'Textbook' of the Future

= Post Event Update =

This project is continuing under the guidance and supervision of Dr. Maya Hammoud. Please contact her at immaya[at]umich.edu if you are interested in staying involved or becoming involved.

We would like to thank all our participants for their contributions and collaboration to this exciting concept and for their dedication to these two sessions.

= Create the Digital Medical 'Textbook' of the Future =

Catalyst Series Description
This set of design jams are part of the Catalyst series, hosted by Open.Michigan and its collaborators. The Open.Michigan initiative facilitates opportunities to exchange knowledge, innovate and connect with likeminded people through projects and ideas that are shared across the world. Are you working on a project you would like to share with others? Could you use some extra hands or expertise to make your ideas become reality? Are you interested in brainstorming your ideas with others?

Once a month we will host a student or community group that needs some extra space, expertise or people power to bring an idea to fruition. Basically, you provide the idea and we provide the logistics. We will provide you with the space, food and publicity you need to help you complete your ideas or projects. We’ll invite members of the community to come out and help you complete these ideas, allowing you to promote your group, your idea or get your work published quickly and easily. Our only requirement is that you make your project open. By applying an open license to your work others may share and adapt your ideas to create new ones. We will either host your work on our website or link to it, promoting it and archiving for future use.

If you’re interested in working with Open.Michigan, please fill out the 'online form'.

If you have questions, please feel free to contact me at: epuckett[at]umich.edu.

Photos and Collaboration
All photos of our events, including whiteboard notes and remarks can be found on our flickr site: Open.Michigan

You can contribute to the notes and conversation by joining ourEtherpad instance for this event.

Introduction to the Events
What would a medical digital ‘textbook’ of the future look like? What kinds of information would it have? How would you interact with it? When would you use it?

The Department of Obstetrics and Gynecology at the University of Michigan Medical School would like to create the medical "textbook" of the future. Flex your design and innovation skills. Join the Open.Michigan and the Medical School's Learning Resources Center Multimedia Development teams and bring your perspective, skills, expertise and interests to shaping this project as we address the educational opportunities of the 21st century. We will host two design jams with the goal of transforming this idea into a reality.

This design jam will bring together students, faculty and staff from across U-M. This event is an opportunity to apply some course concepts to a real world opportunity with a small time commitment. There may also be opportunities for continued involvement in the project.

Facilitators

Dr. Maya Hammoud, Department of Obstetrics and Gynecology, immaya[at]med.umich[dot]edu

Chris Chapman, Learning Resource Center, Taubman Medical Library, chapmanc[at]umich[dot]edu

Emily Puckett Rodgers, Open.Michigan, epuckett[at]umich[dot]edu

Participants 

Jake Seagull, Medical Education Zoe Hruban, School of Public Health Rich Lieberman, Department of Pathology Evan Kerrigan, School of Information Matthew Simpson, School of Public Health/Medical School Shauna Bennett, Microbiology Thomas Piggott, School of Information Michael Todd, Surgery Peter Woolf, Engineering Leeann Fu, Engineering Jon Crane, Taubman Medical Library Brendan Crawford, Medical School Erin Zolkosky, School of Information Chris Voge, Biomedical Engineering Yu Lin, Medical School Marc Stephens, Learning Resource Center, UMMS Jill Lynch, Cell and Developmental Biology Erin Doelling, Obstetrics and Gynecology Natsuko Nicholls, MPublishing Rachel Petrak, School of Public Health Mary Kratz, Global Reach Kevin Hawkins, MPublishing Shana Kimball, MPublishing Claus Borgnakke, Mechanical Engineering Wenche S Borgnakke, Dentistry Chisheng Li, School of Information/Ford School of Public Policy Patricia Anderson, Taubman Health Library Greg Grossmeier, Copyright Office

Logistics

Both sessions will be from 5:30-8:00 pm and take place at the Learning Resource Center’s collaboration space:

3rd floor of the Taubman Medical Library, room 3901 1135 E. Catherine Street (Click here for directions.)

Session I, Thursday, January 13 In the first session we will identify opportunities for how this textbook can be developed and begin the design process.

Session II, Thursday, January 20 The second session will focus on prototyping the textbook and brainstorming ways to scale the project.

