Published by
Stanford Medicine



Media, Medical Education, Medical Schools, Medicine X, Technology

Integrating digital literacy into medical education

Integrating digital literacy into medical education

21474271319_dc2d63f449_zBertalan Mesko, MD, PhD, has cracked the code on convincing medical students that digital literacy skills are equally as important as clinical knowledge. Seats in his Social MEDia course fill up within 45 seconds of registration opening. Former students report a 100 percent satisfaction rate with the class, and 80 percent of those enrolling in the course heard about it from a classmate. How does Mesko do it? As it turns out: daily educational challenges promoted on Facebook, an arsenal of high-tech gadgets and lots of chocolate.

On Thursday at Stanford Medicine X|ED, Mesko shared his secrets with medical educators on how to develop a digital literacy curriculum that will engage millennial learners and keep pace with the ever-changing landscape.

A self-describe medical futurist, Mesko launched his class on social media in medicine in 2008 when Facebook and Twitter were still in their infancy. “I wanted to design the curriculum for students to prepare them for the future that is coming toward us,” he said. “My goal was to help them understand how to use these tools to be more productive and stay up to-date.”

Early on, the curriculum centered on his experience with social media tools, such as blogging, Twitter and Facebook. But as the field of digital media and medical devices has evolved, so has the class. These days, he’s constantly updating the coursework to the point where he never gives the same lecture twice. “Platforms come and go, but it’s the concepts and practices that really matter,” said Mesko, who teaches at Semmelweis University in Hungary. “Whenever I talk about these topics, I do everything live.”

Most students have been active on Facebook, Twitter, Instagram, Snapchat and other social media accounts, long before they enroll in Mesko’s class. However, he still believes it’s important to provide an introduction to social media; discuss search engines and the Google story; and provide instruction on medical blogging, crowdsourcing and mobile health.

“Students need some fundamental digital knowledge before diving into the topics of e-patients and how to empower patients,” said Mesko, author of the recently released book My Health: Upgraded . “Additionally, many students don’t fully understand the privacy polices of these services. I tell them to remember that there is no difference between offline or online conduct.”

Continue Reading »

In the News, Media, Medical Education, Medicine and Society, Science

Wikipedia calls for more scientists to participate

Wikipedia calls for more scientists to participate

3204073130_417b9dc56a_z Wikipedia’s volunteer editors hosted the first Wikipedia Science Conference in London last week to urge scientists to participate in editing the massive online encyclopedia. Scientists often view Wikipedia as a “Wild West” because anyone can edit the pages, reports a piece in Nature, but in reality Wikipedia is a community of “ultra-pedants” obsessed by getting the facts right.

Martin Poulter, PhD, the main convener of the conference, is quoted as saying that many posts are already high quality, but professional academics, scientists, and publishers could improve the information in their field of expertise. He refers to a “cultural barrier” that includes a disinclination to participate in the “admittedly petty discussions” that sometimes crop up around Wikipedia edits. Alex Bateman, PhD, another organizer quoted in the article, adds that Wikipedia articles are written organically, sentence by sentence, which is very different than the research paper process. “There have to be changes from both sides. That’s what we’re discussing,” says Poulter.

One proposed project is to improve the Wikipedia biographies of famous scientists, starting with the fellows at The Royal Society, Britain’s pre-eminent scientific institution. The Society has agreed to take on a “Wikipedian in residence” to spearhead these efforts, which are aimed at reassuring scientists about the quality of Wikipedia articles. Another successful partnership is with the European Bioinformatics Institute, which maintains databases on protein and RNA families that have benefitted greatly from Wikipedia contributions. Wikipedia also maintains a page listing articles that need expert scientific attention.

But the benefits go both ways, says Poulter, who thinks academia can benefit from engaging with Wikipedia’s transparent process of knowledge curation. “Wikipedia is an opportunity to recapture some of the academic ethos that has been weakened by the commercial sector,” he is quoted as saying. “If you’re working in the open, you release all your data, your drafts and everything, and you invite comments from the start, rather than only after a process which is hidden away from the public.”

