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CONSUMER COMPREHENSION of 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 find understand remember use drug information

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CONSUMER COMPREHENSION of EDUCATIONAL MATERIALS: Key Cognitive Principles

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CONSUMER COMPREHENSION

of 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

find

understand

remember

use

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

How much is too much?

Information

Load


LOAD

How much is too much?

Information Cognitive

Load Load


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?

Accuracy

Errors

….

Cognition

&

Actions


FORMAT SELECTION

Basic Strategy

Indications

Warnings

Dosage

Side Effects

….

CONTENT


FORMAT SELECTION

Basic Strategy

Indications

Warnings

Dosage

Side Effects

….

CONTENT


FORMAT SELECTION

Basic Strategy

Indications

Warnings

Dosage

Side Effects

….

CONTENT

Text

List

Outline

….

FORMAT


FORMAT SELECTION

Basic Strategy

Indications

Warnings

Dosage

Side Effects

….

CONTENT

Find

Understand

Text

List

Outline

….

Remember

Use

COGNITIVE

TASK

FORMAT

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


Content

Format


Content

Format

Content


Content

Format

Format 1

Content


Content

Format

Format 1

Content

Format 2


Content

Format

Format 1

Content

Format 2

Format 3


INFORMATION

Physically

present


INFORMATION

Physically

present

Functionally

absent


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