Using the AnyModal Editor: A Guide for the Transcriptionist

Using the AnyModal Editor: A Guide for the Transcriptionist March 2009

Table of Contents Table of Contents... 1 Introduction... 2 Message to All Transcriptionists... 2 Brief Overview of How ShadowScribe Works... 3 Transcribing in the AnyModal Editor... 3 Using Section and Subsection Headings Lists... 4 Inserting a Section Heading... 4 Inserting a Subsection Heading... 5 Inserting a Red Section... 6 Removing a Section... 6 Using lists... 6 Inserting a List... 6 Removing a List... 6 Using Autotext... 7 Transcription Formatting Rules... 7 Using ShadowScribe Document Templates... 7 Using ShadowScribe Dictation Templates (or Normals)...8 Inserting a ShadowScribe Dictation Template... 8 The VR Menu... 9 APPENDIX A...11 InScribe Navigational and Short Cut Keys...11 APPENDIX B...14 Transcription Best Practices...14 Attentive Listening...14 The Power of Suggestion...14 Skills, Tools and Techniques MTs apply when transcribing...15 APPENDIX C...16 FAQ...16 CREATING A SECTION...16 CREATING A LIST...17 SPEEDING UP AND SLOWING DOWN DICTATION...17 FORMATTING: BOLD, ITALICS, UNDERLINE... 17 PLAYBACK SETTINGS...17 VIEW SETTINGS...18 AnyModal Editor Page 1

Introduction AnyModal Editor for the MT Guide The AnyModal Editor is a third party editor developed by M*Modal and is used for transcribing or editing dictators using Emdat s ShadowScribe system. This editor is loaded and hosted by InScribe but is not directly part of the InScribe program. This guide contains instructions for using the AnyModal editor with the Emdat InScribe application. From the MT perspective, the AnyModal editor will be used to create transcription from the dictation. This editor has a few features designed to remove some of the clerical responsibilities associated with the transcription process. For example, it is unnecessary to apply style formatting to the section headings such as bolding, or have to remember that Client A wants text placed two spaces after the section heading while Client B wants their text to start under the section heading. The ShadowScribe system performs these tasks automatically once the job is delivered to the client. The editor also helps improve typing efficiency by providing a drop down list of predefined sections. MTs can use this list to insert a section without having to type out the full section name. Message to all transcriptionists When you type a document from scratch, your goal is to produce a high quality, medically accurate document for the client. Overall document quality is what the ShadowScribe system relies on for learning and higher quality documents result in better training material for the ShadowScribe system. As you transcribe for the client, you are communicating medical information about a patient as clearly, concisely and accurately as possible. When you complete transcriptions and deliver them to the client, copies also go to the ShadowScribe system. ShadowScribe will use your transcriptions to initially learn from. The system will watch your transcriptions to understand how the dictator should be transcribed. This is analogous to a child learning to speak for the first time. Before a child attempts to speak, they watch and listen to their parents, picking up sounds while learning to mouth certain words until they are confident enough to begin to speak on their own. If the parents speak incorrectly, the child will unknowingly learn incorrectly, because the child assumes all words are correct. The same is true with transcription. Sending transcription that has mistakes such as typos, grammar problems, missing words, etc. will train the system incorrectly and lead to poor draft quality. AnyModal Editor Page 2

