Optimizing Readability of Patient-Facing Hand Surgery Education Materials Using Chat Generative Pretrained Transformer (ChatGPT) 3.5.

PURPOSE: To address patient health literacy, the American Medical Association and the National Institutes of Health recommend that readability of patient education materials should not exceed an eighth grade reading level. However, patient-facing materials often remain above the recommended average reading level. Current online calculators provide readability scores; however, they lack the ability to provide text-specific feedback, which may streamline the process of simplifying patient materials. The purpose of this study was to evaluate Chat Generative Pretrained Transformer (ChatGPT) 3.5 as a tool for optimizing patient-facing hand surgery education materials through reading level analysis and simplification. METHODS: The readability of 18 patient-facing hand surgery education materials was compared by a traditional online calculator for reading level and ChatGPT 3.5. The original excerpts were then entered into ChatGPT 3.5 and simplified by the artificial intelligence tool. The simplified excerpts were scored by the same calculators. RESULTS: The readability scores for the original excerpts from the online calculator and ChatGPT 3.5 were similar. The simplified excerpts' scores were lower than the originals, with a mean of 7.28, less than the maximum recommended 8. CONCLUSIONS: The use of ChatGPT 3.5 for the purpose of simplification and readability analysis of patient-facing hand surgery materials is efficient and may help facilitate the conveyance of important health information. ChatGPT 3.5 rendered readability scores comparable with traditional readability calculators, in addition to excerpt-specific feedback. It was also able to simplify materials to the recommended grade levels. CLINICAL RELEVANCE: By confirming ChatGPT3.5's ability to assess and simplify patient education materials, this study offers a practical solution for potentially improving patient comprehension, engagement, and health outcomes in clinical settings.

[Digital educational materials on culinary skills as a health promotion strategy in Primary Health Care]. / Materiais educativos digitais sobre habilidades culinárias como estratégia de promoção de saúde na Atenção Primária.

This study aims to report on the development and validation of digital educational materials based on the dimensions of home cooking skills (HCS) assessed on a scale destined for PHC professionals, following the recommendations of The Dietary Guidelines for the Brazilian Population and on The Food and Nutrition Education Framework (FNE) for Public Policies. Five videos and graphic materials were developed with proposals for activities to develop HCS and encourage its implementation in actions and guidelines in the community and in professional care. The content of the materials was evaluated by experts using the Two-Round Delphi-based technique and statistical analyses for evidence of consensus. Specialists presented comments to improve the products and their applicability. The materials presented decoded language and playful illustrations with characters representative of the target population. Evidence of satisfactory content validity was presented and can be used in permanent education actions, seeking the qualification of the workforce and in FNE actions within the scope of the law. The graphic materials make it possible to associate the content of the videos with practice in contexts consistent with the reality of the individuals.

Este estudo visa reportar desenvolvimento e validação de materiais educativos digitais baseados nas dimensões de habilidades culinárias domésticas (HCD) avaliadas por escala destinada aos profissionais da APS, nas recomendações do Guia Alimentar Para a População Brasileira e no Marco de Educação Alimentar e Nutricional (EAN) para Políticas Públicas. Foram desenvolvidos 5 vídeos e materiais gráficos com propostas de atividades para desenvolvimento de HCD e estímulo à sua implementação em ações e orientações junto à comunidade e em atendimentos profissionais. O conteúdo dos materiais foi avaliado por especialistas utilizando técnica Delphi de 2 rounds e análises estatísticas para evidência de consenso. Especialistas proferiram comentários para aprimoramento dos produtos e sua aplicabilidade. Os materiais apresentaram linguagem decodificada, ilustrações lúdicas, com personagens representativos da população-alvo. Apresentaram evidência de validade de conteúdo satisfatória e podem ser utilizados em ações de educação permanente, visando a qualificação da força de trabalho, e em ações de EAN junto aos sujeitos de direito. Os materiais gráficos possibilitam associar o conteúdo dos vídeos à prática, em contextos condizentes com a realidade dos sujeitos.

