User:Michael rowe

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Short description: Creating an online, distributed authoring environment that would allow South African physiotherapy clinicians, educators and students to collaboratively create a culturally and contextually relevant physiotherapy textbook. It should make use of multiple communication channels (Twitter, blogs, etc.) to create a platform for discussion and debate in the profession.

The problem: Most academic textbooks are published in America or Europe, which brings with it several problems, not least of which is high cost, lack of contextual relevance and outdated evidence. A locally produced textbook that is culturally relevant, inexpensive and able to be updated regularly would solve several problems in physiotherapy education.

Advantages of this approach:

  • The content can continually be updated e.g. links to new studies can be added immediately
  • The content can be distributed across geography and timezones
  • Digital multimedia adds a depth to the content that is impossible to achieve in print e.g. hyperlinking to relevant sources, embedded video and audio, and animated graphics are just a few possibilities
  • Individuals taking responsibility for only small sections, rather than an entire book or even chapter, reducing the time commitment from authors
  • The use of more permissive / less restrictive copyright licenses, allowing greater freedom in how the content is used (and paid for)
  • Print runs could be limited only to the number of students requiring that specific content, with individuals paying only for the content they need, rather than entire textbooks
  • A social and cultural relevance lacking in international publications
  • Encouraging student participation on multiple levels, from basic (editing of grammar and spelling, checking of references) to more advanced (creating digital content that serves as an adjunct to the printed book, translation)
  • Ability to translate the content into any of the 11 official languages
  • The inclusion of content not normally associated with a particular topic e.g. adding a significantly more prominent ethical / human rights component to a chapter on stroke rehabilitation i.e the ability to take the content in directions
  • Finally, as an academic exercise, it will stimulate a national discussion / debate around both educational and clinical practices in South Africa

Audience: South African physiotherapy clinicians, educators and students.


  1. Create a framework for the development of a South African physiotherapy textbook
  2. Make use of local examples, case studies, etc.
  3. Emphasise the unique health-related problems in South Africa
  4. Establish a platform for discussion and debate among healthcare professionals

How does it work?: Summary of the design. I'm uncertain at this point if it's going to be a workspace for the collaborative authoring of a printed textbook, or an online "textbook" that makes use of the internet and communication tools to facilitate engaged learning among students. The more I think about it, the more I'm learning towards an online collaborative authoring environment to create a printed book. Printed books still have a huge part to play in South African education. We can't leave stuff online and expect everyone to have access to it. Maybe each page of the printed book could have it's associated "page" online, where educators/students/clinicians could make use of online technology to enhance the printed book.

Similar projects:

  1. Free high school science textbooks in South Africa
  2. California Open Source textbook
  3. Open Text Book
  4. Connexions: I started a module on ankle rehabilitation on Connexions but didn't enjoy the interface. I didn't feel it was intuitive and simple enough to work on freely, and definitely not collaboratively.
  5. Wikiversity
  6. Wikibooks: I started a book on assessment a few years ago, which has been added to by a few others since then. I haven't put any work into it since I began it because I felt (at the time) that there was no-one else working in this space. Also, it's an international project, so not really relevant for this particular one.

Challenges: These might revolve around subjects such as intellectual property and the management of the content generated in this manner i.e. who “owns” it. I would propose that the "profession" would own the content and it's generation should be seen as a contribution to the continuing evolution of physiotherapy in the country. Authors could be “paid” in terms of the community's recognition of their contribution and with the knowledge that a higher standard of education and patient care will be a direct result of their work.

The technological barrier (access and proficiency) is a huge problem in South Africa but not insurmountable. Accessing the authoring environment through the browser (with a suitable editing dashboard) could virtually eliminate one barrier. Authors could be shown reasonably quickly that the technology has reached a point where it is almost invisible and that only a limited knowledge of computers and the Internet is required to participate. This could be achieved through workshops at conferences, or through students teaching staff.

