1 Introduction

In Thailand, herbal medicines are highly popular. Products from natural herbs are frequently used for improved health. It is necessary for pharmacists and other healthcare professionals to learn about knowledge of traditional medicine for their professional practices [1, 2]. In pharmacy curriculum, most courses can be classified as a modern medicine. Only some courses are provided for traditional medicines. Several topics in herbal information, e.g., herbal nomenclature system and medicinal usages, are useful in professional practice. However, ways to use and apply herbs may be distinct according to cultural background. This kind of data should be contributed by practitioners or experts from different regions. With Web 2.0 technologies, they give us an opportunity for sharing and distributing information from a group of members on a topic of interest [3, 4]. The Knowledge Unifying Initiator for Herbal Information (KUIHerb), a system for gathering herbal information, is used as a platform for building a Web community [5]. To encourage students to learn herbal medicine, the KUIHerb had been planned to use as a computer-mediated activity in a blended learning. However, some reasons that it is not suitable to use as a learning tool. For example, different concepts of information provided by members in KUIHerb and students. Members in the KUIHerb may contribute their opinions based on their experiences while pharmacy students should contribute herbal information related with scientific evidences. In the KUIHerb, herb names are usually contributed in Thai. However, students in the 21st century should be handled herb names in several languages, especially English and languages that are frequently used in the Southeast Asian countries. This feature is not implemented in the KUIHerb. Furthermore, several errors in content from contributed opinions may occur during the learning process. The consequent is that members and visitors of the KUIHerb, may receive incorrect information. In the academic year of 2015, we created a new and clean Website based on the KUIHerb. The KUIHerb was modified to be a Web-based and social network-based learning tool on herbal medicine, which is called KUIHerbRx2016. Information of herbs in several regions can be distributed and exchanged among groups of students. Multi-lingual names of herbs should be collected. Regions of applying the name and methods of assigning the name can be input. Furthermore, opinions given to the KUIHerbRx2016 should be evidence-based opinions. To support this concept, a set of reliable references should be suggested. The quantitative and qualitative evaluations had been done to proof contributions from students.

In the rest of this paper, the detail of herbal information is described in Sect. 2. The concept of blended learning is provided in Sect. 3. Section 4 presents the concept of the KUIHerbRx2016, a blended learning tool in herbal medicines. Section 5 gives the learning process design, settings, and evaluations. The results and discussions are given in Sect. 6. A conclusion and future work are made in Sect. 7.

2 Herbal Information

Herbal information is information about medicinal herbs. Normally, students learn herbal medicines in both lecture and practice classes. In a course of health informatics, a topic of knowledge management is set for applying to herbal knowledge. A supplement-learning tool in herbal medicine is created and used to improve knowledge and skill in herbal medicine with scientific methods and support multi-lingual and multi-script herb names. Therefore, this tool may be applied for both blended learning and knowledge management in herbal information. Some topics are emphasized, i.e., herb names, medicinal uses (indications), precautions and toxicities, as well as additional information. Herb names and medicinal uses, which may be different among cultures, are still problems. The scientific name of an herb and its images are usually used for common understanding. However, scientific names are not usually used as common term in communication between healthcare professionals and patients. In Thailand, Traditional Thai Medicine (TTM) has been developed for a long time. Due to the fact that significant number of Chinese people and their descendants settle in Thailand, Traditional Chinese Medicine (TCM) is also popular. In a Chinese drug store, the names of crude drugs are called in Chinese languages, normally in Chaozhou (Teochew) dialect. However, the standard dialect of Chinese languages, Mandarin, is increasing in popularity among this region [6]. Only two alphabets are usually used in Thailand, i.e., Thai and English. Therefore, names of herbs and crude drugs are presented in Thai, English, or Latin and/or transliterated into Thai and English. Some problems occur when names of these herbs and crude drugs are in other languages, e.g., Chinese. The name in Chaozhou and Mandarin dialects are still important to use for identifying a Chinese herb or a crude drug. However, it is hard for a new generation pharmacist to recognize herbs or crude drugs with these dialects.

At this moment, pharmacy students should be studied more about herbal medicines. Due to Asian Economic Community (AEC) has been established [7], students may be faced with a harmonized healthcare system. For raw materials about herbs and herbal products, students should be able to understand their names in several languages. Traditional and modern applications of herbal medicines for each country should be studied. Moreover, information in herbal medicine provided to professionals and patients should be based on scientific evidences.

3 Blended Learning

Blended learning is a kind of learning which combines some useful methods to enhance the learning by traditional methods. With traditional teaching and learning methods, these are given by simple methods, e.g., orally or a pen. In blended learning, online courses should be combined with the traditional learning and the proportion of online courses should be in range of 30–79% [8]. The great advantage of blended learning is the flexibility to applied learning processes to students [9]. In the twenty-first century, flexibility of teaching and learning methods based on individual students. Students can manage their time and place for learning. Blended learning may be applied on both individual and collaborative learning. Collaborative learning defines learners as a group or team. Learners in a group help each other to search for understanding something. Trend in the 21st century, collaborative learning environment is supported by technology [10].

