Strategies to optimize comprehension of numerical medication instructions: A systematic review and concept map

Sharko, Marianne; Sharma, Mohit; Benda, Natalie C.; Chan, Melissa; Wilsterman, Eric; Liu, Lisa Grossman; Demetres, Michelle; Delgado, Diana; Ancker, Jessica S.

doi:10.1016/j.pec.2022.01.018

Cited by 10 publications

(7 citation statements)

References 45 publications

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“…And yet there have always been indications that people with lower levels of formal education and those who score poorly on literacy assessments can, in fact, act in a literate way -accessing, understanding, and applying health information -when the information is designed for their needs and goals. As one example, medication instructions are followed more accurately when the confusing "2 pills twice daily" is rephrased as "2 pills in the morning and 2 pills at night" [23,24]. Patients can follow health instructions when they are written in plain language and appropriately illustrated, or when they work with providers who receive communication training.…”

Section: Provocation 2: Health Informatics Interventions Target the W...mentioning

confidence: 99%

Provocations for Reimagining Informatics Approaches to Health Equity

2022

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As the informatics community commits to the goal of advancing health equity, it is essential that we openly critique our current approaches and reimagine the ways in which we design, implement, evaluate, and advocate for policies related to informatics interventions. In this paper, we present five provocations as a starting point for building more conscientious informatics practice in service of this goal: 1) Health informatics interventions can create an “illusion of impactful action” without significant material benefits for marginalized patients, families, and communities; 2) Health informatics interventions target the wrong stakeholders, the wrong processes, and the wrong technologies to achieve equity; 3) Informaticians must conceptualize health literacy and other factors shaping patients' experiences as a system-level rather than individual-level characteristic; 4) Informatics interventions wrongly assume that interacting contextual factors can be meaningfully captured by over-simplified structured variables; and 5) Informatics interventions often specify the wrong system boundaries and solution space. We further assert that drastic shifts in our current practices will allow us to honor our claims of valuing patient-centered approaches, especially for marginalized communities.

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Section: Provocation 2: Health Informatics Interventions Target the W...mentioning

confidence: 99%

Provocations for Reimagining Informatics Approaches to Health Equity

2022

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“…[13][14][15][16] Health literacy-informed communication strategies-plain language, pictures or pictograms, teach back, and demonstration with show back-improve communication and comprehension and reduce medication errors and patient harm. 5,[17][18][19][20][21][22] However, clinicians infrequently use these strategies, citing barriers, such as time constraints and competing patient priorities. 15,23 Few studies have evaluated the efficacy of these bundled communication strategies tailored to the unique pediatric inpatient setting.…”

Section: Introductionmentioning

confidence: 99%

“…Health literacy–informed communication strategies—plain language, pictures or pictograms, teach back, and demonstration with show back—improve communication and comprehension and reduce medication errors and patient harm . However, clinicians infrequently use these strategies, citing barriers, such as time constraints and competing patient priorities .…”

Section: Introductionmentioning

confidence: 99%

Health Literacy–Informed Communication to Reduce Discharge Medication Errors in Hospitalized Children