Previously: Science for popular audiences is not just “adding to the noise”Anthropologist discusses Wikipedia’s implications for health information, Is medical information on Wikipedia a public health problem?, How a “culture of permission” prevents doctors from being active in social media and ScienceRoll: What happens when pharma companies edit Wikipedia?
Photo by Johann Dréo

In the News, Media, Medicine and Society, Public Health, Research, Science

Science for popular audiences is not just “adding to the noise”

Science for popular audiences is not just "adding to the noise"

4787885058_d174638233_zIf you’re reading this blog, chances are you’re a fan of popular science – i.e. scientific research made accessible to people who aren’t professional academics. Many academics, myself included, are also in favor of taking cutting-edge knowledge and sharing it broadly with the public.

But some scientists hesitate to share their work on forums like blogs and other social media. According to a recent SciLogs post, they worry that their knowledge might be wrong or incomplete, be misinterpreted, or just add more static to the internet’s noise. But, as the post lays out, those who think about such things are precisely those who should be publishing for broader audiences. Those who publish misinformation are not stopping to question the quality of the knowledge they broadcast; doubt and the recognition of ignorance are the hallmarks of true scientists. Adding even a small amount of high-quality research to the “science media ecosystem” helps.

Moreover, much of the public seems to have little trust in media, much trust in scientists, and is more receptive to information that acknowledges uncertainty. So bring on the science blogs!

Previously: Can science journals have beautiful prose?, The disturbing trend of science by press release, Science rapper “busts a move” to explain Nobel discovery, Science writer Deborah Blum on blogging: “There were so many smaller stories I wanted to tell” and Veteran blogger offers tips for starting a science blog
Photo by Robin Bray-Hurren

In the News, Media, Medical Education, Medicine and Society, Myths, Pregnancy, Research

Reality TV influences perspectives on pregnancy, study shows

Reality TV influences perspectives on pregnancy, study shows

272417047_806faa2243_zA new University of Cincinnati study on the influence that television programs have on pregnant women has found that most women are more affected by TV representations of childbirth than they think.

The study, funded by the NSF and conducted by Danielle Bessett, PhD, assistant professor of sociology, followed a diverse group of 64 women over the course of two years and investigated how they understood their television viewing practices related to pregnancy and birth. It found that class, as measured by education level, had the greatest influence on whether a woman acknowledged television as a significant source of pregnancy-related information. Highly educated women and those who worked outside the home were more likely to dismiss TV, while those with less education and who were unemployed or took care of children at home were more likely to report watching and learning from such shows as TLC’s “Baby Story” and “Maternity Ward” and Discovery Health’s “Birth Day.”

The particularly interesting finding is that TV portrayals affect women’s perceptions even when they don’t believe they have an influence. Bessett developed the term “cultural mythologies of pregnancy” to describe how TV, film, media, and word of mouth create expectations about “the way things are.” Most reality TV and fictionalized programming presents childbirth as more dramatic and full of medical interventions than the majority of births really are, and these images made a lasting impression on women.

As quoted in the press release, Bessett says, “Hearing women –– even women who said TV had no influence on them –– trace their expectations back to specific television episodes is one of the few ways that we can see the power of these mythologies.” Many women mentioned pregnancy representations they had seen long before they got pregnant.

Women who reported watching TV considered it part of a comprehensive childbirth education program and would often evaluate the programs’ reliability, while women who disavowed television saw it as entertainment or education for children, likely from a desire to be seen as valuing science and medical expertise.

“If we believe that television works most insidiously or effectively on people when they don’t realize that it has power, then we can actually argue that the more highly educated women who were the most likely to say that television really didn’t have any effect on them, may in the end actually be more subject to the power of television than were women who saw television as an opportunity to learn about birth and recognized TV’s influence,” hypothesizes Bessett.

“This research implies that many women underestimate or under-report the extent to which their expectations of pregnancy and birth are shaped by popular media,” concludes Bessett, suggesting that “scholars must not only focus on patients’ professed methods for seeking information, but also explore the unrecognized role that television plays in their lives.”

Previously: New reality shows shine harsh light on teen pregnancy and Study: TV dramas can influence birth control use
Photo by johnny_zebra

FDA, Media, Research, Science Policy, Sexual Health, Women's Health

“A historic moment for women”: FDA approves the first drug to treat hypoactive sexual desire disorder

"A historic moment for women": FDA approves the first drug to treat hypoactive sexual desire disorder

20705116491_5351758c67_zRoughly 16 million women over the age of 50 suffer from low sex drive. Yet, until recently, there were no FDA-approved medications to treat the lack of sexual thoughts and desire experienced by women with hypoactive sexual desire disorder (HSDD).

