Saturday, March 17, 2012

Device: Nook Tablet

Barnes & Noble Nook Tablet

Time to look at something other than apps that target a limited selection of goals. Most of the apps I've discussed so far have been for the iPad or iPhone, but what I carry with me every day to work is my Nook. It is a good tablet, at $200 for 8GB and $250 for 16GB much cheaper than the iPad3 (even with the iPad2 dropping to $400 for 16GB), but it's clunky and slower. I use it mostly for its ability to display and notate PDF files and pictures.While it's nice to have additional apps that can target specific goals in a variety of useful and creative ways, I use the Nook for the bread and butter of my clinical practice: all my materials. Let's start with an overview of this device:

Features: The Nook Tablet is Barnes & Noble's fastest tablet. It has a color 7" touch screen that is extremely clear and very high resolution (iPad is closer to 10", and I believe iPad2's resolution was less than Nook Tablet's, but iPad3 wins over all the rest); the Nook Tablet weighs 14.1 oz (iPad is 1.44 lb), and its battery lasts for 11.5 hrs of reading or 9 hrs of video. It has wireless (802.11b/g/n), and free in-store (B&N) tech support (that can come in handy I imagine). There is no camera, but the Nook Tablet has a microphone and expandable memory in the form of a microSD card slot (the other tablet on the market that it most resembles, Amazon's Kindle Fire, does not have a microphone or SDCard capabilities).

OS and apps: The Nook Tablet is an Android device. Barnes & Noble do not give you access to the Android Market; you have to buy all apps and books through their store. Amazon's Kindle Fire has the same story (no access to Android Market, and you have to purchase apps and books through Amazon). So you only have access to the content these manufacturers approve. This is of course the same story with apple's devices, it's just that apple's store IS the equivalent of Android Market because no other manufacturers run iOS; there's plenty to whine about with Apple's often strict monitoring of what apps they'll allow to be sold, but the benefit is that anything released will work on the devices because there is no difference in the hardware. When it comes to Android devices the hardware is very different among them. Some have microphones and cameras, some don't, some have text-to-speech capabilities, some don't (Nook Tablet doesn't), and so on. If you do find a way to purchase apps from Android Market (for example if you root your device, which is the Android equivalent of "jailbreaking" an iDevice) you will not be limited to only those that work with your hardware and may find yourself disappointed in some cases.

Content: Just a quick note on ways you can get your own files onto your Nook Tablet. You can attach it via USB to your computer and just drag and drop files directly into either the internal memory or the SD card (if you have one inserted). You can email them to yourself and set up your email on the Nook Tablet, or you can use cloud storage (like DropBox). I'm a huge fan of DropBox and will certainly discuss it in future posts (if you link through the link I provide here, and create an account, you will get extra free space for being referred by me, as will I for referring... what, it's a win-win).

How I use it in Tx: On my Nook Tablet's SD card I have set up all my materials in PDF form. I have the following main directories: Memory, Puzzles, Problem Solving, Directions, Scanning, Sequences, Language, Voice, Fluency, Evals, Dysphagia, and Resources. Some of these materials I need printed (for example the scanning activities, and some of the word puzzles) but almost everything else I can use right off the device. Through a third party $3 PDF reader (called ezPDF) I can set up a directory structure where I copy (not move) the files I want to use for specific pt's to their own directories, and annotate those files as I use them (keeping track of when I did what, % accuracy, and whatever else I want). I use a stylus to write on the screen, but a finger would do the job as well.

Examples: Most of my materials can be used in one of two ways: I either read stuff off the Nook for the pt, or I let the pt view something on the Nook's screen. I then mark it (with the device facing me, usually) and move on to another page. The Nook lets you zoom in on any parts of the page and view thumbnails. The screenshots here are from my actual notes from doing the tasks with pts.

(1) The screenshot on the left is an example of a word-list task I created myself of homographs and homonyms, where I asked the pt to define each word and then use it in a sentence, then marked accuracy. In the green rectangles I notated the date of when I did each part (I spread it over several sessions so it wouldn't get too tedious). For this task there was no reason for the pt to view the screen at all.

(2) There used to be a screenshot on the right of an example where I actually show my patient something on the Nook; it was a problem-solving in pictures task from Therasimplicity. They have complained, apparently, that showing a screen image of one page of their resources is an infringement of copyright, so I have removed it. All the removed screenshot was meant to illustrate was that there are tasks that require the patients to view the screen; I show each problem-solving picture and ask to identify the problem, and can keep track of accuracy identifying the problem right on the screen. Once the problem is established, I can also rate whether it was solved directly on the screen. Then I sift through the pictures quickly (one picture per page) to count accuracy. I can also keep track of cuing levels right on the screen.

Why this works for me: In my facility I don't have a lot of space to leave my materials, and even if I did, I wouldn't have them available when I'm doing rounds. So I used to carry all my handouts and copies of everything in a bag. Ouch. Now I have everything in the Nook, and if I want to prepare materials for pts in advance I can, and if I want something else I have all my materials on this device and can select what to use at POS. Up goes productivity, down goes weight I have to carry, and I greatly reduce the time I spend at home thinking about it. A nice benefit is also that I have access and record of pretty much all the materials I used with each pt (but without any identifying information, using only initials for pt folders). It did take a few very busy evenings of getting all my materials set up as PDFs. Some I scanned (most scanners will save as PDF files), some I retyped and then printed to PDF (although the Nook will just as easily let you work with Word or Text files), and some I downloaded as PDFs. Now when I create something new (like the homographs/homonyms task pictured above) I just PDF and copy to the Nook instead of printing and making copies for each pt (I also keep a copy of everything on dropbox for safekeeping and easy access for printing if needed). As an aside, making all the PDFs gave me the opportunity to create variations of materials the way I like them (e.g., I had bedside cogn evals from 3 different hospitals which I drew on to make my own that I like best).

Summary: Having all my materials on the nook allows me easy access to all my resources without having to break my back or spend time searching. I can go to any new facility and be just as ready as I am at my home one. I can select resources at point of service, which doesn't only increase productivity but also allows me flexibility if something I thought would work didn't. And the nook is just not attractive enough (like the iPad) where everyone wants to touch it and look at it... I know that doesn't sound like a benefit, but it is.

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