1 A Survey of Patient Comprehension of Readily Accessible Online Educational Material Regarding Plastic Surgery Procedures in An Inner City Population
Goals/Purpose:
Healthcare consumers are increasingly turning to the internet for information regarding surgical procedures. The National Institutes of Health (NIH) suggest that health related information be written at a 4th – 6th grade reading level. When an elective procedure is under consideration the internet is often the first resource utilized by a patient. While previous studies have focused on the grade level at which patient education material is written, to the authors’ knowledge no previous study has specifically examined a patient’s comprehension of material. The goal of the present study was to determine the educational background of the population served in an inner city plastic surgery clinic and to determine the population’s comprehension of readily available online educational material.
Methods/Technique:
Institutional review board approval was obtained for the study. Two surveys were constructed, one based on breast augmentation and one based on rhinoplasty. Passages were constructed based on the aforementioned sections of the patient education portions of the American Association of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS) websites. Age, level of high-school completed and 5 questions regarding comprehension of the passage read were assessed in each survey. Each correct answer was awarded 1 point, for a maximum of 5 points. Questions assessed whether the patient understood the indications, the procedure itself, the final result, and potential complications. A final question assessed whether the patient felt like he or she understood the risks and benefits of the procedure. 100 patients were recruited through the clinic at the University Hospital in Newark, NJ and placed into convenience samples of 25 patients each based on website and procedure.
Results/Complications:
100 patients were recruited. The mean age was 38.8. The mean year of high-school completed was 11.7. Across all groups the mean score recorded was 3.41 out of a possible 5. The mean score for the ASPS web site was 3.54 and the mean score for the ASAPS website was 3.28. This difference was not significant. The mean score for the breast augmentation websites was 3.26 and the mean score for the rhinoplasty websites was 3.56. This difference was not significant. When asked if the patient felt like he or she understood the procedure 95% answered yes.
Conclusion:
An examination using two commonly used methods of determining reading level of the ASPS website’s sections on breast augmentation and rhinoplasty revealed an average grade level of 12.54 and 12.94 respectively. Similarly the ASAPS website revealed grade levels of 12.56 and 12.34. These reading levels are much higher than that suggested by the NIH. Our study illustrates several important points. No significant difference in scores was noted between the two websites or between the two procedures. The average grade level completed by an inner-city population was nearly a 12th grade level. Based on the survey results, patients understood the majority of the information presented in the passage. It is unrealistic to expect a patient to answer all questions correctly, although 23% of the participants scored a perfect 5. Of note is that nearly all of the patients felt as though they understood the procedure. Although patient education material is written at too high of a reading level according to the NIH, patients appear to understand the material and are able to subsequently apply this knowledge to an objective measure of comprehension.