Abstract
BackgroundThere is increasing interest in online collaborative learning tools in health education, to reduce costs, and to offer alternative communication opportunities. Patients and students often have extensive experience of using the Internet for health information and support, and many health organisations are increasingly trying out online tools, while many healthcare professionals are unused to, and have reservations about, online interaction.MethodsWe ran three week-long collaborative learning courses, in which 19 mental health professionals (MHPs) and 12 mental health service users (MHSUs) participated. Data were analysed using a discursive approach to consider the ways in which participants interacted, and how this contributed to the goal of online learning about using Internet technologies for mental health practice.ResultsMHSUs and MHPs were able to discuss issues together, listening to the views of the other stakeholders. Discussions on synchronous format encouraged participation by service users while the MHPs showed a preference for an asynchronous format with longer, reasoned postings. Although participants regularly drew on their MHP or MHSU status in discussions, and participants typically drew on either a medical expert discourse or a "lived experience" discourse, there was a blurred boundary as participants shifted between these positions.ConclusionsThe anonymous format was successful in that it produced a "co-constructed asymmetry" which permitted the MHPs and MHSUs to discuss issues online, listening to the views of other stakeholders. Although anonymity was essential for this course to 'work' at all, the recourse to expert or lay discourses demonstrates that it did not eliminate the hierarchies between teacher and learner, or MHP and MHSU. The mix of synchronous and asynchronous formats helped MHSUs to contribute. Moderators might best facilitate service user experience by responding within an experiential discourse rather than an academic one.
Highlights
There is increasing interest in online collaborative learning tools in health education, to reduce costs, and to offer alternative communication opportunities
The data set was scrutinized line by line in consideration of the two research questions of interest here: How did mental health professionals and service users interact on an online collaborative forum? Did the MHP’s expertise discourage the mental health service users (MHSU) from posting? What appeared to help or hinder collaborative interaction from both parties?
The MHPs, MHSUs, and researchers started off with assumptions about relevant information and appropriate behaviour, which can be seen in what participants chose to introduce as relevant, and how these contributed to posting expectations
Summary
There is increasing interest in online collaborative learning tools in health education, to reduce costs, and to offer alternative communication opportunities for professionals, students and service users. Schneebli et al [7] described a “philosophical shift from passive recipient of services to active participant at all levels of service delivery and policy development” between service users and mental health professionals, which has led to service user involvement as a “mandatory requirement of services”, and increased calls for the involvement of mental health service users (MHSU) in the education of mental health professionals (MHP) [8] Despite this increasing focus on making medicine more “patient centred”, a variety of studies of professional-patient interaction [9,10] have highlighted the persistence of professional dominance and the “remarkable persistence of asymmetry” [11]. There is a tension between increased expectation of service user involvement, and of patient-centred care, and the expectations and behaviour of both professionals and service users in medical encounters
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