Brief Overview of How ShadowScribe Works AnyModal Editor for the MT Guide When a dictator starts using the ShadowScribe system, they will go through a training period. During this period, the system will listen to the dictator s speech patterns and watch the transcription you send. By doing this, it can begin to learn to match voices and speech patterns with transcription. After several hours of clear and uninterrupted audio have been uploaded and transcribed, the system will declare itself accurate enough to transcribe for the dictating user. At this point, all dictations will be transcribed by the ShadowScribe system as draft documents and routed to an Editor to correct. The amount of time this takes depends on a number of factors. The two most influential factors are volume and transcription consistency. If multiple MTs type for the same dictator they should attempt to be as consistent as possible in how they type up transcription. Higher volume dictators whose transcription is typed in a consistent manner are more likely to be trained faster. NOTE: Not all dictations will necessarily qualify to become draft documents. Some dictators jobs, even if they are fully trained, can still go to transcription. This can happen if the ShadowScribe system determines it cannot transcribe the dictation. For example, the dictator could have a cold, or may be speaking while eating, or speaking while driving with the windows rolled down, etc. Dictators can also go to transcription if they do not meet the client acceptable draft quality criteria. This is a measure of quality that is considered acceptable for an editor. Transcribing in the AnyModal Editor The AnyModal Editor is the tool used to create transcriptions for the ShadowScribe system and the client. It is a separate editor that loads into InScribe when the ShadowScribe user s dictation loads. Basically, anything within the purple outline is the AnyModal editor. InScribe will switch between the Emdat Editor and the AnyModal Editor depending on dictator. VR Menu Transcription area When a ShadowScribe job is loaded, all major InScribe functionality will remain the same with a few changes. First, you will notice the editor itself looks nothing like the InScribe editor. There are no toolbars or formatting options available. Text is typed into the transcription area in the illustration above. As you type, the white space of the transcription area will expand to make room for the text. Another noticeable change is that most jobs will not have document templates. Document templates are only used if sections are required by the client. Instead you will create the template, using the section drop down list, as the dictator speaks specific sections. This list appears when you insert a section or subsection. For more information see the Using Section and Subsection heading lists topic in the next section. Finally, the VR menu has additional features for the editor and will only appear when a ShadowScribe job is selected in your dictation queue. AnyModal Editor Page 3

NOTE: Because there are no tool bars, bold, underline, and italics are not available. AnyModal Editor for the MT Guide As with regular transcription, you will playback the dictation, fill in patient demographics, and begin transcription. When the dictator speaks a section such as Subjective, this is your cue to insert a section by using the Ctrl+Alt+H key combination. A drop down list appears with all of the possible section names to insert. You make a selection and begin transcribing below the inserted section. If the dictator speaks a section followed by a subsection, such as Objective followed by Vital Signs, this is your cue to insert a section using the Ctrl+Alt+H key combo and then a subsection using the Ctrl+Alt+J key combo. Just as with Sections, a drop down list appears with all the possible subsection names to insert. You make a selection, insert the correct subsection and begin transcribing below the inserted subsection. Using Section and Subsection headings lists Section and Subsection headings are a quick way to insert a dictated heading into the body of the transcription. They save you time and improve efficiency because you do not need to type out the whole heading. Section Heading Place Marker Transcription area Section/Subsection heading list The illustration above details three main items of the section and subsection heading tool. 1. Section Heading Place Marker. This is the area where the section heading will be inserted after making a selection from the drop down list. Only the section heading should be inserted here. You should not type transcription text here. 2. Transcription area. This is where you type text from the dictation. Text will always appear below the section heading. 3. Section/Subsection heading list. This is list of predefined sections, specified by the client, for the current document type. The numbers to the right of the name are an internal code for the ShadowScribe system and can be ignored. Inserting a Section Heading 1. Place your cursor in the body of the transcription where you want to insert a section heading. 2. Use the Ctrl+Alt+H key combination to make the section heading list appear. AnyModal Editor Page 4

3. Select an item by starting to type the first few letters of the heading. As you type, the word that most closely matches will highlight. Alternatively, you could also use your mouse to make a selection; however, using the mouse is discouraged because it is not efficient. 4. To insert the heading, hit the tab key. 5. Hit the enter key to begin typing the section. Inserting a Subsection Heading 1. Place your cursor in the body of the transcription where you want to insert the subsection heading. 2. Use the Ctrl+Alt+J key combination to make the subsection heading list appear. 3. Select an item by starting to type the first few letters of the subheading. As you type, the word that most closely matches will highlight. Alternatively, you could also use your mouse to make a selection; however, using the mouse is discouraged because it is not efficient. 4. To insert the subheading, hit the tab key. 5. Hit the enter key to begin typing the subsection. NOTE: As you type, the section or subsection heading place marker will change color. If it changes green, the letters typed match exactly to one of the words in the list and you can hit the tab key to insert the section. If it changes red, the letters typed do not match exactly. For example, if you started to type a instead of A for Allergies, the color would display red. The color is not relevant unless you are adding a section that is not part of the list. For more information see Inserting a Red Section. AnyModal Editor Page 5