The Design Problem:

Practitioners in the medical world, including have new opportunities to engage in learning and skill building in online and mobile settings. How does this change the learning landscape? What does the medical textbook of the future look like and how would you use it?

Seeds for Discussion

What does this look like?


 * a resource of distilled information, much like a reference book.
 * a repository for high quality videos and learning tutorials
 * a space for interaction between students, faculty and practitioners

How would students use this?

What are the incentives to use a resource like this?

January 13, 2011 Agenda
Introductions: 5:30-6:00

Emily Puckett Rodgers: Open.Michigan and Why Open? Chris Chapman: Learning Resource Center Dr. Hammoud: Textbook of the Future introduction Emily Puckett Rodgers: Design Process

Session One: Identifying Opportunities

6:00-6:30

Break: Dinner

6:30-6:45

Group Presentations

6:45-7:00

Session Two: Design

7:00-7:30

Group Presentations

7:30-7:45

Wrap up and Next Design Jam

7:45-8:00

Opening Remarks
Emily Puckett Rogers discussed the background of Open.Michigan and the reasoning for creating Open Educational Resources. Her powerpoint presentation can be found at:. The benefits of openly licensing educational material include: providing high quality materials for other instructors and resources to use to fill curriculum gaps; increasing transparency in the education system including understanding and accessing material your colleagues create; providing students with additional resources to review and incorporate into their learning experience; showcasing your own research and teaching ability. Emily's presentation can be downloaded: ([[Media:Textbook_DesignJam.pptx|Textbook Design Jam.pptx]])  and is accessible on Slideshare: Textbook of the Future Introduction

Chris Chapman, Media Services Manager for the Learning Resource Center, discussed how different types of people and skills are needed to develop something like a textbook of the future and how these perspectives are very valuable for designing such a complex resource. The Learning Resource Commons features a collaboration space (used for these events) that encourages people to collaborate, talk, share and interact. It features six staff in the group.

Dr. Maya Hammoud discussed her context and reasoning for this project posing the question: What does next big thing look like? She stated, "this is a great opportunity for us to use new technologies to create something unique. The health sciences often take a backseat in commercial technology development. When you find a unique image or learning object, what's the best way to share it? Wikipedia is easy to use and hard to resist but it isn't as useful in medicine where info must be accurate, trusted, and secure. This is our opportunity to apply the UM brand to information and users will know it is good and can be trusted. With the technology we have today we have the ability to immediately contribute content (photo, treatment plan, drugs, etc.) and receive that content. As a group we can contribute our various expertise and different perspectives to this project."

There is potential in this project not just for the gynecology department but for other University of Michigan Medical School departments and units. These two sessions provide us the opportunity to think broadly about what the future will be for educational resources and design adaptable resources to different kinds of content.

Design Thinking Introduction

The design thinking strategies applied to these two sessions involve four phases: identifying opportunities, design, prototyping and scale and spread. Due to the limited timeframe, these phases were featured to encourage the most productive outcome. Phase one, identifying opportunities, includes contextual research, discussing issues, brainstorming, rapid creation of themes. Phase two, design, includes continued discussion of themes, scoping priorities (such as features or audiences to focus on) and determining the who, how and what of the design. Prototyping and scale and spread will be the themes of the January 20 design jam.

Factors to consider: suspend judgement, practice the "yes, and" approach to encourage conversation and communication flow, serve the scene and be open-minded about approaching this topic.

More information about design jams can be found on our wiki page How to Organize a Design Jam

Session One: Identifying Opportunity
This session included three groups of participants discussing their own background, the design problem as proposed by Dr. Hammoud and scoping the use, priorities, organization and audiences for the 'textbook of the future.' These notes represent the brainstorming session of each group and are reflective of these broadly scoped conversations.

