Clinical Anatomy 28:565–567 (2015)
EDITORIAL
Anatomy and Wikipedia JOEL A. VILENSKY1* 1
AND
Department of Anatomy and Cell Biology, Indiana University School of Medicine, Fort Wayne, Indiana 2 University of Copenhagen, Copenhagen N, Denmark
Wikipedia is often the initial source of information for medical and health professional students searching for quick information about anatomical structures. Although there have been several studies investigating the accuracy of the information provided in Wikipedia including on medical disciplines (https://en. wikipedia.org/wiki/Reliability_of_Wikipedia), this has not been done for anatomy. Most of the studies in other disciplines have found that the information provided in Wikipedia is generally accurate, albeit with some errors especially errors of omission. However, a very thorough recent analysis of the Wikipedia pages on topics related to respiratory physiology concluded the following: “Therefore the Wikipedia articles on the respiratory system and its disorders are not suitable for medical students as learning resources. Medical students should become aware of these problems in the Wikipedia articles, and medical educators should direct them to appropriate resources that have been written/edited by scholarly authors and are regularly updated and accurate,” (Azer, 2015). So what about anatomy? As a soon-to-be retired medical school anatomy professor and long-time coeditor of this Journal, the first author (JAV) of this editorial decided to begin to look closely at anatomy in Wikipedia and perhaps start to edit some of the anatomy pages therein. I enlisted the aid in this project of a well-experienced Wikipedia anatomy editor (JS), who is the second author of this editorial, which primarily relates to JAV’s observations on beginning to look and edit Wikipedia anatomy articles. JS expanded my insights and provided details about Wikipedia editing, and corrected some of my misconceptions. It should be clearly stated that this editorial is not a methodological study of the accuracy of Wikipedia anatomy articles in the manner that Azer and others have done for medically related topics. Because these observations are somewhat random and unrelated, it seemed best to present them as separately numbered thoughts: 1. The number of Wikipedia pages relating to anatomy is enormous. There are certainly thousands, likely more than 12,000. But more than half of these articles are not truly informational pages. For example, there are redirect pages that direct the reader to a better page than what the reader typed into the search box (often used with plural forms, so if you search
C V
JAKOB STEENBERG2
2015 Wiley Periodicals, Inc.
for “arteries” there is a page that automatically redirects the searcher to the “artery” page (https://en.wikipedia.org/w/index.php?title=Art eries&redirect=no). There are also redirect pages for synonyms. Similarly, there are “disambiguation” pages that provide information on the different possible meanings of a specific term. For example, if you look up “abductor muscles” you obtain a page that lists the five Wikipedia pages that refer specifically to the five human abductor muscles (https://en.wikipedia. org/wiki/Abductor_muscle). Thus, it can be safely said that every anatomical term that an anatomy student might need has some type of Wikipedia page. 2. I assumed that editing a Wikipedia page would be similar to editing a Word document. It is not. Except for very simple text, editing Wikipedia articles involves using HTML code. Even with some background in HTML, the learning curve for editing is steep, and without any background, steeper. However, Wikipedia is working to make editing easier—but the drawback here of course is that more people will be able to make changes and introduce errors. 3. For every Wikipedia page, there are tags at the top of the page (History, Talk) that allow anyone to see how and when the page has been changed. The Talk pages allow contributors to discuss changes and potential changes to this page before making them. For example, on the Wikipedia page for the cranial nerves (https:// en.wikipedia.org/wiki/Cranial_nerves), the optic nerve was considered part of the central nervous system (CNS), rather than part of the peripheral nervous system (PNS). Although on a structural or embryological level, this is technically correct, in gross anatomy we consider all of the cranial nerves to be part of the PNS. And on the Wikipedia page for the PNS (https://en.wikipedia.org/
*Correspondence to: Joel A. Vilensky, Department of Anatomy and Cell Biology, Indiana University School of Medicine, Fort Wayne, IN 46805, USA. E-mail: [email protected] Received 13 April 2015; Accepted 13 April 2015 Published online 14 May 2015 in Wiley Online (wileyonlinelibrary.com). DOI: 10.1002/ca.22562
Library
566 wiki/Peripheral_nervous_system), the cranial nerves are noted as being part of the PNS. So here is an example of contradictions within the anatomy pages of Wikipedia, of which I am sure there are many more. Before proceeding to change the text on the cranial nerves page to state that the cranial nerves are part of the PNS, I posted this suggested modification on the Talk page and received a favorable response from another contributor. Doing this before editing a page is of course not mandatory and many of the proposed changes on the Talk pages do not receive any responses. The History tag brings up a page showing all the changes that contributors have made to that particular topic page since the inception of that page. 4. When I began investigating anatomy pages on Wikipedia I learned that there is a Wikiproject specifically devoted to human anatomy (https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Anatomy). Anyone may start a Wikiproject and the goal is to try to give some consistency (organization) to all the pages that the contributors consider within the purview of this project. The anatomy project page attempts to rate the quality of the Wikipedia anatomy pages, lists specific issues that need to be addressed, and lists specific tasks and also pages that need heavy versus light editing (this was particularly helpful to JAV as a beginner). Furthermore, and perhaps most importantly, it has a listing of all participants in the project and allows for general discussion of topics within the project (again, very helpful to the first author as a beginner). There is also a quarterly newsletter. But also important is that members of the anatomy project have no authority within Wikipedia. The members of this group have no more license to edit pages than anyone else. 5. At the time of the writing of this article there were 42 listed active participants in the anatomy project. The 42 names listed on the page are all Wikipedia usernames and there is no way of knowing the qualifications of these individuals or why they have chosen to work on anatomy pages. Reavley et al. (2012) suggested that it might be possible for professional societies to note approval of Wikipedia pages (e.g., the AACA could appoint a Committee to evaluate specific pages). But with so many pages and continuous editing by anyone, it would seem that such a project would not be consistent with the spirit of Wikipedia. 6. On many anatomy pages as well as on other Wikipedia pages there are banners that suggest the type of editing that a particular page needs. These banners may call for less technical language, or the addition of sources or more information (i.e., a Wikipedia stub). Contributors manually add these banners and thus there is no overall scheme as to when these banners are used.
7. Wikipedia encourages its contributors to cite sources. But the first author’s brief foray into Wikipedia suggests that often these sources are obscure or not accurate and certainly not consistently used across pages. The most common source found among the anatomy pages and illustrations is the public domain editions of Gray’s Anatomy (with much copied and pasted from them)—certainly not a source that anatomists would use in a book or article written today. Sometimes the sources are very specific medical discipline texts or articles (e.g., a textbook on hand surgery) that use clinical terminology not used in an anatomy course. And of course there is much uncited information that may be incorrect. For example, the webpage for De Quervain syndrome (https://en.wikipedia.org/wiki/De_Quervain_ syndrome) states that the abductor pollicis longus and extensor pollicis brevis muscles have essentially the same function. Clearly, with one tendon inserting on the proximal phalanx and the other on the metacarpal of the thumb, we would not consider them to have the same function and the names of the muscles suggest otherwise. Furthermore, what I find a bit disconcerting is that even if a contributor accurately cites a source, a change to that page by another contributor may render the citation no longer accurate. In other words, whenever text is changed, there is no verification that the change is consistent with the cited reference. 8. Because any number of contributors can edit a single page, the writing on a particular page is sometimes poor, inconsistent, and repetitive. Further, the pages in Wikipedia are not intended to be written in a manner that is suitable for an upper level student in anatomy, but rather for a layperson. So, technically, strict anatomical terminology should NOT be used, at least not without a definition, e.g., dorsal and ventral or even flexion and extension are not terms used typically by laypersons. This convention is often not followed, with most articles written at a college level (Azer, 2015); my own reading suggests many of the anatomy pages require some knowledge of basic anatomical terminology. 9. The figures used for many of the pages are often of very poor quality and may not even show the structure that the page is discussing. The problem of course with images for Wikipedia is that once posted on a page they are in essence free to use or modify by anyone. So typically Wikipedia pages do not contain textbook- or atlas-quality images, which is presumably a drawback for anyone trying to understand the information on the page. And as noted previously, many of the images are from the pre-1920 editions of Gray’s text because those images are in the public domain. 10. Templates are basically tables of information that are inserted into multiple relevant
567
Fig. 1. Wikipedia template (table) for muscles of the human arms. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
Wikipedia pages. Figure 1 shows a template titled, Muscles of the human arms. Editing such a template is currently beyond my Wikipedia editing ability, but clearly this template needs a great deal of editing because of numerous inaccuracies. It should correctly titled, Muscles of the Upper Limb; the fascial compartments listed are not part of the anatomical lexicon; there is a muscle in the Table listed for the “arm,” articularis cubiti, which is not in any anatomical book I know of, etc. This template could do more harm than good to a student preparing for an exam if he/she thinks he should know all that is in this template.
CONCLUSIONS There is nothing we as anatomy teachers can do to prevent our students from going to Wikipedia as a quick source of information on an anatomical term. And in most cases the information there is sufficiently accurate to provide a general framework for what the student needs to know. However, Wikipedia is not designed for the graduate level courses in anatomy that we teach and students must be reminded that Wikipedia pages are being constantly edited and re-
edited and the information on anatomy pages may not be commensurate with what they are expected to know. Also, the information may be confusing and inaccurate. Certainly, we should tell them that our exam questions might not be consistent with the information in Wikipedia so an incorrect answer by them based on a page in Wikipedia is likely not to be changed to correct by us even if the students show us the Wikipedia page. Wikipedia is a great invention and useful, and the more of us that devote some time to improving the Wikipedia anatomy pages, the more accurate these pages will become. And trust me, there is plenty of work for all of us (if you are interested in becoming a Wikipedia anatomy contributor you should begin by reading this Wikipedia page [https://en.wikipedia.org/wiki/ Wikipedia:Introduction] and/or contacting one of us). We thank Dr. Stephen Carmichael for contextual suggestions and grammatical changes that improved this editorial.
REFERENCES Azer SA. 2015. Is wikipedia a reliable learning resource for medical students: Evaluating respiratory topics. Adv Physiol Ed 39:5–14. Reavley NJ, Mackinnon AJ, Morgan AJ, Alvarez-Jimenez M, Hetrick SE, Killackey E, Nelson B, Purcell R, Yap MB, Jorm AF. 2012. Quality of information sources about mental disorders: A comparison of wikipedia with centrally controlled web and printed sources. Psychol Med 42:1753–1762.
EDITORIAL
Anatomy and Wikipedia JOEL A. VILENSKY1* 1
AND
Department of Anatomy and Cell Biology, Indiana University School of Medicine, Fort Wayne, Indiana 2 University of Copenhagen, Copenhagen N, Denmark
Wikipedia is often the initial source of information for medical and health professional students searching for quick information about anatomical structures. Although there have been several studies investigating the accuracy of the information provided in Wikipedia including on medical disciplines (https://en. wikipedia.org/wiki/Reliability_of_Wikipedia), this has not been done for anatomy. Most of the studies in other disciplines have found that the information provided in Wikipedia is generally accurate, albeit with some errors especially errors of omission. However, a very thorough recent analysis of the Wikipedia pages on topics related to respiratory physiology concluded the following: “Therefore the Wikipedia articles on the respiratory system and its disorders are not suitable for medical students as learning resources. Medical students should become aware of these problems in the Wikipedia articles, and medical educators should direct them to appropriate resources that have been written/edited by scholarly authors and are regularly updated and accurate,” (Azer, 2015). So what about anatomy? As a soon-to-be retired medical school anatomy professor and long-time coeditor of this Journal, the first author (JAV) of this editorial decided to begin to look closely at anatomy in Wikipedia and perhaps start to edit some of the anatomy pages therein. I enlisted the aid in this project of a well-experienced Wikipedia anatomy editor (JS), who is the second author of this editorial, which primarily relates to JAV’s observations on beginning to look and edit Wikipedia anatomy articles. JS expanded my insights and provided details about Wikipedia editing, and corrected some of my misconceptions. It should be clearly stated that this editorial is not a methodological study of the accuracy of Wikipedia anatomy articles in the manner that Azer and others have done for medically related topics. Because these observations are somewhat random and unrelated, it seemed best to present them as separately numbered thoughts: 1. The number of Wikipedia pages relating to anatomy is enormous. There are certainly thousands, likely more than 12,000. But more than half of these articles are not truly informational pages. For example, there are redirect pages that direct the reader to a better page than what the reader typed into the search box (often used with plural forms, so if you search
C V
JAKOB STEENBERG2
2015 Wiley Periodicals, Inc.
for “arteries” there is a page that automatically redirects the searcher to the “artery” page (https://en.wikipedia.org/w/index.php?title=Art eries&redirect=no). There are also redirect pages for synonyms. Similarly, there are “disambiguation” pages that provide information on the different possible meanings of a specific term. For example, if you look up “abductor muscles” you obtain a page that lists the five Wikipedia pages that refer specifically to the five human abductor muscles (https://en.wikipedia. org/wiki/Abductor_muscle). Thus, it can be safely said that every anatomical term that an anatomy student might need has some type of Wikipedia page. 2. I assumed that editing a Wikipedia page would be similar to editing a Word document. It is not. Except for very simple text, editing Wikipedia articles involves using HTML code. Even with some background in HTML, the learning curve for editing is steep, and without any background, steeper. However, Wikipedia is working to make editing easier—but the drawback here of course is that more people will be able to make changes and introduce errors. 3. For every Wikipedia page, there are tags at the top of the page (History, Talk) that allow anyone to see how and when the page has been changed. The Talk pages allow contributors to discuss changes and potential changes to this page before making them. For example, on the Wikipedia page for the cranial nerves (https:// en.wikipedia.org/wiki/Cranial_nerves), the optic nerve was considered part of the central nervous system (CNS), rather than part of the peripheral nervous system (PNS). Although on a structural or embryological level, this is technically correct, in gross anatomy we consider all of the cranial nerves to be part of the PNS. And on the Wikipedia page for the PNS (https://en.wikipedia.org/
*Correspondence to: Joel A. Vilensky, Department of Anatomy and Cell Biology, Indiana University School of Medicine, Fort Wayne, IN 46805, USA. E-mail: [email protected] Received 13 April 2015; Accepted 13 April 2015 Published online 14 May 2015 in Wiley Online (wileyonlinelibrary.com). DOI: 10.1002/ca.22562
Library
566 wiki/Peripheral_nervous_system), the cranial nerves are noted as being part of the PNS. So here is an example of contradictions within the anatomy pages of Wikipedia, of which I am sure there are many more. Before proceeding to change the text on the cranial nerves page to state that the cranial nerves are part of the PNS, I posted this suggested modification on the Talk page and received a favorable response from another contributor. Doing this before editing a page is of course not mandatory and many of the proposed changes on the Talk pages do not receive any responses. The History tag brings up a page showing all the changes that contributors have made to that particular topic page since the inception of that page. 4. When I began investigating anatomy pages on Wikipedia I learned that there is a Wikiproject specifically devoted to human anatomy (https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Anatomy). Anyone may start a Wikiproject and the goal is to try to give some consistency (organization) to all the pages that the contributors consider within the purview of this project. The anatomy project page attempts to rate the quality of the Wikipedia anatomy pages, lists specific issues that need to be addressed, and lists specific tasks and also pages that need heavy versus light editing (this was particularly helpful to JAV as a beginner). Furthermore, and perhaps most importantly, it has a listing of all participants in the project and allows for general discussion of topics within the project (again, very helpful to the first author as a beginner). There is also a quarterly newsletter. But also important is that members of the anatomy project have no authority within Wikipedia. The members of this group have no more license to edit pages than anyone else. 5. At the time of the writing of this article there were 42 listed active participants in the anatomy project. The 42 names listed on the page are all Wikipedia usernames and there is no way of knowing the qualifications of these individuals or why they have chosen to work on anatomy pages. Reavley et al. (2012) suggested that it might be possible for professional societies to note approval of Wikipedia pages (e.g., the AACA could appoint a Committee to evaluate specific pages). But with so many pages and continuous editing by anyone, it would seem that such a project would not be consistent with the spirit of Wikipedia. 6. On many anatomy pages as well as on other Wikipedia pages there are banners that suggest the type of editing that a particular page needs. These banners may call for less technical language, or the addition of sources or more information (i.e., a Wikipedia stub). Contributors manually add these banners and thus there is no overall scheme as to when these banners are used.
