Steph's E-learning and Digital Cultures Blog

Background

This week I attended the annual Cardiology Symposium where presentations were made on the developments and aspirations for the management of a variety of cardiac conditions.  Without harping on too much about the medical I will try to provide some background to my pedagogy. 

I have a particular interest in the management of patients that survive a sudden cardiac death.  These are seemingly fit and well individuals who, without warning, suffer a cardiac arrest.  The group that I see are the fortunate one’s who happened to be in the right place at the right time and therefore received CPR, defibrillation (shock) and immediate hospital treatment.  Among a variety of tests to attempt to diagnosis a predisposition/explanation for this event they usually receive an implantable defibrillator   (battery box attached to wires into the heart that provides a shock) should the event happen again.  

What I learnt at the symposium is that these development of the devices for heart failure patients is going in the direction of a a device that resembles a rod, that sits in the heart and has capacity to wirelessly transmit data  (such as heart rhythm and function) to a system that enables the physician to monitor the patients and remotely alter the function of the device to increase functioning of the heart. 

This reduces the need for hospital appointments to interrogate the device for rhythm abnormalities or device malfunctions.  I can foresee the future developments of this smaller device having defibrillation capability.  This is exciting stuff in my world! 

The adaption of the heart; with the heart being the symbolic essence of human life has made me question whether fabrication between “hybrid of machine and organism” (Haraway, 2001) has made the patient a cyborg. 

The ability for the physician to learn about the heart function from the device is a post human pedagogy in itself but I would like to take this concept a step further…

My Pedagogy

A major concern I have with this patient group is the psychological trauma experienced by these patients and how to educate them about the condition.  The technological advances of the device will inevitably result in less human contact between patient and physician…leaving a void in the psychological and educational support these patient require.  I am neither an inventor nor a programmer but with knowledge in this field can see a future that uses a programme to assist in a patient’s recovery, adjustment and future with a cardiac device.  I propose the development of a system resembling (if not exactly like) an app that provides an educational programme incorporating a programme of cognitive behavioural therapy (recommended in European guidelines for this patient group), access to peer support forums that are mediated by professionals and integration of the wireless data transmitted from the device to make support and treatment plans individualised to the patient.  I envisage it being accessible via mobile phones, tablets and computers and will incorporate the most up-to-date multimedia that will appeal to the age ranges targeted.

This pedagogy resembles an amalgamation of; an online (bank-like) account, virtual community/networking sites and educational support systems such as WebCT but enters unchartered territory in terms of existing within a health care system – an environment that does not have an ‘undo’ or ‘erase’ feature should something go wrong.  In discussing this with peers and colleagues I have had mix reviews as to whether this is progress or merely making the best out of a bad situation.  It is commonly believed that ideally, these patients would have access to structured in-hospital support and educational programmes.  To that I argue that making a person attend regular hospital appointments is costly to both them and the facility.  As the devices are technologically becoming posthuman so too must the pedagogy used to integrate and support them.

Finally, a eureka moment!  Week 9 (and 8!) has significantly encroached on week 10 as I have been struggling with the meaning of post-human.  Until now, I considered it to be related to human action and found myself trying to ‘fit’ it into some schema that sat nicely in my preconceived understanding of being human.  After reading Edwards ’The end of lifelong learning: a posthuman condition?’ it clicked that ’post’ is ‘going beyond’ being human.  Perhaps a simple point to grasp but without it it has been particulary difficult to make meaning of Haraway and Hayles.  Now I have a better understanding of this I feel I can read these again and begin to contruct a blog related to some of their work.

I’ve been looking for examples of posthuman in films and media and storing them in Delicious to keep for my blog.  I also added StumbleUpon to my lifestream.  Unfortunately I now realise I saved them in a folder with the same name as my lifestream tag and so they fed directly onto my lifestream.  This left my page with a range of bizzare and disjointed artefacts when viewed without any context.  I have rectified this problem, leaving me just my page to tidy over the few remaining weeks.

Being the first week of block 3 I obtained the readings and had a brief look at them but have been significantly distracted by finishing the ethnography. A lot of my learning this week has happened in the ‘real world’ and I do not feel I have reflected the significance of this in my lifestream. The opportunity to ‘invite a friend’ has led to some motivating conversations with colleagues and friends. This has turned out being an industrious stage in my course journey as I have been conducting some of my studies within a social circle that functions quite dependently around ‘conventional’ communication and wishes to believe it shy’s away from cyberculture, technology and posthumanities.
A few tweets have fed into my lifestream. Previously, finding it awkward to follow conversations in twitter I have had reservations over whether it would be a chosen means of communicating after this course. I realise now that it will…….I have no reservations that it is an effective way of sharing a links to another website. This is what I have tried to do this week when an ‘invited friend’ made me aware of the Free Thinking Festival and some I found some interesting sessions directly relevant to posthumanities.