4 KUIHerbRx2016: A Tool for Collaborative Learning in Herbal Medicine

This KUIHerb’s version, which was used as a tool for collaborative learning in herbal medicine, is called KUIHerbRx2016. In this version, two types of contributions could be applied, i.e., text and non-text information. For non-text, images and links external sources could be used. Six main topics of opinions are described as follow.

4.1 Herb Name

The thing should be kept in their mind is that an herb may have several names for each naming system and one name may be referred to several herbs. The relationship between herbs and their names is many-to-many. In the KUIHerbRx2016, is modified to be able to input herb names in multiple languages with a systematic pattern. Top 50 most widely spoken languages were used. Although Laos and Khmer (language of Cambodia) languages are not in the top 50 languages, they were added into the system because they are languages in ASEAN. Four methods of inputting are defined, i.e., characters, Romanization, transliteration and combination among these three methods.

4.2 Medicinal Usage

This component is composed of parts used, indication, and how to use for this indication. Medicinal uses may be different among cultures. For example, the aqueous extract of Tinospora crispa has been used for treatment of stomach trouble, diarrhea, and indigestion for Filipinos and Malays [11]. In Thailand, the decoction from its stems, leaves, and roots has been used to treat fever, cholera, etc. Opinions are given by pharmacy students here should cite to reliable sources of information, e.g., scientific research, standard textbooks, and information from the Internet. References can be given in the tab of References. Although information from articles in journal and books is more reliable than information from articles on the Internet, some websites published reliable sources [12], which can be used for references.

4.3 Precaution/Toxicity and Additional Information

These two topics are free text without majority voting. For a precaution, any suggestions will be kept for warning when someone would like to use the herb. For additional information, other valuable information such as cultivation may also be given.

4.4 References for Each Opinion

This space can be applied for suggesting references for an opinion in order to make the opinion more reliable. In KUIHerb, this topic is allowed only an administrator. However, students can access this topic in KUIHerbRx2016. When students contributed their opinions in other topics, each component should be cited by a set of reliable information sources, e.g., scientific research papers, standard textbooks, etc.

4.5 Images of Herbs and Links

A set of images for an herb is an important feature. We can identify the herb from its images. Several herbs can be found in a botanical garden of Faculty of Pharmacy. The images should relate to the whole plant and the parts, which are important for medicinal uses and identifying (e.g., leaves, flowers). A set of keywords should be given to the system. Students were encouraged to take their own photos of herbs (from real herbs). These images should not be taken from the Internet. However, some herbs are rarely found. Therefore, this topic is an optional. To alleviate this problem, the topic of link was created. Only links to images of herbs were kept in the system.

4.6 Images of Health Products from Herbs

In order to introduce herbal products to students, a task of finding herbal products from herbs was assigned to students. The products may be traditional or modern medicines. These products can be normally found in the drug stores.

5 Learning Process Design, Settings and Evaluations

5.1 Learning Process Design and Settings

The third year pharmacy students in Faculty of Pharmacy, Silpakorn University that registered the course “health informatics” in the academic year of 2015 (Jan, 2016 to May, 2016), were assigned to contribute their opinions in KUIHerbRx2016. The number of students was 167. The KUIHerbRx2016 was initialed with information of 911 herbs. The 200 herbs began with information on all topics to use as samples. The rest were initialed in topics of scientific name, English names, and general characteristics (for some herbs). Three assignments were given to students: (1) each student was an initiator on two herbs (assigned by a professor) in all topics (herb images, products and links are optional) as much as possible (2) each student was a participant for at least one herb (can vote or input their opinions), and (3) the student should do the questionnaire about the KUIHerbRx2016. Only the first and the second assignments were input into the KUIHerbRx2016 and reported in electronic documents. These two assignments were discussed in this paper. The students were encouraged to contribute local names in Thai and multi-lingual names especially, languages in ASEAN. Opinions provided to the KUIHerbRx2016 should be evidence-based information and avoid copyright violations. Students can searching herbal information for create their own opinions or vote to existing opinions which they belief to be correct. Herbal information, formats of input, methods to prepare pictures for herb images, and methods for tagging languages can be exchanged. Their tacit knowledge will be transformed into explicit knowledge.

5.2 Evaluations

Three domains of learning were used to evaluate students after an assignment was completed. Details of an evaluation for each domain are described as follow.

Cognitive Skills.

Students’ cognitive skills were evaluated by ability to apply knowledge and understanding of principles for analyzing various situations, especially new situations. In this topic, students were able to apply principles for searching and summarizing herbal information with evidence-based information. Reliable references for an opinion should be given. Quantitative and qualitative analysis of opinions were used for evaluating the cognitive skills.

Responsibility.

Students’ responsibilities were evaluated by the ability to work effectively in groups and social responsibility. In this domain of learning, maximum, minimum, and average numbers of herbs contributed to the KUIHerbRx2016 were used as indicators.

Information and Communication Technology Skills.

These kinds of skills were evaluated by the ability to use information and communication technology. Students should apply information technology for contributing their opinions into KUIHerbRx2016. The tool was use for exchanging information among students. Furthermore, contributions for each student were reported in an electronic document and sent into the Google Classroom for this topic. The numbers of students, which contributed their opinions in KUIHerbRx2016 and send reports into Google Classroom were used as indicators for the domain of learning.

