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Cleveland, Ohio
In this final installment of the CJA New Media series on The Web and Medical Education, we consider the future of the Web with respect to its likely future impact on academic medicine. Issues discussed include the future of electronic journals, academic acceptance of electronic publications, information philanthropy, free software, and the Digital Millennium Copyright Act.
Electronic journals
An important trend in academia is the increasing popularity of new forms of scholarly publishing. In addition to traditional books and journal articles, academics are also publishing CD-ROMs and DVDs as well as peer-reviewed articles in electronic journals and self-published articles on the Web. Of these, the issues associated with publication in electronic journals are particularly important, since publication in peer-reviewed journal articles is usually what counts most in achieving academic recognition, promotion and tenure.
In many cases traditional print journals have made their manuscripts available in electronic formats, usually in PDF format as well as sometimes in HTML format. While the PDF format beautifully preserves page formatting, making it especially "printer friendly", it is usually not possible to copy material from PDF files by the customary means of highlighting selected text and using the copy command. Thus, to copy a paragraph from an electronic journal article to quote in your own work, one must either retype the selected material or access the HTML (or similar) version of the article. Since some journals publish only PDF versions of journal articles, the copy limitation in the PDF format can make scholarship more difficult, but solutions may be around the corner. Barring legal obstacles, we should expect the eventual availability of software that automatically converts from PDF format to HTML or other formats in the near future. Indeed, a visit to Google (www.google.com), arguably the world’s best search engine, allows such software to be evaluated right now. Simply access a desired PDF file on the Web using Google, and Google’s electronic wizardry will produce an editable HTML version of the file for you.
Electronic journals sometimes differ from paper journals in a number of respects. For instance, some paper journals make the electronic version of their journal freely available on the Web as a philanthropic enterprise; no costs to the reader are involved, although some sites require user registration. Clearly, since the costs of running a journal can be considerable, this business model will only work where the paper version of the journal is popular, where Web-based advertising supports the costs, or where the costs are subsidized by some large academic society. As examples, take a look at the British Medical Journal (www.bmj.com) and the Canadian Medical Association Journal (www.cmaj.ca), both which make their electronic material free to anyone.
Some journals have no paper existence at all. For example, Medical Education Online (www.med-ed-online.org) publishes peer-reviewed articles on medical education that are free to download, but are not published in paper format. Presumably, the not insignificant costs of running such a project are born by various sponsors. This raises the issue of the long-term viability of journals lacking any visible means of support. Some electronic journals plan to survive using a system of "page charges", where the authors are expected to pay a fee to help cover the cost of publication. For instance, the BioMed Central journals (www.biomedcentral.org) are a collection of peer-reviewed journals, all of which are indexed in PubMed, but with an electronic-only existence. Authors must pay $500 US to publish in BioMed Central journals, but in return all readers can access the articles free of charge ("open access"). Also, BioMed Central has a copyright policy surprising to find with any publisher - authors retain the copyright to their work and are not required to assign it to the publisher.
Parenthetically, it is interesting to note that BioMed Central has recently launched a very interesting new journal – the Journal of Negative Results in BioMedicine (www.jnrbm.com). Since most journals are reluctant to publish articles where the study hypothesis is not confirmed, this journal is intended as a repository for such studies, so that negative studies are not unnecessarily repeated.
Fears about electronic journals
Despite the obviously rosy future electronic journals appear to have, a number of barriers to their continuing rise in popularity have appeared. Perhaps the most often mentioned roadblock to the growth and acceptance of online academic publishing is the "prestige factor". Most academics want to publish in the most prestigious and most frequently cited journals, and at the moment the most esteemed and respected journals (at least in most fields) are traditional paper journals. The concern many scholars have is that electronic publications will not be valued toward promotion or tenure, that their priceless scholarly efforts will not be recognized by their peers. Such concerns persist despite the fact that the Institute for Scientific Information (ISI) has begun indexing journals that are only published electronically.
Other concerns also exist. Some scholars fear that electronic journals might fail (as many indeed have), sending important research results into a great unreachable void. Similarly, some fear that electronic journals are likely to be less permanent than printed journals, that in the event of some disastrous server crash all will be lost. In both cases efforts are underway to ensure that journal failures or hardware failures do not lead to permanent loss of information by employing appropriate archive technology. As an example, www.archive.org contains a massive archive of present and past web pages that can be accessed whenever information from an old server is no longer available. (Although this is an obviously valuable initiative, not everyone wants to make old information available. For instance, the site has had to remove some old archived web sites that were once critical of the Church of Scientology because of aggressive legal action from that church.)
Peer-reviewed educational resources
In recent years scholars have debated how best to "clean up" the Internet, or at least identify zones where it is safe for students and scholars to tread. One proposed answer to these problems is the practice of peer-review. Peer review is the process in which material submitted for publication is reviewed by subject matter experts as a quality control measure. Thus, peer review may be viewed as a validation process that helps ensure the publication of high-quality materials that users can depend upon.
Of course, the peer-review process in scientific publishing is as old as academic publishing itself. Typically, materials submitted for publication are reviewed by two or more expert referees who are particularly knowledgeable in the subject matter being discussed. Their comments and opinions form the basis upon which an editor will decide whether or not to publish the submitted material, and with what changes, if any.
However, in the case of educational resources, peer-review is relatively uncommon. This is regrettable, because educators and students need resources they can trust and depend on. Still, the idea of establishing a peer-review process for educational resources is not entirely new. For example, the Medical College of Wisconsin, in conjunction with the Robert Wood Johnson Foundation, has launched a Web site at http://www.eperc.mcw.edu/start.cfm designed to be a central repository for peer-reviewed end-of-life educational resources for physician educators.
