Educational Technology & Society 4 (4) 2001ISSN 1436-4522Innovative teaching:Using multimedia in a problem-based learning environmentMai Neo and Ken T. K. NeoLecturers, Centre for Innovative Education (CINE)Faculty of Creative MultimediaMultimedia University, Cyberjaya, SelangorMalaysiaTel: +603-56357817Fax: +603-56357817kneo@pc.jaring.myABSTRACTPresently, traditional educational approaches have resulted in a mismatch between what is taught to the students and what the industry needs. As such, many institutions are moving towards problem-based learning as a solution to producing graduates who are creative, can think critically and analytically, and are able to solve problems. In this paper, we focus on using multimedia technology as an innovative teaching and learning strategy in a problem-based learning environment by giving the students a multimedia project to train them in this skill set.The purpose of this project was to access the students skills in framing and solving problems using multimedia technologies. The students worked in groups and each group had to pick a topic for their project, develop, design and present it in a CD-ROM. They were then surveyed on their attitudes toward the project and their skills as a team. Results showed that the students were very positive toward the project, enjoyed teamwork, able to think critically and became active participants in their learning process. Therefore, multimedia-oriented projects, like many other problem-based learning solutions, can be used alternatively as an innovative and effective tool in a problem-based learning environment for the acquisition of problem-solving skills.Keywords:Problem-based learning, Interactive Multimedia, Macromedia Director, Teamwork, Problem-solving

IntroductionOne of the major concerns of many countries today is that there is a mismatch between graduates skills, acquired from higher education institutions and the skill sets needed in industry. Many of the current graduates are found to be lacking in creativity, communications skills, analytical and critical thinking, and problem-solving skills (Teo & Wong, 2000; Tan, 2000). As such, there is much need for institutions of higher education to focus on training future graduates to be more adaptable to the needs of the industry.Currently, many institutions are moving towards problem-based learning as a solution to producing graduates who are creative and can think critically, analytically, and solve problems. Since knowledge is no longer an end but a means to creating better problem solvers and encourage lifelong learning, problem-based learning is becoming increasingly popular in educational institutions as a tool to address the inadequacies of traditional teaching. Since these traditional approaches do not encourage students to question what they have learnt or to associate with previously acquired knowledge (Teo & Wong, 2000), problem-based learning is seen as an innovative measure to encourage students to learn how to learn via real-life problems (Boud & Feletti, 1999).We would like to extend this contention further by using multimedia technologies to create a multimedia-oriented project. By doing so, we hope to further develop the students' ability to become creative and critical thinkers and analysers, as well as problem-solvers, within this multimedia-mediated problem-based learning (PBL) environment. This learning mode is constructivist in approach whereby the students participate actively in their own learning process and construct their own knowledge (Jonassen, Peck & Wilson, 1999).Multimedia in educationThe use of multimedia in industries has been extensive, as it has been effective in increasing productivity and retention rates, where research has shown that people remember 20% of what they see, 40% of what they see and hear, but about 75% of what they see and hear and do simultaneously (Lindstrom, 1994). This is especially significant in the CBT (Computer-Based Training) modules in corporations like Ernst & Young, and Union Pacific, where employees are trained in organisational procedures, and in flight simulations in the aviation industry to train pilots. It is now permeating the educational system as a tool for effective teaching and learning. With multimedia, the communication of the information can be done in a more effective manner and it can be an effective instructional medium for delivering information. A multi-sensory experience can be created for the audience, which, in turn, elicits positive attitudes toward the application. Multimedia has also been shown to elicit the highest rate of information retention and result in shorter learning time (Ng and Komiya, 2000; Hofstetter, 1995). On the part of the creator, designing a multimedia application that is interactive and multi-sensory can be both a challenge and a thrill. Multimedia application design offers new insights into the learning process of the designer and forces him or her to represent information and knowledge in a new and innovative way (Agnew, Kellerman & Meyer, 1996).Multimedia, defined, is the combination of various digital media types such as text, images, sound and video, into an integrated multi-sensory interactive application or presentation to convey a message or information to an audience. In other words, multimedia means an individual or a small group using a computer to interact with information that is represented in several media, by repeatedly selecting what to see and hear next (Agnew et. al, 1996).Multimedia is changing the way we communicate with each other. The way we send and receive messages is more effectively done and better comprehended. The inclusion of media elements reinforces the message and the delivery, which leads to a better learning rate. The power of multimedia lies in the fact that it is multi-sensory, stimulating the many senses of the audience. It is also interactive, enabling the end-users of the application to control the content and flow of information (Vaughan, 1998). This has introduced important changes in our educational system and impact the way we communicate information to the learners (Neo & Neo, 2000). The evolution of multimedia has made it very possible for learners to become involved in their work. With multimedia technologies, they can create multimedia applications as part of their project requirements. This would make them active participants in their own learning process, instead of just being passive learners of the educational content.Problem-solving: The multimedia project in the classroomThe move towards using problem-based learning in many educational institutions has resulted in a shift in the curriculum model. The focus is moving from content towards problems to provide a more realistic approach to learning and to create an educational methodology which emphasises real world challenges, higher order thinking skills, multi-disciplinary learning, independent learning, teamwork and communication skills via a problem-based learning environment (Tan, 2000). However, this model can be further strengthened with the inclusion of multimedia technology into this problem-based learning environment to enhance the students learning experience. This reinforced model is illustated in Figure 1.