The Use of Artificial Intelligence to Improve Readability of Otolaryngology Patient Education Materials.

OBJECTIVE: The recommended readability of health education materials is at the sixth-grade level. Artificial intelligence (AI) large language models such as the newly released ChatGPT4 might facilitate the conversion of patient-education materials at scale. We sought to ascertain whether online otolaryngology education materials meet recommended reading levels and whether ChatGPT4 could rewrite these materials to the sixth-grade level. We also wished to ensure that converted materials were accurate and retained sufficient content. METHODS: Seventy-one articles from patient educational materials published online by the American Academy of Otolaryngology-Head and Neck Surgery were selected. Articles were entered into ChatGPT4 with the prompt "translate this text to a sixth-grade reading level." Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL) were determined for each article before and after AI conversion. Each article and conversion were reviewed for factual inaccuracies, and each conversion was reviewed for content retention. RESULTS: The 71 articles had an initial average FKGL of 11.03 and FRES of 46.79. After conversion by ChatGPT4, the average FKGL across all articles was 5.80 and FRES was 77.27. Converted materials provided enough detail for patient education with no factual errors. DISCUSSION: We found that ChatGPT4 improved the reading accessibility of otolaryngology online patient education materials to recommended levels quickly and effectively. IMPLICATIONS FOR PRACTICE: Physicians can determine whether their patient education materials exceed current recommended reading levels by using widely available measurement tools, and then apply AI dialogue platforms to modify materials to more accessible levels as needed. LEVEL OF EVIDENCE: Level 5.

Dietary Phosphate Educational Materials for Pediatric Chronic Kidney Disease: Are Confused Messages Reducing Their Impact?

OBJECTIVE: This study aimed to review the quality and content of phosphate educational materials used in pediatric chronic kidney disease. METHODS: The quality of text-based (TB) pediatric phosphate educational materials was assessed using validated instruments for health literacy demands (Suitability Assessment of Materials, Patient Education Material Assessment Tool [PEMAT-P]) readability (Flesch Reading Ease, and Flesch-Kincaid Grade Level). Codes were inductively derived to analyse format, appearance, target audience, resource type, and content, aiming for intercoder reliability > 80%. The content was compared to Pediatric Renal Nutrition Taskforce (PRNT) recommendations. RESULTS: Sixty-five phosphate educational materials were obtained; 37 were pediatric-focused, including 28 TB. Thirty-two percent of TB materials were directed at caregivers, 25% at children, and 43% were unspecified. Most (75%) included a production date, with 75% produced >2 years ago. The median Flesch Reading Easetest score was 68.2 (interquartile range [IQR] 61.1-75.3) and Flesch-Kincaid Grade Level was 5.6 (IQR 4.5-7.7). Using Suitability Assessment of Materials, 54% rated "superior" (≥70), 38% rated "adequate" (40-69), and 8% rated "not suitable" (≤39). Low-scoring materials lacked a summary (12%), cover graphics (35%), or included irrelevant illustrations (50%). Patient Education Material Assessment Tool-P scores were 70% (IQR 50-82) for understandability and 50% (IQR 33-67) for actionability. An intercoder reliability of 87% was achieved. Over half of limited foods are in agreement with PRNT (including 89% suggesting avoiding phosphate additives). Recommendations conflicting with PRNT included reducing legumes and whole grains. Over a third contained inaccuracies, and over two-thirds included no practical advice. CONCLUSIONS: TB pediatric phosphate educational materials are pitched at an appropriate level for caregivers, but this may be too high for children under 10 years. The inclusion of relevant illustrations may improve this. Three-quarters of materials scored low for actionability. The advice does not always align with the PRNT, which (together with the inaccuracies reported) could result in conflicting messages to patients and their families.

Assessment of the Readability, Availability, and Quality of Online Patient Education Materials Regarding Uveitis Medications.