Inserting a Red Section In some cases the dictator will speak a section or subsection that is not in the predefined section list. In this case, you will need to manually add the section. When you add a section or subsection it will always appear in red indicating this is not part of the predefined section list. Make sure to always add the red section or subsection in initial caps E.g. History instead of HISTORY. This ensures the rendering program will choose the proper case when the job is delivered to the client. Removing a Section 1. Place your cursor in the section or subsection you wish to remove. 2. Use the Ctrl+Alt+H key combination (Ctrl+Alt+J for subsection) to convert the section into text and then hit delete. Using lists Under certain section headings the dictator may require a list. When lists are added, they will always appear as bullet points. These bullet points will be converted into numbers or other format once the transcription is delivered. The format is determined by the client and programmed in ShadowScribe. Inserting a List 1. Place your cursor under the appropriate section or subsection. 2. Use the Ctrl+Alt+V key combination to add a list item. As with any bulleted list, you can hit enter after adding the item to automatically start a new list item. You can also indent or unindent a list item by using the tab and shift tab key combination. Removing a List 1. Place your cursor on the line that has the bullet. 2. Use the Ctrl+Alt+V key combination to remove the list item. AnyModal Editor Page 6

Using Autotext Autotext is shared between both the regular Emdat and the AnyModal editor and works the same in both instances. Autotext should be used as an efficiency tool and should consist of words, phrases, sentences or paragraphs. Autotext that contains template formatting or numbered lists should not be used. This is not supported by the AnyModal editor and makes it very difficult for the ShadowScribe engine to learn. If you have autotext that has either formatting or numbered lists, you should request your transcription manager to make this into a document or dictation template. (Examples of autotext that should not be used) Should you choose to use this type of autotext, you will lose all formatting (such as bold, italics, underline, indents, alignment, and extra carriage returns) once it is expanded into the AnyModal editor. Transcription Formatting Rules Formatting rules are applied when the transcription is delivered. These rules are setup ahead of time by the client and affect the overall look of the transcription. In particular, these rules apply to section and subsection headings as well as bulleted lists. Therefore, it is unnecessary to format any text, numbered lists, sections, or subsections. This frees you to focus on the quality and medical accuracy of the document without having to remember formatting details for each client. If you need to see what the transcription looks like with all formatting applied, you can use the Preview with Template Ctrl+Alt+B option under the InScribe file menu. Using ShadowScribe Document Templates The use of document templates is determined by the client and typically used in two cases. First, the client always requires certain sections to be part of a dictator s transcription. In this case, you may only see a partial document template. For example, the client might require only the History of Present Illness and Medications sections always be part of the transcription but the rest of the sections could vary. Second, the client has a set standard look for all transcriptions. In this case, typically none of the sections would vary and you would see a full document template appear as displayed in the screen shot below. AnyModal Editor Page 7

Section heading Transcription area Subsection heading Transcription area for Subsection headings Similar to regular transcription, when a ShadowScribe job loads with a template it will automatically appear in the editor. As with any section or subsection, whether added by the MT or as part of a document template, you will always type text below the section into the transcription area. Using ShadowScribe Dictation Templates (or Normals) ShadowScribe dictation templates are used the same way regular dictation templates are used and have the same purpose. Unlike regular dictation templates, ShadowScribe dictation templates can have two formats. One format will look like canned text such as a few sentences or paragraphs lumped together. The other format looks similar to ShadowScribe document templates in that they appear as section and subsection headings when inserted. Inserting a ShadowScribe Dictation Template 1. Place your cursor in the appropriate section or subsection. 2. Use the Ctrl+Alt+G key combination to make the Dictation Templates dialog appear. 3. Select a ShadowScribe template from the drop down and click OK. NOTE: The VR prefix or suffix may or may not be used. This is a client preference. However, the VR prefix/suffix makes this visually separate from the dictation templates used in InScribe. AnyModal Editor Page 8