6 Results and Discussions

6.1 Process Design for Knowledge Management in Herbal Information

The process of using blended learning for knowledge management in herbal information was designed as described in the previous section. The diagram of the process is presented in Fig. 1.

Fig. 1.
figure 1

The process of using blended learning for knowledge management.

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6.2 Evaluations of Domains of Learning

Evaluations were grouped into 3 parts based on related domains of learning, i.e., (1) cognitive skills, (2) responsibility and (3) information and communication skills. The results for each domain are described in detail here.

Domain of Cognitive Skills

In this research, only opinions in text, i.e., local and multi-lingual names, medicinal usage, precaution/toxicity, additional information and references, were used to perform analysis in both quantitative and qualitative analysis. The result is shown in Table 1. Two patterns of statistics are taken into account, i.e., the total opinion and the total herb. The total opinion (Opinion) is the number of opinions contributed from the students for each topic. The total herb (Total Herb) is the number of herbs that students provide information for each topic. Moreover, the numbers of herb names in top ten languages are shown in Table 2. In order to assess quality of contributions from students, 10 herbs were randomly selected. The numbers of references contributed to each topic for each herb are reported in Table 3. Values in Table 3 are represented in form of a/b, where a is the number of opinions which references are given and b is the total number of opinions for that topics. For contributions of pictures, examples of health products from an herb were shown in Fig. 2.

Table 1. Distributions of students’ opinions on each topic
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Table 2. The numbers of herb names in top ten languages
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Table 3. The ratio of opinions with references/all opinions.
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Fig. 2.
figure 2

Images of health products from an herb (Senna alexandrina).

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From the results of quantitative analysis, some observations can be made. Students can collaborative work and contribute knowledge on all topics. Topics of multi-lingual and local names as well as medicinal usage were the most and the second contributed opinions, respectively. Several references had been suggested. For local and multi-lingual names (Fig. 3), a large number of names were given in Thai and other languages. From the Table 2, English and Chinese names are commonly used in Thai. For other ASEAN languages, Malay and Vietnamese are also frequently found. Several suggestions about precaution/toxicity and additional information were also contributed. The result of qualitative analysis is given in Table 3, the average percentage of opinions with references on three topics, i.e., indications, precaution/toxicity, and additional information (Add. Infor.) was 63.89. Therefore, approximately one-third of opinions on these topics were given without any references. From the results, students could provide adequate information to the system. However, the number of opinions with references and citations for opinions should be improved.

Fig. 3.
figure 3

Local and multi-lingual names of an herb (Senna alexandrina).

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Domain of Responsibility.

In this assignment, each student was an initiator on two herbs (create new opinions) and was a participant for at least one herb (can vote or create new opinions). Therefore, maximum, minimum, and average numbers of herbs contributed to the learning tool for each student were used as indicators in Table 4.

Table 4. Maximum, minimum and average numbers of herbs contributed to the KUIHerbRx2016 for each student.
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From the result, the average number of herbs given new opinions and vote for the existing opinions were 2.52 and 3.07, respectively. Students had good responsibility and do their assignment above expectation. For the minimum number of herb, two students did not do their assignment. The asterisk (*) means, the values are reported minimum number of herbs for students who contributed their opinions in the KUIHerbRx2016. Two students had not been completed their assignment, the number of herbs for new opinions was 1.00. In summary, students could do their assignment completely in terms of the number of herbs and time.

Domain of Information and Communication Technology Skills.

From 167 students in this class, the numbers of students, which contributed their opinions in KUIHerbRx2016 and send reports into Google Classroom were 165 and 163, respectively. Therefore, two students did not contribute any opinion in the KUIHerbRx2016 while four students did not send their reports. Using date/time stamp on opinions recorded in a database, there is no late for inputting students’ opinions. With the monitoring system in Google Classroom, there was also no late for receiving reports. From the results, students had ability to use information and communication technology to do their assignments.

7 Conclusion and Future Work

In this work, the KUIHerbRx2016 was used as a Web-based blended learning tool in herbal medicine to improve three domains of learning, i.e. cognitive skills, responsibility as well as information and communication technology skills. Several topics in herbal information were assigned to students, e.g., local and multi-lingual names, medicinal usages, precaution/toxicity, additional information, references, images of herbs (from their both cameras, and link to images on the Internet), and herbal products. Activities of searching, collecting, contributing new opinions and/or vote to exist opinions, and providing comments to the system with evidence-based information, enhanced skills in herbal medicine, including information and communication. Students gained more experience on herbal medicines. Both quantitative and qualitative contributions from students were evaluated. From the results, students could provide adequate information to the system. However, the number of opinions with references and citations for their opinions should be improved. For responsibility, students could do their assignments completely in terms of the number of herbs, topics of information and time used for contributing their opinions. They expressed their information technology skills to search herbal information, put opinions into the tool, and share information among students.

For references of contributed opinions, sources of information should be categorized and analyzed. Furthermore, the correctness of assigning languages in herb names should be evaluated. We leave these for our future work.