Purpose: To assess the availability, quality, and readability of online patient education materials regarding uveitis medications.Methods: The top 10 Google search results for 10 commonly prescribed uveitis medications (prednisone, azathioprine, methotrexate, mycophenolate mofetil, cyclosporine, tacrolimus, chlorambucil, cyclophosphamide, adalimumab, and infliximab) were analyzed for readability and accountability. Readability was assessed with the Flesch reading ease score, Flesch-Kincaid grade level, Gunning Fog Index, Simple Measure of Gobbledygook Index, and Coleman Liau Index. JAMA benchmarks were used to assign websites accountability scores. Statistical analysis was performed with two-tailed t-tests.Results: Of 100 search results, none complied with the recommended sixth-grade reading level across all readability formulas. Only one website satisfied all 4 JAMA benchmarks, two websites were able to satisfy three benchmarks, and the remainder achieved two or less.Conclusions: Online information regarding uveitis medications lacks accountability and is not written at an appropriate level for the average patient.

Patient Education in Neurosurgery: Part 1 of a Systematic Review.

BACKGROUND: Patient education has become increasingly important in neurosurgery. However, little is known regarding how to comprehensively educate neurosurgical patients. In the first part of a 2-part systematic review, we identify baseline patient understanding and educational needs, examine existing patient education materials, and characterize shortcomings in neurosurgical patient education practices. Our findings may guide neurosurgeons, departments, and professional associations in improving communication with patients. METHODS: A 2-part systematic review was conducted using the PubMed, Embase, and Scopus databases. Titles and abstracts were read and selected for full text review. Studies meeting prespecified inclusion criteria were reviewed in full and analyzed for study design, aim, population, interventions, and outcomes. RESULTS: Of 1617 resultant articles, 41 were included. Patient comprehension was low. Patient informational needs differed across patients and between patients and neurosurgeons. Patient informational needs were often unmet, promoting dissatisfaction. Written educational materials from government agencies, professional associations, neurosurgery departments, neurosurgeons, or widely read Web sites were written at a reading level above the recommended reading level, with complex topics written at a higher level. Information found on hospital and university Web sites was poor quality because of self-marketing and lack of reference to peer-reviewed literature. Educational videos created by universities and hospitals were poor quality. CONCLUSIONS: Current in-clinic discussions and education materials show shortcomings, promoting poor comprehension. Neurosurgeons, departments, and professional organizations can act to improve the effectiveness of patient education initiatives. This policy will better inform patients, increase rapport between neurosurgeons and patients, and improve patient decision making and satisfaction.

Quality assessment of cancer patient education materials: the current state of systemic therapy patient education in fourteen cancer centres across Ontario, Canada.

PURPOSE: Most patients diagnosed with cancer are administered systemic therapy and these patients are counselled and given printed education (PE) materials. High rates of low health literacy highlight the need to evaluate the quality of these PE materials. METHODS: A current state assessment of the quality of PE materials was conducted in Ontario, Canada. Patient education leaders from 14 cancer centres submitted print materials on the topic of systemic cancer therapy to the assessment team. To report adherence to PE quality and health literacy best practices, the following validated measures were used: readability (FRY, SMOG and Flesch Reading Ease), understandability and actionability (Patient Education Materials Assessment Tool (PEMAT)). Materials at grade level 6 or lower and with PEMAT scores greater than 80% were considered to meet health literacy best practices. RESULTS: A total of 1146 materials were submitted; 366 met inclusion criteria and 83 were selected for assessment. Most materials scored below the 80% target for understandability (x̄ = 73%, 31-100%) and actionability (x̄ = 68%, 20-100%), and above the recommended grade 6 readability level (x̄ = grade 9) meaning that the majority did not meet quality standards or best practices. CONCLUSION: Results suggest that there is significant opportunity to improve the quality of PE materials distributed by cancer centres. The quality of PE materials is a critical safety and equity consideration when these materials convey important safety and self-care directives.

What Is a Good Teaching Video? Results of an Online International Survey.