The VR Menu This menu will appear each time a ShadowScribe user s dictation is loaded and contains functions specific to the AnyModal editor. Where applicable you are strongly encouraged to learn and use the shortcut keys as this will help you increase efficiency and productivity. Each item is explained in detail below. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1. Attach Selection to Playback Highlighter. Available only for editing a ShadowScribe draft, not available while transcribing. 2. Move Playback to Cursor. Available only for editing a ShadowScribe draft, not available while transcribing. 3. Split Transcription at Cursor. Similar to the Emdat Editor Copy Transcription to New Transcription function, this will split the transcription at the cursor location and create a new transcription containing all the content after the cursor. 4. Check Spelling as you type. Similar to Microsoft Word, this will place red squiggly underlines under misspelled words. If a word is identified as misspelled but you know it is correct, then leave it alone. This will not affect the ShadowScribe system. 5. Use Double Space After Sentence. This will automatically place two spaces at the end of a sentence. Note: Capitalize First Letter of Sentence as You Type must be enabled in Spelling and Typing Options under the Options menu. AnyModal Editor Page 9

6. Insert Line Break. By default when the enter key is pressed lines will be double spaced. This option is used to override the double space. 7. Toggle Section. Inserts or removes a section heading. 8. Toggle Sub Section. Inserts or removes a subsection heading. 9. Toggle List. Inserts or removes a numbered or bulleted list. Remember, lists will always appear as bullet points in the AnyModal editor. They will be converted to the proper format when the transcription is delivered to the client. 10. Indent List. Indents a list item one level. 11. Unindent List. Unindents a list item one level. 12. Increase Zoom. Increases the size of the text in the editor. The zoom setting will be kept for all ShadowScribe jobs until you logout of InScribe. (This doesn t affect what is delivered to the client.) 13. Decrease Zoom. Decreases the size of the text in the editor. 14. Reset Zoom. Restores the text size to the original default set during install. 15. Help Menu. Additional help documents and user guides can be found here. AnyModal Editor Page 10

Move cursor up one paragraph Move cursor down one paragraph Move cursor to beginning of line Move cursor to end of line Select one whole paragraph up Select one whole paragraph down APPENDIX A InScribe Navigational and Shortcut Keys Navigational Keys Must enable Use Ctrl+Arrow Keys for Navigating Document to use this feature. Located under the Options menu. Must enable Use Ctrl+Arrow Keys for Navigating Document to use this feature. Located under the Options menu. Selection Shortcuts Not yet available for InScribe. This key combination will invoke the Insert Dictator into Transcription feature. Ctrl + up arrow Ctrl + down arrow HOME END Shift +Ctrl + up arrow Shift+ Ctrl + down arrow Select one word to the left Ctrl + Shift + left arrow Select one word to the right Ctrl + Shift + Right arrow Editing Shortcuts Delete one word to the right Ctrl + Delete Delete one word to the left Alt+Backspace Toggle Section Insert or remove a section. Ctrl+Alt+H Toggle Subsection Insert or remove a subsection. Ctrl+Alt+J Toggle List Insert or remove a list. Ctrl+Alt+V Attach Selection to Playback Ctrl+F12 Highlighter Find Shift+Ctrl+F Find and Replace Shift+Ctrl+H Copy selected text Ctrl + C Cut selected text Ctrl + X Paste selected text Ctrl + V Undo Ctrl+Z Redo Not available in the 2.20 version of the AnyModal Ctrl+Y Editor. Select all text Ctrl+A Split Transcription at Cursor Splits the transcription at the cursor location and Ctrl+Alt+S creates a new transcription. The new transcription will have all content that was after the cursor. Spell Check Ctrl+K Move to Comment Ctrl+M Preview with Template Ctrl+Alt+B Dictation Playback Shortcuts Move Playback to Cursor Shift+Ctrl+F12 Play from Beginning Shfit+Ctrl+Z Play/Pause Dictation Shfit+Ctrl+X Rewind Shift+Ctrl+C AnyModal Editor Page 11

