Simplicity and Readability of Patient Educational Materials (PEM): Occam’s Principle

By Jacqueline Nkrumah, October 11, 2024

Occam’s razor is a principle of reasoning employed in a collection of scientific and philosophical arguments [1]. The principle is attributed to William Occam, a 13th-century Franciscan monk [2]. Occam’s principle is related to learning and advocates for simplicity and necessity in scientific arguments. The principle is that an assumption should not be included in an opinion if it is not required for the explanations [1]. The concept has been applied metaphorically to examine a phenomenon and cut through an issue to remove parts that are superfluous and do not add to the explanation of the phenomenon. Simplifying PEM to improve readability and understanding is congruent with Occam’s principle of simplicity.  Clarity and simplicity are essential to the readability of PEM [3]. The basic elements that make a text difficult to read are the syntactic complexity and the lexical difficulty [4,5,6]. Another essential factor of readability is ensuring minimum redundancy in text development.

Simplicity is essential in communicating PEM to audiences from varied backgrounds. Simplicity in this context refers to the ease of vocabulary used in the text. The level of vocabulary difficulty of the PEM may relate to the language used or the cognitive skills of the target audiences. Also, health information has context-specific language, which may not align with the readers’ vocabulary knowledge. Thus, readers may likely be unable to connect the vocabulary of PEM to their existing knowledge for reading and comprehension. Syntactic complexity, which refers to sentence length and textual cohesion [7], may be another aspect that can cause reading difficulties. It is argued that shorter sentences are essential to text readability and comprehensibility [8]. Presenting patient information in longer sentences contradicts the chunking principle espoused by cognitive learning theories [9]. PEMs may be segmented, yet, their text may have multiple unfamiliar and polysyllabic words, which are attributes of a difficult text.

Occam’s principle of simplicity works in tandem with necessity, which is an essential aspect of text readability and cognitive load management. The redundancy principle of the cognitive learning theory advocates for the elimination of elements that do not contribute to the meaning of a passage from a text to free up cognitive space for germane processing [9]. Although it is unknown whether PEMs in Ghana are saddled with unnecessary repetition, texts that have technical words and sentences may affect their overall readability and comprehension. It is worth mentioning that the PEMs mostly provide education on disease conditions and management and the use of technical words may be necessary. However, maintaining a balance between Occam’s principles of simplicity, necessity, and context may be critical.

References

  1. Braithwaite JJ. Occam’s razor: The principle of parsimony. Academia. edu. 2007.
  2. Pretorius EJ. Issues of complexity in reading: Putting Occam’s razor aside for now. Southern African Linguistics and Applied Language Studies. 2010 Dec 1;28(4):339-56.
  3. Gilliver S. Plain language and readability. Medical Writing. 2015 Mar 1;24(1):1-2.
  4. Pitler E, Nenkova A. Revisiting readability: A unified framework for predicting text quality. In Proceedings of the 2008 conference on empirical methods in natural language processing 2008 Oct (pp. 186-195).
  5. Frantz RS, Starr LE, Bailey AL. Syntactic complexity as an aspect of text complexity. Educational Researcher. 2015 Oct;44(7):387-93.
  6. Crossley SA, Skalicky S, Dascalu M. Moving beyond classic readability formulas: New methods and new models. Journal of Research in Reading. 2019 Nov;42(3-4):541-61.
  7. McNamara DS, Louwerse MM, Graesser AC. Coh-Metrix: Automated cohesion and coherence scores to predict text readability and facilitate comprehension. Technical report, Institute for Intelligent Systems, University of Memphis, Memphis, TN; 2002 Sep.
  8. Agency for Healthcare Research and Quality. The Patient Education Materials Assessment Tool (PEMAT) and User’s Guide. 2013.
  9. Mayer RE. Multimedia learning. In Psychology of learning and motivation 2002 Jan 1 (Vol. 41, pp. 85-139). Academic Press.

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