gms | German Medical Science

The Internet offers a wide variety of opportunities to handle and organize information. In the context of e-learning, the internet has also been increasingly used in recent years in veterinary medical education [1]. Widespread tools for academic knowledge management are content management systems (CMS). In contrast to static applications of Web 2.0, content management systems are software tools to manage existing information. They function mostly without linking content and do not give top priority to communication between users [2]. The students’ need for more interactivity, creativity and communication brought about a social change in Internet-based teaching and led to the development of Web 2.0 applications [3]. The term Web 2.0 describes the situation where people on the World Wide Web work together collaboratively and interactively, e.g. in the context of social software and share and publish information with other Internet users or groups. Therefore the Web2.0 is a contrast to static Web pages and the hierarchical structures of the early days of the Internet [4]. Corresponding applications such as Facebook, blogs and wiki systems are becoming very popular among younger users. Web 2.0 applications have great potential to be used in university [5]. This is due to the fact that they enable students to actively create content by means of their increased participation and own initiative. Therefore, the use of Web 2.0 technologies can help to change the traditional teaching model "lecturer-student" (active transmitter, passive recipients) and can enable students to collaborate more actively in creating content. This will result in students having a better understanding of information and achieving more success in their studies. In this sense, wiki systems can also be used throughout students’ university education.

Wiki systems are collaborative software platforms, where their contents can be edited [6]. They enable collaborative and communicative work and a fast, effective and easy modification of text [7], [8], [9]. The attributes Encyclopedia and social software are significant for wiki systems. Encyclopedias collect factual knowledge, thus they are particularly suitable for the neutral and detailed presentation of information [10]. The term social software describes the common participation in the creation of content and their public availability on the Internet [8], [11]. Talk pages are important additional items of many wiki systems to enable communication and hence improve the information.

These features are also used by Wikipedia (http://www.wikipedia.org), the largest, most popular and free encyclopedic wiki system [12]. It currently contains more than 20.9 million articles in about 260 languages, with over 3.9 million articles in English Wikipedia and over 1.4 million articles in the German Wikipedia (Wikipedia January 2012 http://stats.wikimedia.org/DE/TablesArticlesTotal.htm). The voluntary participation of all the editors involved is crucial to Wikipedia’s success [13].

The use of wiki systems in the university and related publications has significantly increased in recent years [9], [14]. The potential of wiki systems in teaching includes the collaborative finding, creating and exchanging of knowledge [15] and the initiation of self-organized collaborative learning processes [16], [17], which have great importance in the educational context. In courses wiki systems are primarily used as a platform for the collaborative creation of content and as an information source [18].

Up to now only a prototype in the German language is available for veterinary medicine (http://www.vetipedia.org). Research on the extent to which alternative wiki systems have been used and accepted in German-speaking veterinary education has been barely done. The aim of this study was to find out how students of veterinary medicine have used wiki systems for private and veterinary questions up to now. Furthermore, it should be clarified whether a subject-specific wiki system is considered to be useful in veterinary medicine and how high the willingness to participate is.

For data collection, an empirical investigation with a questionnaire was used. During the winter semester 2011/2012, written questionnaires concerning the evaluation of wiki systems were given to students at the Faculty of Veterinary Medicine, Freie Universität Berlin. The students were in their first, third or seventh semester, respectively. 260 of the 500 students enrolled in the courses were present. Of those 260 students, 210 students participated in the questionnaire.

Overall, the questionnaire contained a brief introduction to the study and questions about gender, age and semester. The first part of the questionnaire dealt with the general and specific veterinary use of Wikipedia. Wikipedia was chosen because it is the most famous wiki system worldwide [12]. The questionnaire contained 8 statements and questions on the previous use of wiki systems. Participants were asked to state how often they had to date carried out special passive and active activities as part of their use of Wikipedia (see table 1 [Tab. 1]). The second part of the questionnaire dealt with the acceptance and use of a specialized, i.e. veterinary wiki system. It contained 7 statements and questions that should be evaluated using a five-point Likert scale. Alternatively, respondents could choose the statement "I cannot evaluate this statement" (see table 2 [Tab. 2]).

The analysis was performed using the statistical program SPSS ® (SPSS ® Statistics IBM ® version 20). Descriptive variables were analyzed, for example frequencies of answers and frequency distributions. Furthermore, cross-tabs were used to analyze the students’ answers according to the response of their particular group (gender and semester). The data of the tables were tested using the chi-square test, expected frequencies and standardized residuals for correlations. The significance level of the chi-square test was set as α=0.05. The population represented (n) varied depending on the number of students who had answered the respective questions.

