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SIR: Now that several hospitals have videotape equipment and that future growth and spending in this field are obvious, several important points should be discussed and agreed on to avoid waste of effort and money.

1. Standardization of Equipment and Software.-There are about two dozen non-compatible videotape systems. The desirable standard at the present time is the half-inch J standard. This is on grounds of cost, ease of handling, and wide availability. Primary and secondary schools already have such equipment, which could become available for peripheral hospitals and paramedical use. A few years ago it seemed the standard might become one-inch Ampex, adopted then by some universities. Standardization should be less crucial in two or three' years when a central reference bureau (see below) should be able to copy visual material easily from one mode to another, whether other tape standards or cine film. The spools used should be five-inch diameter, to fit the smallest machines. They are cheaper to post, to store, and to use, and any tape running over 32 minutes is unlikely to be of much practical use in most teaching situations, and for group teaching (see below), ten minutes would usually be long enough.

2. Software.-It is wasteful to have more than one teaching tape produced for a given specific purpose. In the United States there are no less than four similar teaching films on myasthenia gravis at the present time, each having cost some tens of thousands of dollars to produce, where one of these would have been adequate (Abrahamson, personal communication). A central reference bureau would be able to advise not only what tapes and films are currently available, but also which ones are being considered for production or in the course of being made.

In the United States there is a National Medical Audiovisual Centre, attached to a government agency (the Department of Health, Education and Welfare). This centre has a comprehensive catalogue and stock of teaching tapes and films. If a particular tape is wanted at one of America's 120 medical schools or similar institutions, a blank tape is posted. to the Centre and on to it is copied the required material. The tape, no longer blank, is posted back. The enormous value of such a centre in Australia should be obvious, but its implications are even wider than may be realized at first.

3. The Proper Role of Videotape.-Books, recordings, slides, and tapes are all methods of information transfer, each with its advantages and disadvantages. The role of videotape is not as a once-a-year wonder but a workaday tool in any training programme, integrated just like 35-millimetre slides with "talk-and-chalk", buzz groups, and whatever other techniques the teacher might use. In the medical library, study carrels should offer a small TV screen with headphones just as it now offers books and ought to be offering audiotape cassettes and play-back equipment.
The areas in which videotape will be used include: (a) Medical education, undergraduate and postgraduate; (b) nursing education, ditto; (c) paramedical education -rehabilitation, ambulance service, home nursing; (d) patient education-diabetic clinic, long-term paediatric illness, home dialysis, colostomy care; (e) self-appraisal -operative surgery, lecturing, patient encounters; (f) psychiatric interviews; (g) teaching and study of subjects not usefully conveyed by words-plastering techniques, orthopaedic manipulation, aspects of anaesthesia, operative microsurgery, ergonomics and surgery; and (h) autopsy demonstrations to observers remote in time and space.

4. A Practical Approach to Cost and Production.-A camera, recorder, and large monitor cost under $1,500, with tapes at about $8 per half hour. These tapes can be -:wiped and reused many times. Some teaching tapes will be larger scale productions costing many thousands of dollars, but most of them should be simple lecturettes with demonstrations and inexpensive graphics, costing little more than the energy and enthusiasm of clinical teachers prepared to make them.

For the interested clinician, however, some modicum of professionalism is vital if this valuable medium is not to be discredited by the usual knockers. These include typewritten titles filmed with a cheap extension tube accessory for the lens, correct camera angles and lighting, care with microphones, a script following a few simple technical rules. of production, and a willingness to scrap and redo tapes which will not withstand general scrutiny of their quality. As with slides, there should never be more than six lines of writing, clearly legible, on the viewing screen. Unlike many medical films, the editing and presentation should be crisp and lively. When a tape is out of date, after perhaps just two or three years, it should be scrapped, also unlike films and gramophone recordings. The big advantages of tape are immediacy and current relevance.

5. Other Aspects.-
Whatever principles and recommendations emerge, the most .important factor in using videotape will be practical experience, with the huge advantage that software mistakes can be erased. In the fields of general education and of business there is great interest and activity in using videotape, and it is a pity for doctors to lag behind. It is especially important that doctors give a strong lead to paramedical fields, both through their built-in professional authority and their technical knowledge of medical subjects, especially at a time when schemes for community television services are being not only mooted but given significant sums of money as well.

In other fields there has been a disturbing lack of initiative among doctors, particularly from academic departments; this includes the use of audiocassettes (a cheaper and easier mode) and microfilming. With adequate information, equipment, and even funds available at present, important opportunities given by videotape should be considered now,

Michael Patkin

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THE MEDICAL JOURNAL OF AUSTRALIA

Arim. 20, 1974, p.649-650

IMPORTANT PLANNING FOR VIDEOTAPE

Michael Patkin
20 Brimage Street, Whyalla, S.A. 5600.