Consumers on panel learn how to evaluate material

Guidelines, experience make the process successful

The three consumers who sit on the material review panel at the Vancouver Coastal Health Authority in Richmond, British Columbia, are given a set of guidelines that helps them determine if the piece is written clearly. However, most of their skills are developed as they serve on the panel.

Each has learned to assume the role of the intended audience. If the intended audience is parents of young babies, children, teen-agers, the elderly, or adults with a specific disease, those on the review panel put themselves in that mindset, says Carol Wilson, RN, an educator with the Education Services of Richmond Health Service Delivery Area of the Vancouver Coastal Health Authority.

"All the consumers on the panel have had health issues themselves so they are able to relate to their past experiences. Also, they all have elderly parents and they all have children. Often they give the pamphlet to someone else in their family to read," says Wilson.

For example, one woman on the panel took a pamphlet written for teen-agers to her 13-year-old son to see if he understood the material.

If the pamphlet is on a topic that the consumers do not understand, they receive a brief lecture before the review process. For example, before they looked at a pamphlet about ostomy care, a nurse explained what an ostomy was because they did not know, says Wilson.

At the beginning of each session, the review panel is told the audience for the pamphlet and at what grade level it is written. For the general population, institutional policy requires that the material be written between grades four and six.

There must be a clear reason as to why the pamphlet was written. If its purpose isn’t clear, the panel asks the writer why they would receive the material.

"They are always asking questions so they will understand the process of the pamphlet. They don’t just take the pamphlet at face value; they want to know how it fits in with the care of a patient," says Wilson.

Review of writing style key

The guidelines the panel uses in the review process prompts them to determine if the information is clear, concise, and makes sense. They also must consider if the words are easy to understand.

The panel keeps lists of standard statements so pamphlets are consistent. For example, drug store is the common term rather than pharmacy, and wound care is used instead of incision care. Also a template of plain language used to describe certain topics, such as pain, is kept so authors aren’t rewriting all the time. "We hang onto things we spent a lot of time on to get it into a plain-language perspective," says Wilson.

Although the panel does not go through each sentence looking for words that have too many syllables, they are aware of the fact that words with three or more syllables are more difficult to understand. Often they flag the word and suggest a term that might be more familiar to the average consumer.

They also look for abbreviations for standard medical procedures that have not first been spelled out. For example, IV is often used rather than intravenous. The panel makes sure that all technical words have been defined as well.

"We often talk about a sentence expressing only one idea so they are sensitive to that and check to see if the author is trying to say too many things in one sentence," says Wilson. For example, when reviewing a pamphlet that had instructions on exercises the patient was to do, the panel pictured themselves doing the exercises based on the information, and most of the sentences were changed to about three words to make it very clear.

Sometimes panel members suggest a graphic or picture to help clarify a point. The health care institution tries to make its pamphlets interactive so if there is a picture of a body part, the doctor can draw on it when explaining surgery, she says.

The review process is a dialogue between the author and the panel so writers understand why a change has been suggested. "It is a consensus. The writer may need to have the information in the pamphlet," says Wilson. However, many times the information is not necessary. For example, medical professionals like to quote statistics, which are generally meaningless to consumers. The consumer panel asks that they use descriptions such as rare, very rare, and most of the time, instead of statistics.

The consumers are paid a $50 honorarium each time they sit on the review panel, which is about four times a year. One has been a panel member for seven years, which is how long the consumer review process has existed. The second has sat on the panel for five years, and the third panelist has been active for more than a year.

The panel has developed its knowledge over the years, yet they are still consumers, says Wilson. "I see them at a little higher level than a focus group because they know what their job is, but at the same time they are still consumers," she says.