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Current discussions of plagiarism in the university have taken something of a criminological turn. At the same time, there is a tendency to focus on technological solutions. Against these trends, we argue that plagiarism remains, fundamentally, a philosophical and pedagogical issue for universities, related to understanding the meaning of originality and using sources for different disciplines. Toward this goal we place the notion of originality in its historical and disciplinary contexts, and question the view that it is a natural and universal quality of good writing. The practice of assessing undergraduate students on their ability to produce "original" texts depends on a notion of originality that is unstable and uncertain. We examine a sample of statements about originality given to students and explore the nature of the demands placed on student writers in the internationalised university.

Over the last decade, in both Australia and Britain, universities have been under increasing pressure to make themselves accountable for the extent to which they cultivate in their students transferable skills and "attributes" that will prepare them for the rapidly-changing world of employment. The Government's "Striving for Quality" document begins by pointing out that "Australia is actively positioning itself within an international "knowledge-based economy," which has placed new demands on higher education." The Government has questioned the effectiveness of higher education in this regard, in view of the Nielsen survey on employer satisfaction with graduates conducted in 2000. Here, employers reported that graduates often had weaknesses in the areas of "creativity and flair"; oral (and, to a lesser extent, written) communication; "interpersonal skills"; and "understanding of business practice." Much consideration has been given to the question of what role universities should play in the preparation for work; and, concomitantly, to ways of measuring the outcome of their efforts. This article looks at a testing instrument commissioned by the Department of Education, Science and Training (DEST) and developed by the Australian Council for Educational Research (ACER). This "Graduate Skills Assessment" (GSA) Test is still at a pilot stage, but the Government has shown some interest in it as a method of quality assurance, and appears to be leaving it open as a policy option in the future. It is timely therefore to look closely at what this test promises and how it works. On its website, ACER has made available a sample set of questions representing the types of questions that might be asked in any iteration of the GSA. It has also posted an example of the assessment report that candidates receive, showing them their score, how it compares to "the distribution of the results for the middle 60% of students from fields of study similar to [theirs]," and what the scores at each level indicate about the candidate's skills in each category. In this article, the authors quote from the sample questions, and from the descriptions of what ACER says can be inferred about a candidate who scores at Level 3 (the highest level). The authors consider to what extent particular sample questions seem able to test what they purport to test, at the level at which they claim to test it. The authors comment only on the ones that are publicly available.

Educational commentators have offered many pedagogical rationales for using Web 2.0 to support learning in higher education, and academics are being encouraged to find ways for their students to use social web technologies. Questions arise as to the value of these activities compared to more conventional assignments, and whether implementing such changes to student assessment is worth the effort. We conducted a survey of academics' assessment of students' Web 2.0 activities in Australian universities and found that this form of assessment is being conducted by a small number of academics, in a range of fields of study, but mainly in Humanities and Social Sciences, with varying kinds of intended and actual learning outcomes. Blogging and wiki-writing predominate, low and medium-stakes assessment are most common, and different methods of marking and feedback are in use. Qualitative feedback from the survey and follow-up interviews gave further insights into benefits and challenges of Web 2.0 assessment in relation to pedagogy, policy and practice. It appears that academics' conservative approaches to conducting assessment and their novice approaches to utilising social web technologies are factors which seriously limit realising the potential of Web 2.0 for medium or high-stakes assessment. (Contains 3 tables.)

Health literacy, defined as an individual's capacity to process health information in order to make appropriate health decisions, is the focus of increasing attention in medical fields due to growing awareness that suboptimal health literacy is associated with poorer health outcomes. To explore this issue, a number of instruments, reported to have high internal consistency and strong correlations with general literacy tests, have been developed. However, their validity as measures of the target construct is seldom explored using multiple sources of evidence. The current study, involving collaboration between health professionals and language specialists, set out to assess the validity of the Rapid Estimate of Adult Literacy in Medicine (REALM), which describes itself as a "reading recognition" test that measures ability to pronounce common medical and lay terms. Drawing on a sample of 310 respondents, including both native and non-native speakers of English, investigations were undertaken to probe the REALM's validity as a measure of understanding the selected terms and to consider associations between scores on this widely used test and those derived from other recognized health literacy tests. Results suggest that the REALM is underrepresenting the health literacy construct and that the test may also be biased against non-native speakers of English. The study points to an expanded role for language testers, working in collaboration with experts from medical disciplines, in developing and evaluating health literacy tools. (Contains 9 tables and 1 figure.)

