How Supporting Wikipedia Editors is Helping Improve Trust in Science

Dr. Amin Azzam, MD, MA, Health Sciences Clinical Professor at the UCSF School of Medicine, Director of Open Learning Initiatives and Lead Faculty Advisor at Osmosis, shares his expertise on the importance of Wikipedia editing, how it can help fight medical misinformation, and how it can improve the public's trust in science when integrated into formal education programs.

Though many view Wikipedia as unreliable, there's no denying its popularity as a free source of health information for patients and students alike. Let's discuss some of the lesser-known aspects of Wikipedia's quality checks, why academia need not see it as the enemy anymore, and the potential it has as both a learning tool and weapon against medical misinformation.

The role Wikipedia plays for students and patients

In 2013, I began teaching a Wikipedia-editing elective course at the University of California, San Francisco (UCSF) School of Medicine for fourth-year students. I've continued offering that course in the decade since while expanding my teaching to other places and platforms, including Osmosis. Though my work has shifted, the popularity of Wikipedia's health-related content certainly hasn't diminished. If anything, it's grown.

A 2015 paper noted that by the end of 2013, there were more than 155,000 medical articles on Wikipedia, and the content was viewed more than 4.88 billion times. As with all good science, the study was replicated with a larger international group of contributors. As of March 2017, they found 30,000 Wikipedia articles on health-related topics in English and another 164,000 in other languages, collectively read more than 10 million times per day. That's right—per day! 

It's clear that whatever your opinion about the reliability and accuracy of its content, we can't ignore that the world uses Wikipedia for health information. For example, tracking viewership by date shows that the English Wikipedia "Hepatitis" page is viewed significantly more on weekdays. That pattern is identical to many other diseases most commonly diagnosed in outpatient clinics. 

We also know that students use Wikipedia for research, even if warned against it. Wikipedia is free, often written in an accessible style, and available in multiple languages. It's an essential resource for science communication, but many academics denigrate it for the lack of quality checks. Ironically, some misinformation persists on that issue too.

The Big Myth: Wikipedia isn't reliable

Most academics proudly refer to Wikipedia as a trash can of information. What many don't know is that, like student papers, Wikipedia articles are graded. The site is open source and available to the public to edit, but articles are assessed according to a rubric, with criteria that include how factually complete they are, along with language quality and layout.

Much of the reviewing work is driven by WikiProjects, i.e., groups of collaborators who work together to improve articles around specific themes and areas of study. Examples include WikiProject Birds, WikiProject Mathematics, and WikiProject Physics. All these groups consist of volunteers whose mission is to edit and improve specific content areas on Wikipedia.

To view an article's quality grade, click the "Talk" option next to the Wiki article header. This section will also reveal the dialogue "Wikipedians" have had regarding the accuracy of a piece and how fairly it represents its topic. These discussions are vital in helping to fight bias and improve information quality.

Healing the relationship between academics and Wikipedia

Though the relationship between academics and Wikipedia is contentious, Wiki Education is a tireless counselor trying to reconcile things. The non-profit helps help lecturers and faculty like me design courses and assignments involving Wikipedia editing. They provide free online training modules, useful assignment guides, and even have a dashboard that educators can use to track students' edits easily.

Another benefit of academia working with Wikipedia is the opportunity to rectify the historical gender gap of Wikipedia contributors—not merely in science but across all content. According to the Wiki Education website, only 22% of Wikipedia editors are women, while 70% of Wiki Education participants are women and/or non-binary.

It's not just Wiki Education that can help tackle this issue. Hack-a-thons, or as we in the Wikipedia editing world call them, "edit-a-thons," are often facilitated by medical schools, libraries, and other institutions where people can join forces to address issues such as racial or gender bias in Wikipedia articles. When it comes to fighting misinformation, we're all one big, inclusive community.

Which articles do we start with?

With thousands of health-related articles on Wikipedia, even the most enthusiastic edit-a-thon enthusiast or educator may need clarification on where to start their work. WikiProject Medicine is a "group of volunteers committed to improving health-related content on Wikipedia." They offer resources on how to edit Wikipedia articles, cite reliable sources, and, notably, which pieces are considered to be of top priority.

They've ranked approximately 45,000 English health-related articles on an importance scale that takes into account the number of views an article has and the global burden of disease. Some of the top pages in both criteria are influenza, lung cancer, and major depressive disorder.

WikiProject Pharmacology performs similar work with a near-identical ranking scale. This stratification of Wikipedia's health-related content by both importance and quality helps volunteers prioritize their potentially most impactful work. That said, in my own courses, I encourage students to simply find topics that connect to their areas of interest or future intended specialties. Their intrinsic curiosity and self-motivation are critical elements to maximize both their effort and impact.

