Tijdschrift voor Taalbeheersing - Volume 47, Issue 3, 2025

Revising and revisability – a study of re-designed patient information leaflets

A large hospital decided to improve the usability of its patient information leaflets. Using 16 pairs of original and revised leaflets, this study (the first of its kind) shows how the revisions affected various aspects of usability. The texts are evaluated via a text quality checklist containing 49 criteria concerning text content, structure, wording, visual appearance of the text, and use of images. Half of the criteria had been used by the revising text professionals; other items were added by the researchers to better cover the text quality construct. In the checklist analysis process we noticed many text problems were initially observed by only one of the two assessors, and were agreed upon in subsequent discussion.

Overall, the texts showed improvement, but criteria differed vastly in progress rate. Some criteria were never problematic, neither in the original nor in the revised texts. Others clearly showed improvements. And some criteria remained problematic, especially ones regarding text content and text structure. No difference was found between the criteria already used by the revisors and those added by the researchers. For text content, structure and wording criteria, we found that relatively lower starting levels go hand in hand with lower end levels, suggesting low revisability. This pattern was not observed for visual appearance criteria, which showed almost perfect end levels.

We offer two explanations for why revising is sometimes hard. First, comprehension problems tend to be forgotten by readers once they are solved. Second, some text quality criteria require highly subtle, context-dependent assessments. These factors complicate both the work of revisors and that of revision researchers. Nevertheless, our checklist can be useful for practitioners, when used to conduct text quality discussions among colleagues.