STUDY OBJECTIVE: To analyze surgeon views on criteria for a good teaching video with the aim of determining guidelines. DESIGN: An online international survey using a self-developed questionnaire. SETTING: A French university tertiary care hospital. PATIENTS: Three hundred eighty-eight participants answered an online questionnaire (154 women [40.53%] and 226 men [59.47%]). INTERVENTIONS: A questionnaire on the criteria for a good quality teaching surgery video was developed by our team and communicated via an online link. MEASUREMENTS AND MAIN RESULTS: The responses of 388 respondents were analyzed and highlighted the pedagogical benefits of teaching videos. The video duration may vary according to the type of media or surgical procedure but should not exceed 10 to 15 minutes for complex procedures. Providing information on the surgical setup (body mass index of the patient, Trendelenburg position degree, pressure of pneumoperitoneum, etc.) is essential. Surgical videos should be reviewed and divided into clearly defined steps with continued access to the entire nonmodified video for reviewers and be accessible on both educational and open platforms. Patient consent and relevant information should be made available. Reviews should include "bad procedure" videos, which are highly appreciated, especially by young surgeons. CONCLUSION: The many advantages of the video format, including availability and rising popularity, provide an opportunity to reinforce and complement current surgical teaching. To optimize use of this surgical teaching tool, standardization, updating, and ease of access of surgical videos should be promoted.

Readability of Online Neuro-Oncology-Related Patient Education Materials from Tertiary-Care Academic Centers.

BACKGROUND: The Internet has become a popular resource for patients to research diagnosed or suspected medical diseases. Medical institutions provide comprehensive online education resources about various conditions to the general public. The U.S. National Institutes of Health and American Medical Association recommend that patient education materials aimed at the general population should be written at or below eighth-grade reading level. The goal of this study is to assess the readability of patient education materials for central nervous system tumors across tertiary-care institutions. METHODS: Patient education materials were collected from National Cancer Institute designated cancer centers in October 2019. Materials were analyzed by Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) score using Microsoft Office Word software. Subgroups were formed based on regions in the United States (Northeast, Southeast, Midwest, Southwest, and West) as well as diagnostic and treatment information. RESULTS: A total of 180 documents were collected across 50 institutions. Overall median FKGL was 12.5, and median FRE was 38.2. Median FKGL for diagnostic information was 11.6 and FRE was 43.0, whereas median FKGL for treatment information was 12.9 and median FRE was 34.3. No statistically significant differences were seen for both FKGL and FRE among geographic regions (P > 0.05). CONCLUSIONS: Online neuro-oncology patient education materials from tertiary institutions are written above recommended reading levels. Future efforts should be taken to improve the readability of brain tumor-specific patient education materials, particularly with information relating to treatment.

Online information on Crohn's disease in Chinese: an evaluation of its quality and readability.

To assess the quality and readability of patient-education information on Crohn's disease on the internet in China. METHODS: Baidu and Sogou were chosen as search engines, and the top 58 webpages on Crohn's disease meeting the inclusion criteria were evaluated. After the data were screened, the quality of information was assessed by two specialists using a simplified DISCERN system. Different levels of official Chinese-teaching materials were used to build a readability model to predict the readability of these information. RESULTS: Altogether 13 pieces of information were included in this study, all of which were derived from commercial webpages. The simplified DISCERN system found an excellent consistency in the Chinese literature, and Spearman's coefficient was 0.685, 0.556 and 0.607, respectively (P < 0.001), for publication reliability, treatment options and the total score. Most of the information lacked clear sources and conflicts of interest statements. The corresponding DISCERN scores were all below 2. In terms of treatment options, many webpages did not provide adequate information about the prognosis, possible side effects of treatment and risks of developing cancer. The scores of treatment-related DISCERN items were all below 2 as well. The webpages did not show enough readability. Altogether 84.6% of the information exceeded the middle-school readability level, and 69.2% exceeded the high-school level. CONCLUSIONS: The quality of patient-education information on Crohn's disease on the internet in China is worrisome, with poor readability, which should be addressed by the academic community.

Assessing Readability: Are Urogynecologic Patient Education Materials at an Appropriate Reading Level?