Notes from Group One:  Problems with Textbooks:


 * heavy
 * provide overview but missing final details; last mile
 * may be outdated
 * 2 dimensional
 * filtering required to find useful information
 * finding authors can be difficult

Textbook of the Future's New Functionality:


 * Links and references to latest sources
 * updates since last visit
 * ebooks/reader compatible
 * iphone/smart phone compatible
 * adaptive (knows your level of education or interest)
 * interactive
 * Provides layering (eg. Google maps or Google Body Browser)
 * Links to current research, articles, conferences (eg. feed)
 * shared annotation (can sort by user demographics)
 * highlighting
 * 3-D, media rich (video and audio)
 * Smart search (eg by most popular, by audience)
 * Organized and browsable by symptom or objective
 * Image recognition and matching (eg. one can take an image with a webcam or phone and search for a match)

Notes from Group Two


 * Concepts of "Information Prescriptions" that allow for quick, easy access to information
 * Multiple users can access and use the site: students, patients, teachers, researchers, practitioners through layers and specific search capabilities
 * Allow for travel from Point A to Point C through Point B (learners) or from Point A directly to Point C (practitioners)
 * Must include visual content and 3-D simulations, for example Medline Plus
 * Embed content within text
 * Allow for twitter-like communication and feeds: short, precise information sharing
 * Allow for aggregation of user-specified information on convenient platforms (mobile, ereader, etc.)
 * Allow for one-one communication or one-many communication
 * Provide generalized, plain language versions of information to make accessible to patients
 * Stories and narratives (from patients and from practitioners especially) should be integrated into this structure (eg. informal case studies)
 * Provide services like google groups for people to collaborate around issues
 * A textbook of the future can address the functions of both a workbook (learner) and a dictionary/reference (practitioner) and should be interactive
 * Information can be crowdsourced and students can learn through concept questions and user-submitted quizzes
 * Incorporate gaming strategies into the structure to incentivize participation

Notes from Group Three


 * Combine media (surgical videos, etc.) Start with disease process. Combine pathology and treatment suggestions. Diagnosis. Take concept "uterine bleeding" branch out to different diagnoses that go with this.
 * Decision aids vs. learning aids. (Problem based or case based learning).
 * Who is it for, clinician? Patient? Self-help?
 * Search by function, very difficult to do. No devices do this well. Browsing and visual search would be great. Search by pathological condition. Query by image (submit slide or photo). Interact around the photos. The "commons" can annotate and add value to the content. MeSH content, consistent terminology and tagging. Spatially tag images. NIH has public access search terms. Translational terminology. Build on resources and collections that are already out there. Peek a boom, game for image identification on Google. Provides tags that help you describe image, even if you don't know what you're looking at. Technology already exists for this. Opportunities to engage with content you're not familiar with. Don't have to be a content expert. (E.g., NASA tool for identifying galaxies. Depending on how people voted, you could determine what is a galaxy and what isn't.)
 * Crowd sourcing.
 * A good way to learn is through self-testing (practice tests). Put learner in virtual environment. Give student opportunities to self test.
 * Haptic, add touch sensitive dimension to learning. Tactile sense. Integrate with existing interactive learning modules and simulations. Include pre-test and post-test evaluation. Immediate feedback on how much you know.

Group Presentations: Identifying Opportunities
Participants reconvened together to present the conversations from each group, distilling the main points of the conversation in a short, succinct set of remarks.

Group One

Knowledge built on different levels. Shared annotation, collects into best notes. Also identify notes by student vs. teacher. Help teach assess learning.

Group Two

Core functionalities. Need dictionaries, glossaries, reference materials. But not structured hierarchically necessarily. Determine a path that leads user from more basic to more complex info. Structure allows for broad and deep searches. Content control and content generation. Want faculty to contribute. Want to scrape public content. Role of crowdsourcing. Give people points for identifying images correctly. (Try to trick each other into selecting the wrong image.) Role of social media in sharing information and asking for help. Privacy needs should be considered. Patients contributing to textbook, sharing their success stories. How does data get shared in the resource?

Group Three

Crowdsourcing, submitting/tagging resources. Visual browsing. Textbooks can play different roles. Sometimes you're looking for A but you end up finding B. Is it an exploratory tool? Or reference tool? Provide decision aides for practical problems. Personal and adaptive model of who is using resource. Could provide multiple models (second life, interactive simulation, patient mentorship, etc.). Serve as a community for sharing resources. Include auditory, haptic, multi-modal approaches. Provide multiple ways to explore information.

Session Two: Design
This session included three groups of participants discussing the next iteration of their brainstorming session. They prioritized goals and scoped their brainstorming outputs to address audience (who), purpose (why), and function (how).

