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ASA NEWSLETTER
 
 
March 1997
Volume 61
Number 3
 

Educational Multimedia Software: Putting It All Together

Thomas P. Engel, M.D., and George J. Sheplock, M.D.
Committee on Electronic Media and Information Technology



Educational multimedia software programs are interactive computer programs with text, sound, diagrams, pictures and digital video. Programs on many subjects are currently available for anesthesiologists, including management of the difficult airway, anatomy for regional anesthesia, operation of the anesthesia machine and transesophageal echocardiography. Multimedia authoring combines content expertise with writing, education, graphic arts and programming skills. Authoring tools are becoming easier to use and allow content experts to produce interactive multimedia computer programs without traditional programming skills.

Educational multimedia software has advantages and disadvantages for users and authors. Advantages to users include convenience, enjoyment, active involvement and potential for very rapid access to information. Active involvement may lead to increased recall. Educational computer programs are especially good for learning physical skills. A picture is worth a thousand words; a movie is worth a thousand pictures. New interactive technologies such as QuickTime VR allow the user to explore an environment and may become worth a thousand movies.

Disadvantages to users include lack of access to computer equipment, software expense, confusing navigation features and limitations as a reference. Access to computers is becoming less of a problem. Authors must make special effort to target a wide variety of computers and help inexperienced users. Most computer software titles are very expensive. Software versions of printed books often cost more than the printed version. Navigation can be a major problem in educational software. Many titles are like mazes. It is difficult to know their location within the program and difficult to know which options are available. Authors must make special effort to build useful navigation features. Educational multimedia software is frequently of limited use for reference. Most titles are tutorials at best. Authors also must support user-directed access.

Advantages to authors include a wide audience, the opportunity for effective communication and prestige. CD-ROMs are less expensive to publish than books. Electronic seminars are not limited by attendance. An author can include sound, animation and digital video to improve communication of material. Users are more enthusiastic about multimedia than other types of publication.

Disadvantages to authors include great time and effort, rapid obsolescence and intellectual property issues. Educational multimedia software is very time-consuming to produce. It is estimated that 1,000 hours of author's time is required for each hour of user's time. Most lectures with slides require about five hours of author's time for each hour of lecture. Timelessness is very hard to achieve in digital medium. Fads and improving technology can quickly date materials. Simplicity, consistency and experience are the best defense. The text in a multimedia title must be able to stand alone. Authors must be meticulous about permissions for materials. Authors also must be meticulous about intellectual property requirements of employment contracts.

CD-ROM is the natural distribution medium for large multimedia programs. CD-ROMs have very high capacity (650 MB). This can hold the entire text of a small library, or about 1,000 color photographs, or about 20 minutes of digitized video, or some fractional combination of these. New formats such as Digital Video Disc (DVD, also called Digital Versatile Disc) offer even greater capacity CD-ROMs and are very inexpensive to produce. A single copy, called a "one-off," costs $50. Duplicated CD-ROMs are $1 each in quantities of 1,000 or more. Prices are going down. A single CD-ROM can be used on Macintosh and Windows computers. This is a Hybrid HFS/ISO 9660 disk. The two parts can share data. Careful attention to the file names, aliases and construction of the disk images is required.

The choice of target platform includes Microsoft Windows, Apple Macintosh or both. Although Windows accounts for more than half of the potential audience for multimedia software, some of these machines have limited capability. Macintosh computers have extensive support for multimedia software. With careful selection of file formats and development tools, it is possible to create one project that will run on both Windows and Macintosh. Other platforms such as IBM OS/2 and Unix are fewer in number and may be able to run Macintosh or Windows software. Cross-platform development tools include Macromedia Director, Macromedia Authorware Professional, Apple Media Tool, Apple HyperCard and the World Wide Web.

Macromedia Director is the most popular authoring tool. It has a steep learning curve. Projects are organized into stages, cast members and a score (time line). Programming is difficult to learn for those with limited experience. With its time-based orientation, Macromedia Director is the best tool for animation.

