Saturday, January 30, 2010

What is required for any successful textbook e-book reader including the iPad

Much has been made of the potential for e-book readers such as the iPad or Kindle to replace traditional textbooks.The e-book has many potential advantages over traditional books these include:

  • E-books can be produced less expensively
  • E-books can be updated more frequently and corrections issued making it less likely for a text to become 'out of date'
  • Multimedia options can be added to the text enhancing the learning experience.

With those advantages in mind it is now time to consider what needs to be done to make a successful e-textbook.

The first thing to remember is that most textbooks at the high school level and beyond, with the exception of some literature, and sociology books, were never meant to be 'read' but rather to be studied and used as references. If you need an example of what I mean all you need to do is pick up a high school math or science text and try to read it. In even the best written textbooks any attempt to read them in a linear fashion is doomed to fail. It is a format which requires continual 'flipping back and forth" between pages to review examples, look up formulas, charts and tables as well as the need to make annotations and highlight important passages. You also need the abilty to skim textbooks to pick out points and issues you wish to review. As an author and co-author of medical textbook chapters (my latest published one was as the co-author of a chapter on quality management issues in the The A.S.P.E.N. Nutrition Support Core Curriculum: A Case-Based Approach - The Adult Patient) and a reviewer of articles for peer reviewed medical journals I have become acquainted with the requirement of what makes a good book chapter or article. 

I have had a Kindle since soon after it's release and, besides using it as my primary fiction and non-fictional reader,  used it's 'download' function to put on textbook chapters and articles I was reviewing for publication.  Very rapidly I realized that the format was not acceptable for technical textbooks.  Although it does have the ability to 'highlight' and annotate it fails in the ability to 'put  your thumb in' at a reference you need to continually refer back to to understand the content presented. Skimming is also an issue due to the slight delay between 'page turns' which tends to break your concentration. I have looked at the specs of other readers including the Nook and so far none of them include these necessary funtions.

When I head about the iPad and it's proposed ability to have a e-book store I started to think what would required to make it a successful e-textbook reader.  In my opinion these include:

  • The ability to highlight and annotate (not shown on the demo but I can't believe that Apple would leave that basic functionality out)
  • The ability to bookmark pages and to rapidly retrieve them this would be greatly benefited by the creation of a 'bookmark' sidebar similar to the sidebar available on the Adobe Reader so that you could quickly 'flip' back and forth to review references, charts, etc. To date this functionality does not exist in any e-book reader
  • The ability to have a pop-up calculator for technical purposes (N.B.  the iPhone/Touch does not have this ability, to use the calculator you have to close the current app. I would presume that would work in the same fashion on the iPad which, at present uses the iPhone 3.x firmware)

Items which would be 'nice to have' would include

  • The ability to 'tear out' charts, tables etc, and park them on the screen so that they would be rapidly available (this would, of course, require a larger screen or a smaller book area)
  • The ability to link to a webpage in a pop-up/out to review on-line content (in the case of the iPad this would most likely mandate flash support for the viewing of on-line media an option which we have already been told does not exist)
  • The abiity to view imbedded multimedia

I would hope that the designers of the i-Book reader on the iPad have taken in mind these considerations in mind.  If the textbooks presented on the iPad are just 'electronic copies' of print books I believe it will be difficult for public school systems, based on their current several year cycle for textbook acquision (books are not replaced yearly but only where there is a change sufficient to require the new expense) to justify the purchase of hundreds of iPads and e-textbooks.  It is true that over time this would likely occur but does the iPad have sufficient other functionality to survive for the 3 - 4 year time period required for the schools to require new books and to justify it's purchase.  For college students who are responsible, in the large part, for purchasing their own textbooks the time cycle does not apply but the expense does.  Remember that many college students already have 'smart phones' and MP3 players and are 'required' to have laptops so that they do not need the iPad to replace those functionalities. Particularlity since the iPad will not replace a laptop in it's current configuration. The e-books will have to be priced competitively with used texts otherwise cost considerations would mandate the purchase of the 'dead tree' book.

I believe that the iPad has potential for a textbook replacement but not in it's current configuration and with the limitations imposed on it by the use of the iPhone OS.



Posted via web from Dr. Mom's Posterous

Thursday, January 28, 2010

What Apple needs to do to make the iPad a truely functional medical device

Disclaimer: This post is based on the publically released specs of the new iPad.  I have not personally seen the device nor used it.  I have, however used, and continue to use an iPod Touch and have experience with the iPhone, MacBook Pro and iMac.

Like many others I watched the Apple annoucement with interest.  I had heard many reports about potential medical uses for the new device and was eager to see what was being released.  Unfortunately, I was underwhelmed by what was released.

On the positive side the size and shape of the device is right to be easily carried from room to room and will easily fit into a messenger sized bag.  The screen is the right size to examine X-rays and other radiographic studies and the listed resolution is more than adequate to produce easily interpretable pictures.  In addition the docking port opens up a wide range of possibilities for monitoring devices to download patient information.

With that being said here is a list of the issues that I believe need to be resolved

  1. OS 3.x is not adequate for such as device.  I have, over the years, written multiple patient databases for use in calcuations and tracking and have come to the conclusion that there is no way, at present, to write an all encompasing patient case application which will cover all needs. 
    This is important to realize because in the case of OS 3 multitasking is not fully possible (push notifications & some background processes will run).  Health care practitioners will need to simultaneously run several applications to do data acquision, calculations and then using 'cut and paste' enter the data into the medical record.  Under OS 3, in it's current configuration, each application closes when switching to the next one making this extremely difficult to perform the switching back and forth needed to easily encorporate data into  the master record. 
  2. To date I have been unsuccessful in getting either an iPhone or iPod Touch to be able to log into our institutions VPN which uses a Juniper Network, Citrix server configuration. No such issues exist for any netbook/notebook/desktop using Linux/OS X.x/Windows.  This issue will need to be corrected in the software before the device will be usable as a remote access portal.
  3. A touch screen raises issues of infection.  When a health care provider makes physical contact with patients proper infection control mandate that adequate barrier precautions be taken.  These can range from simple hand washing before and after contact any provider who makes contact with patients will have to continually clean their hands or change gloves to use a touch screen.  A stylus with  a disposable cover would solve this issue but based on Apple's history such accessories will need to be supplies by a third party.

I would need to try out the virtural keyboard before making any comments but a keyboard will be essential for the entering of patient data into records and the keyboard dock does not meet the need.

With the above comments in mind and before trying one in the local Apple store at present I have no plans to purchase the device for use as a medical tool until the above issues are addressed.

Posted via web from Dr. Mom's Posterous

Tuesday, January 26, 2010

Recipe from the TWiT Army Mess Hall - Mac and Cheese with Mix Ins

Go wild with what you mix in. My family favorites are broccoli, cauliflower & shrimp or shredded cooked chicken.

Mac & Cheese with crunchy topping & mix ins

See Mac & Cheese with crunchy topping & mix ins on Key Ingredient.