Carroll,

Johnson,

Stassun

et al. 2024

JAMA Netw Open

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ImportanceInadequate communication between caregivers and clinicians at hospital discharge contributes to medication dosing errors in children. Health literacy–informed communication strategies during medication counseling can reduce dosing errors but have not been tested in the pediatric hospital setting.ObjectiveTo test a health literacy–informed communication intervention to decrease liquid medication dosing errors compared with standard counseling in hospitalized children.Design, Setting, and ParticipantsThis parallel, randomized clinical trial was performed from June 22, 2021, to August 20, 2022, at a tertiary care, US children’s hospital. English- and Spanish-speaking caregivers of hospitalized children 6 years or younger prescribed a new, scheduled liquid medication at discharge were included in the analysis.InterventionsPermuted block (n = 4) randomization (1:1) to a health literacy–informed discharge medication communication bundle (n = 99) compared with standard counseling (n = 99). A study team member delivered the intervention consisting of a written, pictogram-based medication instruction sheet, teach back (caregivers state information taught), and demonstration of dosing with show back (caregivers show how they would draw the liquid medication in the syringe).Main Outcome and MeasuresObserved dosing errors, assessed using a caregiver-submitted photograph of their child’s medication-filled syringe and expressed as the percentage difference from the prescribed dose. Secondary outcomes included caregiver-reported medication knowledge. Outcome measurements were blinded to participant group assignment.ResultsAmong 198 caregivers randomized (mean [SD] age, 31.4 [6.5] years; 186 women [93.9%]; 36 [18.2%] Hispanic or Latino and 158 [79.8%] White), the primary outcome was available for 151 (76.3%). The observed mean (SD) percentage dosing error was 1.0% (2.2 percentage points) among the intervention group and 3.3% (5.1 percentage points) among the standard counseling group (absolute difference, 2.3 [95% CI, 1.0-3.6] percentage points; P &lt; .001). Twenty-four of 79 caregivers in the intervention group (30.4%) measured an incorrect dose compared with 39 of 72 (54.2%) in the standard counseling group (P = .003). The intervention enhanced caregiver-reported medication knowledge compared with the standard counseling group for medication dose (71 of 76 [93.4%] vs 55 of 69 [79.7%]; P = .03), duration of administration (65 of 76 [85.5%] vs 49 of 69 [71.0%]; P = .04), and correct reporting of 2 or more medication adverse effects (60 of 76 [78.9%] vs 13 of 69 [18.8%]; P &lt; .001). There were no differences in knowledge of medication name, indication, frequency, or storage.Conclusions and RelevanceA health literacy–informed discharge medication communication bundle reduced home liquid medication administration errors and enhanced caregiver medication knowledge compared with standard counseling. Routine use of these standardized strategies can promote patient safety following hospital discharge.Trial RegistrationClinicalTrials.gov Identifier: NCT05143047

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“…Various methodologies and tools, such as concept maps and reflective diaries, are used to determine the degree of understanding of students. Teachers organize their lessons to improve students' comprehension based on the outcomes of assessments [7,8]. Teachers can modify their instruction and lesson plans so that students attain a satisfactory level of knowledge and ability.…”

Section: Introductionmentioning

confidence: 99%

“…In the classroom, appropriate teaching styles and approaches are also anticipated. After the instructional decision phase, this cycle recommences with the elicitation of student knowledge, followed by the pursuit of curriculum-based learning objectives [7][8][9]. The differences between summative assessment and formative assessment are shown in Figure 2.…”

Section: Introductionmentioning

confidence: 99%

Implementation of Formative Assessment in Engineering Education

Sanchez-Lopez

Kasongo

Gonzalez-Sanchez

et al. 2023

Acta Pedagogia Asia

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Formative assessment is an assessment of student learning that aims to improve students' skills or understanding of certain course themes. Formative evaluations are often conducted in class, can be conducted anonymously, and are typically much more focused on certain abilities or knowledge. This article presents a comprehensive literature analysis on formative assessment in engineering education. As an integrated narrative review, this study's methodology included a systematic search, review, and writing of the literature in order to synthesize the important themes and conclusions of research in this field. The authors selected and reviewed the available literature using qualitative thematic criteria, focusing on the relationship between formative assessment and students' attitudes, FA and self-regulation skills, online formative evaluation, validity, reliability, and dishonesty of assessment, and engagement with critical learning processes. An increase in student involvement and centrality in the process as primary actors, as well as the building of a learning community, are among the cited benefits. According to the primary results, effective online formative assessment can generate a student- and assessment-centered emphasis through formative feedback and enhanced learner engagement with significant learning experiences. In the context of online formative assessment, it has been discovered that ongoing authentic assessment activities and interactive formative feedback are vital for overcoming validity and reliability concerns.

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Strategies to optimize comprehension of numerical medication instructions: A systematic review and concept map

Cited by 10 publications

References 45 publications

Provocations for Reimagining Informatics Approaches to Health Equity

Provocations for Reimagining Informatics Approaches to Health Equity

Health Literacy–Informed Communication to Reduce Discharge Medication Errors in Hospitalized Children

Implementation of Formative Assessment in Engineering Education

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