OBJECTIVE: The National Institutes of Health recommends readability of patient material not exceed sixth-grade level. Our aim was to determine readability of American Urogynecologic Society (AUGS) and International Urogynecological Association (IUGA) patient education documents. METHODS: Available English- and Spanish-language IUGA patient information leaflets and AUGS patient fact sheets were scored for grade reading level. Readability assessment was performed using Flesch-Kincaid, Simple Measure of Gobbledygook, and Fry graph formulas for English documents. For Spanish documents, Fernandez-Huerta and SOL readability formulas were utilized. Each document was assessed by a health literacy expert using standards of plain language best practices. RESULTS: We assessed 86 documents: 18 AUGS, 34 IUGA, and 34 IUGA Spanish documents. Readability combined scores for English AUGS documents ranged from 8th to 12th grade level equivalents, whereas English IUGA documents ranged from 7th to 13th. Combined average readability score for AUGS sheets was 9.9 ± 1.2 grade level equivalents versus 10.5 ± 1.3 for IUGA leaflets. The AUGS documents had lower grade level equivalents on all 3 readability scales. Spanish-language IUGA leaflets had an average readability score of 5.9 ± 0.6 grade level equivalents, with a range of fifth to seventh. Health literacy expert analysis found only 1 document met all the criteria for plain language best practice. CONCLUSIONS: All assessed AUGS and IUGA patient information English documents had readability scores above National Institutes of Health-recommended reading level. Spanish IUGA documents were written at a lower reading level than their English counterparts. To best meet patient education needs, future materials development should emphasize readability and utilization of plain language best practices.

Analysis of the quality of patient therapeutic education and information in a high complexity reference hospital.

BACKGROUND AND OBJECTIVES: The application and monitoring of quality criteria in information and therapeutic patient education can identify areas to improve care. The objectives of this study were: (1) To analyze the characteristics of patient information materials, educational activities, and self-management programs, and (2) to determine health care provider (HCP) proposals on therapeutic patient education. MATERIALS AND METHODS: Using a cross-sectional study, an online questionnaire was sent to hospital departments in a high complexity reference hospital from September to December 2013 to record: (a) information materials, (b) patient educational activities, and self-management program characteristics, (c) HCP proposals. The materials were analyzed using Health Promoting Hospitals (HPH) recommendations. RESULTS: (1) An analysis was performed on 258 materials (leaflets [54%]) for chronic patients (86%), acute patients (7%), and the general population (7%). More than half (55%) lacked the authors, and 43% the year issued, and 69% followed HPH recommendations. (2) An evaluation was made of 70 educational activities and 37 self-management programs addressed to patients/relatives with diabetes/obesity, musculoskeletal disorders, COPD/asthma, pelvic-floor disorders, transplantation, bowel-inflammation/liver disease, hypertension, cancer, heart failure, acquired immune deficiency syndrome, chronic renal insufficiency, splenectomy, anticoagulation and older-patient dependence. The structure, process and outcome evaluation varied. (3) HCP proposals included: standardization of materials criteria, web accessibility, list of accredited websites, cross-sectional use, and HCP training in self-management education. CONCLUSIONS: The online questionnaire showed the weaknesses and strengths of patient information and education, and can be used to monitor their quantity and quality. These results help in the definition of a useful model to improve patient information and education policies.

[Designing and evaluating therapeutic education tools for people living with HIV]. / Concevoir et évaluer des outils d'éducation thérapeutique pour les personnes vivant avec le VIH.