Figure 1. The multimedia-oriented Problem-Based Learning curriculum model

With the use of multimedia projects, students can utilise the knowledge presented to them by the teacher, and represent them in a more meaningful way, using different media elements. These media elements can be converted into digital form and modified and customised for the final project. By incorporating digital media elements into the project, the students are able to learn better since they use multiple sensory modalities, which would make them more motivated to pay more attention to the information presented and better retain the information.Creating multimedia projects is both challenging and exciting. Fortunately, there are many multimedia technologies that are available for developers to create these innovative and interactive multimedia applications (Vaughan, 1998). These techologies include Adobe Photoshop and Premier to create and edit graphics and video files respectively, SoundForge and 3D Studio Max to create or edit sound and animation files, respectively. They can also use an authoring tool such as Macromedia Director or Authorware to integrate and synchronise all these media elements into one final application, add interactive features, and package the application into a distributable format for the end-user. Another advantage of creating multimedia projects in the classroom setting is that when students create multimedia projects, they tend to do this in a group environment. By working in a group, the students will have to learn to work cooperatively and collaboratively, using their group skills and a variety of activities to accomplish the projects overall objectives.As stated by Agnew et. al (1996, p9), Student-created multimedia projects are beneficial, in addition, because they often involve substantial work, open-ended assignments, theme-based activities, and knowledge and experiences that the students draw from a wide variety of sources. Multimedia-oriented projects are a way for students to achieve high self-esteem, to increase their ability to function as self-directed learners, to learn to think effectively, and to practice problem-solving and decision-making (Agnew et. al, 1996). Therefore, using multimedia in the teaching and learning environment enables students to become critical thinkers, problem-solvers, more apt to seek information, and more motivated in their learning processes. Multimedia is slowly gaining ground as a way for students to represent the knowledge that they acquire in class and to construct their own interpretation of the information acquired. It also fosters collaborative and cooperative learning between and among students, thus better preparing them with a skill set for real-life work situations (Roblyer & Edwards, 2000; Jonassen et. al, 1999).Course structure of the Interactive Multimedia classThe class was structured toward creating a problem-based learning environment for the students in a multimedia design context in order to harness their abilities to use and appreciate media effectively when representing various pieces of information to convey a message to the audience. This problem-based learning environment is employed to develop the students' capabilities to solve real-life problems and to exercise analytical, critical and creative thinking in their work (Boud & Feletti, 1999; Newby, Stepich, Lehman & Russell, 2000). Thus, by designing a multimedia application that is multi-sensory and interactive, the students are challenged to learn more about their chosen subject material and to develop their abilities to analyse and draw conclusions from it. Some of the goals for a multimedia project that were adapted from Agnew et.al (1996) for use in this class included the following:1. Higher-order thinking skills. Here the students were required to present their information appropriately and effectively. They were also required to select the appropriate media and to use them effectively in conveying their projects message, theme, drama and impact.2. Group and interpersonal skills. This goal requires that the students to work successfully in a group and with members of their groups in class and interacting with people outside of the classroom environment. This is especially true when the students have to interview and do research.3. Content and discipline. This requirement enables the student to learn significant facts and concepts in the multimedia discipline as well as interdisciplinary topics. The students can also familiarise themselves with the vocabulary of multimedia, its terms and interpretations.4. Technical skills. No multimedia project is complete without the use of multimedia software technology. Here the students will learn about project planning and acquire execution skills. More importantly, the students learn how to use a multimedia authoring tool to complete their project and incorporate interactive features into their presentations. These interactive links will work alongside the display of information in multimedia form, using text, graphics, sound, video and animations, in an effective manner. The combination of all these elements will bring about a successful final interactive multimedia application.The Interactive Multimedia course is a course taken by second-year students of the Multimedia University who are taking their Bachelor of Multimedia (BMM) degree. In this course, the students were given interactive lectures on multimedia concepts and multimedia project development. They were also given interactive tutorials and lab sessions on Macromedia Director, which would be the main authoring tool for them to use to create their final multimedia project. Their task was to propose a multimedia topic of their choice and to design and create an interactive CD-ROM application using multimedia technology.Part of the class consisted of lectures that dealt with multimedia and the creation of multimedia presentations. It involved providing students with the fundamental concepts of the multimedia process (see Figure 2). This included deciding on the multimedia hardware and software, what was involved in creating a multimedia project, how media elements were gathered and modified, the creation of the presentation interface, and the use of interactivity in a multimedia presentation. These students have already been exposed to multimedia and using some multimedia software packages. However, they have had no exposure to working with a multimedia authoring tool, and in creating and managing multimedia project in a group setting.

Figure 2.The multimedia process (Source: Neo & Neo, 1999)

The final project for the class involved breaking up the students into groups of 4 to 6 persons. Each group had to create and design an interactive multimedia application of their choice on a CD-ROM. The students had the option of choosing their own team members and the topic, and were given the entire 14-week semester to develop the project. The purpose of this project was to access the students skills in framing and solving problems using multimedia technologies. As a group, the students had to decide on the concept of the presentation, the design of the presentation interface and navigation, and the appropriate digital multimedia elements and interactive features to use to best convey their topic of interest.Planning the application: Project proposalThe first stage in a multimedia development process is to come up with a project plan. This project plan will define the scope of the final multimedia application, the targeted market and the treatment of the presentation. After introducing the general theme to the class, the students had to submit a project proposal outlining their topic of choice and the team members and their specific functions. They had to identify the target audience and concept of their final project. Upon proposal approval, the team then had to create a storyboard. In their storyboard, the group had to outline the specific interfaces of each screen, the media elements to be used and the information that was to accompany the screen design. They also had to outline the type of interactivity that they were going to use in each screen and their navigational structure. Each screen of the application was sketched and the entire storyboard was submitted on paper.It is also at this stage that the groups elected their group leader. The group leader would be responsible for providing the direction and objectives for the final project and to moderate any disagreements that may arise from the groups discussions. The groups were to meet and discuss their proposal outside of class times. After the groups had been formed and the area of interest was identified, each group gave a short presentation and a brief summary of their project in class.Research: Acquiring the resourcesAt this stage of the multimedia project development, materials had to be gathered from the applications sources to be used as information in the final project. To be able to assemble the various media elements for the final multimedia projects, the groups had to collect materials from the various sources of their topics. These materials range from brochures to product information, to photographs taken at the respective sites, to video footage shot at the sites themselves. The media materials assembled were usually in analogue format. This meant that they were collected in their raw state and not yet ready to be processed in the PC. The collection of materials at this stage is critical because the groups had to make sure that they had enough material for use in their multimedia presentations. Therefore, their brainstorming and planning stage prior to this provided them with their direction and objectives for the project. The acquisition of the materials thus required the groups to visit the sites of their topics, interview the necessary people and collect data on the topic.Converting the media elements to digitalAfter all the materials have been collected and assemble in their raw analogue state, they have to be converted into a standard digital format in order for the PC to be able to process them. This would entail using scanners to convert images and graphics, and digitising any analogue video footage into digital movie clips. These files were then saved as appropriate media formats and stored in the PCs hard drive. For example, images were scanned and stored as JPEG (Joint Photography Experts Group), GIF (Graphic Interchange Format), or BMP (Windows Bitmap) files, and digital movie clips were stored as AVI (Audio Video Interleave) or MOV (Quicktime Movie) files.Editing or creating mediaOnce the media elements have been digitised and stored in the PC, they can then be edited or modified in software packages. In these packages, the media elements are modified to include special effects and filters to further enhance its look and perspective. The group members who were designated as graphic designers had the responsibility to edit images in image-editing packages. Many chose to use Adobe Photoshop for this purpose. Adobe Photoshop is a sophisticated image-editing tool that is popularly used to modify and edit digital images. Other media elements like animations were digitally created in animation software like Macromedia Flash and 3D packages like Kinetix 3D Studio Max.Multimedia authoring: Macromedia DirectorAuthoring is the stage where all the media elements that have been created or modified and stored digitally in the PC are brought together into one final application and integrated into a cohesive presentation for the purpose of conveying a specific message to the audience. It is also at this stage that elements of interactivity and navigation are incorporated to involve the user in the application and to create a multi-sensory experience.Macromedia Director was chosen to be the primary authoring tool for this course. Director is currently the de facto authoring tool for creating interactive multimedia applications such as kiosks, product brochures, interactive advertising applications, and multimedia presentations. It is also very popularly used in the Multimedia University for multimedia application development and interactive presentations. Director follows a movie metaphor and has many elements of movie-making incorporated in its authoring scheme (see Figure 3). These include a Cast Window to house media elements, a Stage to showcase the production, a Score to synchronise the entire presentation, and Scripts to control each Castmember (Neo & Neo, 1999).The students were taught the basics of Director and given tutorials in creating interactive applications using Directors tools and features, and packaging techniques to save multimedia applications as standalone presentations for CD-ROM delivery. In particular, they were introduced to Directors interface and working areas and taught how to create animations, incorporate interactivity using Behaviors, writing simple Lingo scripts and creating projectors to package Director movies for CD-ROMs or shocking the application for the Web (Neo & Neo, 1999). Students also had to incorporate design principles acquired from any of their previous classes into their interface design to be able to create screen interfaces for their final applications.Packaging for deliveryMultimedia applications inevitably have large file sizes. Therefore, they cannot be accommodated by floppy disks, but by multimedia-capable optical storage devices. Packaging involves the physical packaging of the application and saving it onto an optical storage device. Thus, as the final step in their multimedia project development, students had to create a standalone application andburn their application onto a CD-ROM. A standalone application is a self-executing file that, when clicked, can be played back on an end-user's PC without a helper software programme (i.e., the authoring tool, or Director, in this case). They also had to design a CD-ROM cover for their applications. The CD cover would be a conceptual representation of their final multimedia application and would have their production company listed. This was to give them authentic experiences in packaging applications for market distribution.Assessment criteriaAt the end of the semester, the groups submitted their final projects on CD-ROM together with a copy of their storyboard and project proposal. They were assessed on the following criteria:1. Originality: How original or creative was their concept?2. Critical thinking: How well were they able to convert their concept of their topic on the storyboard into the final CD application? Was it well thought out?3. Use of media: How successful were they in their use of media elements to represent their ideas?4. Director: How well were they able to use the Director tools taught to them in their tutorials and lab sessions?5. Difficulty: How complex were their navigational scheme and interactivity (linear vs. non-linear) and how was this accomplished?6. Presentation: How well was the material presented?7. Cohesion of application: How consistent were the digital materials used with the message to be conveyed.8. Team work: How did the team work together to produce the application? Did everyone perform their specific functions?Student evaluationsThe groups or respondents (N=46) were also given a survey on their project and interviewed individually. The survey consisted of questions to assess their interest in group project work and whether or not they were motivated in their project development. The survey also tried to gauge their level of understanding and their critical thinking skills, as well as how they worked as a team. The survey was measured using a 5-point Likert scale, with 1 for Strongly Disagree (SDA), 2 for Agree, 3 for Undecided, 4 for Disagree and 5 for Strongly Agree (SA). These questions made up several constructs to measure the students problem-solving skills, collaborative efforts and team work. The results of the survey were tabulated and their corresponding means are illustrated in Table 4.Questions askedMean score%