The ethnography task has been interesting. I would until now have consider myself quite distance to the virtual world. However, the varied contributions from the class have been an eye opener to the fact that many communities that I consider common place in ‘my world’ are in fact virtual communities. This slowly developed realisation is perhaps representative of the fact they are so integrated with the real world…and how little appreciation I had for the fact that ‘my world’ was actually so involved in the virtual world.
Always looking for a new challenge I decided to use Prezi to present my ethnography. I had seen it used my previous students and was attracted to the slick linking between ideas – perfect for snap shots of a community. However, the challenges related to ethics (already identified in week6) became even more apparent when building the ethnography and it the intricacies of Prezi proved to be very time consuming. Despite this, it was worth the effort as I felt my ethnography turned out well for a first attempt and the feedback I received would indicate that posting it supported within a blog enabled me to convey the ethical challenges I encountered.
Looking at my lifestream I see that I have not been adding very varied feeds over the last few weeks so I have gone back to trying to use delicious some more. It takes practice to integrate using sites as a new way to support my learning, thus I realise I must practice some more.

Arrival Story:
As a person who has little association with virtual communities, other than to keep in touch with geographically distance friends and relatives on a very ad hoc basis, the decision of which community to study was not an easy one. Many uncertainties emerged. Primarily, if using the only virtual community I am a member of; can I be impartial when observing a community of loved one’s that were part of my life long before we started conversing by social network sites? I was also troubled by the thought of researching people I know well and did not feel that I would be able to separate my preconceived ideas created in the real world from those observed in the virtual world.
However, I identified that a motivation for embarking on the ELDC course was to see if it is possible to use the virtual world as a medium for patients/carers to correspond with healthcare professionals in an effective (if not more so) way than they might do in a face to face encounter. In order for this to work I consider it necessary for people in a virtual world to not lose their ‘real life’ identity whilst online and not adopt the persona of a fictitious avatar, for example. So, in order to study this I identified it necessary to know them in both worlds. A work colleague of a few years appeared to fall in the middle ground between complete stranger and childhood friend/family member. Fortunately a colleague with an online community was readily identifiable.
BanPlasticBagsEdinburgh (BPBE) was a community that I was aware had an online presence, created by a colleague.

The Journey:
The destination envisaged was towards the BPBE static website and to discover what other routes passed through there. However, on further investigation it became apparent that BPBE was a small organisation housed with a much larger community. There are recurrent opportunities when starting on the static BPBE site to travel (via hyperlink) into TheGlobalWe community. Inevitably then, much time on this ethnography journey was spent within TheGlobalWe and this became the environment to base this ethnographic.

Considering whether the community I chose to study should be aware of my actions I decided that as no information was password protected it can be considered of a public domain.

As the researcher I lurked, observed and reviewed previous interaction between members. This ethnography was studied in its natural state and those being studied did not know they were a part of my micro-ethnography. On a project of such a small scale I did not consider it right to participate in subjects that were of obvious importance to the members without having much insight or genuine interest of my own.

Observations:
It is apparent that the founder of TheGlobalWe is a ‘networker’ as described by Kozinets (2010). The smart use of social networking enables campaigns such as BPBE to reach a wider community and potentially gain support from other communities where members may have values complementary to its own cause. The ‘World Opera for World Peace’ is powerful and has potential to attract an audience drawn to the music, possibly before appreciating the motivation of the community as outlined by the mission statement. Strikingly, on arrival into TheGlobalWe community, reference to the Dalai Lama is paramount. Whilst being in the forefront of content, this remained a particular area that I did not feel comfortable commenting on. Inevitably, an ethnographer will make observations but their categorising and processing of observations are not easily made without influence of their own experiences, beliefs and morals. Hine (2000) suggests that the ethnographers ‘process of self-discovery’ can be necessary in developing insight into this community. Perhaps in a larger project more attention would be paid to the moral underpinning of a community and what bearing the individual ethnographer (with their individual beliefs/values) has on the study, but for the purposes of this community I have neither the time, information or intention to express opinion on something as complex as moral belief and behaviour. However, I can verify that the face to face observations, I have made over the past few years, regarding the founder of BPBE are in keeping with the persona that is displayed within the virtual community.
It is worth mentioning here that when the observations were already completed I mentioned to my colleague, for courtesy, that I was using his virtual community for this ethnographic study. With no apparent concerns to my studying the community his response did state that he ‘should make sure the site is up-to-date’. Whilst made as a passing comment this does demonstrates how, in order to study a community in an undisturbed, natural state (Hine, 2000) the ethnographer may need to be ‘undercover’.

Observing this virtual community enabled me, as a novice ethnographer, to conclude that it is possible to develop a virtual community to enhance a face to face connection. In this micro-ethnography it also appeared that the person does not necessarily alter themselves as a result of having a virtual presence. Despite thorough consideration of ethical implications of observing people prior to embarking on the journey through cyberspace I failed to appreciate that what I observe for myself may be ethically sound but the sharing of these findings in a transparent manner for the reader is complex. This would require further consideration if an additional study were to be conducted. As for my personal motivation regarding virtual communities as support networks within healthcare, the ethical consideration would become much more complicated. Encouragingly, the findings of this simplistic study would indicate that the negotiation of such ethical challenges could be of long term benefit to patient education/support and treatment.