The other problem with access is the lack of broadband access and high costs involved. If we assume that a wiki is the best platform, it requires "always on" connectivity (writing offline and pasting text ignores the whole concept of collaborative authoring by not allowing selective editing). Do any wikis have the ability to synchronise edits made offline, in the same way that Google Docs does it?

How will we manage the problem of multiple languages? It seems crazy to not have an implementation that permits multiple versions of the same document in other languages, especially since we have 11 official languages in South Africa. Again, a wiki will allow this.

Many editors will also introduce the problem of inconsistent typographical rendering, which is unacceptable for any textbook. Learners must be comfortable that the formatting used is consistent throughout. Authors will have to comply with simple formatting conventions (e.g. APA style for citations and referencing)

Open Technology

Uncertain about the best tool for collaborative authoring. Wikis (e.g. Mediawiki) clearly have the upper hand with the "collaboration" part, but aren't great for authoring/ formatting a book. I'm thinking it might be a good idea to use a wiki for creating content and then exporting the content to another platform to manage the editing? Editing a book will involve a lot that a wiki couldn't handle efficiently, like specific annotation of various components. Does anyone know of an open source, distributed book authoring platform?

A blogging environment would be useful to syndicate the progress of the project, and Twitter (or maybe a more secluded platform like laconica, seeing that Twitter is now mainstream) for pushing out relevant content. I'm thinking multiple streams of content e.g. having different blogs/microblogs for clinical content (and maybe even split that again into different subject areas), educational content, writing guidelines, etc. Contributors can then subscribe to the content areas that they specialise in.

The fact that it's online should make use of that fact e.g. the "book" could have an IRC channel, Twitter stream, blog, etc.

I've been wondering about using Google Docs (I now it's not open, but I'm a pragmatist before being an idealist and will consider anything that works). I've used it for small collaborative authoring projects between 2-3 people, but don't know how it would scale for larger projects. It also lacks the ability for efficient communication and annotation (possibly the "comment" and "footnote" feature would suffice?).

I found this blog post by Mark Shuttlework looking for exactly the same thing. Going through the comments it seems the strongest contenders would be:

It seems that the most efficient way would need to go through the browser, rather than a desktop application that uses an extension to publish documents to a shared server ( and the extension that allows this...I forget it's name). Everyone has a browser and it's a barrier to expect people to install additional software and extensions to participate.

Open Content / Licensing

What types of content are you using or producing, and how are they licensed. Do you need to clear copyright for any of them? Are there institutional policies that affect what you can (or cannot) do?

I'll push to use a Creative Commons license but ultimately it might depend on the wishes of the profession as a whole (I'm hoping it will be a national project). The use of open content studies for background evidence will also be encouraged.

The "textbook" will also make use of free online resources to further inform their learning.

Open Pedagogy

How do participants learn? What forms of assessment are you using?

Each section / chapter will incorporate various ongoing assessment tools (e.g. self-study questions, personal reflection). Chapter structure will be an important component to decide with other educators. This article talks about integrating online books with scientific workflow through cross-navigation with online journals. This would be easily accomplished, as editors continuously link to emerging (and established) research. Each iteration of the printed textbook would therefore contain links to the most up to date evidence.

This is significant in the current move towards evidence-based practice in healthcare. We trying to not only encourage students to base their clinical practice on the best available evidence, but also as educators, to teach the most up to date content.

It's also important to remember that this is about collaborative editing, not mere reproduction of book technology on the screen.

Although once again I come up against the idea of an authoring environment to create a traditional textbook, or an online book that uses technology to facilitate teaching and learning? Could it be both?

I'm especially attracted to the possibility of using a language module (I know Mediawiki has one) to allow the creation of the textbook / course notes in multiple languages. This is one area in which students could be particularly active, translating content between languages. This is especially relevant in South Africa, where all the teaching institutions use English or Afrikaans as the language of instruction. This wouldn't change that, but would allow students to have copies of the notes in their home language.

Diagram / Sketch