ABC of Medical Computing: GETTING YOUR THOUGHTS ON PAPERBMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.6999.245 (Published 22 July 1995) Cite this as: BMJ 1995;311:245
- Nicholas Lee,
- Andrew Millman
Word processing is almost always the first facility people use on the computer, and for many people it is the main reason for buying a computer. The tremendous flexibility of even the most basic word processors has ensured that they have almost totally replaced the typewriter. Word processors allow you to create and then amend parts of the document before printing so that you never have to retype the whole document.
Advantages of word processors
Text is fully editable
Work can be saved and stored
Documents look professional
Writing tools such as spell checker
Macros for doing repetitive tasks
Graphics, spreadsheets, and charts
Until recently, most business word processing has been done with DOS based programs that use character based screens. These programs load, run, and print quickly even on old computers but have the disadvantage that you cannot see exactly what the page will look like when printed without switching to a preview screen. However, newer programs have moved to graphical screens with a WYSIWYG display (what you see is what you get). This means that you see exactly what the printed page will look like as you type it, which is invaluable with more complex documents.
Typing is a keyboard activity, and all word processors allow functions to be selected by pressing various keys. This is both a strength and a weakness. Once you have learnt the key strokes of a particular program most people are reluctant to learn new ones. The Windows environment is starting to introduce uniformity between programs, with the same key strokes performing the same action. The mouse pointing device, which is used with windows and other graphical interfaces, is used to simplify adjustments to the page and to duplicate control of many standard functions. Although it is easier to learn to use, the keyboard is usually quicker.
Character based screen from WordPerfect for DOS and same file on a graphical screen with WYSIWYG display.
An important advantage of a word processor over a typewriter is the ability to move blocks of text around a document or to cut text from other documents and paste it into the current document. This is performed by blocking an area of text, copying or cutting the block, and then moving it to the document in which you wish to insert the text and pasting it in. Many word processors now allow several documents to be open at once, which is a big help when cutting and pasting.
Text is easily moved by cutting and pasting.
Choosing the typeface
Most word processors allow you to choose which typeface or font that you want to use in your document. The old Courier monospaced font used by typewriters is much more difficult to read than proportionally spaced fonts. There are over 20000 different fonts available from font libraries, but the two most used are Times Roman and Universal. A different font increases the impact of newsletters, handouts, posters, invitations, etc. In the Windows environment all programs share a common font pool enabling fonts supplied with one program to be used by any other program. You can also change the appearance of a font by using features such as bold, italic, and underline.
Some fonts and attributes available
Univers font (sans serif)
Brush Script italics
SMALL CAPITALS/NORMAL CAPITALS
Tables and graphics
The table facility allows you to create a grid into which you can precisely place text, numbers, or graphics. The more advanced tables have over 100 powerful spreadsheet functions enabling complex calculations to be performed on the data. You can also import data from other spreadsheet programs or databases. It is often easier to process data with a spreadsheet program, but a word processor is far more flexible for printing out the report on the data. Once you have created a table it is easy to adjust the style or even sort the data alphabetically.
Adding a graphic image can increase the impact of your document. To do this you need to create a box into which the picture is placed. Most word processors allow images to be imported from a variety of other drawing programs. Windows word processors also have basic drawing tools available and can import images from a scanner.
Undoubtedly the most useful accessory is a spell checker. Though the larger dictionaries have over 100000 words that include the basic medical words, most medical terminology will not be included. Individual new words can be inserted in the dictionary, and Stedman's Medical Dictionary can replace the main WordPerfect dictionary. This provides over 165000 additional medical words including medical procedures, devices, diseases, drug names, acronyms, and abbreviations. A spell checker will not identify the use of an incorrect but correctly spelt word, such as “too” instead of “to” or the absence of a full stop. A grammar checker can analyse and suggest corrections for such errors. The thesaurus is also useful.
Spell checkers can have medical dictionaries added.
You will often need a particular phrase such as “Kind regards” or “Yours sincerely” time and time again. This can be simplified by creating a macro which inserts the text automatically. The macro recorder memorises a sequence of keystrokes and allows you to play them back at will by pressing a simple combination of keys such as Alt K or Ctrl Y. The recording facility can also be used to simplify the creation of complex documents such as letters and discharge summaries. Those willing to spend time learning the macro language will be able to add very powerful features to their word processor.
Merge facilities allow you to personalise mass mailing.
Talking to others
New computers have the facility to send faxes through a modem. This means that your letter can be at its destination moments after you finishing typing. the quality of faxes sent directly from the computer is better than that of those sent by a stand alone fax machine.
Unfortunately all programs save files in different formats. For example, to use work created in WordPerfect on another computer running Word you have to save on to a floppy disk and then import it with the WordPerfect filter of Word. Most word processing packages have an extensive range of export and import filters, and you can usually find a common file format for transfer. Exchanging data between PCs and Apple computers is also possible.
Most programs allow you to open files saved with different packages.
Speech recognition allows you to dictate text directly into the computer at speeds of over 100 words per minute. The whole computer can be controlled by voice so that it is hardly necessary to touch the keyboard.
A personal voice module is first created for each person using the system. As you use the system and correct any mistakes or add new unrecognised words it continually improves and soon provides a very accurate reproduction. An additional module can be bought for medical words. Speech is dictated into a dictation window, where it can be played back and corrected. A single voice command transfers the text to the word processor or to any other program.
Using a speech recognition system.
Desk top publishing
If you plan to create a document containing a complex mixture of text, headings, subheadings, and graphics you should consider using desk top publishing. Laying out the page in a desk top publishing program is much easier because text and graphics are entered into individual boxes on the screen, which can then be moved around at will allowing you to experiment with different layouts. The programs also contain templates for popular documents such as newsletters and brochures, which make designing a document even easier. There are now several excellent budget programs which offer more facilities than the average user is ever likely to need.
Desk top publishing
Ideal for handouts, patient information leaflets, etc
Works like a paste board
Much easier to control the precise position of figures and text than with a word processor
Special effects such as drop caps, complex text flow around drawings, creative text art forms
Advanced document management for large documents--page, figure, and chapternumbering; automatic indexing; cross referencing
Wide range of import filters for text and graphics created in other programs
Page grids for automatic alignment of text and graphics
Colour separation and colour control for professional colour printing
Saving your work
One of the advantages of word processors is that all your work can be saved on your hard disk or a floppy disk for later use. It is wise to save the document regularly as you type and to set the automatic save option of the program to “on” so that if you accidentally clear the screen or there is a power failure you will not lose the entire document.
Your computer's hard disk is essentially a filing cabinet. You should divide it into directories (drawers) with subdirectories (subdividers) so that you can easily find your filed material again. The word processor will suggest a main directory for storing your work, and it is a good idea to create subdirectories off this.
Most word processors require you to give your work a filename with a maximum of eight characters followed by a full stop and a three character extension--for example, document.jun. Some programs, however, allow longer, more informative filenames (Letter-to-John-Monday-5-June). It is a good idea to type the filename at the beginning of the document for later reference.
Organisation of files.
Finding a file
Even with detailed filenames and well organised subdirectories it can eventually become difficult to find a document again among the thousands on your computer. It helps to save a document summary with the file, but this requires some discipline.
A more efficient method is to use a text retrieval system such as that included in WordPerfect 6.0. The Quick Finder index can index every word in all the documents on the hard disk allowing instant searching of all words in your files.