A total of 210 students completed the questionnaire, 179 women (85.2%) and 30 men (14.3%). One participant did not specify the gender. The average age was 23 (+/-3.7).

Male and female respondents did not differ in the answers they provided. Exceptions were the statements dealing with creating and editing articles and finding satisfactory veterinary information on Wikipedia. More male participants stated that they have already created or modified an article on Wikipedia (p=0.008, 6 of 30 (20%) male respondents) compared to only 6.7% of women. Furthermore, more male participants stated that they have found satisfactory veterinary medical information on Wikipedia (p=0.004, 13 of 30 male respondents (43.3%) on more than 10 articles). Regarding the finding of satisfactory veterinary medical information on Wikipedia, students from higher semesters found more relevant information than students from the 1^st semester (7^th semester = 57.8%, 1^st semester = 22.2%).

Among the female respondents, 10.1% (part of all female respondents) stated that they had never found relevant information.

The questionnaire showed that the majority of students (99.5%) had already read articles on Wikipedia. Veterinary medical information was also looked for (98.1%) and found (91.4%) on Wikipedia. The search for veterinary information was affected by the year of study. The number of statements that students had already searched for veterinary information on Wikipedia more than 10 times increased with the year of study: 1^st semester = 38.6%, 3^rd semester = 53.0%, 7^th semester = 72.2% (p=0.039). The writing and editing of articles on Wikipedia was carried out by 8.6% of the students. 1.9% of the articles edited by these students comprised of veterinary topics. In this context, edits of veterinary information were only done by students in the 7^th Semester (7.4% of the 7^th semester).

When searching for articles, a veterinary wiki system was used by 61.7% of the students. Of these students, only 15.3% had also created or modified articles. Reading articles in veterinary wiki systems, especially a number higher than 10, was mostly done by students in early semesters (1^st semester = 46.1%, 3^rd semester = 38.5%, 7^th semester = 15.4 %). Wiki systems, which were provided by the university as part of their teaching program, have not previously been used by 64.6% of respondents. However, the integration of wiki systems into teaching at university is welcomed by more than one third of students (41.6% of respondents).

Most students (96.2%) stated that they want to read articles in a veterinary wiki system. The establishment of such a system is considered to be useful (95.7%). However, only 10.6% of the respondents agree with the statement that they are willing to create or edit articles. 40.9% chose the statement "moderately agree". However, the willingness ("Strongly agree") increases the higher the year of study (1^st semester = 14.3%, 3^rd Semester = 28.6%, 7^th Semester = 42.9%, p=0.026). Nearly half the students (46.2%) state that they achieve more success in their studies when they write their own texts. In total, 1.4% strongly agree with the statement that there are doubts about the quality of information in a wiki system. In addition, 12.9% agree and 49% moderately agree with this statement.

In the context of the increasing importance of Internet and Web 2.0 applications at university [19] and in medicine and veterinary medicine [20], it was evaluated whether veterinary students take advantage of wiki systems to obtain information. Furthermore, we wanted to clarify whether they consider wiki systems to be a useful source of reference. Finally, an aim of this study was to clarify if students are motivated to use wiki systems in the long term and if they trust this type of information. A German-language, subject-specific wiki system for veterinary medicine (http://www.vetipedia.org) is currently being established. The results of this study are important to appraise the significance of such a wiki system, and to develop strategies for its establishment. So far, the influence and the use of Web 2.0 applications for students has barely been investigated [19]. 210 students answered the questionnaire, roughly half of the students officially registered in the respective semesters. For surveys of this type, this is a relatively high response rate, even if the survey cannot be regarded as being totally representative. It must also be noted that only students at the Freie Universität Berlin were asked. It remains open whether these results represent the opinions of students from other universities.

The results of the questionnaire confirm that wiki systems are welcomed and used by students. The active use of wiki systems, i.e., as part of creating and editing an article, is primarily done by students in higher semesters. According to our survey, Wikipedia was also used for the search of veterinary topics. According to the students’ answers, satisfactory information on veterinary issues on Wikipedia was found to be limited. Students in higher semesters, however, found the information to be more satisfactory.