That’s why the U.S. Food and Drug Administration’s recent approval of the drug flibanserin (sold under the brand name Addyi™) to treat women with HSDD, is such big news.

“It’s a historic moment for women,” said Leah Millheiser, MD, director of Stanford’s Female Sexual Medicine Program, in a story published today in the San Francisco Chronicle. HSDD, Millheiser explains, is more than the occasional loss of sexual desire that can result from changes in hormones, stress and discontent in a relationship. “These are women who want to have sex with their partner, they’re attracted to their partner and used to love having sex,” Millheiser said. “It’s as if someone turned off the lightbulb.”

It’s tempting to equate flibanserin to Viagra (the drug approved to treat erectile disfunction in men), but this is clinically inaccurate. As explained in the article, Viagra treats erectile dysfunction by increasing blood flow to the penis, while flibanserin works on the brain.

From the story:

The drug [flibanserin] was first developed as an antidepressant. Like other antidepressants, it works on the brain’s serotonin levels, but researchers say it works on different serotonin receptors than other similar antidepressants.

It didn’t work to relieve depression, as it turned out, but patients reported increased sexual desire.

In clinical trials, researchers said 53 percent of women who took the drug reported an increased desire for sex and 29 percent said the drug decreased their level of distress over their condition. In the trials, the number of “satisfying sexual events” reported by participants essentially doubled from an average of 2.5 per month before they received flibanserin to five while taking it.

Millheiser credits Viagra for helping to pave the way for this new approved treatment for HSDD.  “As a result of Viagra, there was an explosion in research and understanding into what sexual dysfunction is and how we treat it,” she said. “It took 17 years to … get to this day,” she said.

Previously: When hormonal issues interfere with mental healthFemale sexual health expert responds to delay in approval for “Viagra for women and Speaking up about female sexual dysfunction
Photo by Day Donaldson

Humor, Media, Medicine and Society, Neuroscience, Research, Stanford News

Did extraterrestrials chew up my news release, or does artificial intelligence still have a ways to go?

Did extraterrestrials chew up my news release, or does artificial intelligence still have a ways to go?


Almost two years ago, in a Scope blog entry titled “Can Joe Six-Pack compete with Sid Cyborg?” I posed the question: “Just how long will it be before we can no longer tell our computers from ourselves?”

I think it’s safe to say we’re not there yet. Either that, or extraterrestrials have been reading my news releases and finding them puzzling.

Last week we put out a news release I’d written about a dramatic discovery by Stanford radiologists Mike Zeineh, MD, PhD, Brian Rutt, PhD, and their colleagues. In brief, they’d analyzed postmortem slabs of brain tissue from people diagnosed with Alzheimer’s, compared them with equivalent brain-tissue slabs taken from people who’d died without any Alzheimer’s-like symptoms, and noticed some striking and intriguing differences. In a key brain region essential to memory formation, Zeineh and Rutt had spotted – only in Alzheimer’s brains, not normal ones – iron deposits engulfed by mobile inflammatory cells. This observation’s potentially big implications were plenty newsworthy.

It so happened that, on the day we issued the release, a high-powered five-day-long meeting on Alzheimer’s sponsored by the eponymous Alzheimer’s Association was in session in Washington, D.C. As a result, many of the brain-oriented science writers to whom my news release was targeted were preoccupied.

I was a little anxious about that. So, the other day, I turned to my favorite search engine to see if the release had managed to get some traction in the popular press. As I’d feared, the Washington conference had sucked up a lot of the oxygen in the earthly neuroscience arena.

But apparently, the release had done better in Outer Space. I saw that it had been picked up by, for example, Red Orbit (a website that I’ve always assumed, based on its name, emanates from Mars).

My eyes were next drawn to a link to an unfamiliar outfit called AZ News, which bills itself in a tagline as an “International Online News Site.” I clicked on the link, and saw a news report with the same title as my release. I started reading the text below.