Fast Forward Shift+Ctrl+V Decrease Playback Rate Shift+Ctrl+, Increase Playback Rate Shift+Ctrl+. Set Playback Rate to Normal Ctrl+R Mark Index Shift+Ctrl+I Jump to Index Shift+Ctrl+J Clear Index Shfit+Ctrl+K Insert Time Ctrl+Alt+T Carbon Copies, Authorizations (Signatures) New Associate Ctrl+Alt+N Edit Associate Ctrl+E Delete Associate Ctrl+D Edit Data Field Shift+Ctrl+E Delete Data Field Shift+Ctrl+D Add Authorization Ctrl+Alt+A Remove Authorization Ctrl+Alt+D Transcription Functions Move up in list Move up to the previous dictation in the dictation Shift+Ctrl+Up arrow queue. Move down in list Move down to the next dictation in the dictation Shift+Ctrl+Down arrow queue. Set Cursor Focus on Transcription Moves cursor from demographics panel to Alt+; transcription editor. Complete (done) Mark the transcription as done. Ctrl+O Mark for QA Ctrl+Q Mark for Review Ctrl+W Next Transcription Get next transcription. Shift+Ctrl+Enter Upload Completed Transcriptions Alt+U Get Prior Transcriptions Shift+F1 New Transcription Create a new blank transcription. Shift+Ctrl+N Copy Transcription to New Not available for AnyModal Editor. Shift+Ctr+Y Transcription Copy Dictation to New Not available for AnyModal Editor. Ctrl+Alt+Y Transcription Append/Unappend by Shift+Ctrl+A Transcription ID Lock Transcription Ctrl+Alt+K Save Ctrl+S Count Lines Ctrl+T Auto Text Expand auto text within transcription. Shift+Ctrl+T Insert Dictator into Transcription Shift+Ctrl+Down arrow Transcription Log Show log of all transcription work. Ctrl+L Edit Problem List Ctrl+Alt+P Insert Problem List at Cursor Ctrl+Alt+I View Work Pool Shift+Ctrl+P Re Pool Dictation Ctrl+H Invalidate Transcription Ctrl+J Patient Appointment Tools Find by Name Ctrl+F Find by Number Ctrl+N AnyModal Editor Page 12

Dictator Appointment Listing Only available for clients who use this feature. Shift+Ctrl+L Edit Patient Information Ctrl+Alt+E Template Functions Go to Next [Field] Ctrl+G Get Document Template Shift+Ctrl+G Get Dictation Template Ctrl+Alt+G Remove Remaining [Fields] Ctrl+[ Hide Data Fields Stop Downloads for This Session List Document Types by Description Tools and Options Ctrl+Tab Ctrl+Alt+Z Ctrl+Alt+X AnyModal Editor Page 13

Transcription Best Practices APPENDIX B Attentive Listening Attentively listening helps you to transcribe a complete and accurate document. Failing to listen attentively may lead to making mistakes, such as transcribing a word or phrase incorrectly. When you attentively listen you put extra conscientious effort into listening, tuning your ear to listen to not just the words, but also the context in which the words are spoken. When you put this type of effort into listening, you have a heightened awareness of the dictation which is a powerful tool for the transcriptionist. This tool can help you accurately, efficiently, and quickly transcribe and also help you more easily identify dictator mistakes. Objectives Listening well is imperative to document accuracy and quality Listen for context to help you transcribe accurately Keep your mind, and yourself, focused and relaxed The Power of Suggestion Sometimes you may assume what you heard and read are the same, when they are not. As human beings we are prone to misunderstanding what we hear. When transcribing you have probably come across situations where you believed you had heard the dictation correctly, only to re listen to it and discover the dictator actually said something different. This phenomenon is often referred to as the Power of Suggestion. Here are some examples: Dictated: drug eluting stent MTE heard: drug alluding stent Dictated: ejection fraction MTE heard: injection fraction Dictated Marni Wichman MTE heard Marney Wickman Dictated Dr. Benitez MTE heard: Dr. Bonitas Transcribing and listening at the same time makes us more susceptible to falling prey to the Power of Suggestion, as we may be more readily misled into thinking what we read and heard are one and the same. By listening attentively for content, we can avoid the Power of Suggestion. Power of Suggestion often occurs with: Sound alike words Sloppy dictation Accented dictators Repetitions AnyModal Editor Page 14

Skills, tools and techniques MTs apply when transcribing Choosing and Manipulating Format Recognition and Interpretation of Sounds o Select those sounds that have meaning from those that don t o Inserting silent letters where applicable o Analyze dialects and accents to select appropriate spellings o Recognize and correctly transcribe mispronounced words o Differentiate between preferred and less preferred spellings o Remember medical words that change spelling as they change form o Choose the appropriate spelling from among sound alike words Supplying Punctuation and Correcting Grammar Style o Punctuation o Verb agreement errors o Minor Editing of Content Deleting redundancies Differentiating between brief forms and slang Translating slang forms Investigating and correcting inconsistencies o Major Editing of Medical Content major changes in structure or grammar AnyModal Editor for the MT Guide AnyModal Editor Page 15

