Understand your audience for more effective copy

Consumer review improves writing skills

Having consumers review new patient education material has greatly improved the writing of health care professionals at the Vancouver Coastal Health Authority in Richmond, British Columbia.

"The way I have set up the review, people who are doing the writing understand how to do the communicating and their writing has improved. The consumers can always tell when it is someone who has never written for us before because of the way it is written," says Carol Wilson, RN, an educator with the Education Services of Richmond Health Service Delivery Area of the Vancouver Coastal Health Authority.

All writers bring their pamphlets to a review panel before the final draft is completed. This panel consists of three consumers, a nurse educator and the librarian. The consumers are people from the community, and they sit on the review panel for as long as they want to participate.

Wilson selects panelists through the contacts that she has in the community. Currently, all three consumer panelists are women, but all have children and elderly parents. One is a native and speaks a foreign language fluently. Those who work do it from their home. This makes it possible for them to attend the review sessions, which are scheduled during the day.

The advantage of having a consistent group is that they learn what they are looking for in the review process. Wilson has used focus groups before, but they really don’t know how to critique the pamphlet, she says.

"When you have a group of people who have come and looked at over 100 different pamphlets, they now know how to put themselves in the place of the consumer who would be receiving this pamphlet," says Wilson. They look at the language, the order of the information, and whether or not the instructions are logical.

Educators rotate through the position every two years to learn how to write for the consumer. A librarian sits on the panel because he or she usually works with writers from the conception of the piece beginning with the literature search. Also, librarians are knowledgeable about proper English and punctuation and have been taught plain language, says Wilson.

During the review process, the consumers sit the closest to the presenters and Wilson sits in back so as not to give the impression she is acting as a mediator. The panel then reviews the materials asking questions and making suggestions. The process increases the writer’s understanding of how to communicate with consumers, she says.

When an anesthetist brought a pamphlet to the committee about having an epidural during labor, it was written at a 16th-grade level. One consumer explained that she had an epidural when having a baby, but she couldn’t understand the material. He then began to explain the process in plain language, and Wilson wrote his comments down. After this encounter, he understood how to write for consumers.

During the review of another pamphlet, a consumer reviewer told a group of nurses that she could not explain the information to her elderly mother because she did not understand. The nurses put down their pens and asked her to tell them how to write the information so that she and her mother would understand.

"That is what I want. I want the professionals to understand how to communicate with their clients easily," says Wilson.

The review panel meets four times each year to review new work. During that time, about three to five projects are reviewed and writers are scheduled to appear before the panel at half-hour intervals.

When this process was first implemented about seven years ago, the review took about an hour for each pamphlet. Now, because most educators have been through the review process, they know how to write for consumers. Wilson rarely gets material written at grade 14 and above anymore.

The consumers who sit on the panel do not go through extensive training. Basically, they are given a set of guidelines for clear and concise copy that they use when looking at a pamphlet. The rest of the training is observation as they sit on their first panel. Also, Wilson spends time with them on a one-to-one basis explaining what is expected of them so that they understand their role. 

Often organizations hire professional writers to create plain language material, but that is a waste of money, says Wilson. "The way I have set the process up here, the people who are doing the writing learn how to communicate," she explains.

The process has been very beneficial. Because written instructions are clear, the health care institution has very few return errors, or clients coming back with problems because they did not understand what it was that they were supposed to do, says Wilson.

Also, pamphlets written in plain English are much easier to translate into another language. When material is written at a high reading level in English, it is too difficult for translators to understand the intent of the message, says Wilson.


For more information about creating a consumer review panel to improve writing among health care professionals, contact:

Carol Wilson, RN, Educator, Education Services, Richmond Health Service Delivery Area, Vancouver Coastal Health Authority, 7000 Westminster Highway, Richmond, BC V6X 1A2, Canada. Telephone: (604) 244-5509, ext. 8. E-mail: Carol_Wilson@RHSS.BC.CA.