Notes from Group One

Who: Enrolled students, residents, CME, faculty and patients (empathy)


 * Need to be able to impart knowledge on patient interaction, put into appropriate words
 * build user communities (ability to know who experts are)
 * ability to contribute small modular pieces (eg. on a single concept) to the infrastructure
 * ability to create different layers for different audiences for the same concept
 * prominent attribution for contributors (eg. avatar, die, trademark

Faculty uses


 * quick reference
 * must be up to date
 * images, other diagrams to show patients about their condition
 * add annotations
 * view others' annotations
 * filter, aggregating
 * keep track of quizzes and simulation progress
 * references to relevant research and teaching materials
 * ratings
 * suggest and review content

Student uses


 * all of the above plus:
 * CME credit
 * points
 * percentage read (eg progress bar)
 * adaptive (identifying and addressing individual student learning weaknesses or gaps)
 * comparison with peers
 * competency achieved, can choose to display in profile
 * levels: student, resident practicing

Notes from Group Two

Must strike balance between all users: learners, patients, teachers and practitioners

Goal: link practitioners with learners and provide opportunities for continual education, learning and skill assessment; leverage the expertise (deep and rich) of UMMS faculty and staff


 * Courses build on each other to break down silos between teachers and courses
 * provide a centralized location
 * build on the e-binder/e-portfolio concept and provide mobile use and highlighting and annotation functions
 * allow for personal and professional insights (stories, narrative and communication sharing)
 * provide case studies
 * allow for distributed use and access

Needs to have:


 * wiki functionality
 * built in query structure
 * custom search engine (based on user, information desired, resource type, etc.)
 * provide adaptable microservices
 * crowdsourced information
 * provide browsable features by theme (eg disease, technique, body feature) or by expert
 * build in decision tree functionality

Question: how to vet content shared among peers?

Notes from Group Three

Note: this group broke into subgroups to each address smaller topics. Our notes for each subgroup are currently incomplete.


 * Dentists want to "connect the mouth with the rest of the body."
 * What topics need more fleshing out? Visual search was common need and not currently met in existing technology. Concrete elements could come out of this (e.g., by submitting image, you're providing content. By annotating the image, you're providing data. Every time someone searches for the image, the resource gets bigger and better through content sharing).
 * Haptic stuff very exciting with potential for unique applications. Tool could keep track of what an individual has been learning. "Did I learn it right? Is the content at the right level?" Too hard vs. too easy (adaptive learning)
 * Opportunities for college of engineering partnership? Corporate partner? Grant funding?
 * Users could view video first, then perform same procedure haptically. Tactile feeling important, packing amalgam in filling, using probe to measure depth. Importance of sound (heart, blood flow). For example, testing hardness of surfaces.
 * Could provide interactive diagnosis. It feels like this, sounds like this, what is the diagnosis? Important use in telemedicine, expert providing remote consultation. Transfer "feel" to remote locations (transfer the "feel" of an abdomen).
 * Would be useful to receive assessment on your performance.
 * Visually and auditory information and resources are much further along than tactic. Smelling also important for diagnosis, but further behind ("smells like sulfur," "smells like ammonia"). There is a potential to recreate test cases of this.

Group Presentations: Design
Group One

Who and what targeted this resource is targeted at. Education continuously built on in layers, but two views: patient and practitioner. Spectrum of learning. Second Life format with continual adaptation of learning environment to individuals needs and learning styles. "You have to achieve certain competencies before you progress to different modules." Build upon this in different layers. Incentives to faculty. Identify themselves as expert and people will know them as reliable authorities and information source wherever they appear.

Group Two

Practitioners, patients, learners. Each requires different educational level. Everyone is learner, but students are "captive learners." ISeek, tool for collecting info. Individuals could have e-portfolio that they take with them. Content of textbook would vary depending on needs/level of learner. Need interactive wiki component so users can improve information. Content not static. Custom search engine. Recommend existing sites for specific audiences or needs (external sites, independent of Google searches).

Group Three

Users have images, sounds, things they need to feel. These contribute to user interactions. The query would be "what is this?" (text query) result could be sound, image, etc. AI interface feed this out to community. Feeds into large repository of annotated information. The more people that use it, the better it gets. Grows exponentially, feeds on itself. Twitter analogy, put out a question and get a lot of answers.