1. I found the project challenging4.1791

2. The project allowed me to be creative in my thinking4.1591

3. We were better able to present the concept using digital multimedia4.1191

4. I was able to have creative input in the project4.0283

5. This project allowed me to think critically about the topic3.9883

6. The project enhanced my understanding of the subject3.9883

7. I felt very motivated doing the project3.9876

8. I understood the subject matter better after the project development3.9889

9. I was able to learn more working with my teammates3.9178

10. The team was able to create the project with the existing software3.8576

11. The group was able to achieve its goals3.8376

N = 46

Table 4. Means and percentages of students (ranked)

On the whole, the students in the Interactive Multimedia class responded very well to the course structure and were able to have a positive attitude toward this problem-solving learning environment. Based on the results of the survey, we found three areas that were significant in shaping these students' attitudes towards the project. The first is that they were very motivated, enjoyed being challenged and able to have creative input and use multimedia technology and software. This was represented by Questions 1, 2, 3, 4 and 7 with means of 4.17, 4.15, 4.11, 4.02 and 3.98, respectively. The second area is in their ability to think critically about the topic and develop a deeper understanding of the subject via the project, represented by Questions 5, 6 and 8, each with means of 3.98. The third area is the student's ability to function well as a team, represented by Questions 9, 10 and 11, with means of 3.91, 3.85 and 3.83, respectively.Figures 5 (a), (b) and (c) illustrate some of the percentages of students who answered in the "Agree" and "Strongly Agree" category (numbers 4 and 5 on the Likert scale). As shown below, 91% of the students found the project challenging (see Figure 5 (a)), 89% felt that the project allowed them to have a better understanding of their topic (see Figure 5 (b)), and 78% were able to learn from their teammates (see Figure 5 (c)).

Figures 5 (a), (b) and (c). Percentages of responses

ShowcasesThe final presentations by the different groups in the class were varied. For example, one group chose to focus on the Malaysian Petronas Twin Towers as their topic and highlighted areas such as its architecture, retail shops, prominent features and information on how to get there, focusing on a more kiosk-based application (see Figures 6 (a) and (b)). As shown below, this group used customised cursors and hot spots, and combined 3D images with text and sound for a more futuristic approach. Their information was complied from brochures obtained from the company and translated into electronic form. They also had a link to the official website for users to access more information about the Twin Towers.

Figures 6 (a showase on Malaysia's Petronas Twin Towers

Another group chose to focus on the racial mix of Malaysians, particularly those with mixed parentage (see Figures 7 (a) and 7 (b)). They chose this topic in hopes to highlight the advantages and disadvantages of being of mixed parentage, and intended this to be an educational application. Interviews were carried out on students around campus who were racially mixed and their opinions on having mixed parentage were elicited. The interface consisted of buttons linking to the specific mixed races and their various attributes, how specific racial mixes are created and where they popularly reside in Malaysia, and statistics.Both groups were also able to utilise a suite of multimedia packages other than the Macromedia Director, such as Macromedia Flash, Adobe Photoshop and Premier, to complete their project.

Figures 7 (a) showcase on mixed parentage in Malaysia

Student interviewsWe also conducted interviews with the groups to find out more about their problem-solving skills and team efforts. We found that the groups that did very well in their projects had very good group leaders and worked well together. Interviews showed that these groups collaborated well in their collective efforts. Many of these groups divided themselves into the general categories of Graphic Designers, Multimedia Author/Programmer (using Director), Resource Manager, and Researcher.From the interviews we did with the students as well as the surveys that we conducted, we found that the majority of these students were very motivated and found working on their multimedia project very inspiring and challenging. Many of them enjoyed exercising their creativity and multimedia skills in visually representing their content material. Some even said that they liked doing the project because it allowed them to fully understand what it takes to create a multimedia application from the beginning to end and how to work as a team. They were able to learn more about their topic as well as creating multimedia presentations, and able to design an interactive multimedia application with active links, thus supporting the propositions made by Agnew et. al (1996) and illustrated by Table 8.Group responses from interviewsQuestion: What did you learn from this project?Group 1 : "We learnt more about topic as well as the software. We also developed a positive group attitude."Group 2: "We learnt more about multimedia, developing a CD-ROM, software, navigation and interactivity."Group 3 : "Teamwork is not so easy, but I learnt how to be a good leader. We learnt more about our topic. Fun to know everyone on the team and had fun shooting video, never done it before."Group 4: "Learnt more about group members."Group 5: "Learnt more about software and hardware in multimedia."Group 6: "I can use Director for my other projects now. It was very challenging"