Macromedia Authorware Professional is flowchart-based. Screens and elements are part of the chart. Its learning curve is also fairly steep. Authorware Professional automatically keeps track of questions answered correctly and is best for making quiz-oriented tutorials.

Apple Media Tool is page-oriented. Projects consist of a map of connected screens. Media elements include text, pictures, sound and digital video. Pictures can act as buttons. Apple Media Tool offers the best cross-platform delivery. Media elements are created with other applications. Apple Media Tool is the easiest cross-platform authoring tool to learn. It is the best for kiosk-type applications with limited typing on the part of the user. The Wood Library-Museum of Anesthesiology Virtual Tour on the 1996 ASA Annual Meeting CD-ROM sampler was created with the Apple Media Tool.

Apple HyperCard is also a very commonly used development tool. Similar programs include Allegient SuperCard, Asymetrix ToolBook and Oracle Media Objects. These have the most flexible programming environment but also make the greatest demands on the programmer. Cross-platform support is awkward. The best cross-platform solution available currently among those mentioned here is Oracle Media Objects. Future versions of HyperCard, SuperCard, ToolBook or Oracle Media Objects are expected to improve cross-platform results. HyperCard and related programs are best for calculations, highly interactive applications, searching and integration with other programs. HyperCard is the only tool that supports clicking on a word in a text field.

The World Wide Web currently has greater limitations for interactivity than the other environments. The World Wide Web consists of pages written in a simple programming language called hypertext markup language (HTML) with links between the pages. The Web is designed for network delivery of pages. With careful attention, linked Web pages may be placed on CD-ROM. To accomplish this, file names must be in the 8.3 format, all links must be relative and image maps must be client side only. The 1996 ASA Annual Meeting CD-ROM sampler was created in this way.

World Wide Web pages are excellent as a secondary application. Once materials are converted to digital form for another project, it is easy to turn them into Web pages. HTML may be created with any text editor. New tools such as Adobe PageMill and Microsoft FrontPage reduce the need for knowledge of HTML. New additions such as Shockwave for Macromedia Director, Java and Microsoft Active X promise greater interactivity for World Wide Web pages but with a corresponding increase in complexity for authors.

Most material may be converted to digital form in a straightforward manner. Text can be scanned and converted to a useful format by optical character recognition (OCR) software. Due to errors and formatting problems, care is required to correct the OCR-converted copy. For small amounts of text, it is usually best to just type the text by hand.

Diagrams and tables are easily created in digital form with drawing programs like Adobe Illustrator. Existing illustrations can be scanned. Photographs are digitized with a color flat-bed scanner. Slides are digitized with a slide scanner. These scans are very high quality. Inexpensive digital cameras like the Apple QuickTake 150 are excellent when the result will be displayed on a computer screen. Expensive digital cameras are required for magazine-quality printed output.

Sound input is part of most modern computers. If synchronization is required, it is important to capture audio at the same time and with the same device as video. Video is most easily obtained with a video camera and imported with a video digitizing card. S-VHS input is desirable. Digital video editing software like Adobe Premier can do any video trick seen on broadcast television (e.g., fades to black, "wipes," split screens). Digital video can rival broadcast video in quality, but computer hardware demands can be high.

Here are recommended steps to create an educational multimedia program: 1. Make an outline of information to be covered; 2. Collect existing content in any available format; 3. Plan navigation features; 4. Create a graphic design. (In general, it is easy

to change the appearance of an item but often hard to change the position of an item.); 5. Make a storyboard of screens and paths; 6. Create new media elements; digitize existing content that is not in digital form; 7. Put it all together; 8. Test it on real users from your target audience; 9. Have it reviewed by content experts; 10. Revise! Authors must be humble about revising their work. Sections of the project may need major changes even though great effort went into creating them.

Thomas P. Engel, M.D., is Assistant Professor of Anesthesiology at Loma Linda University School of Medicine, Loma Linda, California.
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George J. Sheplock, M.D., is Assistant Professor of Anesthesia, Indiana University School of Medicine, and Center Associate of the Center for Excellence in Education at Indiana University, Indianapolis, Indiana.
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