Paul Garrud discusses the potential for on- line patient education multimedia. This article appears in only the Web version of Ariadne.
Multimedia has been used as a learning resource in HE for a few years now. Whilst some
early products were little more than books-on-CD-ROM, current material commonly uses
the additional functionality that multimedia offers - e.g. animation. Programs intended
primarily for higher education, however, still mostly lack the appeal of commercial
"edutainment". Yet one shouldn't neglect the presentation and visual
impact of educational packages because they engage the user's motivation, attention
and aesthetic sense. Stephen Heppel, Director of UltraLab
[1]
, often argues that: "...interactive media should delight." After all, it is up to the
learner whether or not they use this sort of resource.
When one considers health education needs, there are some striking similarities. It's critical to get the audience interested and to maintain their attention. The advantages of interactive media over the ubiquitous printed leaflets that festoon clinics and waiting rooms are self evident. There's another important feature in common. Effective multimedia uses much less text than books; and while this has dangers for a scholar in HE, it is spot on for many patients. (Have you tried reading an entire drug information leaflet supplied with a prescribed medicine?)
There are now several examples of health education multimedia. One, concerned with
educating children about their bed wetting, was produced as part of the King's Fund
[2]
Promoting Patient Participation initiative. This has produced a suite of programs
- About Nocturnal Enuresis - that is being evaluated in Nottingham and
Leicestershire clinics [3], [4]. Early results
show that after using the program there are reliable increases in children’s knowledge
about enuresis, which are preserved a year later, that there is very good take up by
patients (over 90%), and that the users are positive about the medium. Work is now going
on to discover what effect the package has on clinical outcomes and children’s self-esteem
[5].
This is just one example of a general trend in using multimedia for health education,
targeted at those people for whom it is relevant. The approach utilises the attractiveness of
a new medium, with its added functionality, to engage patients' interest and promote
effective learning (about preventive behaviour, treatment, prognosis and so on). It is also
using multimedia with people for whom it is relevant and who perceive it as relevant, thus
avoiding the counterproductive consequences of "stuffing it (the message) down
people's throats". In the enuresis example, the multimedia package is set up at
a specialist clinic and the patients attending are invited to use the program by one of the
clinic staff. Other mechanisms to achieve the same end might be prescription by a doctor
(e.g. your GP advises you to look at a program because you are at higher than average
risk), information from a special interest group, or just an enquiring patient.
The other key component of this trend is the delivery. Over the next five years, the
delivery mode will almost certainly change from local CD-ROM to telecommunications
networks. The programs will be stored at one site and down loaded when the user wants
to run them. The equipment will be simpler and cheaper (than an interactive kiosk) and it
will be available for many different purposes. Health centres as well as libraries will have
strong incentives to invest in terminals and software producers will be able to maintain
educational material easily at a central site.
In this scenario there are some real challenges. One can already get lost on the Web, so a patient wanting to learn something specific will need clear, direct guidance to the right resource. The link (to that resource) needs to give a brief outline about its contents and an indication of the time required to use it. Curriculum management software may help here [6] . Other vital concerns are disappearing pages (e.g. the Health of the Nation pages on skin cancer), and the validity of WWW information, though the latter is being met by peer- review processes operated at some sites [7] . A last one for debate is giving freedom to a patient to surf beyond the initial domains. There are advantages in health education to an approach which allows someone to discover both sides to a question, but would one want a queue for the computer as well as the physician?
Material on this page is copyright Ariadne/original authors. This article last updated/links checked on 12-Mar-1997