For most of the semester, the groups would work either during class times to discuss their projects, or schedule meetings outside of class times. The lecturer also met with the various groups each week to discuss their progress and to act as a consultant and a guide to these groups.Some groups did encounter scheduling problems with conflicting class schedules and problems with deciding on which theme and topic to concentrate on during the initial stages of the project development, but they were able to resolve them as the weeks progressed. They encountered some more problems when researching the site of their topic of interest as not all groups received cooperation from their chosen topic. Therefore, they had to work around that problem by either using information publicly available or by highlighting that topic indirectly. By doing so, they exercised their creative and critical thinking toward these problems.Groups that had good leaders and good teamwork were able to finish their projects early. Their applications had little or no problems. The translations of their storyboards into electronic presentations showed minimal changes and they made good use of many media elements. The navigational links and interactive features were also intact and the presentation ran smoothly from beginning to end. Some even went beyond what was taught in class to include a difficult component like scripting.Some groups had good leaders but were weaker in their application of multimedia knowledge. However, they were still able to make a multimedia presentation of their topic, although the representations of their information by the media elements were simpler than the stronger groups. Groups that did not have a strong leader or were unable to cooperate did demonstrate a weakness in their overall presentations. This was due to the fact that the dynamics within the group were not colloborative or cooperative at all. Statements elicited from them include,"Don't take friends when doing groupwork,"and"I will be more careful when choosing my group members next time,"and"I would work individually next time." For these groups, they would schedule meetings with the lecturer to discuss their problems and present their solutions, with the lecturer acting as the facilitator in these meetings.However, these groups were small in number and still managed to complete their project, indicating that although they were not able to fully cooperate with each other, they managed to stay as a group long enough to finish the project. Surveys taken by these individuals still indicated that they were very much motivated to doing their project but were unable to do their best because of their inability to get along as team members.Overall, despite some problems in scheduling and personality conflicts, the students enjoyed working in teams to develop their project. As the means and percentages had shown in Table 4, over 75% of the students favourably rated team efforts (Questions 9,10, 11) and group participation as a factor in completing their project, indicating that they were able to learn from their teammates, collaborate to achieve the group's goals and collectively solve their multimedia design problems together. Specific questions on teamwork showed a lower percentage in student responses (76% and 78%) as compared to the rest of the questions. This is probably due to the fact that this is a new experience for these students who have little experience in working together to solve problems. This is also reflected in some of the statements given by the groups in Table 8. However, teamwork is still positively viewed by the students and should therefore be encouraged so that they will have the necessary problem-solving skills when they face real-life situations, particularly in the IT-oriented business environment of today.LimitationsAlthough the class demonstrated a positive attitude toward using interactive multimedia in a problem-solving learning environment, there are some limitations to this study which should be addressed. Firstly, to be able to be successful in such endeavours, there must be adequate number of computers made accessible to the students and teachers, in order for the work to be properly carried out. Secondly, multimedia authoring software like Director or Authorware must also be provided. And lastly, training in these softwares should be provided to the teachers so that they can conduct these types of classes. By making the hardware and software available, such as in the Multimedia University, Cyberjaya, Malaysia, both the teachers and students can use multimedia successfully in their teaching and learning processes.ConclusionThis paper has presented and discussed the use of multimedia in a problem-based learning environment to equip students with high-order thinking and problem-solving skills and to enable them to experience an IT-oriented learning situation. From the results, we are able to conclude that by integrating multimedia into the teaching and learning process, the conventional PBL curriculum model is reinforced and strengthened and a multimedia-oriented PBL curriculum model can be instituted. The multimedia project in this course enabled the students to exercise their creative and critical thinking skills in solving their design and development problems, work collaboratively to gain team-based experience, and to face the real-life situation of problem-solving. This is a student-centered learning approach which allows them to construct their own knowledge and understanding, and determine their own learning goals. The role of the teacher, on the other hand, changes from the sage on the stage to a guide on the side, assisting the students in the construction of their knowledge.As such, the use of multimedia technology and project are an innovative and effective teaching and learning strategy because they motivate the students in their learning process and help them to acquire good problem-solving skills. As evidenced by this project, students became very active participants in their learning process instead being passive learners, and were able to use various digital media elements to accomplish their project. These findings are significant in that:1. by using a multimedia project, we can move towards the Constructivist learning mode, which is student-centric. In this context, the students had to utilise their prior knowledge in other disciplines to breakdown the problem into component parts, and then synthesize and re-construct a possible solution. This experience is invaluable in creating a new generation of effective problem-solvers for the current industry needs.2. we successfully integrated multimedia technology into the problem-based learning classroom, instilling effective learning how to learn and lifelong learning attitudes into the students, and3. they are in line with the Tapscott's (1998) proposition that today's generation is IT-savvy and look to digital media for learning and they expect universities and other institutions of higher learning to provide IT-oriented programmes in their curriculum as well as in teaching and learning methodologies. As such, the multimedia-oriented PBL curriculum model serves as a strong framework for teaching and learning in this respect.Multimedia-oriented projects, therefore, like many other problem-based learning solutions, can be appropriately used as an innovative and effective tool in a problem-based learning environment for the acquisition of problem-solving skills.References Agnew, P. W., Kellerman, A. S. & Meyer, J. (1996).Multimedia in the Classroom, Boston: Allyn and Bacon. Boud, D. & Feletti, G. (1999).The Challenge of Problem-Based Learning, (2ndEd.), London: Kogan Page. Hofstetter, F. T. (1995).Multimedia Literacy, New York: McGraw-Hill. Jonassen, D. H., Peck, K. L., and Wilson, B. G. (1999).Learning With Technology: A Constructivist Perspective, New Jersey: Merrill/Prentice Hall. Lindstrom, R. (1994).The Business Week Guide to Multimedia Presentations: Create Dynamic Presentations That Inspire, New York: McGraw-Hill. Neo, M. & Neo T. K. (1999).Director: The Multimedia Movie, Subang Jaya, Malaysia: Meway Computec Sdn. Bhd. Neo, M & Neo, T. K. (2000). Multimedia Learning: Using multimedia as a platform for instruction and learning in higher education.Paper presented at the Multimedia University International Symposium on Information and Communication Technologies 2000(M2USIC2000),October 5-6, 2000, Petaling Jaya, Malaysia. Ng, K. H. & Komiya, R. (2000). Introduction of Intelligent Interface to Virtual Learning Environment.Paper presented at the Multimedia University International Symposium on Information and Communication Technologies 2000 (M2USIC2000),October 5-6, 2000, Petaling Jaya, Malaysia. Newby, T. J., Stepich, D. A., Lehman, J., D. & Russell, J. D. (2000).Instructional technology for Teaching and Learning: Designing Instruction, Integrating Computers, and Using Media(2ndEd.), New Jersey: Merrill/Prentice Hall. Roblyer, M. D. & Edwards, J. (2000).Integrating Educational Technology into Teaching(2ndEd.), New Jersey: Merrill/Prentice-Hall. Tan, O. S. (2000). Thinking Skills, Creativity and Problem-Based Learning.Paper presented at the 2ndAsia Pacific Conference on Problem - Based Learning: Education Across Disciplines, December 4-7, 2000, Singapore. Tapscott, D. (1998).Growing Up Digital: The Rise of the Net Generation, New York: McGraw-Hill. Teo, R. & Wong, A. (2000). Does Problem Based Learning Create A Better Student: A Refelection?Paper presented at the 2ndAsia Pacific Conference on Problem Based Learning: Education Across Disciplines, December 4-7, 2000, Singapore. Vaughan, T. (1998).Multimedia: Making it Work(4thEd.), Berkeley, CA: Osborne/McGraw-Hill.

