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We appreciate the comments of Wofford and Wofford and the opportunity to respond. With regard to the expense of multimedia computer-assisted instruction (MCAI), there are two types of cost associated with its production: system costs and development costs. System costs are determined primarily by hardware, eg, laser disc vs CD-ROM technology. We chose the former in order to achieve the highest possible video quality. Development costs depend on a variety of factors, including whether the authoring program is off-the-shelf or has to be developed and the number of people involved with the effort. We developed authoring and administrative software and chose a consortium approach. These steps have afforded unique software advantages and have allowed us to draw on a diverse pool of talent for illustrative materials as well as program design and content. Some initial costs, such as those related to hardware and software development, were considerable but
Waugh RA, Mayer JW, Safford RE, Felner JM. The Affordability and Efficacy of MCAI-Reply. Arch Intern Med. 1995;155(15):1682–1684. doi:10.1001/archinte.1995.00430150178022
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