CONSUMER COMPREHENSION of EDUCATIONAL MATERIALS: Key Cognitive Principles
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CONSUMER COMPREHENSIONof EDUCATIONAL MATERIALS:
Key Cognitive Principles
Ruth S. Day
Duke University
FDA Drug Safety & Risk Management July 17, 2002
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“COGNITIVE ACCESSIBILITY”
The ease with which
people can
findunderstandrememberuse
drug information
in a safe and effective manner.
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COGNITIVE PRINCIPLES
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COGNITIVE PRINCIPLES
Information Load
Chunking
Coding
Representation
Location
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COGNITIVE PRINCIPLES
Information Load
Chunking
Coding
Representation
Location
ReadabilityComprehensibility
Attention
Cognitive Task
Metacognition
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LOADHow much is too much?
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LOAD
Information Load
How much is too much?
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LOAD
Information Cognitive Load Load
How much is too much?
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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.
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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
~~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~• ~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~
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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
~~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~• ~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~• ~~~~~~~~~~~~~~~~~
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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 supplementsMedical 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
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COGNITIVE TASKS
Read
Free Recall
Recognition
Comprehension --text, pictures
Problem Solving --what do if ?
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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?
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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 ….
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Indications
Warnings
Dosage
Side Effects ….
CO
NTE
NT
FORMAT SELECTIONBasic Strategy
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Indications
Warnings
Dosage
Side Effects ….
CO
NTE
NT
FORMAT SELECTIONBasic Strategy
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Indications
Warnings
Dosage
Side Effects ….
CO
NTE
NT
Tex
t
Li
st
O
utline
…
.
FORMAT
FORMAT SELECTIONBasic Strategy
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Indications
Warnings
Dosage
Side Effects ….
CO
NTE
NT
Use Remember
UnderstandFind
Tex
t
Li
st
O
utline
…
. COGNITIVETASKFORMAT
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.
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Format
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FormatContent
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Format
Content
Content
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Format
Format 1
Content
Content
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Format
Format 1
ContentFormat 2
Content
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Format
Format 1
Content
Format 3
Format 2
Content
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Physically present
INFORMATION
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Physically present
Functionally absent
INFORMATION