BMC Med Educ. 2011; 11: 38.Published online 2011 Jun 21.doi:10.1186/1472-6920-11-38PMCID:PMC3152531Instructional multimedia: An investigation of student and instructor attitudes and student study behaviorA Russell Smith, Jr,#1Cathy Cavanaugh,#2andW Allen Moore#1Author informationArticle notesCopyright and License informationGo to:AbstractBackgroundEducators in allied health and medical education programs utilize instructional multimedia to facilitate psychomotor skill acquisition in students. This study examines the effects of instructional multimedia on student and instructor attitudes and student study behavior.MethodsSubjects consisted of 45 student physical therapists from two universities. Two skill sets were taught during the course of the study. Skill set one consisted of knee examination techniques and skill set two consisted of ankle/foot examination techniques. For each skill set, subjects were randomly assigned to either a control group or an experimental group. The control group was taught with live demonstration of the examination skills, while the experimental group was taught using multimedia. A cross-over design was utilized so that subjects in the control group for skill set one served as the experimental group for skill set two, and vice versa. During the last week of the study, students and instructors completed written questionnaires to assess attitude toward teaching methods, and students answered questions regarding study behavior.ResultsThere were no differences between the two instructional groups in attitudes, but students in the experimental group for skill set two reported greater study time alone compared to other groups.ConclusionsMultimedia provides an efficient method to teach psychomotor skills to students entering the health professions. Both students and instructors identified advantages and disadvantages for both instructional techniques. Reponses relative to instructional multimedia emphasized efficiency, processing level, autonomy, and detail of instruction compared to live presentation. Students and instructors identified conflicting views of instructional detail and control of the content.Go to:BackgroundIn order to meet the educational needs of a diverse population of students, physical therapist educators are utilizing instructional multimedia to teach psychomotor skills [1-3]. Traditional strategies to teach psychomotor skills in healthcare education include lecture, textbooks, self-instruction, and live demonstration [2]. Instructional multimedia has been applied as a component of classroom activities, in pre-class preparation, or as a stand-alone learning experience [4-6]. Increasing integration of instructional multimedia across disciplines has been noted as access to educational technology has increased [7]. Some recently employed multimedia technologies, including video, film, DVD/CD-ROM, computer simulations, slide presentations, audio recordings, and web based content, have been utilized to present lectures, supplement classroom activities, and demonstrate psychomotor skills [1-3,8-11]. Advantages of instructional multimedia include increased availability and repetition of instructional content, improved ability of students to learn at their own pace, increased student control of material, less demand on instructor time, and the provision of an alternative approach to describe complex topics or three-dimensional relationships. Instructional multimedia may help instructors address a range of diverse student needs including increasing study time and addressing multiple learning preferences [3,5-7,12,13]. These advantages, especially when applied in a professional degree program, align well with research on development of expertise, which attributes such development to intense practice with directed feedback on performance [14]. Given that physical therapy is to a large extent a psychomotor domain of practice, a physical therapy degree program may be considered in a sense predominantly a performance improvement program [15]. Thus, the instructional multimedia program described here was designed to improve student performance through practice and feedback without increasing lab, classroom, or instructor time.Much of the health education research concerning instructional multimedia has focused on cognitive [16,17] and/or psychomotor [4,16,18-20] performance. Recently, investigations concerning student/instructor perceptions of instructional multimedia have been published [21,22]. However, published reports examining student/instructor perceptions of instructional multimedia in physical therapy education were not found. Where cognitive and psychomotor performance are concerned, traditional forms of instruction and teaching with instructional multimedia yield similar levels of performance among students and increased efficiency in learning time [19]. For example, Kinneyet al.(1997) found no differences in written test scores between physical therapist students receiving instructional multimedia and students receiving interactive lecture presentation for the management of patients with carpal tunnel syndrome. However, the authors reported less time was needed for the multimedia instruction group (mean 82.6 minutes) to complete the lesson compared to the interactive lecture group (124.6 minutes) [19]. Barker (1988) investigated the effectiveness of interactive videodiscs in the acquisition of upper extremity range of motion assessment skills in 40 undergraduate physical therapist students. Although no differences in written or psychomotor performance were observed between the multimedia group and the traditional group, participants in the multimedia group reported greater time practicing than the traditional group, 11.16 hours as compared to 8.39 hours [4].In health science education, when instructional multimedia increases the richness of the experience and are accompanied by guidance from instructors or professionals, performance gains may be seen [15], as in Holzinger et al.'s study of a supported simulation to teach blood flow. The study showed increased knowledge when video, computer-based simulation and learning guidance were combined to scaffold learning through increasingly complex stages. In fact, the more complex the learning demands, the greater the contribution of dynamic media may be to the learning process [23].Instructional multimedia for cognitive and psychomotor learning across higher education appears to be most effective as a complement to classroom instruction rather than a substitute for classroom instruction [22,24]. Previous investigations of nursing students' attitudes towards instructional multimedia found learners identified that instructional multimedia enhanced learning, allowed for greater flexibility, and provided a platform for independent self-management of learning [22,25,26]. While students appreciate the increase in control instructional multimedia provides them over their learning, many students may find motivation to be a challenge in the absence of instructors or other students. In addition, learners may have preexisting attitudes about the value of instructional multimedia based on their past learning experiences and knowledge of their personal learning preferences. In fact, students' attitudes toward the instructional multimedia format are significant predictors of course performance [27]. For example, students who believe they have difficulty learning from reading will place high value on image-rich multimedia, while students who state they learn best through interpersonal interaction will place low value on the time they spend using instructional multimedia The degree of control students are able to exercise in a course activity depends on the structure and flexibility designed into the activity by the instructor. Instructor satisfaction derives from congruence between the instructor's beliefs about learning and the methods the instructor uses to facilitate learning [29]. Instructor motivation to use instructional multimedia is based on the premise that students in health professions have diverse needs and a preference for multimodal learning tools [30-32], and that multimedia may better serve multiple learning styles [27].Students/subjects in the present study were provided video clips with concurrent text of psychomotor techniques (CD-ROM) to review and practice prior to the classroom meeting. This methodology is similar to learning in an online environment where students learn through interaction within the online environment, not during actual physical interaction with an instructor. In this way, the instruction represents a blended course model and provides insight into a blended physical therapy course design. The application of video demonstrations with audio narration and text for learning numerous psychomotor skills is supported by Mayer's multimedia learning principle of modality [33]. Students using the physical therapy multimedia materials acquired knowledge of the techniques through simultaneous visual and auditory modes, increasing the likelihood that the students would successfully apply the techniques in the lab and clinic setting.Bates and Bartolic-Zlomislic (1999) proposed the following as a framework to investigate the effects of independent learning in an online environment: 1) performance-driven benefits (e.g., learning outcomes, student satisfaction, instructor satisfaction); 2) value-driven benefits (e.g., access, flexibility, and ease of use); and 3) value-added benefits (e.g., increased revenue related to new product/service generated, and reduced traffic/parking needs) [34]. The focus of investigations of instructional multimedia in physical therapist education has often been limited to the effect on learning outcomes [1-3]. The present study focuses on the first two benefits as presented by Bates and Bartolic-Zlomislic, specifically performance-driven and value driven benefits.The performance-driven benefit of student satisfaction is of particular importance because of its task, course, and program level implications. Students who are satisfied with their own performance and with their progress are more likely to persist in their educational endeavors [35]. Therefore, it is in the best interests of the student, the instructor, and the program for students to reach a motivating level of satisfaction in their courses. In the case of the physical therapy courses investigated in this study, students were asked to use instructional multimedia for self-directed learning, a method for which students vary in readiness and need for support [36]. The continual need for learning within individuals and the need to explore and to develop responsibility among maturing learners [37] may be satisfied with instructional multimedia tools that students can control and use as their abilities dictate.The purpose of this study was to examine the effects of instructional multimedia on student study behavior, and student and teacher attitudes toward instructional multimedia. Two research questions guided this study: (1) What are the experiences of students and teachers of instructional multimedia as an instructional strategy? and (2) Does instructional multimedia affect student study behavior?

MethodsSampleStudents from two entry-level physical therapist graduate education programs agreed to participate in the study. Program 1 had 27 participants (18 females and nine males, mean age = 24.69 years) in a first-semester course. Program 2 had 23 participants (13 females and 10 males, mean age = 25.13) in a second-semester course. Both groups were enrolled in introductory level orthopedic physical therapy courses.ProceduresThe study was conducted over five weeks at each of the two universities. During the first week of the study, all participants provided written informed consent and basic demographic information. Next, participants from each university were divided into one of two groups, Group A or Group B. Students in Group A received reading assignments and content objectives related to knee special tests and accessory movement testing. Participants in Group B received compact discs (CDs) with knee techniques, in addition to, the same reading assignments and content objectives that Group A received. During week two of the study, students from Group A received live instructor demonstration of knee techniques followed by practice with instructor feedback. Participants in Group B, having received CDs during week one of the study, moved directly to practice with instructor feedback. Both groups received a total of 120 minutes of time with the instructor during separate sessions. Group A's session included live demonstration, Group B's session did not include live demonstration. During week three of the study, participants received instruction on ankle/foot techniques. During this week, Group A received CDs and practice time with instructor feedback, and Group B received live demonstration and practice time with instructor feedback. Once again, each group received a total of 120 minutes with the instructor during separate sessions. During weeks 4 and 5 of the study, students underwent practical and written testing related to knee and ankle/foot techniques and students and instructors completed the questionnaire examining their attitudes toward the learning process. Data pertaining to performance on written and practical examinations were published previously [3].Research DesignThe independent variable was instructional method, either multimedia instruction or traditional classroom demonstration. The dependent variables were student study behavior, and student and instructor attitudes. Student and instructor attitudes and student study behavior were assessed by a written questionnaire consisting of seven statements with Likert scales and six open-ended questions. Approval for this study was obtained from the Institutional Review Board of the University of North Florida.Instructional MultimediaInstructional CDs containing psychomotor skills of accessory movement testing and special tests for examination of the knee or ankle/foot were developed by the primary investigator. Twenty-three techniques were presented for the knee and 20 techniques were presented for the ankle/foot. Each technique was described in text format with concurrent audio-video presentation of the technique (Figure(Figure1).1). The audio/video presentation of each of the skills was approximately 30 seconds in length. Media was rendered into a Flashformat and students were required to install Adobe'sfree Flash Playerto view the videos on their personal computers.