An even bigger initiative is Project Merlot, located at http://merlot.org/, which seeks to provide high-quality teaching materials in a number of disciplines of higher education. Here is a description of Project Merlot taken from the Web site:
MERLOT conducts structured peer review of online teaching-learning materials. The primary purpose of the reviews is to allow faculty from any institution of higher education to decide if the online teaching-learning materials they are examining will work in their courses. The emphasis on the user’s perspective is the reason why the peer reviews are performed by peer users of instructional technology, and not necessarily peer authors of instructional technology. The MERLOT peer review process for evaluating teaching-learning materials follows the model of peer review of scholarship. Each review is conducted by at least two higher education faculty members who, from their individual reviews, compose a "composite review" that is posed to the MERLOT website. Currently peer review is being conducted in twelve discipline-based communities.
Peer reviews are informed by standard evaluation criteria that divide the review into three dimensions: Quality of Content, Potential Effectiveness as a Teaching Tool, and Ease of Use. Each of these dimensions is evaluated separately. Generally, in addition to written findings by the reviewers, there is also a rating for each of these dimensions (1–5 stars, 5 being the highest). A review must average three stars (or textual equivalent) in order to be posted to the site.
Because the review and publication process can sometimes take considerable time, some journals offer authors the opportunity to archive manuscripts under review for public scrutiny. In the same manner, I would propose that in any such system, materials submitted for review by educators be made available in the original non-reviewed format at a special place on the Web, so long as the author is in agreement. In this way interested parties would still be able to access the material with the understanding that it is unreviewed, as well as comment critically on the materials if they so wished.
Free software
The Free Software Foundation (FSF), founded in 1985, aims at "promoting computer users’ right to use, study, copy, modify, and redistribute computer programs". The FSF promotes the development and to use free software and free documentation. The FSF also helps to spread awareness of the ethical and political issues of freedom in the use of software. It has a Web presence at http://www.gnu.org/fsf/fsf.html The FSF uses the term "free" in a somewhat more comprehensive sense than one might ordinarily expect. Here is their position on this matter:
"Free software" is a matter of liberty, not price. To understand the concept, you should think of "free" as in "free speech," not as in "free beer." Free software is a matter of the users’ freedom to run, copy, distribute, study, change and improve the software. More precisely, it refers to four kinds of freedom, for the users of the software:
A program is free software if users have all of these freedoms. Thus, you should be free to redistribute copies, either with or without modifications, either gratis or charging a fee for distribution, to anyone anywhere. Being free to do these things means (among other things) that you do not have to ask or pay for permission.
A number of commercial software vendors are concerned about the possibility that the free software movement will significantly diminish the demand for commercial software, particularly as the quality of free software improves and as it becomes more user friendly. Only time will tell how the free software movement evolves, but I would expect to be pleasantly surprised.
Copyright issues and information philanthropy
Material on the Internet is generally subject to the same laws as material published in print or in other traditional media. Thus, it is illegal to post copyrighted material on the Internet without permission of the copyright holder. Similarly, it is illegal to download and retain illegally posted copyrighted material. This concept applies especially to copyrighted software that may be illegally posted on an Internet server or on a bulletin board system. In the same vein, while there are many works of art that have been scanned and made available on the Internet, it is likely that most of this material is actually copyrighted material.
Information philanthropy is the term sometimes used to describe the free availability of information resources without requiring that one obtain prior permission to copy and redistribute material. It is important to recognize that such materials are not usually public domain property, as the holder usually still retains copyright to the material. The stipulation that the material must not be altered or edited, and that credit information is retained, is usually part of this "copyleft" arrangement.
While information philanthropy allows for freer distribution of information, this is an asset only if the information is of high quality. Thus, there is a continuing need for auditing processes to assure readers that the information made available is accurate, as discussed earlier in this article.
Digital Millennium Copyright Act
The 1998 American Digital Millennium Copyright Act (DMCA) represents the most comprehensive reform of United States copyright law in many years. The DMCA seeks to update U.S. copyright law for the digital age. Among the issues covered in the DMCA are provisions concerning the circumvention of copyright protection systems, fair use of copyrighted materials in a digital world, and issues related to online service providers.
In recent months the DMCA has received much criticism because of its apparent support of corporate interests over the rights of individuals, and for its particularly draconian nature. Even identifying security flaws in some software systems can get you in trouble. For instance, on July 17, 2001, the FBI arrested Dmitry Sklyarov, a Russian computer science student, for an alleged DMCA violation after he delivered a presentation at a US computer conference regarding security flaws in Adobe’s eBook system. While some individuals feel that free speech rights in the US should allow someone to demonstrate flaws within corporate products, the DCMA makes even this a violation of American law. Specifically, the DMCA makes is a crime to "circumvent" copyright protection systems. Here is the language:
Sec. 1201. Circumvention of copyright protection systems
(2) No person shall manufacture, import, offer to the public, provide, or otherwise traffic in any technology, product, service, device, component, or part thereof, that ...
This means that computer researchers can no longer research software products to ensure they provide adequate protection.
In response to Sklyarov’s arrest and other issues a coalition of anti-DCMA activists has been organized, with a web presence at http://www.anti-dmca.org/
[A full listing of the DMCA is available at http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=105_cong_bills&docid=f:h2281enr.txt.pdf ]
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