For the second-language learner, the affordances of a virtual world have the potential to confer benefits conventionally aligned with real world experiences. However, little is known about the pedagogical benefits linked to the specific characteristics of the virtual world, let alone the issues arising for staff hoping to assess students' participation in these worlds. This case study is based on a two-part assignment in a first-year Chinese unit at an Australian university, exploring the virtual world assessment practices of one lecturer. The findings, while suggesting the strengths of the assessment regime with respect to many of the affordances and to alignment with policy, highlight deficient aspects of the design and implementation processes which can relatively easily be addressed. The case study reveals the critical importance of sufficient scaffolding and support, feedback and appropriate communication of students' achievement to them in order to promote further reflection. (Contains 3 figures.)

Students now have at their disposal a range of Web 2.0 authoring forms such as audio and video podcasting, blogging, social bookmarking, social networking, virtual world activities and wiki writing. Many university educators are interested in enabling students to demonstrate their learning by creating content in these forms. However, the design and conduct of assessment for such student-created content is not straightforward. Based upon a review of current literature and examples in the public domain, this paper identifies key challenges for academic assessment that arise from students' use of Web 2.0 authoring forms. We describe and analyse selected cases where academics have set assessable student Web 2.0 activities in a range of fields of study, noting especially the inter-relationship of learning objectives, assessment tasks and marking criteria. We make recommendations for practice, research and understanding to strengthen educational quality and academic integrity in the use of Web 2.0 authoring forms for assessable student learning. (Contains 1 table.)

Web 2.0 authoring forms such as wikis and blogs, social bookmarking, and audio and video podcasting pose a challenge to academic authorship traditions. This paper reviews the provisions made in major academic referencing and citation style guides for acknowledging content and ideas that may be published using these new web authoring forms. It offers an overview of features of web 2.0 authoring forms and explores concepts of authoring that can help academics to understand the challenges of working with these forms. It provides examples of referencing and citation in scholarly and scientific communication, and concludes that the conceptual basis of referencing and citation as expressed in current systems and standards needs reform in order to bring academic integrity to the use of these new forms of authorship. (Contains 2 tables.)

Patient information leaflets are an important adjunct to verbal exchange between doctor and patient. Their value is dependent upon whether they contain useful information from the viewpoint of the patient and are easily understood. We developed a framework based upon linguistic theory for assessing the quality of written patient information and applied it to a set of leaflets about methotrexate treatment. Items included the overall structure of the text, the technicality of the vocabulary used, the number of content words per clause ("lexical density"), and the clarity of the role relationship between author and reader. The leaflets consisted of up to nine identifiable sections (range 3-8): background information about the drug, summary of its use, dosage instructions, outline of benefits and side-effects, monitoring information, constraints on patient behavior, storage instructions, and clinical contact availability. Most leaflets contained a high number of content words per clause and the identity of the author was clear in only three (17%). Linguistic analysis provides highly relevant information about written patient information. Together with critical assessment of factual and visual aspects, consideration of key linguistic features should improve the quality of informational texts for our patients. (Contains 3 tables and 1 figures.)

