Bridging Online and Offline Social Networks to Promote Health Innovation

Complex problems require strategies that leverage the knowledge of diverse actors working in a coordinated manner in order to address them in a manner that is appropriate to the context. Such strategies require building relationships among groups that enable them to network in ways that have the intensity of face-to-face meetings, but also extend over time. The Complexity, Networks, EHealth, & Knowledge Translation Research (CoNEKTR) model draws upon established methods of face-to-face social engagement and supported with information technology and proscribes an approach to issue exploration, idea generation and collective action that leverages social networks for health innovation. The model combines aspects of communities of practice, online communities, systems and complexity science, and theories of knowledge translation, exchange and integration. The process and steps of implementing the model are described using a case study applied to food systems and health. Implications for health research and knowledge translation are discussed.

Integrating Medical Education with Medical Practice

Education is essentially a social phenomenon. As such, a social constructivist approach to teaching and learning is highly applicable to all disciplines and especially medicine where most graduates are required to deeply engage with society and need to communicate with a diverse array of people as part of their professional responsibilities. While traditional models of medical education are predicated on the establishment of face-to-face interactions, particularly within teaching hospital settings and residencies, there may be some opportunities to utilize current developments in online social networking technologies to enhance students’ and instructors’ experiences {references}. A review of social networking in the professional preparation of medical students and their subsequent practices would be helpful in determining the viability of such an approach. In this chapter, we provide a review of two key concepts of online social learning (social presence and media richness), explore how they can be implemented in the current wave of web based collaboration tools, and indicate their place in medical education. We provide a few examplars of how educators are incorporating web based or online social tools in student learning in the context of medical education and indicate some ways to extend this approach further.

Unlearning and Relearning in Online Health Education

This chapter discusses the role of integrating medical education with medical practice through online collaborative learning among the various stakeholders involved with healthcare education and practice. It elaborates the discussion with examples of information needs and information-seeking behaviors of patients and physicians. The role of the Internet (infrastructure), and especially the WWW (applications and content), is elucidated with respect to the concepts of online collaborative learning as applied to medical education and practice where the emphasis is on user driven healthcare. “

Online Learning in Discussion Groups

Recently, theorists concerned about the democratic quality of electronic group discussions have advocated the incorporation of situational information to facilitate consensus/dissensus activity. In this chapter, we demonstrate the utilization of a discussion group design and analytical process informed by Sense-Making Methodology to highlight the relationship between situational aspects of online dialogue and consensus/dissensus activity. We analyzed 1,360 messages submitted to three pedagogical discussion groups. The postings fell into two broad situational modes: (a) dialogic, which coincided with an outward orientation and a greater number of agreeing/disagreeing micro-practices, and (b) contemplative, which demonstrated more inwardly-focused personalized observations and far fewer agreeing/disagreeing micro-practices. These findings suggest that, counter to received theories advocating the privileging of user-to-user interaction within online discussion groups, both modes appeared to be important for robust communicative activities.

Medical Humanities

Medical Humanities (MH) provide a contrasting perspective of the arts to the ‘science’ of medicine. A definition of MH agreed upon by all workers is lacking. There are a number of advantages of teaching MH to medical students. MH programs are common in medical schools in developed nations. In developing nations these are not common and in the chapter the author describes programs in Brazil, Turkey, Argentina and Nepal. The relationship between medical ethics and MH is the subject of debate. Medical ethics teaching appears to be commoner compared to MH in medical schools. MH programs are not common in Asia and there are many challenges to MH teaching. Patient and illness narratives are become commoner in medical education. The author has conducted MH programs in two Nepalese medical schools and shares his experiences.

Critical Illness and the Emergency Room

The care of the critically-ill patient in the acute setting, an ‘everyday’ occurrence in most urban emergency departments, often proceeds through the dictates of Parsonian paternalism: the Physician knows best. But through a discussion of three such ‘everyday’ encounters, we hope to complicate this notion and find a place for healthcare users in the decision making process while developing a language and analytic basis for thinking seriously about the clinical dyad and the construction of knowledge in relationship economies. Finally, we discuss the escalation and de-escalation (terms derived from the military industrial complex) of care as it relates to medical futility.

A Healing Journey with a Thousand Echoes

In this personal account, the author describes her engagement with the healthcare system and the insights she gained during her struggle to restore her health. It also chronicles how this life-changing event prompted her to help educate others diagnosed with similar diseases and to form an active community for sharing and expanding medical knowledge. After a synopsis of the author’s medical journey in the Introduction, these topics are woven into three main sections: Medical Evidence, Complementary and Alternative Treatments, and the Influence of Technology.

Emerging Trends in User-Driven Healthcare

The purpose of this chapter is to explore transformations in market roles and relations that reflect collaborative, connective and communal characteristics among healthcare market actors, in light of technological advances and changing consumer-marketer institutional relationships. I exemplify how these transformations influence current market dynamics by providing a deep understanding of Web 2.0 applications in healthcare, specifically organizations that turn social networking into an enterprising virtual community in healthcare. In doing so, I explore how and why such systems develop and function, what makes patients and other actors in healthcare become a part of these systems, and how their interest and participation in these systems are maintained as they share their private health information and contribute to real-time medical research. Consequently, I suggest that current market dynamics in healthcare may be changing as a result of these systems utilizing social networking and engaging in reformation/reconstitution in the healthcare market.

Healthcare Narratives and Self-Care Stories

The aim of this chapter is to explore how a group of adults with cystic fibrosis (N=40) manage and account for self-care. By focussing on the development of character and plot, narrative analysis will illustrate how distinct patient identities may be constructed and performed as participants defend and justify their preferred self-care practices. These stories do not, however, always fit with the prevailing master narratives on which healthcare is often premised. Drawing on exemplars of 5 distinct types of storytelling an alternative user-driven taxonomy will be suggested which not only recognizes a range of self-care practices but also affirms their legitimacy beyond the horizons of mainstream biomedicine1.

Stories of Illness and Healthcare from a Physician Perspective

Doctors have unique and privileged opportunities to observe and participate in the illness narratives (stories) that patients present with. Hearing, understanding and respecting the patient narrative is as important as correctly practising the technical aspects of medical diagnosis and treatment, and yet traditionally has received much less emphasis during medical education. The stories below (which have all been altered to preserve patient confidentiality) illustrate how attention to the patient’s narrative enables a richer and deeper interaction with them that enhances the therapeutic aspects of the consultation.