Intended for healthcare professionals

Feature Christmas 2017: Language and Literacy

Santa’s little helpers: a novel approach to developing patient information leaflets

BMJ 2017; 359 doi: (Published 13 December 2017) Cite this as: BMJ 2017;359:j5565
  1. Catrin Wigley, foundation year one doctor1,
  2. Vittoria Bucknall, speciality registrar2,
  3. Simon Fleming, speciality registrar3
  1. 1University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
  2. 2Royal Infirmary of Edinburgh, Little France Crescent, EH16 4SA
  3. 3Barts Health Whitechapel, London E1 1BB, UK
  1. Correspondence to: C Wigley catrin.h.wigley{at}

Asking children to design information leaflets may improve patient understanding of surgical procedures, say Catrin Wigley and colleagues

Obtaining valid consent before any intervention is a legal and ethical principle that underpins patient autonomy.1 For consent to be valid, the patient must have received sufficient information and understood the nature and purpose of the procedure.2 Emphasis is placed on providing information in a variety of formats that is comprehensible and free from technical jargon, which the average patient cannot reasonably be expected to understand.3

One solution to increasing patient understanding and capacity for self determination is using patient information leaflets. Time constraints on clinicians and the growing importance of providing patient information have made patient leaflets a popular adjunct to verbal communication, particularly where consent is required.4 Studies have shown that patient satisfaction correlates strongly with the amount of information received.56

But using patient education tools to help patients make informed decisions has its own disadvantages, particularly regarding readability.

Readability is defined as “the ease with which written materials are read” and is crucial in assessing how well a patient resource might be understood.7 Over 40 formulas exist for measuring the readability of text, the most widely used of which is the Simple Measure of Gobbledygook (SMOG).89

The average reading age in the UK is 9 years. 810 This places the UK around 17th worldwide with regard to literacy, lagging behind Australia, Canada, Germany, and the US.1112 …

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