Readability of postoperative discharge instructions is associated with complication rate in companion animals undergoing sterilisation

• Published in: Veterinary record 2024-03, Vol.194 (5), p.no-no
• Main Authors: Biancaniello, Christopher M., Rolph, Kerry E., Cavanaugh, Sarah M., Karnik, Priti, Peda, Andrea, Cavanaugh, Ryan P.
• Format: Article
• Language: English
• Subjects: complications; comprehension; education; Flesch–Kincaid; Readability
• ISSN: 0042-4900; 2042-7670
• DOI: 10.1002/vetr.3796

Background Readability of client communications is a commonly overlooked topic in veterinary medical education. In human medicine, it has been advised that the readability of patient materials should be at USA schooling sixth‐grade level or below. We hypothesised that student written discharge instructions would be of an inappropriate readability level, and discharges scored with higher reading grade levels would be associated with more complications. Methods The cohort comprised 149 dogs and cats presenting for sterilisation. The readability of discharge instructions was assessed using the Flesch Reading Ease (FRE) and Flesch–Kincaid Grade Level (FKGL) formulas. Records were examined for evidence of postoperative complications. Results The mean FRE score of the discharge instructions was 61.97, with 30.87% being classified as ‘difficult’ or ‘fairly difficult’, 60.4% as ‘standard’ and 8.72% as ‘fairly easy’. The mean FKGL was 8.64, with 98% being above reading level 6. Overall, there was an association between FKGL and complication occurrence (p = 0.005). Stratification by species demonstrated FRE and FKGL to be associated with complication occurrence in dogs (FRE score, p = 0.038; FKGL, p = 0.002), but not cats (FRE score, p = 0.964; FKGL, p = 0.679). Limitations Due to the retrospective nature of the study, there were difficulties associated with extracting relevant complication information from the medical records. Conclusion Only 2% of owner‐directed discharge instructions were written at readability levels aligning with the recommendations set forth in the human guidelines.