In the context of therapeutic education for people living with HIV in Africa, educational tools must be adapted to their living environment. OBJECTIVES: To describe the process of designing education tools for patients living with HIV and evaluate their use by African caregivers-educators. METHODS: An eight-step participatory and formative process was carried out to design educational tools. Twenty-one caregivers-educators from nine French-speaking African countries in three focus groups were interviewed on the way in which they used these tools. RESULTS: Fourteen people were trained in the process of designing the tools and training caregivers-educators in their use. Two toolkits were developed (adults and children/adolescents). The image folder was the tool most commonly used. Educators in all countries used tools to address self-care and psychosocial coping skills. The criteria for choosing the tools were linked to their attractiveness, ease of use, their adaptation to the patient's needs and characteristics, and the degree of mastery by the caregiver-educator. The tools helped to structure the education sessions. Brakes to their use were organizational and lack of experience or mastery. CONCLUSION: The participatory and formative approach enabled educators working with patients living with HIV in French-speaking Africa to appropriate the tools. Training was a crucial step in enabling caregiver-educators to master and disseminate the tools, and design new tools.

What is the quality of drug safety information for patients: An analysis of REMS educational materials.

BACKGROUND: Poor-quality patient drug information has been identified as a major cause of preventable medication errors in the United States. The US Food and Drug Administration (FDA) has the authority to require marketing authorization holders of medicinal products to implement risk evaluation and mitigation strategies (REMS) to ensure that the benefits of a drug or biological product outweigh its risks. Aside from medication guides, no research has been conducted to assess the quality of patient-targeted REMS materials, including whether, and to what extent, patients find these materials understandable and actionable. PURPOSE: To describe the readability, understandability, and actionability of patient educational materials in currently approved REMS programs, and to highlight opportunities for improving both the quality and effectiveness of these important drug safety tools. METHODS: Seventy-seven REMS programs were identified from the FDA REMS database. We excluded medication guides (MGs) from our analysis because of the fact that there is a mandatory MG template. Based on this, we identified a total of 27 (non-MG) REMS patient materials on the FDA REMS website for analysis purposes. The materials were tested for readability using the Lexile Measure, the Gunning Fog Index, and Flesch Kincaid and then assessed using the Patient Education Materials Assessment Tool for printable materials, for understandability and actionability. RESULTS: Twenty-three of 77 (30%) REMS programs used educational materials to communicate serious risks to patients, yielding a total of 27 REMS patient materials for analysis. The median readability score for these materials was at a ninth-grade reading level or higher. While most (89%) of these patient education materials met established criteria for being understandable, less than half (49%) were deemed actionable. DISCUSSION: Currently approved REMS patient materials fell short in terms of recommended reading level, and over half did not meet recommended standards for actionability. Developers of these materials should apply plain language principles when design these materials to improve their readability and to assess both understandability and actionability in order to increase the effectiveness when distributed to patients.

Bring on the Machines: Could Machine Learning Improve the Quality of Patient Education Materials? A Systematic Search and Rapid Review.

PURPOSE: Clear and trustworthy information is essential for people who are ill. People with cancer, in particular, are targeted with vast quantities of patient education material, but of variable quality. Machine learning technologies are popular across industries for automated tasks, like analyzing language and spotting readability issues. With the experience of patients with cancer in mind, we reviewed whether anyone has proposed, modeled, or applied machine learning technologies for the assessment of patient education materials and explored the utility of this application. METHODS: We systematically searched the literature to identify English-language articles published in peer-reviewed journals or as conference abstracts that proposed, used, or modeled the use of machine learning technology to assess patient education materials. Specifically, we searched MEDLINE, Web of Science, CINAHL, and Compendex. Two reviewers assessed study eligibility and performed study screening. RESULTS: We identified 1,570 publications in our search after duplicate removal. After screening, we included five projects (detailed in nine articles) that proposed, modeled, or used machine learning technology to assess the quality of patient education materials. We evaluated the utility of each application across four domains: multidimensionality (2 of 5 applications), patient centeredness (1 of 5 applications), customizability (0 of 5 applications), and development stage (theoretical, 1 of 5 applications; in development, 3 of 5 applications; complete and available, 1 of 5 applications). Combining points across each domain, the mean utlity score across included projects was 1.8 of 5 possible points. CONCLUSION: Given its potential, machine learning has not yet been leveraged substantially in the assessment of patient education materials. We propose machine learning systems that can dynamically identify problematic language and content by assessing the quality of patient education materials across a range of flexible, customizable criteria. Assessment may help patients and families decide which materials to use and encourage developers to improve materials overall.