The first words were: “In autopsy mind hankie from people not diagnosed with Alzheimer’s…” I don’t know what an “autopsy mind hankie” is, but I suspect it’s a mind-blower.

I checked our release. That’s not what I’d written at all. What I’d said was, “In postmortem brain tissue from people not diagnosed with Alzheimer’s…”

It seemed pretty clear that the release had been translated into some language – I had no idea which – and then, for some reason, reverse-translated back into English. I read on.

Continue Reading »

Infectious Disease, Media, Public Health, Stanford News

Stanford doctor-author brings historic figure Jonas Salk to life

Stanford doctor-author brings historic figure Jonas Salk to life

JacobsStanford professor emerita Charlotte Jacobs, MD, spent the past decade with the ghost of polio vaccine creator Jonas Salk, MD, the subject of her second biography, Jonas Salk: A Life. She dug through archives, conducted over a hundred interviews and read countless first-hand accounts and period news.

But she still had a difficult time choosing the opening scene for her book, the first written biography of the man hailed as an international hero for his role in ending the polio epidemics that ravaged the world during the first half of the 20th century.

Should she start with start with Salk’s humble beginnings as a child born to poor Jewish immigrants in New York City, dive into the life-saving research that propelled him to fame and antagonized his scientific peers, or begin at the end of his life, when he was striving to regain his prestige by seeking an HIV vaccine?

The choice for Jacobs became clear when, during a dinner at a writers’ residency, she described her book and its subject to her fellow participants. As the mostly younger writers quietly nodded, Jacobs realized they not only didn’t know who Salk was, they had no idea of the scope or severity of the polio epidemics. Jacobs, a child during the 1950’s, has chilling memories of this time.

Salk book cover“It was a fear that hovered over us every summer,” Jacobs recalled, “no matter what you did — eat your vegetables go to church, mind your mother — you could be the crippler’s next victim. And it was mostly children who caught the disease.”

Jacobs begins her book, excerpted in the new issue of Stanford Medicine, with a vivid account of the New York City 1916 outbreak. That year, in New York state alone, 8,900 people were infected, 2,400 died and many of the survivors were paralyzed or crippled.

The book has received numerous positive reviews. While Jacobs is happy with the attention, she is most excited for her audience to learn about the remarkable work that Salk and his team did in developing the vaccine and how the American public, through the March of Dimes, funded and carried out the first vaccine trials.

“This trial was run by volunteers; housewives collected the data,” she said. “Never before, and never again, has the public itself conducted a trial of this magnitude.”

Having read the excerpt in Stanford Medicine, I’m eager to read more.

Kim Smuga-Otto is a student in UC Santa Cruz’s science communication program and a writing intern in the medical school’s Office of Communication and Public Affairs.

Previously: This summer’s Stanford Medicine magazine shows some skinHenry Kaplan’s crusade against Hodgkin’s disease, TED Talk discusses the movement to eradicate polio, and Researchers tackle unusual challenge in polio eradication
Photo by Max Aguilera-Hellweg

Media, Neuroscience

Neurologist explores accuracy of the brain in the movie Inside Out

Neurologist explores accuracy of the brain in the movie Inside Out

brain imageHave you seen the movie “Inside Out” yet? I went over the weekend with my family, and despite reports that some parents weep throughout the last 20 minutes, I only shed a few tears. (A real miracle given what a sap I normally am when it comes to Pixar films – don’t even get me started on the last scene of “Monsters, Inc.”)

The movie takes place inside the brain of an 11-year-old girl, Riley, with different characters playing the role of various emotions (joy, anger, sadness, etc.). I found the movie’s journey through the brain visually stunning and highly entertaining, but I admit to not thinking much about its accuracy – until yesterday, when I came across this post on the NeuroLogica Blog.

Neurologist Steven Novella, MD, writes that he loved the movie and would highly recommend it, but “as a metaphor for brain function, the movie was highly problematic.” He outlines the various ways in which accuracy was sacrificed for plot, or for the sake of simple storytelling, starting with the control panel used in the “command center” of Riley’s brain. “There does not appear to be any equivalent of a command center or control panel in our brains. There is no ‘seat of consciousness’ or ‘global workspace,'” he writes. “Rather, consciousness appears to be highly distributed, with each part of the brain contributing its little bit.”