APPENDIX C FAQ CREATING A SECTION WHAT IS A SECTION? A section refers to both the section title and its content. AnyModal Editor displays a section between purple lines. HOW DO I MAKE A NEW SECTION? You can create a new section by typing Ctrl+Alt+H. MY SECTION TITLE SHOULD BE BOLD. HOW DO I DO THAT? Formatting of section titles is done automatically when you submit the report. There is no need to bold, or make any other formatting changes, to section titles. I INSERTED A SECTION TITLE AND IT IS DISPLAYED IN RED. WHY? If your section title is red, this means that it is not one of the predefined sections for the document type. Predefined sections are displayed in your drop down when you use Ctrl+Alt+H for sections. Usually you only need to add a red section if the dictator spoke a different section that was not in the predefined list. This can happen from time to time. HOW DO I KNOW WHICH SECTION TITLE TO ADD? When you create a new section title, press Ctrl+Alt+H for a list of predefined section titles. Choose the best title from this list. I INSERTED A SECTION TITLE AND IT IS DISPLAYED IN GREEN. WHY? This occurs as you type the letters of the section. As you type, the AnyModal Editor will try to match your characters to one of the predefined sections. If a possible match is close then the section title will appear in green. ONCE I FINISHED TYPING MY SECTION TITLE, IT DISPLAYED IN PURPLE. WHY? A purple section title means that the section is one of the acceptable predefined sections. I INSERTED A SECTION TITLE AND IT IS DISPLAYED IN RED, BUT I KNOW THE TITLE IS CORRECT ACCORDING TO MY ACCOUNT SPECIFICS. WHAT DO I DO? It is possible to submit a report with a red section title. Please clarify with your account manager that the title is correct and that it does not exist as a predefined section title for the document type you are working with. THERE ARE MANY TITLES TO CHOOSE FROM WHEN I PRESS CTRL+ALT+H. DO I NEED TO SCROLL THROUGH ALL OF THEM? No, you may type the first few letters of a section title and then press Ctrl+Alt+H. The menu option will begin with those titles that match your selection. THE SECTION TITLE I AM LOOKING FOR IS NOT INCLUDED IN THE OPTIONS WHEN I PRESS CTRL+ALT+H. I AM CERTAIN THAT THE TITLE IS PERMISSIBLE IN THE WORK TYPE I AM EDITING. WHAT DO I DO? If the document type was incorrectly identified when the audio was submitted, the wrong list of predefined sections would be assigned to the draft. AnyModal Editor Page 16

Change the document type to ensure that the correct predefined section list displays. CREATING A LIST I WANT TO TURN THE CONTENT OF A SECTION INTO A LIST. Place your cursor in the section or line you wish to turn into a list and press Ctrl+Alt+V. HOW DO I SEPARATE MY PARAGRAPH INTO A LIST? If your paragraph is already a list, simply press Enter after each item. For instance, if your paragraph is a list of medications and dosages, press Enter after each dosage. WHY IS MY LIST BULLETED WHEN MY ACCOUNT WANTS IT ENUMERATED? AnyModal Editor only displays bulleted lists. The appropriate formatting will be applied after you submit the report in the rendering process. HOW DO I CREATE A SUBLEVEL WITHIN MY LIST? You can create a sublevel by clicking on the indentation icon on the toolbar. When you type Enter, you will continue your sublevel, much the same as you would in Microsoft Word. I ACCIDENTALLY CREATED A LIST. HOW DO I TURN IT BACK INTO A PARAGRAPH? It is easy to turn a list back into a paragraph. Simply place your cursor in your listed item and press Ctrl+Alt+V. Alternatively, if you just made your paragraph into a list, you can press Ctrl+Z to undo your previous action(s). SPEEDING UP AND SLOWING DOWN DICTATION I WANT TO SPEED UP THE DICTATION I AM WORKING ON. HOW DO I DO THAT? To speed up dictation, press Shift+Ctrl+. (Shift+Ctrl+period) HOW MUCH SHOULD I SPEED UP THE DICTATION? Each time you press Shift+Ctrl+. (Shift+Ctrl+period) the dictation speeds up a certain percentage. In order to see a real gain in productivity using this feature, it is best to press Shift+Ctrl+. (Shift+Ctrl+period) at least 2 or 3 times. Use your best judgment to speed up the dictation further. HOW DO I RETURN PLAYBACK TO NORMAL? Press Ctrl+R to return playback to normal. HOW DO I SLOW DOWN PLAYBACK? To slow down dictation, press Shift+Ctrl+, (Shift+Ctrl+comma). FORMATTING: BOLD, ITALICS, UNDERLINE HOW CAN I BOLD, UNDERLINE, OR ITALICIZE TEXT? At this time, the AnyModal Editor does not support this feature. PLAYBACK SETTINGS HOW DO I CONTROL PLAYBACK WHEN USING ANYMODAL EDITOR? AnyModal Editor Page 17