Figure 1Screen capture of interactive video layout. Study participants were given a CD-ROM containing multiple short videos of various ankle and knee examination skills to practice before class.Tests and InstrumentationThe written questionnaire used in this study to assess students' attitudes toward each instructional strategy was modified from a survey developed by Toth-Cohen (1995) [38] (Appendix 1). Instructors' reactions to the instructional strategy were assessed by a written questionnaire similar to the student version (Appendix 2). Student study time alone and with classmates were recorded by the student on the written questionnaire. Total study time was calculated by adding the reported alone study time and the classmate study time.Data AnalysisIndependent, group, and total study time data were analyzed using ANOVA. Analysis included a comparison of study times between the two physical therapy programs and between the two instructional methods. Additionally, descriptive analysis was conducted for study times for each program and for the instructional strategies. For study time analysis, data were transferred to SPSS 18 and alpha level was set at p < .05. Qualitative descriptive analysis was performed for the Likert scale statements and for the open-ended questions. In addition, response frequency for each of the Likert statements were tabulated using Microsoft Excel 2007. Lastly, Mann-Whitney tests were performed for each of the seven Likert statements within the knee and ankle groups. Data was transferred to SPSS 18 for this analysis and alpha level was set at p < .05.Go to:ResultsStudy TimesTwenty-five subjects in the live demonstration knee group completed the questionnaire regarding study times. The mean time studying alone was 47 minutes, mean group study time was 24.8 minutes, and total study time for this group was 71.8 minutes. Twenty-one students in the knee instructional multimedia group completed the questionnaire regarding study time. The mean study alone time for this group was 32.9 minutes, group study time mean was 32.9 minutes and total study time was 65.7 minutes. Twenty-three subjects in the live demonstration ankle group completed the questionnaire regarding study times. The mean study alone time was 30.7 minutes, mean group study time was 32.6 minutes, and total study time for this group was 63.3 minutes. Twenty students in the ankle instructional multimedia group completed the questionnaire regarding study time. The mean study alone time for this group was 24.3 minutes, group study time mean was 7.5 minutes and total study time was 31.8 minutes (Table(Table1).1). ANOVAs comparing study times for each instructional method and for each program are presented in TableTable2.2. Results of ANOVA related to student study behavior related to knee content indicated no main effects and no interaction. Results for study alone and total study time of the ankle content indicated no interaction between strategy and school and no significant main effects. Results of ANOVA related to study time with classmates of ankle content indicated there was no interaction between strategy and school, however, group study time was significantly different when comparing instructional strategies and group study time (F = 6.496; p = 0.015). Students in the live ankle demonstration group spent more time studying in groups than students in the instructional multimedia group.

Table 1Descriptive statistics for knee and ankle study times

Table 2Results of ANOVA comparing study times between subjects and program, and subjects and instructional methodStudent AttitudesMann-Whitney U compared student responses to knee and ankle Likert statements for the two instructional groups. No significant differences were found (Table(Table3).3). Response frequency for student attitudes toward instructional strategy for knee and ankle are presented in figurefigure2.2. Forty-one subjects from the combined knee and ankle multimedia groups participated in the survey, for a response rate of 82%. Forty-eight subjects for the combined knee and ankle live demonstration groups participated in the study, for a response rate of 96%. Of the 41 students in the multimedia group, 87.8% either agreed or strongly agreed, while 2.4% either disagreed or strongly disagreed that the "method of learning was interesting". Within the live demonstration group, 87.5% either agreed or strongly agreed that the "method of learning was interesting", while 4.2% either disagreed or strongly disagreed. The remaining students were neutral. When asked if the "method of learning was a waste of time", 87.8% of the students in the multimedia group either disagreed or strongly disagreed, while 2.4% agreed or strongly agreed, and 91.6% of the students in the live demonstration group disagreed or strongly disagreed, while 0% agreed or strongly agreed. Of the subjects in the multimedia group 78.1% of the students agreed or strongly agreed they "learned a lot from this method of learning", while 9.8% either agreed or disagreed. Within the live demonstration group, 85.4% agreed or strongly agreed they "learned a lot from the method of learning" and 6.3% either disagreed or strongly disagreed. When asked if they would "use the method again", 87.8% of the multimedia group agreed or strongly agreed, and 83.3% of the live demonstration group agreed or strongly agreed. Only 7.3% of the multimedia group and 4.2% of the live demonstration group disagreed or strongly disagreed.

Table 3Mann-Whitney Test for Likert scale statements

Figure 2Student responses to Likert scale statements. Results of students' responses to several statements.Qualitative ResultsThe open-ended questions on the survey allowed students to discuss, in their own words, their opinions on various aspects of the teaching methods employed in this study. TablesTables44andand55list the questions and a summary of the responses students provided. TableTable66displays results of open-ended questions instructors answered at the end of the study.

Table 4Open-ended responses for students receiving CD instruction

Table 5Open-ended Responses for Students Receiving Live Demonstration Instruction