More students in higher semesters use Wikipedia to search for information than students in the first semester, but they use less veterinary wiki systems. There may be several reasons for this, which should be explored in more detail in future projects. On the one hand, it is possible that veterinary wiki systems are more known among students in the first semester. For example, Vetipedia currently contains more articles on preclinical topics than on clinical topics. On the other hand, Wikipedia contains many articles on medical terminology and human diseases. Some of these articles are also relevant for veterinary medicine (e.g. topics such as bacteriology). In addition, Wikipedia also contains some articles on veterinary medicine. This is particularly relevant for students in higher semesters. It is possible that the higher the semester the student is in and the more clinical knowledge they possess, the greater their desire is for high-quality, illustrated and linked articles, which are currently more likely to be found on Wikipedia than in veterinary wiki systems.

The English Wikipedia is, compared to other providers of online health information [21], a widely used source of health information available online. Many physicians use Web 2.0 contents, especially Wikipedia. In particular, young physicians are the most productive in their use of the Internet and Web 2.0 technologies [22]. The quality of the information remains a challenge [23]. Medical information of Wikipedia does not sufficiently meet the internationally recognized criteria for evidence-based patient information [24]. However, according to a study by Mühlhauser, the quality of information on Wikipedia and the quality of information provided by two large German health insurance companies is similar [24]. Nevertheless, recently there has been a lack of comparable data on the quality of veterinary information.

Information provided by medical and veterinary wiki systems must be critically assessed before use, especially if they are created mainly by students. One solution may be a two-way quality management. On the one hand, there could be a permanent quality control by specialists (lecturers), who check the contents of the articles written by students for errors. On the other hand, student moderators could supervise specific subject categories, in order to eliminate errors, verify compliance with scientific standards and send technically advanced or clinically important articles to lecturers for review. Furthermore, peer-reviewed and revised articles could be protected from further editing. Wiki systems, that do not establish a professional and permanent quality management, run the risk of creating a collection of articles, where the quality of information is inadequate for medical claims. This can result in a less confidence in the quality of information on the part of veterinarians. This would mean a less use of veterinary wiki systems. Some medical wiki systems already claim to provide evidence-based information on medical knowledge to health care professionals [25].

In future it will be necessary to clarify whether the free creating and editing of content and the controlling and correcting of information by lecturers in university-orientated wiki systems is useful and effectively feasible.

The survey shows that most students of veterinary medicine regard wiki systems to be a useful source for veterinary information. Students also regard as positive the fact that they achieve more success in their studies when they write their own texts. Wiki systems enable an active creation of texts. The writing of texts often seems to be lacking in veterinary teaching. The study of medicine and veterinary medicine encourages and places more emphasis on acquiring knowledge and carrying out hands-on activities [26]. Wiki systems offer students a new medium for alternative ways of learning, collaboration and participation [7]. The non-linearity, dynamic and linking of wiki texts provides a suitable basis for the collaborative, interactive and argumentative work of students.

A key problem is the discrepancy between the passive and active use of Wikipedia and wiki systems. The students state that they are less willing to create content for wiki systems. Almost all students (99.5%) have already read articles on Wikipedia, but only 8.6% have also created or edited articles. The editing was done only by students in higher semesters and especially by male respondents. That men are more involved in the editing of wiki articles than women has been confirmed in other studies [27]. However, other authors point out that the gender difference related to the frequency of editing of wiki articles is not as high as is often assumed [28]. These hypotheses cannot be conclusively assessed in this survey because of the large proportion of women in veterinary medicine studies. The low proportion of men in this survey (n=30) does not allow general conclusions to be made. Nevertheless, the presented results indicate that female students, in particular, should be encouraged to participate more in veterinary wiki systems. In order to develop relevant strategies, one idea could be to hold focus group discussions.

There is also a lack of active participation in Wikipedia. A mere 2.5% of registered users do half of all edits [29]. Likewise, only a few physicians are actively creating content for Wikipedia [30]. The reasons for this may be due, on the one hand, to the amount of time taken up by work and to the high workload involved in producing high quality products. On the other hand, the reasons for this may be due to a lack of interest in the editing of articles and to a lack of confidence in the medical information provided by Wikipedia.

Wikipedia is an open, editable encyclopedia and offers the possibility to edit veterinary topics by lay people. This greatly limits the usefulness of the information for academic education and practice.

It is difficult to determine how qualified the authors of an article are [31]. However, in Wikipedia professional efforts are being made by the "WikiProject Medicine" (group of editors in Wikipedia from medical and non-medical fields) to provide high quality medical information, e.g. by providing guidelines for verifying information [32].

