CONSUMER COMPREHENSION of EDUCATIONAL MATERIALS: Key Cognitive Principles Ruth S. Day Duke University FDA Drug Safety & Risk Management July 17, 2002
Jan 02, 2016
CONSUMER COMPREHENSIONof EDUCATIONAL MATERIALS:
Key Cognitive Principles
Ruth S. Day
Duke University
FDA Drug Safety & Risk Management July 17, 2002
“COGNITIVE ACCESSIBILITY”
The ease with which
people can
findunderstandrememberuse
drug
information
in a safe and effective manner.
COGNITIVE PRINCIPLES
COGNITIVE PRINCIPLES
Information Load
Chunking
Coding
Representation
Location
COGNITIVE PRINCIPLES
Information Load
Chunking
Coding
Representation
Location
Readability
Comprehensibility
Attention
Cognitive Task
Metacognition
LOAD
How much is too much?
LOAD
Information Load
How much is too much?
LOAD
Information Cognitive Load Load
How much is too much?
EXAMPLE (Original)
Tell your doctor, nurse, and pharmacist if you …• are allergic to any medicine, either prescription or nonprescription (OTC);• are pregnant or intend to become pregnant while using this medicine• are breast-feeding;• are using any other prescription or nonprescription (OTC) medicine, especially diuretics (water pills) or potassium-containing medicines or supplements;• have any other medical problems, especially heart or blood vessel disease or kidney disease;• are on a strict low-sodium diet or dialysis, or use low-salt milk or salt substitutes;• have had a kidney transplant
Source: Day, R. S. (1999) Optimizing patient comprehension through
medicine information leaflets: Cognition experiments. In A.G. Hartzema, S. Tolleson-Rinehart, B.L. Sleath, and R.S. Day, Optimizing Patien Comprehension through Medicine Leaflets. Rockville, MD: U.S. Pharmacopeia. Pp. 60-176.
EXAMPLE (Original)
Tell your doctor, nurse, and pharmacist if you …• are allergic to any medicine, either prescription or nonprescription (OTC);• are pregnant or intend to become pregnant while using this medicine• are breast-feeding;• are using any other prescription or nonprescription (OTC) medicine, especially diuretics (water pills) or potassium-containing medicines or supplements;• have any other medical problems, especially heart or blood vessel disease or kidney disease;• are on a strict low-sodium diet or dialysis, or use low-salt milk or salt substitutes;• have had a kidney transplant
~~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~• ~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~
EXAMPLE (Original)
Tell your doctor, nurse, and pharmacist if you …• are allergic to any medicine, either prescription or nonprescription (OTC);• are pregnant or intend to become pregnant while using this medicine• are breast-feeding;• are using any other prescription or nonprescription (OTC) medicine, especially diuretics (water pills) or potassium-containing medicines or supplements;• have any other medical problems, especially heart or blood vessel disease or kidney disease;• are on a strict low-sodium diet or dialysis, or use low-salt milk or salt substitutes;• have had a kidney transplant
~~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~• ~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~
EXAMPLE (Revised)Tell your doctor, nurse, and pharmacist if you have:
Allergies to Medicines --prescription medicine --nonprescription medicine (OTC)
Female Circumstances --are pregnant --intend to become pregnant while using this medicine --are breast-feeding
Other Medicines --prescription medicine --nonprescription medicine (OTC) --especially: --diuretics (water pills)
--potassium-containing medicines or supplements
Medical Conditions --any other medical problems --especially: --heart disease --blood vessel disease --kidney disease
--kidney transplant --on dialysis
Diet --on a strict low-sodium diet --use low-salt milk --use salt substitutes
COGNITIVE TASKS
Read
Free Recall
Recognition
Comprehension --text, pictures
Problem Solving --what do if ?
COGNITIVE TASKS
Read
Free Recall
Recognition
Comprehension --text, pictures
Problem Solving --what do if ?
Search & Find
Decision Making --self selection --de-selection
Metacognition --easy/hard? --like it?
COGNITIVE TASKS
Read
Free Recall
Recognition
Comprehension --text, pictures
Problem Solving --what do if ?
Search & Find
Decision Making --self selection --de-selection
Metacognition --easy/hard? --like it?
Cognition&
Actions
Accuracy
Errors
….
Indications
Warnings
Dosage
Side Effects
….
CO
NT
EN
TFORMAT SELECTION
Basic Strategy
Indications
Warnings
Dosage
Side Effects
….
CO
NT
EN
TFORMAT SELECTION
Basic Strategy
Indications
Warnings
Dosage
Side Effects
….
CO
NT
EN
T
Tex
t
List
Out
line
….
FORMAT
FORMAT SELECTIONBasic Strategy
Indications
Warnings
Dosage
Side Effects
….
CO
NT
EN
T
Use Remember
UnderstandFind
Tex
t
List
Out
line
….
COGNIT
IVE
TASKFORMAT
FORMAT SELECTIONBasic Strategy
Source: Adapted from Day, R.S. (1988) Alternative representations.
In G.H. Bower (Ed.), The Psychology of Learning and Motivation, 22, 261-306. New York: Academic Press.
Format
FormatContent
Format
Content
Content
Format
Format 1
Content
Content
Format
Format 1
ContentFormat 2
Content
Format
Format 1
Content
Format 3
Format 2
Content
Physically present
INFORMATION
Physically present
Functionally absent
INFORMATION