Evaluation of Readability Scores of Discharge Summaries Written by Senior Veterinary Students and Clinical Instructors on a Primary Care Rotation

Health literacy, the ability of patients to understand and make informed decisions regarding health care, is an integral determinant of compliance and satisfaction with care. Readability of patient-oriented materials is a major factor affecting health literacy. As a result, the National Institutes of Health (NIH) and the American Medical Association (AMA) have published recommendations that public-oriented health education materials be written at a maximum of a sixth-grade equivalent reading level. Animal caregivers' health literacy likely has a similarly significant impact on animal care and welfare. Current literature, however, shows that many veterinary education materials are written at higher than recommended levels. Educating veterinary students in the utility and methodology of creating readable medical discharge documents is paramount to addressing this issue. In this study, student-created discharge documents and clinical instructor edits were collected from medical record software at the beginning and conclusion of the clinical year. Discharge documents were categorized by the patient's reason for presentation (wellness, non-wellness, or procedural) as well as whether the recipient had advanced veterinary training. Using a readability calculator, the Flesch-Kincaid (F-K) readability score was reported for each document. Mean readability scores for both groups exceeded the recommended sixth-grade reading level. No significant difference was found between student and instructor scores for all document types at both time points. Wellness documents had the highest mean readability scores, and procedural documents had the lowest. Student scores collectively increased at the second time point, with non-wellness documents exhibiting the largest degree of disparity between the two time points. The recipient's degree of veterinary training did not significantly affect readability scores.