How schools around the world are adding to the collaboration chain

While mine was the first course of its kind to offer credits to students for their Wikipedia editing work, other universities have created similar offerings or helped facilitate ways for students to get involved. As previously discussed in an article for Wiki Education, here are some of the creative strategies I've seen health professional schools use when adding Wikipedia editing to their curriculum:

• As an assignment within an existing course, e.g., a "health policy" course.
• Embedded into an "educator track," e.g., for students interested in becoming future teaching faculty.
• As a component of information-seeking and application threads (a critical skill for all health professionals to develop).
• As a service-learning option, e.g., learn while also providing services to patients that you're learning from.
• As part of a profession-specific competency-based framework (most often practice-based learning or systems-based practice).
• As a component of required patient education activities (another skill all health professionals should develop).
• As an optional "edit-a-thon" in partnership with faculty and staff.
• As a stand-alone course (similar to my approach).

The movement is inspiring: this 2021 journal article highlights health professional school examples across six countries and five different health professions, as well as efforts with a global epilepsy organization. And Wiki Education aggregates courses into a "students in the health professions" campaign. As of June 2023, there were 157 courses within that campaign: 2,400 students have added 2.42 million words, 29,100 references, and 245 images to 1,590 health-related Wikipedia pages. Those pages have been collectively viewed over 88.2 million times since students' efforts.

Case Study: Addressing vaccine misinformation

What does a Wikipedia editing project look like for medical students aiming to boost people's trust in science? Here's an example from one of my 2019 UCSF courses. 

A student, Derek Smith, decided to focus his attention on the anti-vaccine backlash movement. He researched the issue extensively and even joined an anti-vaccine Facebook page to, in his words, "better understand the common pieces of misinformation."

He then edited the Wikipedia vaccination page, focusing most of his efforts on creating and building a vaccine safety section, including monitoring and common ingredients of concern. In the month he spent editing the page during my course, it was viewed 33,152 times. There's no way Derek could have seen that many patients in a month, so he did a disproportionate amount of good while still being "merely" a medical student.

If we're to defend against misinformation and ultimately rebuild medical trust with the public, thoughtful contributions to Wikipedia are a tool that all health professionals—and student health professionals alike—should be employing.

How Wikipedia editing gives back to students

Anyone online or on social media can see how damaging health-related misinformation is out in the world. Wikipedia editing is an opportunity to show students how they can help change that. Integrating Wikipedia editing into medical education is not just a matter of building trust in science; it offers an opportunity for students to engage with effortful, rewarding learning. We know that effective learning requires some level of cognitive difficulty and effort; it takes significant energy to edit a Wikipedia page in a manner that will address public concerns while also validating factual information. Students practice communicating science in ways that are concise, clear, and public-facing. But don't take my word alone. Here's a direct quote from Sarah Watanaskul, one of the students enrolled in my 2022 course: 

"As a medical student, I felt like I had a chance to make a difference beyond the clinic or hospital walls…the Wikipedia elective allows students to break down barriers of healthcare jargon, practice simplifying complex information, and uphold quality control of information on the topic pages. The importance of health is universally relevant, spanning all races, genders, socioeconomic classes, and educational levels. I felt like I was contributing to the public good… it's meaningful to help empower people to be able to take care of themselves and to help them lead the lives they want to live." 

Which Side Are You On: Health or misinformation?

Most health professional students and clinicians I've crossed paths with have been open about their desire to do good in the world. We all want and benefit hugely from high-quality health information.

To that end, we have a clear choice: meet patients where they're at, which is likely on Wikipedia checking information after receiving a diagnosis, or passively supporting misinformation by simply not getting involved. Supporting Wikipedia editors and integrating this work into health professional school curricula is an actionable step we can take to boost trust in science and improve public access to high-quality health information.

Why be someone who complains about Wikipedia when you can be someone who makes it better? For anyone interested in engaging further with this work, I highly recommend WikiProject Medicine and Wiki Education as resources. I also run an online summer course on Wikipedia editing for health professional students through Osmosis, which you can read more about here. Can you imagine a world where everyone has free access to high-quality health information clearly written in their own language? Join us!

About the Author

Dr. Amin Azzam, MD, MA, is a professor at three San Francisco Bay area universities: UCSF, UC Berkeley, and Samuel Merritt University. He has dedicated his career to providing innovations in health professional schools, including Problem-Based Learning (PBL), Simulation-Based Learning (SBL), and Open Educational Pedagogy (OEP). He remains clinically active, running long-term psychotherapy groups for patients with chronic illnesses. 

Beginning in 2013, Dr. Azzam created the world's first elective course for medical students to receive academic credit for improving health-related information on Wikipedia, which has since spawned many other health professional schools to adopt this practice. As the Osmosis Director of Open Learning Initiatives, Dr. Azzam continues to promote Wikipedia editing as a teaching and learning strategy across Osmosis-affiliated health professional schools. To maximize the educational value of Osmosis resources, Dr. Azzam also serves as the Osmosis Faculty Engagement Coordinator, which involves training faculty at Osmosis-affiliated partner health professional schools to optimize student engagement with the Osmosis platform alongside—and within—the formal curriculum. Dr. Azzam lives in Oakland with his wife (June) and children (Remy and Margo). They enjoy camping, board games, and international travel.