Fixing Birth Control Pill Problems Commentary

This lecture begins with the familiar classroom image, followed by the appearance of the avatar, which is my picture. I use the avatar to establish rapport with the students, and because the use of avatars is a well-established means to speed the learning process and deepen the duration of the learning.

The content begins with a standard black background and contrasting white letters. Short words or bullets are used to link the visual learning with the audio sound track.

I tried to stress the basic physiology of birth control pills as essential to understanding why they sometimes caused clinical problems, and also how to fix those clinical problems.

Progestins in the BCPs act to suppress ovarian function, but also interrupt uterine contraction patterns that would otherwise facilitate conception.

I wanted the students to understand the significance of progestin half lives in the impact of BCPs on the patient. Not all BCPs are the same, and some are more forgiving than others as far as effectiveness and absence of side effects are concerned.

Recognition that a given BCP may block pregnancy without suppressing ovarian function is key to understanding why some women taking BCPs seem to be a little short on hormones, while others are super hormonal all the time.

The audio was recorded in a studio setting, using an Audio Technika 3035 cardiod microphone, tripod and spit shield. The signal was fed through a Lexicon Lamda pre-amp before going on to the computer.

When speaking, I tried to position my mouth as close to the spit shield as possible, without bumping it. This is harder than you might think, because while trying to stay close to the microphone, I had to be able to also read the script and make it sound conversational. I got better at this with practice, but some of my earlier attempts were a little rough.

All extraneous noise (fans, other computers, etc.) were stopped during the recording to provide as clean a voice signal as possible. I wore studio headphones (AKG K-271 Mk II) so I could hear exactly what my voice was sounding like to the computer.

The signal was recorded on a computer (Windows PC), using Audacity, a free audio recording and editing software program.

The audio was scripted and written in a tight, but conversational tone. I recorded everything one morning, in a single take, although there were many stops and starts. I would sometimes get lost in the script, or skip words, or cough, or make some mistake that required me to stop, pause, breathe and then begin again.

To keep my voice clean, I had hot tea nearby that I periodically swigged to clear my throat.

After completing the initial recording, I started the post-processing of the audio. I switched my headphones from the pre-amp to the computer to avoid the processing lag. Then I began fixing the audio with Audacity.

After selecting the entire recording (about an hour), I hit “normalize” to make all the recording equally loud. This was important because over time, as my mouth drifted away from the spit shield, the loudness of the recording would decrease.

After the mic was turned on, but before I started speaking, I recorded about 10 seconds of background sound. I selected a portion of this background as my sample for “noise removal”. Then I selected the entire recording and had the selected “noise removal” selection digitally removed. By this simple maneuver, virtually all background noise was was removed.

Next, I selected and deleted all of my false starts and mistakes. This shortened the 1-hour audio recording to about 20 minutes.

I began at the beginning of the recording and modified each pause between sentences, so that they were equal in length, silenced, and paced for smooth, quick transitions, without rushing. This shortened the recording to about 9 minutes.

I save the audio file in mp3 and wav formats.

The audio file then became the foundation for the video.

For video editing, I used the program Pinnacle Studio. It allowed me to put the audio track in place, and then insert images, text or video clips in parallel with the audio track.

Depending on what the audio track was discussing, I might have an image or drawing that would illustrate the content. I always tried to use simpler drawings rather than more complex drawings.

In some of my lectures, I have good video clips to illustrate my points, but in this case, I had no video. So I was left with text to fill in the video portion of the recording.

In the case of text or bullets, less is better than more for the purpose of education. The primary training comes from the audio track. The visual track needs to be supportive of the audio, and importantly, not in conflict with the audio.

I use the text to highlight the key points of a sentence, or to provide a general orientation of where we are in the lecture. I might use it to highlight the general topic I’m discussing.

I close the lecture with the familiar avatar, me, to re-establish contact with the students and seal their learning of the topic.

Blend in the lecture hall with crowd noise, and fade to black.

Notes from a Medical Educator