Describes the Online Student Resource Centre Web site, developed at Monash University (Australia), which offers stand-alone tutorials. Outlines the process and philosophy of development of the tutorials, based on a constructivist framework, with guided and self-directed learning paths designed to accommodate a range of learning styles. (LRW)

This article aims to increase an awareness of caring for Saudi families by non-Saudi nurses to improve their understanding of culturally competent care from a Saudi perspective. Healthcare providers have a duty of a care to deliver holistic and culturally specific health care to their patients. As a consequence of 'duty of care' obligations, healthcare providers must facilitate culturally congruent care for patients of diverse cultural backgrounds. For the Saudi family considerable cultural clashes may arise when Saudi patients are hospitalized and receive care from healthcare professionals who do not understand Islamic principles and Saudi cultural beliefs and values. The healthcare workforce in Saudi Arabia is a unique multicultural workforce that is mix of Saudi and significant other nationalities. Saudi nurses for example represent only 36.3% of the workforce in the different health sectors. Whilst the different ethnic and cultural background expatriate nurses represent 63.7% (Ministry of Health, 2010). This article also could increase the awareness of healthcare professionals caring for Arab and Muslims patients in another context in the world. [ABSTRACT FROM AUTHOR]

Health literacy, defined as an individual's capacity to process health information in order to make appropriate health decisions, is the focus of increasing attention in medical fields due to growing awareness that suboptimal health literacy is associated with poorer health outcomes. To explore this issue, a number of instruments, reported to have high internal consistency and strong correlations with general literacy tests, have been developed. However, their validity as measures of the target construct is seldom explored using multiple sources of evidence. The current study, involving collaboration between health professionals and language specialists, set out to assess the validity of the Rapid Estimate of Adult Literacy in Medicine (REALM), which describes itself as a “reading recognition” test that measures ability to pronounce common medical and lay terms. Drawing on a sample of 310 respondents, including both native and non-native speakers of English, investigations were undertaken to probe the REALM's validity as a measure of understanding the selected terms and to consider associations between scores on this widely used test and those derived from other recognized health literacy tests. Results suggest that the REALM is underrepresenting the health literacy construct and that the test may also be biased against non-native speakers of English. The study points to an expanded role for language testers, working in collaboration with experts from medical disciplines, in developing and evaluating health literacy tools. [ABSTRACT FROM AUTHOR]

Educational commentators have offered many pedagogical rationales for using Web 2.0 to support learning in higher education, and academics are being encouraged to find ways for their students to use social web technologies. Questions arise as to the value of these activities compared to more conventional assignments, and whether implementing such changes to student assessment is worth the effort. We conducted a survey of academics' assessment of students' Web 2.0 activities in Australian universities and found that this form of assessment is being conducted by a small number of academics, in a range of fields of study, but mainly in Humanities and Social Sciences, with varying kinds of intended and actual learning outcomes. Blogging and wiki-writing predominate, low and medium-stakes assessment are most common, and different methods of marking and feedback are in use. Qualitative feedback from the survey and follow-up interviews gave further insights into benefits and challenges ofWeb 2.0 assessment in relation to pedagogy, policy and practice. It appears that academics' conservative approaches to conducting assessment and their novice approaches to utilising social web technologies are factors which seriously limit realising the potential of Web 2.0 for medium or high-stakes assessment. [ABSTRACT FROM AUTHOR]

For the second-language learner, the affordances of a virtual world have the potential to confer benefits conventionally aligned with real world experiences. However, little is known about the pedagogical benefits linked to the specific characteristics of the virtual world, let alone the issues arising for staff hoping to assess students' participation in these worlds. This case study is based on a two-part assignment in a first-year Chinese unit at an Australian university, exploring the virtual world assessment practices of one lecturer. The findings, while suggesting the strengths of the assessment regime with respect to many of the affordances and to alignment with policy, highlight deficient aspects of the design and implementation processes which can relatively easily be addressed. The case study reveals the critical importance of sufficient scaffolding and support, feedback and appropriate communication of students' achievement to them in order to promote further reflection. [ABSTRACT FROM AUTHOR]

Student web 2.0 authoring in higher education involves a number of challenges and opportunities for assessment and academic integrity. In this article we describe an Australian project that is investigating how lecturers are using web 2.0 activities in university assessment tasks. In the first stage of the project we documented current web 2.0 assessment practices by conducting a survey and interviews with lecturers who teach in different discipline areas across Australia. Initial findings from this stage of the project are presented here, with a focus on using examples from the interviews to illustrate the opportunities and challenges that web 2.0 affordances introduce for learning, teaching, and assessment in higher education. Student authoring in web 2.0 environments can be quite different from traditional academic writing tasks. Using web 2.0 technologies, students can publish their work to an open audience, use different communication styles and texts, draw on their unique personal identity and experiences, co-create content with other students, and manage their content outside the confines of the university. Each of these affordances provides opportunities for enhancing students' learning in higher education, while simultaneously imposing new ways of thinking about scholarly writing and assessment that can be challenging for both students and staff. [ABSTRACT FROM AUTHOR]

Students now have at their disposal a range of Web 2.0 authoring forms such as audio and video podcasting, blogging, social bookmarking, social networking, virtual world activities and wiki writing. Many university educators are interested in enabling students to demonstrate their learning by creating content in these forms. However, the design and conduct of assessment for such student-created content is not straightforward. Based upon a review of current literature and examples in the public domain, this paper identifies key challenges for academic assessment that arise from students' use of Web 2.0 authoring forms. We describe and analyse selected cases where academics have set assessable student Web 2.0 activities in a range of fields of study, noting especially the inter-relationship of learning objectives, assessment tasks and marking criteria. We make recommendations for practice, research and understanding to strengthen educational quality and academic integrity in the use of Web 2.0 authoring forms for assessable student learning. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To obtain patient feedback about the structure and quality of medication information leaflets and validate the usefulness of the Evaluative Linguistic Framework (ELF) for improving written communication with patients. Methods: Triangulated feedback about a set of rheumatoid arthritis (RA) medication leaflets, some developed with knowledge of the ELF, was obtained from 27 people with RA from interviews, focus group discussion and self-administered questionnaires. The principal elements of the framework were investigated: overall generic structure and functions of each stage, interpersonal relationship between writer and reader, technicality of language and density of information. Results: Participant assessments of the leaflets aligned with the framework in terms of what constituted a good leaflet. While the main purpose of the leaflets was identified as being information provision, participants also wanted clear instructions, benefits to be highlighted and side effects to be comprehensively listed. For comprehensiveness and user-friendliness, leaflets developed with guidance of the ELF were consistently preferred. Conclusion: According to people with RA, leaflets generated from a linguistic framework are clearer and more effective in communicating information about medications. Practice Implications: The ELF is a user-friendly, structured analytic system that can assist with the development of effective high quality patient information materials. [Copyright &y& Elsevier]

While clinicians may routinely use patient information leaflets about drug therapy, a poorly conceived leaflet has the potential to do harm. We previously developed a novel approach to analysing leaflets about a rheumatoid arthritis drug, using an analytic approach based on systemic functional linguistics. The aim of the present study was to verify the validity of the linguistic framework by applying it to two further arthritis drug leaflets. The findings confirmed the applicability of the framework and were used to refine it. A new stage or 'move' in the genre was identified. While the function of many of the moves appeared to be 'to instruct' the patient, the instruction was often unclear. The role relationships expressed in the text were critical to the meaning. As with our previous study, judged on their lexical density, the leaflets resembled academic text. The framework can provide specific tools to assess and produce medication information leaflets to support readers in taking medication. Future work could utilize the framework to evaluate information on other treatments and procedures or on healthcare information more widely. [ABSTRACT FROM AUTHOR]

One of the great opportunities we have in this era of mass higher education is to share understandings and foster international relations by means of the provision of international education. And increasingly, Western institutions of higher education devote themselves to attracting students from overseas counties. With the consequent diversity of the student body, identifying who students are and what they need from their learning experiences now poses sizable and critical challenges for universities. This paper asks what institutions need to know to be able to support students, particularly those from other countries, in their learning. It also asks what needs to be done as a consequence: that is, how can institutions support what can be termed a "learner curriculum: where the starting-point is the student. Focusing on student writing as a ‘literacy event’ where a number of the critical issues become salient, the paper explores some theroretical perspectives which help us conceptualize some of the connections between diversity and internationalization of the curriculum. These may be used to help guide policy, principle and practice in the development of student literacies and learning in higher education. [ABSTRACT FROM AUTHOR]

The provision of stand-alone, web-based materials is one way of making language and academic skills support for first-year students accessible, flexible, and more or less permanently available. "Writing in Subject Areas" is a web-based resource developed at Monash University in Australia to facilitate students' transition to the kinds of thinking and writing valued in higher education. The research and pedagogy underpinning the site is based on the significance for first-year students of understanding: (1) textual structures; (2) discursive processes; and (3) institutional practices in the academy. Using a common template, the site provides materials for ten subjects in four faculties. The current paper discusses the student evaluation of the resource, elicited via questionnaire from almost 1,000 respondents over two years. In 2005, 29% of students at the University were international and so the learning needs of this group are of particular interest. The paper compares the international to the local student response on a series of key issues. The results suggest significant differences between the two student cohorts. While the resource's usefulness was commended by both groups, the international student cohort was more likely to use all elements and to be more motivated, even while finding it more difficult than local students. The difficulty was found to be more pronounced for a subgroup of offshore students. The study concludes by reinforcing the benefit of theoretically grounded and specially targeted assistance. Further, it underscores the need for ethnographically inspired investigations by staff providing online teaching and academic support for diverse cultural groups. [ABSTRACT FROM AUTHOR]

Patient drug and treatment information leaflets are an important adjunct to primary health care for medical practitioners to use with patients. To assess comprehensibility of these documents, readability formulas are still used by medical researchers but are arguably of limited value. Checklists to guide the development of printed information, even when based on a systematic review of the literature, have not provided the desired guidance. An approach based on a systemic functional linguistics framework is offered here as one that can provide insight and directions for the improvement of these materials. A set of 18 rheumatology drug leaflets was analyzed at the levels of genre, discourse semantics, and some aspects of the lexicogrammar, so as to identify their characteristics and possible shortcomings as comprehensible documents for patients. While the drug information leaflet was identifiable as a genre with potentially up to nine structural moves, there was a high degree of variability in inclusion of moves, rhetorical functions within moves, and use of headings. The quality of patient information material can be improved by using an analysis that takes account of suitability of generic structure and rhetorical functions, specialization of lexis, status relations, macro-Theme, lexical density, and modalization. A usability strategy should be employed to support the directions provided by the analysis. [ABSTRACT FROM AUTHOR]

The diverse student population at large multi-campus universities requires English language and academic skills support which is targeted to their needs and easily accessible. The Online Student Resource Centre website, developed at Monash University, provides opportunities for students, no matter where they are, to make contact with staff and to access information, but more significantly offers a suite of stand-alone tutorials and downloadable resources, using NetObjects Fusion as the platform. These derive from some 100 print booklets covering academic writing, reading, listening, speaking, grammar and study skills/exam strategies. This paper outlines the process and philosophy of development of these tutorials, based on a constructivist framework, with guided and self-directed learning paths designed to accommodate a range of learning styles. Two tutorials are analysed to highlight some of the pedagogical challenges in translating print resources for the online environment. The paper concludes by reporting on a pilot evaluation of the two tutorials. [ABSTRACT FROM AUTHOR]

Maintenance of academic standards, assessment and monitoring are key tasks for tertiary education, as the system attempts to meet government targets for universal participation. Tertiary education therefore demands more attention to the measurement of outcomes. However, the use of a graduate skills assessment test, we contend--particularly in the form this currently takes in Australia--implies a limited sense of the value added by a university education. We question the validity of national testing both on grounds of its suitability to assess the skills cultivated by university study and on grounds of equity and cultural inclusiveness. [ABSTRACT FROM AUTHOR]

The 'successful' Arts student of the new millennium in Australia is likely to be female and studying full-time, having just completed her final year of schooling. Increasing numbers of students, however, are mature-age, are working long hours in paid employment, or may be the first in their family to attend university. A significant proportion of this heterogeneous population may appear on campus only rarely. In order to engage the hearts and minds of these students in their arts and humanities studies, it is necessary to acknowledge such realities. Last century's solutions to the 'academic adjustment' question will not hold. The new transition to study initiatives rely to an extent on differentiating between student groups to establish starting points, but must also find broad and stable ways of supporting the student cohort to make the transition successfully, particularly to the kinds of writing and thinking that characterize the individual disciplines. [ABSTRACT FROM AUTHOR]

Background: Instruments to assess the quality and comprehensibility of printed patient education materials may lack proper consideration of how readers derive meaning from text. The Evaluative Linguistic Framework (ELF) considers how factors that influence readers' expectations about health care texts also affect their ability to understand them. The ELF has demonstrated value in improving the quality of patient materials about medication, consent, and self-reported questionnaires, but has not yet been used to evaluate a corpus of patient education materials about chronic disease self-management., Objective: This study sought to apply the ELF to examine specific elements of printed self-management patient education materials for chronic kidney disease (CKD) not captured by other tools., Methods: From a previously published systematic review, we identified 14 patient education materials (eight self-management, six diet and nutrition) for people with CKD. We used the ELF to identify the different ways the text could be structured, its intended purpose, the relationship established between reader and writer, presence of signposting, its complexity and technicality of language, and factual content., Key Results: Our analysis identified nine possible structural units, of which "introducing the problem" and "instructing the reader to self-manage" were common to all materials. However, there was no consistency or common sequence to these units of text. The intended readership and aims of the author(s) were not always clear; many materials made assumptions about what the reader knew, the language was often complex and dense, and the meta-discourse was sometimes distracting., Conclusions: Our analysis suggests CKD document developers can benefit from a theoretically grounded linguistic tool that focuses on the intended audience and their specific needs. The ELF identified structural units of text, aligned with rhetorical elements that can be uniformly applied for developing self-management education materials for CKD, and provided checks for language complexity. Further work can determine its usefulness for other (e.g., electronic) formats and other chronic diseases. [ HLRP: Health Literacy Research and Practice . 2018;2(1):e1-e14.] ., Plain Language Summary: Helping patients make meaning from information about their condition is a key goal of health care organizations. We analyzed chronic kidney disease patient education materials on self-management using the Evaluative Linguistic Framework. The purpose and intended audience were frequently unclear. We identified nine structural units of text that may assist information providers to plan and structure content.

Abstract This article aims to increase an awareness of caring for Saudi families by non-Saudi nurses to improve their understanding of culturally competent care from a Saudi perspective. Healthcare providers have a duty of a care to deliver holistic and culturally specific health care to their patients. As a consequence of 'duty of care' obligations, healthcare providers must facilitate culturally congruent care for patients of diverse cultural backgrounds. For the Saudi family considerable cultural clashes may arise when Saudi patients are hospitalised and receive care from healthcare professionals who do not understand Islamic principles and Saudi cultural beliefs and values. The healthcare workforce in Saudi Arabia is a unique multicultural workforce that is mix of Saudi and significant other nationalities. Saudi nurses for example represent only 36.3% of the workforce in the different health sectors. Whilst the different ethnic and cultural background expatriate nurses represent 63.7% (Ministry of Health, 2010). This article also could increase the awareness of healthcare professionals caring for Arab and Muslims patients in another context in the world.

Background: Health consumers increasingly want access to accurate, evidence-based information about their medications. Currently, education about medications (that is, information that is designed to achieve health or illness related learning) is provided predominantly via spoken communication between the health provider and consumer, sometimes supplemented with written materials. There is evidence, however, that current educational methods are not meeting consumer needs. Multimedia educational programs offer many potential advantages over traditional forms of education delivery., Objectives: To assess the effects of multimedia patient education interventions about prescribed and over-the-counter medications in people of all ages, including children and carers., Search Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2011, Issue 6), MEDLINE (1950 to June 2011), EMBASE (1974 to June 2011), CINAHL (1982 to June 2011), PsycINFO (1967 to June 2011), ERIC (1966 to June 2011), ProQuest Dissertation & Theses Database (to June 2011) and reference lists of articles., Selection Criteria: Randomised controlled trials (RCTs) and quasi-RCTs of multimedia-based patient education about prescribed or over-the-counter medications in people of all ages, including children and carers, if the intervention had been targeted for their use., Data Collection and Analysis: Two review authors independently extracted data and assessed the risk of bias of included studies. Where possible, we contacted study authors to obtain missing information., Main Results: We identified 24 studies that enrolled a total of 8112 participants. However, there was significant heterogeneity in the comparators used and the outcomes measured, which limited the ability to pool data. Many of the studies did not report sufficient information in their methods to allow judgment of their risk of bias. From the information that was reported, three of the studies had a high risk of selection bias and one was at high risk of bias due to lack of blinding of the outcome assessors. None of the included studies reported the minimum clinically important difference for the outcomes that were measured. We have therefore reported results from the studies but have been unable to interpret whether differences were of clinical importance.The main findings of the review are as follows.Knowledge: There is low quality evidence that multimedia education was more effective than usual care (non-standardised education provided as part of usual clinical care) or no education (standardised mean difference (SMD) 1.04, 95% confidence interval (CI) 0.49 to 1.58, six studies with 817 participants). There was considerable statistical heterogeneity (I(2) = 89%), however, all but one of the studies favoured the multimedia group. There is moderate quality evidence that multimedia education was not more effective at improving knowledge than control multimedia interventions (i.e. multimedia programs that do not provide information about the medication) (mean difference (MD) of knowledge scores 2.78%, 95% CI -1.48 to 7.0, two studies with 568 participants). There is moderate quality evidence that multimedia education was more effective when added to a co-intervention (written information or brief standardised instructions provided by a health professional) compared with the co-intervention alone (MD of knowledge scores 24.59%, 95% CI 22.34 to 26.83, two studies with 381 participants).Skill acquisition: There is moderate quality evidence that multimedia education was more effective than usual care or no education (MD of inhaler technique score 18.32%, 95% CI 11.92 to 24.73, two studies with 94 participants) and written education (risk ratio (RR) of improved inhaler technique 2.14, 95% CI 1.33 to 3.44, two studies with 164 participants). There is very low quality evidence that multimedia education was equally effective as education by a health professional (MD of inhaler technique score -1.01%, 95% CI -15.75 to 13.72, three studies with 130 participants).Compliance with medications: There is moderate quality evidence that there was no difference between multimedia education and usual care or no education (RR of complying 1.02, 95% CI 0.96 to 1.08, two studies with 4552 participants).We could not determine the effect of multimedia education on other outcomes, including patient satisfaction, self-efficacy and health outcomes, due to an inadequate number of studies from which to draw conclusions., Authors' Conclusions: This review provides evidence that multimedia education about medications is more effective than usual care (non-standardised education provided by health professionals as part of usual clinical care) or no education, in improving both knowledge and skill acquisition. It also suggests that multimedia education is at least equivalent to other forms of education, including written education and education provided by a health professional. However, this finding is based on often low quality evidence from a small number of trials. Multimedia education about medications could therefore be considered as an adjunct to usual care but there is inadequate evidence to recommend it as a replacement for written education or education by a health professional. Multimedia education may be considered as an alternative to education provided by a health professional, particularly in settings where provision of detailed education by a health professional is not feasible. More studies evaluating multimedia educational interventions are required in order to increase confidence in the estimate of effect of the intervention.Conclusions regarding the effect of multimedia education were limited by the lack of information provided by study authors about the educational interventions, and variability in their content and quality. Studies testing educational interventions should provide detailed information about the interventions and comparators. Research is required to establish a framework that is specific for the evaluation of the quality of multimedia educational programs. Conclusions were also limited by the heterogeneity in the outcomes reported and the instruments used to measure them. Research is required to identify a core set of outcomes which should be measured when evaluating patient educational interventions. Future research should use consistent, reliable and validated outcome measures so that comparisons can be made between studies.