The Importance of Readability in Medical Literature and My Year Long Journey Immersed in The Scientific Method

By: Kimberly Menezes

Readability and the scientific method are two terms that I was asked to explain during my interview for an internship with Dr. Deepak Nair in Sarasota, Florida. After I defined both words, Dr. Nair expanded on each of my definitions for another 10 minutes. His last intern had started to ask questions about the readability of medical websites. He asked me to apply the scientific method to this topic and come up with a research proposal. Over the following weeks, I constructed a hypothesis (the readability of web sites on non-surgical approaches to varicose veins was not appropriate for the general population), developed methods, and began recording results. I did this while additionally gaining exposure to patients with arterial and venous diseases.

The foundation of Dr. Nair’s long-standing internship program finds its roots in the scientific method. ‘The scientific method is a process to explore observations and answer questions in daily life, not just in research,’ he touts to his interns. When developing our hypothesis, I learned that I was putting forth my best guess based on what I knew, and not trying to prove or disprove a theory. This helped to ease my mind, as I had perceived medical research to be much more intense. We went over the data, analyzed the results, and drew conclusions. Once we demonstrated that our hypothesis was correct, we submitted our results to the American Venous Forum for presentation. The acceptance letter was one of the highlights of my 4 years in high school.

The American Venous Forum in New Orleans provided the podium for conveying our message about readability to the medical community. We found that the grade-level of what patients in the United States read on the Internet about varicose veins was greater than that of a freshman in college. In comparison, The New York Times has an 8th grade reading level; Time magazine has a 7th grade reading level; and Readers Digest has a 6th grade reading level. Popular websites tend to have lower readability scores. Patients should have access to content that is at least high school level, but ideally between 6th and 8th grade. This will not only improve the informed consent process, but should allow for more efficient office visits. A general rule of thumb is to have shorter sentences (average sentence length=the number of words divided by the number of sentences) and shorter words (less syllables per word). Though we used two complex formulas (Flesch Kincaid and Gunning Fog Reading Indices), we have demonstrated a simpler automated method below for use in Microsoft Word:

 

  1. Click the File tab, and then click Options.
  2. Click Proofing.
  3. Under When correcting spelling and grammar in Word, make sure Check grammar with spelling and Show readability statistics are selected.
  4. Click OK.

Once you setup this feature, here’s how to get your readability score for a given document.

  1. Go to the Review tab and click Spelling and Grammar.
  2. When Word finishes checking the spelling and grammar of your document, it displays the readability score along with other information (Figure 1).

Figure 1

The data in the figure are reflective of this article.

I hope that our work encourages others to make their websites and brochures more readable. I also hope more physicians open their practices to high school students and provide them with exposure and mentorship in the field of medicine.

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