The entire post is an entertaining and educational read, and I know I’ll keep it in the back of my mind – no pun intended – upon my next viewing of the movie. (Anyone with kids knows there’s no way I’m getting away with seeing a Pixar movie only once.)

Previously: From brains to computers: How do we reverse-engineer the most mysterious organ?, From phrenology to neuroimaging: New finding bolsters theory about how brain operates and Anger: The most evil emotion or a natural impulse?
Photo by geralt/Pixabay

Cancer, In the News, Media, Medicine and Society

Oncology hashtag project aims to improve accuracy of online communication about cancer

Oncology hashtag project aims to improve accuracy of online communication about cancer

6399145505_49e812a63d_zThere’s lots of talk about the need for doctors to communicate better with their patients, and social media is taking off as a medium for doing so. At this year’s meeting of the American Society for Clinical Oncology, which ends in Chicago today, Matthew Katz, MD, a radiation oncologist at the University of Texas’ MD Anderson Center, exhibited a poster displaying a new series of hashtags for different types of cancer. There are at least 20: #leusm for leukemia, #melsm for melanoma, #blcsm for bladder cancer, etc. Patients and doctors alike can use them to be more accurate and specific in sharing information.

As reported in a MedCity News piece, Katz is a big believer in social media as a way for patients and doctors to communicate. He developed the hashtags to provide better access to reliable, high-quality health information for both patients and providers, and he’s quoted as saying:

Hashtags are a filter that can make it possible to make Twitter less noisy. Twitter has a lot of discussion of healthcare, but finding reliable information is not as easy… Patient-physician engagement is important, but the purpose is not to enhance therapeutic relationships. The disease-specific tags may be a way to adapt Twitter’s open platform to focus conversations and bring people together for education, advocacy and support.

Katz’s “cancer tag oncology” is based on research begun in 2013, which found that a wide variety of people did use the Twitter hashtags. Katz also founded Rad Nation, an online community of radiation oncologists.

Previously: Upset stomachs and hurting feet: A look at how people use Twitter for health information, Finding asthma outbreaks using Twitter: A look at how social media can improve disease detection, Advice for young doctors: Embrace Twitter, Twitter 101 for patients, and How using Twitter can benefit researchers
Photo by Michael Coghlan

Media, Medicine and Society, Technology

Upset stomachs and hurting feet: A look at how people use Twitter for health information

Upset stomachs and hurting feet: A look at how people use Twitter for health information

MedCity News ran an incredibly informative article earlier this week on how people use social media – and more specifically, Twitter – to consume and discuss health information. Reporting on a recent talk from Twitter engineer Craig Hashi at Cleveland Clinic’s ePatient Experience: Empathy + Innovation Summit, Neil Versel shared:

Some 40 percent of consumers believe that information they found on social media affects how they deal with their health, [Hashi] said. A quarter of Internet users with chronic illnesses look for people with similar health issues. And 42 percent search online for reviews of health products, treatments and providers.

Twitter processes 23,000 weekly tweets with the words “feet hurt,” and the frequency naturally increases as the day and the work week go on, though many people tweet that when they get home on Saturday night as well. “Dr. Scholl’s can actually come in and reach these people,” Hashi suggested.

“Allergy” tweets mostly occur between March and June, Hashi said. “Sunscreen” also peaks in the late spring and summer. “Uncomfortable tummies” is highest on Thanksgiving, with lesser spikes at Christmas and on Super Bowl Sunday. Hashi said that Tums advertised on Twitter around Thanksgiving.

And for those who question the value of Twitter, or don’t quite understand its place in health care, these figures might give you pause: “The volume of information available on Twitter is staggering, Hashi said. There are half a billion tweets send every day. There will be more words on Twitter in the next two years than in all books ever printed. An analysis Hashi put together found that there were 44 million cancer-related tweets in the 12 months ending in March 2015, and traffic spiked in October, which happens to be Breast Cancer Awareness Month.”

Previously: Finding asthma outbreaks using Twitter: How social media can improve disease detectionAdvice for young doctors: Embrace TwitterTwitter 101 for patientsBertalan Meskó discusses how mobile technologies can improve the delivery of health care and What to think about when using social media for health information

Stanford Medicine Resources: