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Web 2.0 Technologies, Tools and Applications

in the Realm of Medicine: A Survey and
Review
Faiza N. AlOtaibi ¹ and Nervana M. Bayoumy ²

Abstract— Since the internet field has been recently developing very rapidly and since the participation and collaboration
have been remarkably established with the evolution of Web 2.0, this study is aimed at delving into Web 2.0 in the medical field
as well as identifying the familiarity and the use of Web 2.0 technologies, applications and tools among medical professionals
and students in King Saud University, Riyadh, Saudi Arabia, and to view their potential benefits as well as the barriers to using
such technologies and services in the medical education. An online questionnaire was distributed among all medical staff and
students in king Saud University, College of Medicine and University Hospitals. The data were analyzed using Microsoft excel.
One hundred seventy respondents participated in this study. Considering the familiarity with Web 2.0 technologies and services,
most responses showed almost high familiarity with major types of Web 2.0 tools and applications but less actual use. As for the
frequency of use, Wikis, search engines, instant messaging and media sharing were highly used in regard to learning purposes.
Regarding usefulness and confidence in professional learning, Wikis, search engines and media sharing were viewed by the
majority as being extremely to very useful in helping learning process. Easy and fast accessibility to information and sharing
experiences and resources were amongst the advantages indicated. Insufficient definition of the concepts and technologies
behind Web 2.0 was among the main disadvantages indicated along with the lack of credibility in professional purposes.
Internet requirement was also pointed out as a major disadvantage of such technologies. Web 2.0 represents a highly
beneficial and well-developing field in terms of medical use. Therefore, awareness and education about these Web 2.0 tools,
technologies and applications should be emphasized among medical students and professionals. Despite the relatively high
familiarity with Web 2.0 technologies and tools, there is a lack of knowledge and effective use in the medical application and
educational purposes.

Key Words— Web 2.0, Medicine, Health care professionals, Medical education

——————————  ——————————

INTRODUCTION

R ecently, there has been a great deal of revolutions in

the web-based collaboration ware. With the emer-
gence of what is known as "Web 2.0", a raising num-
ber of tools, technologies and applications have been
widely used in all walks of life including Medicine.
The term "Web 2.0" that was coined by O’Reilly Media
in 2004 refers to a blizzard of almost free web services
and technologies including web-based communities,
blogs, wikis, social-networking sites, folksonomies (tag-
ging), social bookmarking and photograph annotation,
podcasts and multimedia-sharing sites, and Really Simple
Syndication (RSS). 1-3
Wikis:
Ward Cunningham, who firstly invented the notion of
wiki, used the word “wiki” to describe this user-editable
software (Wiki means “quick” in Hawaiian) . A wiki is a
collection of web pages that can be easily edited by users.
Wikis can be described as “shared repository of know-
ledge with the knowledge base growing over time”
(Godwin-Jones, 2003).4,5 Examples include Wikipedia: the
————————————————
 ¹ Medical Student, College of Medicine, King Saud University, Riyadh,
Saudi Arabia.
 ² Department of Physiology, College of Medicine, King Saud University,
Riyadh, Saudi Arabia.
collaborative editable free encyclopedia, PBWiki, Wikis-
paces, WikiAnswers or Google Docs and Spreadsheets. Med-
ical Wikis include: AskDrWiki, Medpedia, Ganfyd , Wiki-
Doc, or Wikisurgery.
Blogs:
Blog is a contraction of "web log" which are an online
collection of user-generated commentaries and links on
different subjects with a reverse-chronological order.
They are communications tools that don't only function as
personal diaries but became highly regarded medium for
editorials on specific subjects. Entries can be Photographs,
videos and audios besides the texts and hyper-
links.6Examples include Blogger, Live Journal and micro-
blogging such as twitter. Blog search engines include
Technorati. Examples of medical blogs include Science Roll.
Podcasts:
A podcast is a collection of digital media files (either
audio or video) distributed over the Internet that can be
played on some mobile devices, personal computers or
any other digital portable players e.g. MP3, MP4, or
IPod.7,8 The seamless integration of data, text, images and
sound is clearly delineated with this newly emerging
technology. Certain popular sites offer podcast search
engine such as Yahoo. Podcasters are programs that re-
lease downloadable media. Examples of them include:
Doppler, iTunes, Juice and MediaGo.
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RSS:
RSS (most commonly translated as "Really Simple
Syndication" but sometimes "Rich Site Summary") is a
format for delivering regularly changing web content.
Many news-related sites, weblogs and other online pub-
lishers syndicate their content as an RSS Feed to users
through subscription so that RSS feeds can be read using
software called an "RSS reader", "feed reader", or "aggre-
gator", which can be web-based, desktop-based, or mo-
bile-device-based.9
My Yahoo, Bloglines, and Google Reader are popular web-
based feed readers. PhysEmp allows subscribers to RSS
feeds to track jobs form the user's desktop or phone. Ex-
amples of RSS medical search sites include: MedWorm,
RSS4medics. Most of Web 2.0 sites, technologies and ap-
plications as blogs and podcasts can be syndicated to in-
ternet users through RSS feeds.
Social bookmarking , folksonomies and Social network-
ing sites:
Folksonomy is a means by which internet users can
tag, share, save and organize their favorite resources on
the web. Social Bookmarking is a tool to get hundreds of
sources of interest being tagged; this in turn would create
a community of the same interest and expertise.10 The
most leading social bookmarking sites examples include
delicious and Digg. CiteULike and Connotea promote shar-
ing of academic publications by many users of common
interest7. Diigo for example is a collaborative research tool
and knowledge sharing community that allows users to
bookmark and annotate contents. Now many web sites
offer bookmarking options for a favorite page to be
tagged using their toolbars as Google and yahoo. Social
networking sites in essence are online communities that
provide users means for interaction and shar-
ing.10Facebook, MySpace, LinkedIn and NING are the most
popular social networking sites that are used world wide-
ly.
Social and medical search engines:
In contrast to the traditional notion of search engines,
present search engines with the web development have
become more relevant to the field of interest and deli-
neate the search with various features, tools and services.
Examples of medical search engines include: Healthline,
OmniMedical Search, Google health and Google scholar. More
options have been developed for searchers to share, tag
and invite others.
Media sharing, and peer to peer file sharing:
One of the greatest benifits of Web 2.0 is the extreme
capability of almost all kind of multimedia to be shared
including texts, audios, videos, photo, graphics or anima-
tions. Flicker, slideshar, scribed and YouTube are well-
known media sharing sites. File sharing has played an
enormous role in the development of peer-to-peer com-
munities. Examples of these include: KaZaa, Bit Torrent,
and LimeWire.
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Instant messaging, videoconference and voice calls:
A much faster and easy way to get updated in a real
time and be synchronized (connected in a real time) with
another individual or to your community is instant mes-
saging with its developing features that enable voice or
video calls. Web links, photos and files can be shared
through most instant messaging programs.11 Voice calls
(VoIP) or telephony describes the technology of voice
transmission through IP networks.12 Videoconferencing
and videocalling are advanced techniques that deploy
greater capabilities allowing people in different locations
to get involved in many bossiness or educational fields.13
The most common examples in this regard are: MSN live
messenger, Yahoo, Google talk and Skype.
Medical users now can create a web page or blog, use
peer to peer file sharing and post messages to chat rooms,
newsgroups or forums. They can distribute a wide variety
of podcasts or educational multimedia with the folkso-
nomic evolution; medical users can bookmark favorite
medical contents or tag search bookmarking sites. Syndi-
cation feeds have made it much easier to get updated
with medical contents or any form of Web 2.0 tools.
Search engines such as Google facilitate the easiness and
promptness of getting medical or health resources. Medi-
cal users can really contact individuals or groups via in-
stant messaging or Voicecalls (VoIP), videophones or
through videoconferences. A great example of Web 2.0
smashup is HealthMap.org which is an automated freely
accessible electronic web site that integrates and aggre-
gates data and resources on global infectious disease and
their impact on health acting as an alert system. With
SEOmoz.org-a search engine optimization, medical users
can get a comprehensive and wide variety of Web 2.0
sites, tools and applications.
Numerous research in the recent literature have hig-
hlighted the evolution and the rapid usage of these web
services as well as how much they facilitate interactive
information sharing, participation and collaboration, and
enhancing user-centered design, accessibility and intero-
perability on the World Wide Web.3,7,14-19 Several studies
have also tackled the issue of Web 2.0 adoption in the
educational systems and how Web 2.0 significantly is de-
veloped in the learning and teaching processes, in libra-
ries and in many educational aspects.20-29 A number of
publications have forged ahead with this emerging web
in terms of user-generated content and social collabora-
tion, supporting tools or toward advancements.30-32
Since medicine is one of the most influential and ever-
growing filed, it has become involved in the technologies,
applications and tools of Web 2.0.7,33-36Starting at 2008,
Medicine 2.0 has become an annual international confe-
rence on Web 2.0 applications in health and medicine that
is also known as the World Congress on Social Network-
ing and Web 2.0 Applications in Medicine, Health, Health
Care, and Biomedical Research. It is organized and co-
sponsored by The Journal of Medical Internet Research, the
International Medical Informatics Association, the Centre for
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Global eHealth Innovation, CHIRAD, and a number of other
sponsoring organizations. Medical community, health-
care professionals and consumers are eager to get up-
dated with the recent knowledge easily and instantly.
Consistent with this goal, many studies with regard to
medicine 2.0 or health 2.0 have been conducted to explore
the implication of Web 2.0 services in the health centers
and hospitals and the effect of this on physician's im-
provement, patient-physician relationship and public
education.
The objective of this study was to examine the familiar-
ity and the use of Web 2.0 technologies, applications and
tools among medical professionals and students in King
Saud University, Riyadh, Saudi Arabia and to look into its
potential benefits as well as the barriers to using such
technologies and services in the medical education. This
study was also meant to be enriched with Web 2.0 review
and its role in the medical field.
METHODS
An online questionnaire was prepared for this study and
was distributed via an email introductory invitation be-
tween December 2009 and January 2010. The sample in-
cluded all male and female medical staff and students in
king Saud University, College of Medicine and University
Hospitals.
The questionnaire was based on the reviewed litera-
ture.37, 38 Questions considered of information on the so-
cial and educational use of Web 2.0 technologies, tools
and applications. It was provided with the purpose of the
study and was explicit with examples and explanations. It
contained six major questions; the first one was on the
four main distinctive features of Web 2.0 including: RSS,
Wikis, Blogs and Podcasts, the rest were about the fre-
quency of use in professional learning, the usefulness in
professional learning, general confidence in use, and the
advantages and disadvantages of Web 2.0 use in medi-
cine. A question lastly asked for comments on the use or
potential use of these technologies to aid medical educa-
tion.
Data were collected by www.esurveypro.com, and
responses were downloaded both as summaries and de-
tailed spreadsheets. The data were analyzed using Micro-
soft Excel 2007. As the demographic data responses were
incomplete, no comparative analysis was considered in
this study. However, an analysis aimed to provide an
overview of the respondents' insight and their behavioral
patterns was conducted.
RESULTS
Of all medical professionals and students in King Saud
University, College of Medicine and University Hospitals,
One hundred seventy respondents participated in this
study.
Regarding the characteristic types of Web 2.0 with con-
sideration to RSS, respondents varied between familiarity
and non familiarity. 32.98 % of the respondents didn’t
147
know what RSS feeds are while 24.47 % never used them.
25.53% used them for both personal use and professional
learning while 11.70% used them for personal use only.
The minority (5.32%) used them for professional learning
only.
As for Wikis, most of the respondents were familiar
with wikis. 50.54 % used wikis for both professional
learning and personal use, while 24.37% used them for
professional learning only. 8.60% used them for personal
purposes only. When asking about the contribution to
wikis, the majority (62.77%) had never contributed to a
wiki, while 19.15% had for professional learning purposes
only, 5.32% for personal use only and 12.77% for both.
Concerning blogs, 28.41% of the respondents used
them for personal purposes only. 13.64% used them for
both professional learning and personal use. The least
majority was with 3.41% using them for professional
learning only. How respondents used blogs in profes-
sional learning is indicated in (table 1).
Table 1 - How do you use Blogs?*
% of respondents Answers
39.53% I only read blogs
2.33% I only write my own blogs
12.79% I read blogs and write my own blogs 
*Not familiar with and never used answers were excluded.
As for podcasts, the vast majority of respondents
were familiar with podcasts with 34.09 % using them for
both personal use and professional learning. %21.59 used
them for personal use only while 6.82% for professional
purposes only. When asking about the creation of pod-
casts for professional learning, the vast majority (89.66%)
had never created podcasts for professional learning.
Their use in professional learning is indicated in (table 2):
Table 2 - How do you use podcasts?*
% of respondents Answers
18.39% I only listen to or watch podcasts online
9.20% I only download podcasts
31.03% I listen to or watch podcasts online AND 
download podcasts 
*Not familiar with and never used answers were excluded.
About the frequency of use Web 2.0 technologies and
services, respondents were asked to rate their frequency
of use on a one-five scale. Those who were always and
usually using Web 2.0 services are shown in (figure 1).
Most of the respondents were always using search en-
gines, instant messaging and wikis (probably Wikipedia
among all Wiki-based sites), Podcasts, social bookmark-
ing sites, videoconference calls, voice calls and RSS feed
had the lowest frequency of use.
Regarding how beneficial are the services offered by
Web 2.0 in aiding learning, respondents were asked to
rate the usefulness in regard to professional learning on a
one-five scale. Respondents who regarded these as being
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extremely and very useful are shown in (figure 2). The media  sharing,  in  contrast  to  social  networking  sites,  vi‐
majority regarded search engines and wikis as being ex- deoconference  calls  and  instant  messaging  of  which    the 
tremely useful. majority  of  respondents  considered  themselves  as  being 
      As  for  the  confidence  in  using  Web  2.0  technologies  slightly confident in using them. Respondents who consi‐
and services, respondents were again asked to rate this on  dered  themselves  extremely  and  very  confident  in  Web 
a one‐five scale. most respondents considered themselves  2.0 use are shown in (figure 3). 
extremely  confident  in  using  search  engines,  wikis  and   

Fig. 1. Frequency of Web 2.0 use in professional purposes among respondents .

Fig. 2. Usefulness of Web 2.0 tools and applications in professional development among respondents.
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Fig. 3. Confidence in Web 2.0 use as indicated by respondents.

Fig. 4. Familiarity with Web 2.0 tools and applications as indicated in this study.
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Concerning the advantages and disadvantages of Web
2.0 in medical education, a number of explored advantag-
es and disadvantages were proposed in the question as
reported by Gabriela Grosseck (2009) . Free text box was
made to allow further suggested ones. The most impor-
tant advantages as emphasized by respondents were; the
reduction of costs, the flexibility in choosing a technology,
150
the easier and faster accessibility to information and shar-
ing experiences and resources. Few also suggested that
the new generation of portable players and new mobile
devices has made Web 2.0 tools and application easily
maintained, and this new wave of innovations helped in
distant and e-learning (Table 3).

Table 3- Web 2.0 Advantages

% of respon- The most applicable advantages
dents in this
study
10.29% Easier and faster access to information, when and where it is needed
9.78% Flexibility, as far as the possibility of choosing technologies is concerned
9.78% Reduction of costs
7.89% Sharing accumulated experiences (blogs, microblogs, wikis, flickr, youtube) and
resources
7.20% The low level of complexity needed for use (minimum skills in using the Internet)
6.69% Creating digital content (especially media, podcasting, videocasting)
6.00% Independence from the platform (a computer, with browser and Internet connection
is enough)
5.49% Redistribution of effort, so that less and less time and energy are spent during search
and information management (del.icio.us, RSS)
4.97% The integration of a variety of Web 2.0 technologies in the teaching-learning activi-
ties
4.80% The increase in number of modalities of use and the heterogeneity of didactic prac-
tices and of types of formation, due to the diversity of the new technologies
4.80% Reliability in continuous usage, over an extended period of time
4.46% Compatibility with the elements of the educational field and the existing contextual
dynamics
3.60% The major focus on didactic innovation, and not on the technology per se
3.60% The major focus on didactic innovation, and not on the technology per se
3.43% Compatibility with the elements of the educational field and the existing contextual
dynamics
0.34% (other)  Web  2.0  applications  are  easily  maintained  with  the  generation  of  digital 
platforms  such  as  windows  mobile,  iPod,  iPhone,  blackberry  and  many 
media  players  that  facilitate  learning  and  communication  whenever  and 
wherever needed.  
 A new wave of innovations in distant and e‐learning.  

As for disadvantages; the most majority agreed on the They also indicated that it leads to low quality of the ac-
internet connection as being a must- requirement. They tual content and gives anyone the opportunity to com-
emphasized that a sum of technologies and concepts are plain thus creating a community without rules (Table 4).
hidden behind Web 2.0 and are still insufficiently defined.
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Table 4 - Web 2.0 Disadvantages

% of respondents in The important applicable disadvantages:
this study
16.25% An Internet connection is required (especially a broadband connection)
13.36% It leads to a low quality of the actual content, with sites which struggle in deep
informational mediocrity
10.83% It gives everyone the opportunity to complain, thus creating a community with-
out rules
10.47% It hides behind it a sum of technologies and concepts which are still insufficiently
defined
10.11% It has limited security
7.94% It promotes amateurishness by invaluable contents generated by users
6.50% It is a kind of second-hand Web, a medium for persons with low digital abilities
6.14% It has monetary quantification (the Internet as a business - Google)
5.42% It offers free things, in open-source structures, with a rather vague significance
5.05% The speed of programs is incomparably lower than the one of desktop programs
5.05% The extremely diversified offer of technologies which can be used and which
exist on the market at the moment, make the actual selection process difficult
2.53% It doesn’t mean anything per se, it is just electronic junk
0.36% (other)  Its software must be compatible with that operating system to work on 
your device.     

Regarding respondents' thoughts about the use or
potential use of Web 2.0 in the medical education, 10
comments were received, one pointed out that: "since
healthcare professionals and medical students are often on the
move, I find that these emerging tools and technologies are of
ultimate benefit for their busy work and personal lives. With
just one device in their pocket, they can manage their daily
tasks, access vital information, and stay connected to col-
leagues, family, and patients." Another referred to the sim-
plicity of taking advantages of communications and data
updates and that blackberry for instance had made it easy
for instant messaging. Two of the respondents suggested
for adopting new subjects or courses on Web 2.0 in the
medical curricula and workshops about the utilization of
these technologies and tools in the medical field. Half of
the respondents expressed their concerns about the inter-
net or WIFI connectivity that should be enabled through-
out all medical facilities in the college. The remaining
suggested for promoting KSU (King Saud University)
educational Web 2.0-based tools e.g. a new channel on
YouTube for KSU to encourage medical education and for
improving many KSU network sites in terms of accessibil-
ity and content enrichment.
DISCUSSION
The concept of creating and sharing content has made
tremendous progress with the new web known as Web
2.0. A myriad of significant social software are shaping
our life in terms of communication and education. The
use of Web 2.0 technologies, tools and applications is
greatly overwhelming globally,3 and the impact of these
technologies on medicine is becoming more acknowl-
edged. This study tests the acquaintance and experience
with the newly developing services offered by Web 2.0. It
shows insights into the applicability of these tools to un-
derpin medical applications in the college of medicine.
On the basis of familiarity with Web 2.0 technologies
and services among KSU medical staff and students (Fig-
ure 4), most responses showed relatively high familiarity
with most of Web 2.0 tools and applications. Albeit less
real and effective use, as shown by J Sandars & S Schroter
(2009). 37On the frequency of use basis, Wikis, search en-
gines, instant messaging and media sharing were the
highest being always to usually used in regard to learning
purposes. The finding of wikis and search engines as be-
ing most frequently used for professional purposes cor-
responds with the percentages of physicians using Web
2.0 tools as reported by B Hughes,  I  Joshi et al. (2009).39
On the basis of usefulness and confidence in professional
learning, Wikis, search engines and media sharing were
viewed by the majority as being extremely to very useful
in helping learning process. Extreme to very high confi-
dence was also shown by the majority in using these. This
is to be anticipated since these three Web 2.0-related sites
are convenient and quickly accessed.
As with every single innovation, Web 2.0 has its own
advantages and disadvantages, however, Web 2.0 has
excelled beyond the expectations in terms of collabora-
tion, openness and user-generated content. Most of the
advantages related to learning purposes selected by the
respondents evolve around the fast and easy accessibility,
reduction of costs -since almost all Web 2.0 technologies
and tools are free- and flexibility in choosing technolo-
gies. Many respondents also pointed out to the great deal
of experiences that can be shared through community
spaces and interaction within groups as one of the advan-
tages. This in turn would be part of young user's motiva-
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tion and learning. Requirement of minimum skills for use,
creating digital content and independence of platform are
mostly selected among other advantages as these facili-
tate a quick and easy handling . Disadvantages selected
by respondents in reference to learning development are
represented by the internet connection requirement as a
major concern in this study, the rest revolves around the
low quality of the actual content, generating community
without rules and thus promoting amateurishness, less
knowledge about the use, insufficient definitions of these
technologies and limited security. Information credibility
and user confidence with regard to authenticity and re-
liability is a major worldwide issue in this era of internet
openness. However, the effect of this might not be
daunted with a highly and widely growing informative
web. The undeveloped knowledge and skills acquisition
to a verity of Web 2.0 technologies, and the Lack of clarity
about Web 2.0 integration in medicine in order to leve-
rage its use are the main interpretations of this study find-
ings.
Interest in the influence of e-learning in medical edu-
cation has been highlighted recently and it has been also
increased within the realm of Web 2.0.40,41 consistent with
this and based on respondents' comments in reference to
educational aspects of Web 2.0, respondents showed a
great renaissance of interest in significant applications of
Web 2.0 in the medical sphere. They emphasized on ad-
vancing the knowledge of Web 2.0, developing Web 2.0 in
the education system and overcoming deterrents against
Web 2.0 use.
Limitation to this study is the low responsiveness to
the invitation of the questionnaire. Demographic charac-
teristics couldn’t be overall judged due to a lack of com-
plete data obtained. However, overview estimation is
given. This study would've become more interesting and
enriched if it had been provided with the whole study
population and with a full and comprehensive demo-
graphic attributes so that further extensive analysis
would be made.
Further investigations regarding Web 2.0 applications
in KSU medical school need to be done and the education
about the technology impact on medical practice and
learning needs to be raised among medical practitioners
and students to support medical education and profes-
sional development. This might be established through
courses and workshops for instances. KSU data base to
enhance and facilitate Web 2.0-based medical educational
system would be of ultimate improvement to be issued.
Web 2.0 is the future of education as stated by Stever
Hargadon (2008) .The future of Web 2.0 particularly in
medicine is promising with the burgeoning digital envi-
ronment and virtual reality. The challenges of Web 2.0 in
medicine are to get handled as the web develops.
152
CONCLUSION
With medicine being now in the era of Web 2.0, medi-
cal personnel and health care professionals should
gain competence in the information technology up-
dates.
Frequency of use and familiarity with Web 2.0 tech-
nologies, tools and applications vary considerably ac-
cording to each of Web 2.0 types with research en-
gines, wikis, media sharing and instant messaging
having the highest familiarity and frequent use.
Corresponding to the effective use of Web 2.0, search
engines, wikis and media sharing were also considered
highly aiding in learning purposes. And also being
confidently used.
In this study, most respondents referred to many
advantages when considering professional learning
development. Nevertheless, the internet requirement
and information credibility were the major considered
disadvantages.
Web 2.0 awareness and knowledge need to be pro-
moted and its potential use in medical practice and
health field should be further emphasized.
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