Effectiveness of Printed Educational Material in Nursing Printed educational materials (PEMs) are a vital tool for patient education in nursing. Their effectiveness depends on clarity, ease of understanding, and relevance to the audience. Many patients struggle with reading and comprehension, making it essential for nursing educators to develop materials that can be easily understood by a diverse population. This document provides a comprehensive guide on how to create and evaluate PEMs that are effective for nursing education.

Effectiveness of Printed Educational Material

The first consideration in developing effective printed educational material is ensuring that the content meets the needs of the target audience. Effective reasoning and clear linking between ideas are key components of readability and comprehension.

Effective Reasoning and Linking:

• One critical aspect of effective material is to establish a logical flow of ideas. Readers should easily follow the reasoning behind the information presented. For example, a clear explanation might be: “If you sunburn easily and have fair skin with red or blonde hair, you are more likely to get skin cancer. How much time you spend in the sun also affects your risk of skin cancer.”
• This sentence structure links related concepts (skin type and sun exposure) to explain the risk of skin cancer clearly and effectively. When nursing educators develop PEMs, they should ensure that each section flows naturally into the next, reducing confusion and enhancing understanding.

Avoid Rare Vocabulary Words

Another crucial factor in ensuring the effectiveness of PEMs is the language used. It is essential to use common words that are familiar to the target audience, avoiding rare or complex vocabulary that may confuse the reader.

• Use Common Words: Rely on high-frequency words, also known as sight words, that are recognized by almost everyone. For instance, use “shot” instead of “injection,” “doctor” instead of “physician,” and “use” instead of “utilize.” These simpler words are easier for patients with varying literacy levels to understand.
• Avoid Complex Words: Compound words, such as “lifesaver,” and words with prefixes or suffixes, such as “reoccur” or “emptying,” should be avoided, as they create longer words that can challenge readers with lower literacy skills. Similarly, technical words and medical terms should be replaced with lay language. For instance, use “stroke” instead of “cerebrovascular accident.”
• Careful Word Selection: While simplifying the language, it is important to select words carefully to avoid confusion. For example, using “drug” instead of “medicine” may lead readers to think of illegal drugs. Always choose the most appropriate terms to convey the intended message.

Avoid Use of Abbreviations

Many people, especially those with lower literacy levels, struggle with abbreviations and acronyms. This includes not only medical terms but also commonly abbreviated words like the months of the year or the days of the week.

• Spell Out Words: Avoid abbreviations such as “i.e.” or “e.g.” Instead, use “that is” or “for example” to make the material clearer. When medical acronyms like “CVA” or “NPO” must be used, they should be defined clearly and early in the material. For instance, “CVA (stroke)” or “NPO (nothing by mouth)” ensures the reader understands the term.
• Limit Numbers: Use numbers sparingly, and only when necessary. For instance, statistics are often confusing and do not provide meaningful information for low-literacy readers. Lists should be kept short, containing no more than seven items, as people generally have a hard time recalling more than seven consecutive points.

Easy Formulation of Sentences

The structure of sentences is just as important as the words used. Long, complex sentences are difficult to follow, particularly for individuals with low literacy skills.

• Short Sentences: Sentences should generally be no longer than 20 words, though fewer is often better. Shorter sentences are easier for clients with short-term memory challenges or reading difficulties to process. For example, instead of writing, “The medicine should be taken twice a day, one in the morning and one in the evening, with food,” simplify it to, “Take the medicine twice a day, with food: once in the morning and once in the evening.”
• Avoid Complex Punctuation: Commas, colons, or dashes should be used sparingly, as they create longer, more complicated sentences that can be challenging for the reader. Titles and headings should be short and convey the purpose of the section that follows.

Avoid Use of Unfamiliar or Technical Words

Technical jargon and medical terminology can confuse readers, even those who are generally well-educated.

• Provide Definitions: When using technical terms or unfamiliar words, define them clearly within the text. For example, “bacteria (germ)” or “Alzheimer’s (pronounced Alt-hi-merz)” helps demystify the term and allows readers to understand the material better.
• Glossary and Repetition: A glossary can be helpful, but it is preferable to define terms directly in the text. Repeating key terms throughout the material also helps reinforce understanding.

Avoid Multiple Vocabulary of Synonyms

Consistency in word choice throughout the text helps prevent confusion.

• Consistent Terminology: Avoid switching between synonyms that may confuse readers. For instance, if the material begins by discussing “diet,” the term “diet” should be used consistently throughout, rather than replacing it with words like “meal plan” or “menu.”

Avoid Being Judgmental

It is crucial to avoid value-laden language that may be interpreted in different ways by different readers.

• Avoid Subjective Terms: Words like “excessive,” “regularly,” or “frequently” can be interpreted differently by each reader. Instead, use precise terms that define quantity and frequency. For example, rather than saying, “Drink milk frequently,” say, “Drink three full glasses of milk every day.” This specific instruction is more actionable and clearer to the reader.

Prioritizing and Making Hierarchy

The organization of information within PEMs is essential for clarity and comprehension.

• Prioritize Key Information: Put the most important information first. Nursing educators should focus on providing “need-to-know” information upfront, as this is more likely to be retained by the reader. Unnecessary details or less critical information should be omitted or placed toward the end of the material. By reducing cognitive load, educators can help ensure that essential messages are not lost in a sea of extraneous content.

Presentation of Written Materials

Proper formatting and organization of content can improve readability and make the material more appealing to the reader.

• Use Headings and Subheadings: Advance organizers, such as topic headings and subheadings, provide readers with a roadmap of the content. This organizational tool helps readers quickly locate specific information and makes the material easier to navigate.
• Bullet Points: Bulleted lists can also help break down complex ideas into smaller, digestible pieces, making it easier for readers to follow along.

Avoid Use of Conjunctions

Connecting words often make sentences more complex and harder to understand.

• Limit Conjunctions: Avoid using conjunctions like “however,” “consequently,” or “in spite of,” which may create longer and more difficult sentences. For example, instead of writing, “You may feel dizzy; however, this side effect will go away,” split the sentence into two: “You may feel dizzy. This side effect will go away.” This restructuring makes the information more accessible.

Title and Topic Presentation

The way a topic is presented can significantly impact the reader’s ability to understand and engage with the material.

• Use Clear Topic Sentences: Begin each paragraph with a topic sentence that summarizes the main idea. If possible, use the topic as the first word in the sentence. This makes it easier for the reader to follow along and comprehend the material. For instance, instead of writing, “Many people with fair skin get sunburned easily and are at risk for skin cancer due to sun exposure,” you could write, “If you have fair skin, you are more likely to get skin cancer. Spending time in the sun increases your risk.”

Conclusion

By following these guidelines, nursing educators can significantly improve the effectiveness of printed educational materials. The key is to use simple, familiar language; present the most important information first; and ensure the material is structured in a way that is easy to follow. Printed educational materials play a critical role in patient education, and by adhering to these strategies, educators can better support patients in understanding and applying health-related information.