The widespread experience students have with Wikipedia provides some familiarity with wiki systems. This prior experience reduces the learning curve and thus facilitates the active start with a wiki system.

Furthermore, the results showed that 61.7% of the surveyed students have already used a veterinary wiki system. It was mainly used to search for information and it was more frequently used by students in early semesters. 15.3% of respondents stated that they had actively used a veterinary wiki system. This number is roughly seven times higher than the number of those who edit veterinary articles and twice as high than the number of those who edit general articles on Wikipedia. Although Wikipedia is more popular, the higher use of veterinary wiki systems by students may be due to several factors. Firstly, wiki systems have been actively used by lecturers at the Freie Universität Berlin in several courses between 2007 and 2012. In these courses, students were asked to write an article or edit articles on clinical cases. Secondly, a restricted, subject-specific wiki system focusing on veterinary topics may be more attractive to students than Wikipedia which contains articles covering every sort of topic. This survey confirms the high acceptance of veterinary-specific wiki systems. It highlights the potential contained in wiki systems to help students deal with information early in their studies. However, they are used more at home by students and less at university. So far, only 35.5% of respondents have used a veterinary wiki system during their studies, even though the survey shows that their integration into university is desirable. Possible reasons for this could be that the integration of wiki systems into university teaching has not yet been carried out intensively. In addition, corresponding wiki systems may not yet be sufficiently known.

Wiki systems used at university are usually non-public wiki systems [33] with a specific focus [20]. Their use is usually limited to one semester in the context of specific university courses. Most students (96.2%) would welcome a veterinary wiki system and use it passively, because they regard it as a useful source of reference.

The flexibility of wiki systems accounts for a wide range of applications at university. Wiki systems can be used effectively [34], in fields ranging from research to teaching. They even allow a simple, logical and profitable connection between research and teaching. Further advantages of wiki systems for teachers [18] are the opportunities to teach media literacy, the temporal flexibility in the planning of courses and the simple ways for organization, which wiki systems offer in terms of permanent access, control and communication. A resulting disadvantage could be an enormous amount of time and effort it takes up.

As a consequence, didactic methods that support active student participation should be established. Recent developments in medical education may change the focus from passive to active learning [35]. For example interactive, multi-disciplinary education in the field of anatomy was established and evaluated, which is more likely to meet the needs of clinical work [36]. In this regard, wiki systems offer extensive potentials.

This survey cannot be regarded as fully representative. On the one hand, there are participants who have voluntarily participated in the survey. On the other hand, not every student from the Faculty of Veterinary Medicine in Berlin was consulted. In addition, only students at the Freie Universität Berlin were consulted. Nevertheless, the survey comes to some interesting conclusions. In veterinary education, distinguishing the responses given by female and male participants is quantitatively problematic, since the proportion of female students is currently over 85% [37]. The questionnaire contains preformed statements, using a five-point Likert scale which allows affirmative or negative answers. Such Likert scales are often used in surveys [38], but can also affect the response behavior. One reason for this is that Likert scales, on the one hand, record the approval or rejection of a statement and on the other hand record the degree of agreement or disagreement. This can lead to an underrepresentation of the extreme positions (strongly agree, strongly disagree), since many people tend to adopt a more neutral position [39]. This can also lead to a negative bias, since more answers are at the positive end of the scale [38].

Students accept Wikipedia and veterinary wiki systems in university teaching because of their dedicated usefulness and quality of information. Therefore, a successful establishment of a wiki system for veterinary medicine is possible. Other wiki systems in the field of medicine already contain high numbers of articles and show a high level of user participation, e.g. UMMedWiki with about 1600 articles and a high number of page views [40] or Medpedia (http://www.medpedia.com). Although Wikipedia contains many articles on veterinary topics, it is not exclusively used for retrieving information concerning veterinary medicine. A specific wiki system addresses the audience directly and enables a thematic unity. It must be taken into account that in veterinary medicine only a limited number of people are potentially available for writing content. At the moment there are about 6300 students enrolled to study veterinary medicine at German universities. The number of persons who would actively participate in a veterinary wiki system is relatively low. Therefore, students in the early semesters should be encouraged to actively use wiki systems by availing of a good didactic integration of the wiki system into university education. It should be investigated in future projects, how veterinary practitioners and academics would use a veterinary wiki system.

The authors declare that they have no competing interests.