Rapid Prototyping and Scale and Spread
Results from last week's sessions

Dr. Maya Hammoud has challenged us with an opportunity to look into the future and imagine how technology can facilitate the spectrum of learning in medicine, from the student to the practitioner. What does the next big thing look like? What would the textbook of the future look like? Last week's session brought together students, faculty and staff across departments at the University of Michigan in order to brainstorm and begin designing what such a 'textbook' would look like. Many agreed that the opportunities afforded by digital production of learning materials and resources make it possible to have many "textbooks" that are personalized to suit individual learner's needs and goals. We divided ourselves into three groups. While each of the three groups discussed the textbook of the future separately, common themes emerged from all the conversations and this is what we will move forward with today as we begin prototyping and considering the infrastructure and resources needed to support such a textbook. All groups addressed the need for such a textbook to address the wide spectrum of learning, from novice to expert learners. In medicine, even practitioners continue to learn new skills, theories and applications and gain continuing medical education (CME) credits as they advance in their careers.

Common themes from each group  A textbook of the future would, by necessity, be flexible enough to meet the needs of a student through tracking personal progress, built-in learning assessments and intuitive searching for the practitioner who many need to quickly find very specific information. Participants also agreed upon building a community of practice, allowing users of the textbook to annotate, rate, and comment on resources housed in the textbook, and enabling users to interact with each other in collaborative environments, employing strategies used in gaming and microblogs to foster participation and content creation. We decided it was also important to include collections of case studies and personal narratives (from the perspective of practitioner, student and patient). Faculty contributions would be denoted as expert resources and in this way all users of this textbook would benefit from the high quality education and expertise at U-M. As a teaching and a reference tool, all groups felt it is important that this textbook have robust search capabilities, offering both broad and deep searches with a variety of media including text, images, audio, video and 3-D simulations (and, potentially in the future, haptic or olfactory resources). Overall this resource should be agile and modular, adapting to new information easily and quickly, allowing for user-control of content through the creation of personal collections, author content tools, group collaboration and feedback mechanisms. It should also be able to address the needs of all learners in the medical fields and be device compatible, serving users in a variety of settings.

January 20 Agenda
Opening Remarks

5:30-5:35 Emily PPR welcome, brief introduction of Open.Michigan and staff 5:35-5:40 Chris Chapman, brief introduction of LRC and staff 5:40-5:50 Maya Hammoud, brief introduction of design challenge 5:50-6:00 Emily PPR, summary of activities and outcomes from last week's session and outline of expectations for this session

6:00 Dinner and informal discussion 6:30 Rapid Prototyping: Two groups: Novice and Expert learner 7:15 Group Presentations 7:30 Scale and Spread: One group 7:45 Discussion of next steps

Major themes from last week's sessions:


 * tracking personal progress
 * built-in learning assessment
 * ability to find specific information
 * community of practice
 * feedback features: annotation, rating, comments
 * collaborative environments
 * case studies and personal narratives
 * expert resources
 * robust search capabilities
 * resources in a variety of media (text, image, audio, video, 3-D)
 * agile and modular
 * user ownership features (group collaboration, feedback, personal collections, author content)
 * device compatible

Rapid Prototyping: User Scenarios and Physical Prototyping Tips
During this session you will employ two methods to prototype: rapid prototyping with physical objects and creating user scenarios.

User Scenarios, 30 minutes  Develop this to allow you to imagine what someone using this textbook of the future will do when looking for information or working in a class. You will be assigned to address either the novice or the expert learner and you can identify these in any way your group sees fit (for example, a novice learner could be either a student, a patient, etc., an expert learner could be either a practitioner, faculty member, resident or other member of the medical learning community). User scenarios are like brief stories that describe a real life person, need and situation.

These exercises include:

Scenario: a short narrative describing the person and their need to interact with the textbook. Is it a student studying for a class? Is it a doctor looking for additional information to inform a diagnosis? This will feature details such as the background of the person, the identified need, and the desired results.

Process: how does the person find the information or resources he or she needs? What steps do they take to navigate through the textbooks, what resources do they need to be able to access to meet their need, what tools do they use to find their information?

Physical prototyping, 15 minutes  Build a prototype of the 'textbook' with paper, pens and objects we've provided you. Get creative and think out of the box. The objects can represent information flow, communication, wayfinding, portals, layers and pages. Anything you would like. You can use a combination of objects and writing to get your point across.