An analysis of the operative experience of plastic surgery trainees in the United Kingdom using eLogbook.

INTRODUCTION: We performed a comprehensive analysis of the operative experience of UK Plastic Surgery Trainees using the web-based eLogbook. METHODS: An analysis of data recorded prospectively by Plastic Surgery Registrars 2010-2014 in eLogbook. RESULTS: The eLogbook data of 336 Specialty Registrars entered from 2010 to 2014 was analysed. Over the six-year training programme, trainees participated in a mean of 2117 procedures and performed a mean of 1571 procedures with or without supervision. We also determined the mean number of procedures for 14 indicative operative domains performed during training and compared these to current (2012) indicative numbers required prior to the award of a Certificate of Completion of Training (CCT). CONCLUSION: The eLogbook contains valuable data to determine the operative experience of UK Plastic Surgery trainees. This new data will be reflected in the updated indicative numbers required for CCT. Both trainees and trainers may use the data to monitor the acquisition of operative experience over time and target training where necessary.

Estrategias didácticas para potenciar el aprendizaje de Farmacología clínica / Didactic strategies to improve the learning of clinical Pharmacology

Introducción: Al realizar una primera aproximación al problema del aprendizaje de la Farmacología por la ausencia de estrategias didácticas efectivas, se ha observado como problema, que médicos practicantes reducen el proceso de prescripción a una práctica centrada en el fármaco, y dejan de lado el carácter diagnóstico y terapéutico centrado en el paciente. Objetivo: Analizar las diferentes estrategias didácticas aplicadas en el proceso enseñanza-aprendizaje de la Farmacología en la Educación Médica Superior. Material y Métodos: Se realizó una revisión a partir de bibliografía y documentación académicas que aporten a la investigación, mediante bases de datos especializadas (PubMed, EMBASE, LILACS y Web of knowledge). Resultados: El Aprendizaje Basado en Problemas o ABP es una metodología activa donde el estudiante interactúa, participa o construye su propio conocimiento a través del análisis crítico, búsqueda de soluciones, del pensamiento análogo, pero sobre todo, de su papel como centro del proceso de enseñanza-aprendizaje. Se reconoció el juego como una actividad entretenida, creativa y dinámica como también la aplicación en las aulas de clase del software educativo. Conclusiones: Se concluye que existe una gran diversidad de estrategias y metodologías que pueden aplicarse con éxito para el aprendizaje de la Farmacología pero que requieren un cambio estructural y curricular que apoyen su integración a la asignatura(AU)

Introduction: When carrying out a first approach to the problem of the learning of the Pharmacology for the absence of effective didactic strategies, it has been observed as problem that medical practitioners reduce the prescription process to a practice centered in the medicine, and they leave aside the diagnostic and therapeutic character centered in the patient. Objective: To analyze the different didactic strategies applied in the process teaching-learning of the Pharmacology in the Superior Medical Education. Material and Methods: it was carried out a revision starting from bibliography and academic documentation that contribute to the investigation, by means of specialized databases (PubMed, EMBASE, LILACS and Web of knowledge). Results: The Learning Based in Problems or ABP(in Spanish) is an active methodology where the student interacts, participates or builds their own knowledge through the critical analysis, search of solutions, of the similar thought, but mainly, of their paper like the center of the teaching-learning process. It was recognized the game like an amusing, creative and dynamic activity as well as the application in the classrooms of educational software classes. Conclusions: as conclusion in taken that a great diversity of strategies and methodologies that can be applied with success for the learning of the Pharmacology exists but that they require a structural and curricular change to support their integration to the subject(AU)

Design of a patient information leaflet in a surgical centre in Cambodia.