Table 6Instructors' Evaluation of Instructional MethodGo to:DiscussionThis study compared the effects of instructional multimedia and live demonstration of psychomotor skills on student study behavior and student/teacher attitudes. The first guiding research question was: "What are the attitudes of students and instructors using instructional multimedia as an instructional strategy?"Attitudes were measured by a modified questionnaire used in Toth-Cohen's (1995) investigation of the effects of instructional multimedia on occupational therapy student understanding of anatomy and kinesiology. Toth-Cohen found more positive attitudes in quantitative and qualitative responses from students receiving instructional multimedia as compared to students receiving traditional self-study with textbooks [38]. In the present study, responses by students were similar regardless of method of instruction. The differences in results noted between the Toth-Cohen study and this study may relate to sample characteristics, differences in the type of skills taught, access to the instructional strategy, and/or differences between the instructional methods in the present study versus Toth-Cohen's study. Participants in Toth-Cohen's study were undergraduate occupational therapy students as compared to graduate physical therapy students in this study. Additionally, Toth-Cohen limited content to cognitive skills related to the elbow as compared to this study's emphasis on cognitive and psychomotor skills.Student responses to the open-ended questions in this study were consistent with Toth-Cohen [38]. Strengths of the instructional multimedia presentation reported by students in the present study included greater opportunity to view and/or review content and control of the pacing and content quantity. Instructors also identified greater opportunity for review of the content as a major strength of CD presentation and highlighted the facilitation of self-directed learning and increased efficiency. Instructors reported observing higher cognitive level interactions during lab time with students in the interactive multimedia group. The students in our study identified weaknesses of instructional multimedia as including the lack of direct human contact and visual limitations of the CD. Instructors reported decreased student participation and decreased preparation by some participants in the instructional multimedia groups.Conversely, students appreciated the hands-on aspect of live presentation but disliked the lack of detail, excessive speed of presentation, memory overload, and lack of resources for continued study of live presentation. Instructors perceived having greater control of the teaching-learning interaction and greater participant attention to the details of the techniques during live presentation. Predictably, students reported a greater sense of autonomy with the instructional multimedia presentation and the instructors reported a greater sense of autonomy with live presentation. Another contrasting view related to the detail of the instruction. Instructors reported greater detail with live presentation, however the students reported less detail with live presentation.The degree of control that students are able to exercise in a course activity depends on the structure and flexibility designed into the activity by the instructor. Instructor satisfaction derives from congruence between the instructor's beliefs about learning and the methods the instructor uses to bring about learning, and most adult educators value high levels of student control and involvement [29]. If this tendency extends to physical therapy educators, then instructors should realize increased satisfaction when teaching a course in which students have opportunities to control their learning, as with instructional multimedia for practicing skills.Benefits of instructional multimedia for self-directed learning include flexibility in time and place of learning and continual access to the learning materials. Technology used in support of unlimited student practice can be a central strategy for the type of mastery learning that supports adult learners' self-efficacy and persistence in education [39]. However, these benefits can be neutralized if students do not find the technology easy to use. Student attitudes toward using the technology and toward the value of learning new technology will impact their motivation and satisfaction to learn [40]. If students believe that their professional value is enhanced by acquiring technology skills, their motivation and satisfaction will increase.The performance-driven benefit of student satisfaction is of particular importance because of its task, course, and program level implications. Students who are satisfied with their own performance and with their progress are more likely to persist in their educational endeavor [35]. Therefore, it is in the best interests of the student and instructor to reach a motivating level of satisfaction in their courses. In the case of the physical therapy courses investigated in this study, students were asked to use instructional multimedia for self-directed learning, a method for which students vary in their readiness and need for support [36]. When teaching a varying group of students, the instructor should expect a range of satisfaction outcomes unless differential amounts of self-direction are afforded, as is the case with interactive media. The continual need for learning within individuals and the need to explore and to develop responsibility among younger adult learners are well satisfied with multimedia tools that students can control and use as their abilities dictate [37].The second guiding research question was "Does instructional multimedia affect student study behavior?" This study demonstrated no significant differences in study time with classmates, study time alone, or total study time between the instructional strategies for the knee. However, participants receiving instructional multimedia of ankle skills reported significantly less study time with classmates than participants receiving live presentation of the ankle content. No difference was observed for study time alone or group study time between the instructional strategies for the ankle. The decreased study time found with total study time with the ankle instructional multimedia group was consistent with the decrease in study time noted in physical therapy students using computer-assisted instruction (CAI) in the study by Kinneyet al. (1997). The CAI group in the Kinney study completed a lesson related to examination and treatment of a patient with carpal tunnel syndrome in approximately 83 minutes as compared to 125 minutes for the lecture group [19]. The difference between the results of Kinneyet al. and this study maybe related to student level and the operational definition of study time. The students participating in Kinney's study were undergraduate students. Kinney included class time as a component of study time as compared to only out-of-class study time measured in this study. The improved classroom efficiency of approximately 25% noted by the teachers in this study was consistent with the 24% efficiency reported by Kinneyet al. (1997) [19].Future directions and limitationsInterestingly, while students reported an appreciation of the autonomy received with the use of the instructional multimedia, instructors reported an appreciation of the autonomy that they received from live presentation. This conflicting view of autonomy raises several pedagogical issues for future researchers. The level of perceived autonomy, not measured in this study, and the effect of this autonomy on student performance is of significant interest, particularly to educators of adult learners. The conflicting views between students and instructors of the level of detail provided by the instructional strategies in this study are of interest as well. Students attributed greater detail to the instructional multimedia as opposed to instructor perception of greater detail from their own presentations. These conflicts raise questions related to instructor pedagogy not assessed in this study. Future research of the role of instructor pedagogy in the application of interactive multimedia is indicated. The findings of this study are limited to written answers from students and teachers without follow-up clarification of their answers. Future investigations into these conflicting views and their effects are indicated and may include interview and other methods to clarify. Conflicting views between instructors and students of the benefits of instructional multimedia and live presentation were identified by the results of this study.A limitation of this study is the inclusion of only two physical therapy programs. Future multi-site investigations are needed with attention to curricular implications. The use of a non-validated survey tool limits the generalizability of the findings. While used previously in the literature, the survey from Toth-Cohen (1995) has not been extensively examined for reliability and validity. Other limitations include student self-reporting of the study time.Since the conclusion of the study the authors have started to distribute video using a university owned media server and through Apple's iTunes. Video being distributed now is in MPEG-4 format.Go to:ConclusionsThis study investigated the effects of instructional multimedia on student/teacher attitudes and student study behavior. No practical differences between the instructional groups were noted between student attitudes toward the instructional method as measured by seven statements with Likert scales. Responses to five open-ended questions relative to instructional multimedia emphasized efficiency, processing level, autonomy, and detail of instruction of instructional multimedia. This study suggests that instructional multimedia may improve efficiency and may promote higher level processing during practice of the techniques in a supervised setting.Go to:Competing interestsThe authors declare that they have no competing interests.Go to:Authors' contributionsARS and CC conceived and designed the study. All authors collected and/or analyzed data. All authors were involved in writing and revising the original manuscript. WAM and ARS designed the tables and prepared the paper for submission. All authors read and approved the manuscript prior to submission.Go to:AcknowledgementsPublication of this article was funded in part by the University of Florida Open-Access Publishing Fund.Go to:Appendix 1 - Student Experience QuestionnaireEVALUATION OF EXPERIENCE WITH METHOD OF LEARNINGI. Please check the appropriate box below: CD Group Classroom PresentationII. Please circle the correct answer below:1.The instructions for using this method were clear.Strongly disagreeDisagreeIndifferentAgreeStrongly agree012342.This program served as a useful review of material I previously learned.Strongly disagreeDisagreeIndifferentAgreeStrongly agree012343.This method of learning was interesting.Strongly disagreeDisagreeIndifferentAgreeStrongly agree012344.This method of learning was a waste of time.Strongly disagreeDisagreeIndifferentAgreeStrongly agree012345.I learned a lot from this method of learning.Strongly disagreeDisagreeIndifferentAgreeStrongly agree012346.This method of learning was helpful to me because I am a visual learner.Strongly disagreeDisagreeIndifferentAgreeStrongly agree012347.I would use this method again, if available.Strongly disagreeDisagreeIndifferentAgreeStrongly agree01234III. Please answer the following questions.8.What did you like best about the method of learning?9.What did you like least about this method of learning?10.What are the strengths of this method of learning?11.What are the weaknesses of this method of learning?12.Compared to other ways of learning, was this method of learning useful? Why or why not?13.Any other comments?14.Please estimate below the total number of minutes you studied this contentoutsideof the classroom:alone___________________ minuteswith classmates___________________ minutes