Group One (Novice User) Notes
Group 1 Novice User scenario: Emily is a first year medical student. She just had her first class in ob/gyn. She is interested in learning more about herself. She goes for a pap smear every year but doesn't know much about the procedure, concepts, or terminology. She just received a phone call saying that she had an abnormal pap smear. Emily wants to to understand the possible causes of the pap smear. She remembers that her professor Maya Hammoud just told her about her new website for for teaching gynecology.

She goes to the website. She logins and fills out a short profile, indicated her discipline, her level, and answers a broad question "tell us your story." When she submits the form, the website detects the keywords "abnormal pap smear" and asks if she would like to search for that phrase. Emily answers Yes. On the resulting page, the first item listed is an animation on how a pap smear is done. She clicks the link and watches the video.

She sees another link for a virtual patient case of a woman who goes to the doctor for her annual pap smear. Emily selects the case. She clicks through the interactive stem case which contains a series of bimodal questions that follows the patient through the entire pap smear procedure and diagnosis. At one point, she is presented with an option to choose normal or abnormal diagnosis. She chooses abnormal. The next screen lists potential causes and tests that may be conducted. She interacts with the various tests and follows them through to a final diagnosis. She has the option to go back to any of the previous decision points.

After completing the case, Emily notices the option to download a version for her mobile phone. She clicks the link and reads that the mobile version has less functionality but the same basic content. There's also a quiz only app which downloads to help her study for class.

User Scenario Discussion:


 * Need for common language information integrated with specific terms, complicated phrases or words
 * Ability to access a linear progression of a topic or search for specific terms
 * "Pre-test" or informational questions to tailor the site information to the user: is this a barrier? Could this be "tell us your story?" (look at: Patientslikeme)
 * Fictional stories (eg case studies) can take a reader through a diagnoses to various branching nodes that discuss treatment decisions or scenarios that address the progression or cure of a disease
 * Search could be through traditional glossary/Table of Contents/Index/ Syllabus that can lead to a database with terms and explanations
 * Allow for cross referencing
 * Access to case studies, narrative or stories that contextualize information

Group 1 Novice User Prototype presentation: Downloadable mobile applications very important. Need to accommodate for resource constrained environments (lack of access to electricity and connectivity). Algorithms and that search along proscribed taxonomy. "These words are featured 50 times on site." Users get anonymous chat name so they can interact online. Show how far along the search path you are. Story telling features that help provide contextual sense of information. Who contributes stories? "Patients Like Me," is a website that lets you tell your story and it does crowd sourcing so you learn about other people's experiences.

Note: Members of the novice group discussion each contributed one piece of functionality to this design they thought necessary to its success. This paper prototype is being stored in the Learning Resource Center.

Group Two (Expert User) Notes
Group 2 Expert User scenario:

Dr. Jenny sees patient who has pelvic prolapse. Dr. Jenny has to perform quick search on drug dosing for this condition. Wants to write prescription on the spot. She uses a computer or tablet to perform the search, returns a set of results that she clicks on to read or flags it to come back later. She also has the option to share or print immediately. Compares this search to earlier ones using a reference table of previous search results and rankings.

Group 2 Expert User Design discussion:


 * Prototyping Task: Dr. Jenny wants to look up pelvic prolapse.
 * Group 2 assigned to design these features: users initial interface with system, get information (search), work with search results, and leaving the system.
 * First Interface: Clinicians work with decision trees. Start with a diagnosis and then think 3D or 2D model, holographic and haptic interface. Navigate through the body from any entry point.
 * Search: provide options for basic, advanced, pathway (decision tree, hierarchy, controlled vocabulary, search only images or journal articles or expert opinions) searches.
 * Results: Show faceted results (like Amazon). Can narrow results based on needs (image, video, text, diagnosis, drug, etc.). Example: Novoseek
 * Include patient profile. Provide quick info in clinical setting. Specifying quick vs. more delayed/detailed result (accommodate for Internet speed vs. phone speed).
 * Subject search, keyword search, question tree, diagnosis, symptom, treatment. Choices important because keywords not always logical or consistent or don't always return what you expected.
 * Left nav features categories. Top nav offers basic/advanced options. Three levels of search: interface, context, database. Search results include ratings.
 * Pre-tailor results list, provide drop down box with more options.
 * Final Outcome/Results: Drug questions. Dosage info, picture of pill. More interactive features. Links to other search engines.

