Getting the reader to engage, ask and act
A patient material can get its reader to engage with it, to ask the questions they would otherwise hold back, and to act: through interactive devices on the page, questions that teach rather than test, and scripts for situations the reader has to navigate.
Interactive devices on the page
Readers are encouraged to read further when they interact with the text. The interaction can be a question and answer that lets readers feel satisfied that they "got it", or a simple review of the key point. Inviting the reader to respond by writing in a blank space can be an effective form of interaction, and a visual aid is an especially effective way to help readers confirm their understanding of a section they have just read. Testimonials from people who have successfully followed the advice can be added to foster the reader's self-efficacy, the belief that "I could do this".
Permission to ask
A material can also make it easy for patients to ask questions of their doctors. Each culture has its own logic about health, and many racial and ethnic groups believe that the doctor knows best, and such an authority figure is seldom questioned, even when a patient thinks the doctor has misunderstood them. One way to make asking easy is to model the questions after the AskMe3 initiative, developed by the Partnership for Clear Health Communication at the National Patient Safety Foundation to promote better patient-clinician communication. AskMe3 encourages patients to understand the answers to three questions: What is my main problem? What do I need to do? Why is it important for me to do this? Another approach is a visual of a patient asking questions of a smiling doctor or nurse, which shows the reader that it is acceptable to ask questions.
Questions that teach rather than test
Interactive questions can be used to facilitate learning while giving corrective and reinforcing feedback. A question should be about the most important point of the preceding section. That point could be a concept that later sections expand on and that the patient may need in order to understand what comes later, or it could concern how the patient can practise self-care at home, prevent medication errors, identify a complication or know when to contact their healthcare provider. A question should be written so that it applies to a wide variety of patients in different healthcare settings. Questions should ask how patients can help themselves and improve their health or quality of life, and testing patients on terminology is not always critical to understanding the main concepts.
Clear and simple questions increase the likelihood that the patient will retain correct information later on. Questions should not test the patient on concepts the lesson did not explain, trick questions can undermine patient confidence, and being able to answer a question correctly increases patient satisfaction. When a patient answers incorrectly, the feedback should explain the correct answer and give the patient a hint.
Common misconceptions should be question topics wherever possible. During the informed consent process, for example, patients who read about the many potential complications of a procedure may conclude that the risk of complications is high. Where the clinical evidence applies, the rarity of complications needs emphasising after the risks are listed, by asking a question that confirms that rarity. Confirming that the risk is nonetheless a possibility helps mitigate liability.
Scripts for medical and interpersonal situations
To help readers navigate common medical and interpersonal situations, a material can present common scenarios with potential talking points or scripts for the reader.