A Prescription for Clearer Medical Communication

21 June, 2019

When you’re writing or editing for healthcare professionals, there’s no need to worry about fancy things such as “readability” – they’re professionals, so they’ll understand it, right?

Ask a pharmacist if readability matters. They get hand-scrawled prescriptions from MDs every day. Of course they know what Synthroid 150 µg means and can dispense it appropriately. Too bad the doctor actually prescribed Rythmol 150 mg – but wrote it messily. (That’s a real case, and that sort of error happens often.)

Bad writing – stiff, convoluted, inconsistent – can get in the way of communication just as bad handwriting can. Healthcare professionals take in a lot of information and must make important decisions based on it. Anything that increases the effort of taking in that information increases the likelihood of errors.

The general style, structure, and vocabulary of medical and other science information are well known for their insistent use of such distancing and complexifying features and passive voice, preference for nouns and prepositions over verbs, and inclination to longer and less frequently used words over commoner ones – similarly, for example, to the present sentence of which you are now completing the reading. Writers seem to think that complex information should be matched with complex grammar and complex words. But the energy your readers put into parsing the prose is energy they don’t have for assimilating the information.

It’s what’s called cognitive load. There are three kinds of cognitive load in reading:

• Intrinsic load is how much there is to learn and figure out from the information. Understanding the Krebs cycle (or how to assemble a motorcycle) has much more intrinsic load than dissolving sodium chloride in water (or filling a gas tank).
• Extrinsic load is how much extra effort the material requires to understand. Scrawled handwriting imposes more extrinsic load than neat typing. Text loaded with spelling erors and inconsistencies of formatting imposes more extrinsic load than clean, tidy text. Awkward and convoluted sentences impose more extrinsic load than clear and straightforward ones – especially if you have to read them several times to figure them out.
• Germane load is the work you, the reader, do to assimilate the information into what you already have mapped in your mind. In other words, it’s the actual learning.

You don’t want a doctor or nurse to have trouble understanding life-and-death information. You also don’t want a regulator or journal editor to have a hard time understanding the value of the facts you’re presenting. If your article or product is rejected, no one will get the benefit of it!

Here are some things you can do to make sure that your readers receive your information accurately and usefully, with no unnecessary cognitive load.

Write a Good Abstract or Summary

Healthcare professionals are busy people who have specific problems to solve, and they want to know the action items. Even if you’re giving them continuing education lessons, they’re going to want to know what they’ll be tested on or what they’ll run into in the real world. So tell them, briefly and clearly. Use direct language that answers the question “What am I supposed to do about this?” If they need to know more detail, they’ll look for it in the body of the article.

Make the Key Details Findable

Your readers may read through what you write word for word. If so, great! But they may also be scanning to find specific details. Help them. Make key information stand out – you may be able to use headings or bolding. Handle numbers clearly: use numerals so they don’t get lost on the page, and be correct and consistent with measurement abbreviations. Even for people who read every word, making the key details stand out will help them remember.

Pay Attention to Your Tables and Figures

Tables and figures stand out and, if handled well, offer up information in highly usable ways. If handled well. Unnecessary visual clutter, such as bold dividing lines in a table or too many black grid lines on a chart, gets in the way of the facts, as does careless handling of X and Y axis data or putting several kinds of information in the same column of a table. Get to know the work of Edward Tufte, who has written several books that lay out good principles of conveying information visually.

Don’t Make Language Stiffer Than You Have To

Depending on the context, a certain formality may be required. Some journals insist on the passive voice in the apparent belief that dehumanizing the text makes it more factual. (Healthcare is all about humans; why erasing the central actors would increase fact value is a whole other subject for debate.) But you can still spend a bit of time on your phrasing to make sure that your sentences go from A to B without circling past V and W on the way. You can stop and ask yourself whether you are using more words than necessary, and whether you can change, for example, “titration of the dosage was performed” to “the dosage was titrated” or even “the researchers titrated the dosage.”

Don’t Be Sloppy

Messy spelling and messy punctuation get in the way of reading and understanding. But so does using several variant names for the same thing. Be clean and be consistent. Don’t make your readers do your tidying up for you in their heads. As Professors Andrew Carter and Laura A. Webb found in regard to legal writing, even small mistakes affect comprehension. To help your readers follow your logic, Professor Webb suggests zealously editing for “missing punctuation, grammar oversights, awkward syntax, and semantic inconsistencies.” And given the similar complexity, the same doubtlessly applies to medical writing. You don’t want to spell public consultation without the first L. And you don’t want to “mange” a condition. Spellcheckers won’t find mistakes like these, but PerfectIt will.

Manage Your Own Cognitive Load

You’ll do a better job of managing clarity and effectiveness if you’re not weighed down with unnecessary extra burden. Attempting to find and correct small typos and inconsistencies while you simultaneously check meaning and coherence inevitably means you don’t do either of them as well as you could. A better way to ensure your writing is clear and easy to understand is to use PerfectIt for checking consistency. PerfectIt checks for consistency in spelling, punctuation, and handling of abbreviations and numbers. It frees up your cognitive load so you can make sure your text is readable and easy for decision-makers and healthcare professionals. Click to download a free trial of PerfectIt.