You may control playback using a foot pedal when working with AnyModal Editor. AnyModal Editor for the MT Guide Alternatively, you may also use the shortcuts F2, F3, and F4, which rewind, play/stop, and fast forward, respectively. WHAT IS THE AUTO REWIND FEATURE? When you stop playback, AnyModal Editor will automatically rewind. This feature allows the user to re listen to the last word or phrase that was spoken prior to stopping playback. The default setting is 5 seconds. I WOULD LIKE TO AUTO REWIND MORE WHEN I STOP PLAYBACK. CAN I CHANGE THIS FEATURE? Yes, you can choose how far you would like to auto rewind. You may increase or decrease this feature by opening the Options menu and select the Set Date/Time Values option. Increase or decrease the number of seconds in the Rewind, Fast Forward, and Rewind after Pause fields. I WOULD LIKE TO TURN OFF THE AUTO REWIND FEATURE. IS THAT POSSIBLE? Yes, you can turn off the auto rewind feature by setting the Rewind after Pause option to zero. HOW FAR DOES ANYMODAL EDITOR REWIND EVERY TIME I TAP THE REWIND PEDAL (OR PRESS F5) Each time you press the rewind pedal or the shortcut F3, AnyModal Editor will rewind playback 5 seconds. HOW DO I CHANGE THE AMOUNT OF TIME ANYMODAL EDITOR REWINDS EACH TIME I TAP THE REWIND PEDAL (OR PRESS F3)? You may increase or decrease this feature by opening the Options menu and select the Set Date/Time Values option. Increase or decrease the number of seconds in the Rewind field. HOW FAR DOES ANYMODAL EDITOR FAST FORWARD EVERY TIME I TAP THE FAST FORWARD PEDAL (OR PRESS F4)? Each time you press the fast forward pedal or the shortcut F4, AnyModal Editor will fast forward playback 5 seconds. HOW DO I CHANGE THE AMOUNT OF TIME ANYMODAL EDITOR FAST FORWARDS EACH TIME I TAP THE FAST FORWARD PEDAL (OR PRESS F5)? You may increase or decrease this feature by opening the Options menu and select the Set Date/Time Values option. Increase or decrease the number of seconds in the Fast Forward field. VIEW SETTINGS THE FONT SIZE IS TOO SMALL AND I CANNOT READ IT. HOW DO I MAKE IT BIGGER? To make the font size bigger, go to the VR menu and then click the Increase Zoom. This will magnify the text without affecting the actual draft. There is no need to change the font size to match any account specifics. THE FONT SIZE IN ANYMODAL EDITOR IS NOT THE RIGHT FONT SIZE FOR MY ACCOUNT. HOW DO I CHANGE THE FONT SIZE TO MATCH THE ACCOUNT SPECIFICS? There is no need to change the font size to match any account specifics. AnyModal editor will render the report in the appropriate font size when you submit the edited draft. THE FONT IN ANYMODAL EDITOR IS NOT THE RIGHT FONT FOR MY ACCOUNT. HOW DO I CHANGE THE FONT? There is no need to change the font style to match any account specifics. AnyModal editor will render the report in the appropriate font when you submit the edited draft. AnyModal Editor Page 18