Appendix 2 - Instructor Experience QuestionnaireTEACHER EVALUATION OF INSTRUCTIONAL METHODI. Please check the appropriate box below: CD Group Classroom PresentationII. Please answer the following questions relative to the method checked above.1.What did you like best about this method of instruction?2.What did you like least about this method of instruction?3.What are the strengths of this method of instruction?4.What are the weaknesses of this method of instruction?5.Compared to other ways of instruction, was this method instruction useful? Why or why not?6.Any other comments?References1. Osborn R, Tentinger L. Video clips as an adjunct teaching tool in a musculoskeletal physical therapy course.Journal of Physical Therapy Education.2003;17:7174.2. Ford G, Mazzone M, Taylor K. Effect of computer-assisted instruction versus traditional models of instruction on student learning of musculoskeletal special tests.Journal of Physical Therapy Education.2005;19:2230.3. 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multimedia for teaching, learning and presentationsKhoo Cheng Choo, National University of SingaporeAs the world hurtles towards the 21st Century, it is necessary that educators should pause to evaluate the development of new technologies like interactive multimedia and understand its impact on education. This paper will discuss the rationale for interactive multimedia use and examine its ability to enhance instruction, learning and presentations through interactive, hypertexting and linkage techniques Through this innovative approach, users are stimulated via their multisensory modalities to better focus on and retain the messages sent to them. Learners benefit from multimedia because they can now enjoy learning intuitively, independently or socially. Proper integration and use of interactive multimedia in education can help smooth the path to instructional enlightenment because it can, among other things, provide effective communication, clarify, concepts and enhance teaching and learning via the natural multisensory and intuitive approach. Therefore, our task as instructors and trainers, is to sort, absorb, understand and utilise these new technologies to optimise teaching, training and learning.

IT and interactive multimediaThe past three decades have seen vast changes in the world of information technology (IT). The growth of IT has nurtured the acceleration of multimedia in its various forms and phases. Compared to the personal computer revolution of the 80s, the multimedia revolution has escalated to the extent that it will transform computing and create a colossal impact on those who depend on information for survival. Basically, the essence of multimedia is that it is composed of integrated digital media with the capability of creating desktop videos, incorporating narration and other audio effects, visual simulations and animations to enhance a users' learning experience. IBM's Vice president, Mike Braun aptly describes multimedia as "a revolution in personalisation that combines the audio visual power of television, the publishing power of the printing press and the interactive power of the computer."Since the 1960s, the use of CBT, CMI, CAI and CAL were established norms for training in industry, medicine, the military and for. instruction in education. Although they have shown great promise, they've been rather disappointing as they tend to be largely verbal, textual and linear in structure and still employ limited sequential 'page turning' techniques. Also, the older CBT, CMI, CAL packages lost impact simply because they were not tailored to meet the needs of the users.Nevertheless, some CAI programs tried 'marrying' Artificial Intelligence with computer assisted instruction which resulted in ICAI or 'Intelligent CAI' (Wyer, 1987). This was the predecessor of attempts to "approach the learning situation from a less controlled, less technology driven and more student driven perspective" (Sleeman & Brown, 1981). Attempts by Colby to develop a program which attempted to simulate the exchange between a psychotherapist and a patient proved to be rather 'primitive'. Authoring of such ICAI was very complex and the constraint of limited computing power at that time made such projects problematic.Thus, the multimedia revolution of the 1990s is not entirely new. The computer theorist, Dough Engelbart, initially expressed the idea in the 1960s and the concept was later refined by Ted Nelson in his bookComputer Lib.It was Nelson who coined the termshypertextandhypermediato refer to "non-sequential documents" made up of text, audio, and visual information. This concept of accessing different levels of information of the various formats (text, graphics, audio, animation) grew with the increasing power of computers.Why use interactive multimedia?Today, users require access to or communication of information in the most speedy and efficient manner as possible. With multimedia, navigational and participatory features provide more flexibility and control to the users. These unique features allow them to quickly access information when they need it and how they want it. With multimedia, users become participants in an exciting experience involving the sensory modalities of sight, sound and touch, all of which naturally facilitate learning.The 90s is an age where the learner environment is more learner oriented when compared with the teacher oriented emphasis of the past. The following is a summary of some advantages that can be gained by utilising multimedia in the modem smart classroom:1. Reduced learning time:According to some research, interactive multimedia/ videodisc training can reduce training time up to 60% over traditional classroom methods. This can be attributed to the immediate interaction and constant feedback which provides excellent reinforcement of concepts and content. Also, self paced instruction which allows students to control the pace and content of their learning ie, more difficult concepts can be repeated or familiar content can be skipped.2. Reduced Cost:The cost of interactive multimedia lie in the design and production. When the same program is used by more students, the cost per student is reduced, unlike the traditional instructional system which needs to cater to teacher salaries and overheads regardless of the number of students.3. Instructional Consistency and Fairness:Instructional quality and quantity are not compromised as technology based interactive instruction is consistent and reliable.4. Increased Retention:The interactive approach provides a strong learning reinforcement and therefore boosts content retention over time.5. Mastery of Learning:A good interactive system can ensure the learning of the prerequisites by learners before proceeding to new content. This provides a strong foundation for continued learning and therefore helps to achieve mastery learning.6. Increased Motivation:Immediate feedback and personal control over the content provided by an interactive multimedia system has proven to be highly motivating to learners.7. More Interactive Learning:Interactive systems enable learners to have more responsibility and better control over their learning and this generates a greater interest to actively seek new knowledge rather than passively accept instruction.8. Increased Safety:Interactive multimedia and the simulations they provide, allow the safe study of hazardous phenomena such as dangerous scientific experiments on harmful substances or natural disasters like volcanic eruptions or earthquakes by the learners.9. Privacy/ accommodates Individual Learning Styles:This system allows for one to one learning and caters to the different learning styles of individuals. The freedom to ask questions repeatedly without embarrassment and the involvement of each individual learner motivates them and reduces the potential for distraction.10. Flexibility:The flexibility comes from the ability to navigate, by using a keyboard, mouse or touch screen, through an interactive program and to choose what and how much information we want and when we want it.Interactive multimedia and teachingWe are all aware that in the traditional teaching model, the teacher holds on to the knowledge base and delivers that knowledge base directly to the student as is shown in Fig. 1. The use of innovative multimedia practices, however, allows for a change in the role of the teacher in education.

Figure 1:Traditional role of the teacher(N. Paine)With this change in role, the teacher becomes a true facilitator, a manager of the learning process rather than the source of all knowledge. The teacher still remains in control but steps to one side to allow the student a more direct access to knowledge (as shown in Fig. 2), with the teacher facilitating and organising the learning process.

Figure 2:Desirable new teaching model(N. Paine)

This can be achieved because the state of the art of interactive multimedia has opened up new possibilities of knowledge engineering and knowledge linkage. The layers of information can be made intuitively available to the learners, without the learners having to understand the complexity of knowledge engineering and linkages that went behind its creation.

Learning and interactive multimediaGenerally, multimedia caters to individuals with different learning styles and allows the application of knowledge engineering to learning through the building of a cohesive web of cross references and keyword searches of databases. Through this knowledge engineering, interactive multimedia is also ideal for self testing, allowing students to challenge themselves and evaluate their own level of content knowledge before the actual classroom examination. Thus far, the long history of education has been dominated by the spoken and written words. Generally, learning in schools, colleges and universities, is extremely verbal. It is a recognised fact that a large part of the human brain tends to be visual. The brain readily perceives still or moving images and many learners prefer processing and interpreting raw sound rather than cope with the verbal description of sound. Many learning tasks can therefore be more efficiently catered to by interactive multimedia methods rather than the traditional verbal ones. If conventional verbal information presentation is replaced by interactive multimedia which appeal to the learner's multiple modalities, increased learning will invariably result.The learner is given more control over what and how he/she wants to learn. This transmission of information is done via the different modalities like sight, sound and touch, that is it allows learning through the most natural means - the senses. The more user friendly and intuitive an interactive multimedia program becomes, the more likely the learners will become motivated and benefit from the interactive learning experience. A recent study on the ef