7. Wikipedia encourages its contributors to cite sources. But the first author’s brief foray into Wikipedia suggests that often these sources are obscure or not accurate and certainly not consistently used across pages. The most common source found among the anatomy pages and illustrations is the public domain editions of Gray’s Anatomy (with much copied and pasted from them)—certainly not a source that anatomists would use in a book or article written today. Sometimes the sources are very specific medical discipline texts or articles (e.g., a textbook on hand surgery) that use clinical terminology not used in an anatomy course. And of course there is much uncited information that may be incorrect. For example, the webpage for De Quervain syndrome (https://en.wikipedia.org/wiki/De_Quervain_ syndrome) states that the abductor pollicis longus and extensor pollicis brevis muscles have essentially the same function. Clearly, with one tendon inserting on the proximal phalanx and the other on the metacarpal of the thumb, we would not consider them to have the same function and the names of the muscles suggest otherwise. Furthermore, what I find a bit disconcerting is that even if a contributor accurately cites a source, a change to that page by another contributor may render the citation no longer accurate. In other words, whenever text is changed, there is no verification that the change is consistent with the cited reference. 8. Because any number of contributors can edit a single page, the writing on a particular page is sometimes poor, inconsistent, and repetitive. Further, the pages in Wikipedia are not intended to be written in a manner that is suitable for an upper level student in anatomy, but rather for a layperson. So, technically, strict anatomical terminology should NOT be used, at least not without a definition, e.g., dorsal and ventral or even flexion and extension are not terms used typically by laypersons. This convention is often not followed, with most articles written at a college level (Azer, 2015); my own reading suggests many of the anatomy pages require some knowledge of basic anatomical terminology. 9. The figures used for many of the pages are often of very poor quality and may not even show the structure that the page is discussing. The problem of course with images for Wikipedia is that once posted on a page they are in essence free to use or modify by anyone. So typically Wikipedia pages do not contain textbook- or atlas-quality images, which is presumably a drawback for anyone trying to understand the information on the page. And as noted previously, many of the images are from the pre-1920 editions of Gray’s text because those images are in the public domain. 10. Templates are basically tables of information that are inserted into multiple relevant
567
Fig. 1. Wikipedia template (table) for muscles of the human arms. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
Wikipedia pages. Figure 1 shows a template titled, Muscles of the human arms. Editing such a template is currently beyond my Wikipedia editing ability, but clearly this template needs a great deal of editing because of numerous inaccuracies. It should correctly titled, Muscles of the Upper Limb; the fascial compartments listed are not part of the anatomical lexicon; there is a muscle in the Table listed for the “arm,” articularis cubiti, which is not in any anatomical book I know of, etc. This template could do more harm than good to a student preparing for an exam if he/she thinks he should know all that is in this template.
CONCLUSIONS There is nothing we as anatomy teachers can do to prevent our students from going to Wikipedia as a quick source of information on an anatomical term. And in most cases the information there is sufficiently accurate to provide a general framework for what the student needs to know. However, Wikipedia is not designed for the graduate level courses in anatomy that we teach and students must be reminded that Wikipedia pages are being constantly edited and re-
edited and the information on anatomy pages may not be commensurate with what they are expected to know. Also, the information may be confusing and inaccurate. Certainly, we should tell them that our exam questions might not be consistent with the information in Wikipedia so an incorrect answer by them based on a page in Wikipedia is likely not to be changed to correct by us even if the students show us the Wikipedia page. Wikipedia is a great invention and useful, and the more of us that devote some time to improving the Wikipedia anatomy pages, the more accurate these pages will become. And trust me, there is plenty of work for all of us (if you are interested in becoming a Wikipedia anatomy contributor you should begin by reading this Wikipedia page [https://en.wikipedia.org/wiki/ Wikipedia:Introduction] and/or contacting one of us). We thank Dr. Stephen Carmichael for contextual suggestions and grammatical changes that improved this editorial.
REFERENCES Azer SA. 2015. Is wikipedia a reliable learning resource for medical students: Evaluating respiratory topics. Adv Physiol Ed 39:5–14. Reavley NJ, Mackinnon AJ, Morgan AJ, Alvarez-Jimenez M, Hetrick SE, Killackey E, Nelson B, Purcell R, Yap MB, Jorm AF. 2012. Quality of information sources about mental disorders: A comparison of wikipedia with centrally controlled web and printed sources. Psychol Med 42:1753–1762.
