Measurement of General Reading Skills and Literacy In Nursing Education

Skills and Literacy In Nursing Education Overview of Tests for General Reading Skills and Health Literacy

In nursing education and healthcare settings, evaluating both general reading skills and health literacy is crucial for ensuring that educational materials are accessible and comprehensible to patients. Several standardized tests are used for this purpose, including:

1. Wide Range Achievement Test (WRAT)
2. Rapid Estimate of Adult Literacy in Medicine (REALM)
3. Test of Functional Health Literacy in Adults (TOFHLA)
4. Newest Vital Sign (NVS)
5. eHealth Literacy Scale (eHEALS)
6. Literacy Assessment for Diabetes (LAD)
7. Suitability Assessment of Materials (SAM)

WRAT (Wide Range Achievement Test)

The WRAT is a tool used primarily to assess word recognition and pronunciation abilities, which are essential for understanding written material.

Key Aspects of WRAT:

1. Purpose: Measures the ability to recognize and pronounce words out of context. It provides a quick assessment of reading skills by focusing on word recognition.
2. Administration: The test consists of a graduated list of 42 words, starting with simpler words and progressing to more complex ones. The individual is asked to pronounce the words, and the test is stopped after five consecutive mispronunciations.
3. Scoring: The number of correctly pronounced words is recorded, and the raw score is used to determine the equivalent grade level.
4. Time: The WRAT is quick to administer, taking approximately 5 minutes.
5. Limitations: It only assesses word recognition and does not evaluate other reading skills such as vocabulary or text comprehension. It is also limited to English-speaking individuals and is not suitable for assessing reading comprehension.

Grading of WRAT Test: The raw score is compared to a table of grade ratings to determine the reader’s grade level.

REALM (Rapid Estimate of Adult Literacy in Medicine)

The REALM test is specifically designed to assess a patient’s ability to read medical and health-related vocabulary, making it a valuable tool in healthcare settings.

Key Aspects of REALM:

1. Purpose: Measures the ability to read and pronounce medical terms, which is crucial for understanding health-related instructions.
2. Administration: Patients read aloud from three lists of medical words. The test includes 66 words, starting with simpler ones and progressing to more complex terms. There is no time limit for the test.
3. Scoring: Words are marked as correctly pronounced or skipped. The total number of correctly pronounced words is used to determine the raw score, which is then converted into a grade level.
4. Time: The test is quick to administer, and the REALM-R (a revised, shorter version) takes less than 2 minutes.
5. Limitations: The REALM offers less precision compared to other tests and is less effective for assessing comprehensive reading skills. It is also more suitable for individuals with at least a sixth-grade reading level.

REALM-R and REALM-SF: Shorter versions of the original REALM, designed for quicker screening. REALM-R contains 8 items, while REALM-SF has 7 items, and both correlate well with the original test.

TOFHLA (Test of Functional Health Literacy in Adults)

TOFHLA is a comprehensive tool that assesses both reading comprehension and numeracy skills, focusing on functional health literacy.

Key Aspects of TOFHLA:

1. Purpose: Evaluates the ability to understand and use health-related information, including reading comprehension and numerical calculations.
2. Administration: Includes two sections: reading comprehension and numeracy. The reading section assesses comprehension of health-related passages, while the numeracy section involves interpreting numerical information.
3. Scoring: Scores are based on the number of correct responses in both sections, providing a measure of functional health literacy.
4. Time: Takes approximately 22 minutes to complete.
5. Limitations: Requires more time to administer compared to other tests and may be less practical for quick assessments in clinical settings.

NVS (Newest Vital Sign)

The NVS is a brief assessment tool used to measure health literacy through a combination of reading comprehension and numeracy tasks.

Key Aspects of NVS:

1. Purpose: Assesses the ability to understand and use health information, with a focus on numeracy and comprehension.
2. Administration: Consists of a single page with a nutritional label and six questions related to it. The questions assess the ability to interpret the label and apply the information.
3. Scoring: Scores are based on the number of correct responses, with a total of 6 points possible.
4. Time: The test takes approximately 3 minutes to complete.
5. Limitations: The NVS may not provide a comprehensive assessment of all aspects of health literacy and may be less effective for evaluating complex health information.

eHealth Literacy Scale (eHEALS)

The eHEALS measures an individual’s comfort and confidence in using the Internet to obtain health information.

Key Aspects of eHEALS:

1. Purpose: Assesses the ability to find, understand, and apply health information from online sources.
2. Administration: Consists of 8 items rated on a scale of 1 to 5, with higher scores indicating greater eHealth literacy.
3. Scoring: Scores are calculated by summing the responses, with higher scores reflecting better eHealth literacy.
4. Time: Takes a few minutes to complete.
5. Limitations: Focuses on online health information and may not fully capture overall health literacy.

Literacy Assessment for Diabetes (LAD)

The LAD is tailored specifically for patients with diabetes and assesses their ability to understand diabetes-related information.

Key Aspects of LAD:

1. Purpose: Measures literacy skills in the context of diabetes management.
2. Administration: Includes tasks related to diabetes education materials, such as reading and interpreting information about diabetes care.
3. Scoring: Based on the accuracy of responses to diabetes-related questions.
4. Time: Varies depending on the complexity of the tasks.
5. Limitations: Specific to diabetes and may not be applicable for general health literacy assessments.

Suitability Assessment of Materials (SAM)

The SAM evaluates how well instructional materials are presented to clients, focusing on factors such as clarity, layout, and design.

Key Aspects of SAM:

1. Purpose: Assesses the appropriateness and effectiveness of educational materials for the target audience.
2. Administration: Involves reviewing materials based on criteria such as readability, visual appeal, and content relevance.
3. Scoring: Materials are rated on various criteria to determine their suitability.
4. Time: Time required varies based on the number of materials assessed.
5. Limitations: The SAM assesses materials rather than individuals and may not provide direct measures of literacy skills.

Conclusion

Understanding and measuring general reading and health literacy skills are crucial in nursing education and patient care. The WRAT, REALM, TOFHLA, NVS, eHEALS, LAD, and SAM are valuable tools for assessing these skills, each with its strengths and limitations. Using these tests helps ensure that educational materials are suitable for the intended audience and that patients can effectively understand and use health information.