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      Differences in Memory, Perceptions, and Preferences of Multimedia Consumer Medication Information: Experimental Performance and Self-Report Study

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          Electronic health resources are becoming prevalent. However, consumer medication information (CMI) is still predominantly text based. Incorporating multimedia into CMI (eg, images, narration) may improve consumers’ memory of the information as well as their perceptions and preferences of these materials.


          This study examined whether adding images and narration to CMI impacted patients’ (1) memory, (2) perceptions of comprehensibility, utility, or design quality, and (3) overall preferences.


          We presented 36 participants with CMI in 3 formats: (1) text, (2) text + images, and (3) narration + images, and subsequently asked them to recall information. After seeing all 3 CMI formats, participants rated the formats in terms of comprehensibility, utility, and design quality, and ranked them from most to least favorite.


          Interestingly, no significant differences in memory were observed ( F 2,70=0.1, P=0.901). Thus, this study did not find evidence to support multimedia or modality principles in the context of CMI. Despite the absence of effects on memory, the CMI format significantly impacted perceptions of the materials. Specifically, participants rated the text + images format highest in terms of comprehensibility (χ 2 2=26.5, P<.001) and design quality (χ 2 2=35.69, P<.001). Although the omnibus test suggested a difference in utility ratings as well (χ 2 2=8.21, P=.016), no significant differences were found after correcting for multiple comparisons. Consistent with perception findings, the preference ranks yielded a significant difference (χ 2 2=26.00, P<.001), whereby participants preferred the text + images format overall. Indeed, 75% (27/36) of participants chose the text + images format as their most favorite. Thus, although there were no objective memory differences between the formats, we observed subjective differences in comprehensibility, design quality, and overall preferences.


          This study revealed that although multimedia did not appear to influence memory of CMI, it did impact participants’ opinions about the materials. The lack of observed differences in memory may have been due to ceiling effects, memory rather than understanding as an index of learning, the fragmented nature of the information in CMI itself, or the size or characteristics of the sample (ie, young, educated subjects with adequate health literacy skills). The differences in the subjective (ie, perceptions and preferences) and objective (ie, memory) results highlight the value of using both types of measures. Moreover, findings from this study could be used to inform future research on how CMI could be designed to better suit the preferences of consumers and potentially increase the likelihood that CMI is used. Additional research is warranted to explore whether multimedia impacts memory of CMI under different conditions (eg, older participants, subjects with lower levels of health literacy, more difficult stimuli, or extended time for decay).

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          Most cited references 58

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          A split-attention effect in multimedia learning: Evidence for dual processing systems in working memory.

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            Constructing Mental Models of Machines from Text and Diagrams

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              The instructive animation: Helping students build connections between words and pictures in multimedia learning.


                Author and article information

                JMIR Hum Factors
                JMIR Hum Factors
                JMIR Human Factors
                JMIR Human Factors
                JMIR Publications (Toronto, Canada )
                Oct-Dec 2020
                1 December 2020
                : 7
                : 4
                [1 ] School of Health Information Science University of Victoria Victoria, BC Canada
                [2 ] School of Nursing University of Victoria Victoria, BC Canada
                Author notes
                Corresponding Author: Helen Monkman monkman@ 123456uvic.ca
                ©Helen Monkman, Andre W Kushniruk, Elizabeth M Borycki, Debra J Sheets, Jeffrey Barnett. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 01.12.2020.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Human Factors, is properly cited. The complete bibliographic information, a link to the original publication on http://humanfactors.jmir.org, as well as this copyright and license information must be included.

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