerkship.

Two recent studies have provided more support for the idea of using wikis in medical education, and perhaps give guidance on how they can be most effectively deployed. One study employed “social pedagogy” (I love that term!) for their pharmacology course; by using Bloom’s taxonomy to guide learner activities and self-assessment, their wiki was successful in achieving learner success, as measured quantitatively, and also was able to demonstrate several qualitative benefits (and a generally positive reception by learners). Another recent study examined the effect of a wiki in conjunction with a flipped classroom, which also showed positive response from students, and demonstrated that flipped classroom pedagogy buttressed the use of the wiki.

Knowing what I know now, I absolutely would repeat an experiment with use of wiki-style learning, specifically for surgical learners. I have to admit that I would be more “intentional” about it- what is my goal that I’m trying to achieve for the learners- and I would absolutely have a plan for evaluating the intervention. Also, reinforcing the use of the wiki with existing tools or frameworks appears to be important to supporting learner success. Finally, having clear “ground rules” of community engagement and a rubric to evaluate interactions is absolutely necessary. I don’t know that we’ve got the details of how to deploy wikis in medical education completely ironed out, but I do know that it’s an idea that it’s worth our time as a continued experiment.