Group 2 Expert User Prototype presentation:

Expert would have options for two search styles: slow time to ramble and explore information vs. quick needing immediate results for patient information. Uses tablet or computer front end. Previous searches are saved and ranked. Multiple types of users can input content. Allows for free search like Google and advanced search like Library. Upload images for identification. Search along biological pathway and expand/narrow results. Might want to enter biomarker or patient profile to return info. Perform drug search and symptom search. Users can add refinements to their search terms and results. User can request quick search vs. more elaborate search. Might depend on what bandwidth is available. Save search and update it later. Subscribe it to "My Textbook" which displays updates to previously flagged searches. Use like and dislike features. Rankings feed into relevance of results.

Scale and Spread: Large Group Discussion
Also consider how this works as a teaching tool. Use parables to provide explanations and bring out important points. Provide scenarios that raise important questions before you enter didactic portion of learning process. Like a pre-test way without standard questioning. Stories can raise and answer questions. Stories help you retain information. Textbooks don't allow for this style of learning.

Stories useful for beginners. Context important for them. But, in the 3rd year they just want the information. "Students want three bullet points and then tell them what's on the test." Video could accomplish this. Engaging, but let's you go at your own pace. Give users an option: stories or straight up info. Stories could be presented in video or text. What is end result? Am I getting tested on this? Or am I trying to prescribe the right drug for a patient.

Expert systems used to provide one result. Now we want to see a range of answers. Also, inter-disciplinary scientists want more depth of info. Plus shift in medical education to provide focus on patient (longitudinal studies, emphasis on whole patient). System should not make users feel like we are "making them do it", build it so they jump in and engage. Look at what are they doing in K-12 education. By the time we're done building this, those students will be here. They are learning now using virtual worlds, augmented reality, etc.

Features


 * What about assessment? How long are users spending looking at videos? What's engaging and not? Funders are going into want to know this.
 * "Textbook" would know when you returned what your level of interest is.
 * Qualtrics model. Embed objects (video, etc.) and get feedback. Fast, rapid prototyping -- but maybe not useful for final product.
 * Make content and technology open so other institutions can take advantage. Look to Drupal, Django platforms. Find a template for teachers/researchers to use to add content (and metadata) onto.
 * Same story should be presented multiple ways (text, video, stories, etc.).
 * How do we make this real? Funding? Staffing? Hope some design jam participants will stay involved and help move this forward

Management


 * Need strong editorial board for this information landscape.
 * Get crowd sourcing or student help with tagging. Students making a game out of putting images of a disease in order of severity. Build these tasks into games.
 * Catalog info (take easy stuff first, e.g., images). Then generate stories or supporting info around these resources. Get biggest bang for your buck. Role of editor very important.
 * Wikimedia Commons – UM could partner or collaborate with them. Donate collection of images to Wikimedia. Have a conversation with institutions who are doing this. We donate our collection and let them do the tech for it. In return we have access to them and repurpose them.

Architecture


 * How do you make something this large out of nothing? Start with low hanging fruit, do what you can do first. Module based designs (Drupal applications). Use wikis.
 * Need structure in place first and then put call out to faculty to provide info: build interoperable platform. Info shouldn't be a problem. Faculty have 1000's of images. "Give me a template for input and I'll add tags, etc."
 * Peter Woolf's model from last week: different levels for input (video, audio, case studies, keywords, etc.)

Input layer:

images --&gt; process

articles --&gt; process

case studies --&gt; process

term definitions --&gt; process


 * GROCs funds programs. Few years ago they funded something with med students and case search tool. Open tools available. Cloud based tools. Take things from different technologies and pull together. Bigger challenge will be to pull content together.

Continue the Discussion
Keep the conversation going! You can contribute your notes, questions and share resources on our Etherpad instance for this event.

We have created a flickr set of photos from the two sessions that you can access at: http://www.flickr.com/photos/openmichigan/sets/72157625713635235/ and if you would like to contribute images, please send them to me and I will upload them with the CC license you choose.

If you would like additional resources relating to open textbooks, you may want to visit the following sites:

http://www.edtechpost.ca/wordpress/2010/02/25/open-textbooks-followup/ http://www.collegeopentextbooks.org/