Physical therapists find themselves involved in many roles throughout their careers, including a significant teaching role. This includes teaching fieldwork students, patients, family member, physicians, teachers, and many other people involved in the care of others.
Cognitive Processing of New Information
Multimedia learning is a school of thought that has been used in the education field for many years. It has only been enhanced with the new available technologies many of us enjoy. The multimedia learning concept uses the cognitive theory of sensory memory, working memory, and long term memory in employing the best learning techniques for students.
The best learning occurs when students are able to build mental representations based on works and pictures presented. 1 It has been shown that verbal-only modes of instruction are often inadequate and students taught with this method find it difficult to remember most key ideas presented, and may have difficulty using the material presented to solve new problems.2 Multimedia learning, on the other hand, occurs when a student receives a message presented in two formats - as words (spoken or printed) and pictures (animation or illustrations). Deeper learning has been found to occur when combining both words and pictures, as they then use two separate information-processing systems - the auditory/verbal channel, and the visual/pictorial channel. 3
It has been found that the human information-processing system has limited capacity for types of information.3 For example, only a limited amount of cognitive processing can take place in the verbal channel at one time. The same goes for the visual channel. In order to make the learning meaningful, humans require a substantial amount of cognitive processing to take place in the verbal and visual channels. 4 The dual-processing model of working memory involves separate visual and auditory channels. 2 In order for meaningful learning to take place, it is important that each channel is not only acknowledged, but utilized in as efficient and non-overloading means as possible.
Uses of Multimedia Learning in Therapy
The ever-changing impacts of healthcare delivery are much too broad a topic to include in this article, however, it suffices to say we believe many therapists are looking for the best possible way to educate their patients in both cost-efficient and enriching ways. It seems we all want to provide the most comprehensive, easily-understandable information to patients in as few visits as possible. This is to both keep costs of healthcare provided down, and to allow patients to comprehend as much information we are giving them as possible. Because we may only see patients one or two times, we as therapists, want to offer them all the information they need to continue gaining function to perform all meaningful pursuits possible. It is difficult, however, to do this in a manner which is both concise and comprehensive.
More than ever, therapists have the luxury of using not only written and verbal techniques, but also technology-based educational materials including computers, videos, animations, and music, to supplement their expertise in the clinic. Many therapists now use video game and computer training in the therapy setting, but the research above shows we should also provide these multimedia learning opportunities to aide in the deeper understanding of educational materials in which we provide.
In an outpatient therapy clinic, the typical number of therapy sessions for people with CMC arthritis was five visits. These visits included patient education handouts and verbal instruction on splint wear, joint protection, activity modification, heat and ice, etc. The clinic then employed a multimedia learning model which included education provided verbally in the clinic setting as above, with the addition of a supplemental DVD of patient education.
The DVD included approximately 20 minutes of similar education, but with the use of animation, demonstration, narration, and written text, which patients were able to take home and watch as often as needed until they understood the information. The demonstrations included how to don/doff their splint (if indicated, any exercises which were indicated, and examples of joint protection techniques. Animation was added to visual representation of the joint to enable patients to better understand their diagnosis.
The benefit of the DVD was that patients were able to take time to process the information given, and watch again as needed. Patients were then asked to return to the clinic to review all information provided. Patients were observed by therapists to have a clearer understanding of their diagnosis, treatment, compensatory strategies, and preventative techniques. All of which can be employed life-long to deal with their disease. With this example of utilizing the multimedia learning technique, the number of visits needed went from the average of four to five down to two to three visits, saving the healthcare system money, and empowering the patient to take a more active role in their home program to improve outcomes.
As occupational therapists, we understand and appreciate the necessity to evaluate each individual's preferred learning method in a comprehensive way. We know that teaching methods must vary based on the individual needs of our patients. If we use the multimedia learning model, however, it is suggested that patient outcomes will be better, and money will be saved in the long run.
1. Mayer, R. (2003). The promise of multimedia learning: Using the same instructional design methods across different media. Learning and Instruction, 13, 125-139.
2. Mayer, R.E. & Moreno, R. (1998). A split-attention effect in multimedia learning: Evidence for dual processing systems in working memory. Journal of Educational Psychology, 90, 312-320.
3. Mayer, R.E. & Moreno, R. (2003). Nine ways to reduce cognitive load in multimedia learning. Educational Psychologist, 38, 43-52.
4. Wittrock, M.C. (1989). Generative processes of comprehension. Educational Psychologist, 24, 345-376.
Tricia Ostrander practices at The Portland Clinic in Oregon. Miranda Materi is the owner of AZ Hand Therapy in Mesa, Arizona. They are both research division members of the American Society of Hand Therapists.