Great points Linda.
 
I agree that it's always important to consider whether something is 'need to know' or 'nice to know', especially when we are writing abstract concepts for people to grasp. We all need to remember that translating a medical term into lay terms (cholesterol = 'fats in the blood') is great, but additionally we need to remember what 'fats in the blood' means to the patient. Why is it important the patient is aware of fats in the blood? What does the patient need to associate with keeping fats in the blood down (or up)? Food, exercise, the weather??
 
Personally, I don't pay too much attention to reading level in the end. It's an appropriate tool to demonstrate the importance of having a literacy professional take a look, but, as has been reiterated many times on here, it is simply a tool to help evaluate a product. You don't buy a car based solely on the horse power under the hood, so you shouldn't approve a document based only on the reading level. Tone, nomenclature, (and sometimes) passive sentences, are not reflected in reading level assessments and should be taken into account during evaluation. Graphics, white-space and typeface/fonts are also not accounted for, and should also be considered. 
 
As for egos, I always tell people who write health information well above their audience's reading level "that it would be fantastic if it was written for a journal or a paper". I have a real "reader's ear" for narrative tone, and reading some of our lab's information was like listening to someone who was really embarrassed to talk about fecal sample collection, and the continuing care handbook read more like a contract before I helped them with it. When I send back my drafts of health information that I have edited in Word, they are often covered in "red ink". I always tell people not to take the edits personally, but alas,it's human nature to. 
 
Hope everyone is enjoying Summer,
Nicola
 

Nicola Davies, BA<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />


Health Literacy Specialist

Wellness Centre Coordinator

Consumer Health Information Technician

8 ndavies at dthr.ab.ca

)  (403) 352-7643

* Red Deer Regional Hospital

        3942-50A Ave

        Red Deer, AB

        T4N 4E7
 
-----Original Message-----
From: healthliteracy-bounces at nifl.gov [mailto:healthliteracy-bounces at nifl.gov]On Behalf Of Linda Benn
Sent: Wednesday, August 27, 2008 6:56 AM
To: seubert.douglas at marshfieldclinic.org; healthliteracy at nifl.gov
Subject: [HealthLiteracy 2271] Re: CAUTION in printing out Medlinetutorials!


Hello all!
I have been following the discussion of this group for 6 months now with great interest. I come from a nursing background and started as the Patient Education Coordinator for our facility in February. I have been learning a great deal from this group indeed! 
 
I used Doug's last E-mail about using readability scores as a learning exercise (see attached). Using the online SMOG readability formula, the origional passage scored a grade 21.97 grade level. I then re-worked the passage and took it down to a grade 12.49. A big drop, but still too high. When put into a bullet format and rescored, it is a grade 5.07.
 
Comming from a cardiology background I was concerned that I may alter the content,intent or flavor/essence of the passage by revising it. Does homocysteine, C-reactive protein and fibrinogen really add to the content? Does the patient really need to know these terms? Is it appropriate to exchange "fats in the blood" for the word "chloesterol". I think that as health care providers trying to write for the public, we need to remember who will be reading the material and what they need to know. Sometimes we need to give up some of those exact/precise details and what sounds good to our ear (and ego?) to get the key point across to our readers.    
 
Linda Benn, Patient Education Coordinator
QEII, Capital Health
Rm. # 010, 4B, Centennial Bldg. 
Victoria General Site
1278 Tower Road
Halifax, Nova Scotia
B3H2Y9
(902)473-7835
Linda.Benn at cdha.nshealth.ca
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