Hand deformities cause a large surgical burden on Cambodian society. They significantly affect the quality of life, limit hand function and can cause severe mental health issues. The visited surgical centre provides free rehabilitative surgery in Phnom Penh for those unable to afford private or public healthcare. As part of the postoperative care provided, a team of local Khmer physiotherapists help patients with early mobilisation, passive and active movements, and functional exercises. Leaflets are widespread in high-income countries, but are scarce in low-income countries. This study suggests a patient information leaflet to help with patient education after their discharge from hospital. The main challenges identified during the creation of such a leaflet were the low levels of education, low literacy and poor understanding of the disease process. A simple visual leaflet was created and will help reduce the anxiety and stress associated with hand disfigurement in this region.

Aproximación al consumo de materiales de contenido sexual explícito en adolescentes y jóvenes / Approach to the consumption of materials with explicit sexual contents by adolescents and youths

Introducción: la sexualidad humana es considerada un fenómeno pluridimensional que comprende aspectos biológicos, psicosociales, conductuales, clínicos, morales y culturales, expresándose en todas las dimensiones existenciales. Objetivo: determinar las motivaciones acerca del consumo y reproducción de materiales de contenido sexual explícito. Métodos: estudio descriptivo, transversal, en el Instituto Politécnico 5 de Septiembre en Cienfuegos, del 1ro de septiembre de 2014 al 31 de mayo de 2015. El universo fueron 109 estudiantes de 2do año de carreras técnicas de oficio, la muestra, 29 seleccionados de forma no probabilística. Fueron revisados el diagnóstico y caracterización psicopedagógica grupal e individual para obtener datos que fueron tabulados mediante el coeficiente de concordancia de Kendall. Resultados: existe poco conocimiento sobre sexualidad en los adolescentes estudiados, así como poca percepción de riesgo por las familias y las instituciones con respecto al consumo y reproducción de materiales de contenido sexual explícito por los adolescentes y jóvenes. Conclusiones: los adolescentes encuentran motivaciones intrínsecas para el consumo de materiales de contenido sexual explícito, a partir de necesidades centradas en la satisfacción sexual, intereses pobres que orientan a la búsqueda de información, con sentidos personales, ideales concretos, hábitos y prácticas habituales de genitalidad y actitudes marcadas por los estereotipo de género. Las motivaciones extrínsecas son evidenciadas en los mecanismos de presión social, de imitación o contagio y de aprendizaje social, reforzado por la insuficiente educación de la sexualidad y el fácil acceso a las nuevas tecnologías de información y comunicación, que condicionan actitudes y conductas que propician el consumo de materiales pornográficos, o incluso su reproducción(AU)

Introduction: Human sexuality is considered a pluridimensional phenomenon enclosing biological, psychosocial, behavioral, clinical, moral, and cultural aspects, expressed through all existentional dimensions. Objective: Determine the motivations for the consumption and reproduction of materials with explicit sexual contents. Methods: Descriptive, cross-sectional study at 5 de Septiembre Polytechnic Institute of Cienfuegos, from September 1 2014 to May 31 2015. The target group was made up by 109 students of second year from technical trade majors. The sample was 29 chosen by a nonprobabilistic way. We reviewed both the group and individual diagnosis and psychopedagogical characterization to obtain data that were tabulated using Kendall's coefficient of concordance. Results: There is scarce knowledge about sexuality in the adolescents studied, as well as a low perception regarding the consumption and reproduction of materials with explicit sexual contents by the adolescents and youths. Conclusions: The adolescent find intrinsic motivations for the consumption of materials with explicit sexual contents, starting in need centered around sexual satisfaction, poor interests that orientate towards the search for information, with personal senses, concrete ideals, habitual practices of genitality and attitudes marked by the gender stereotypes. The intrinsic motivations evidence the social pressure mechanisms, others of imitations or contagion and of social learning, reinforced by the scarce sexuality education and the easy access to the new information and communication technologies, which condition attitudes and behaviors the foster the consumption of pornographic materials, and event their reproduction(AU)

Readability of Patient Education Materials in Hand Surgery and Health Literacy Best Practices for Improvement.

PURPOSE: This study aimed to update a portion of a 2008 study of patient education materials from the American Society for Surgery of the Hand Web site with new readability results, to compare the results to health literacy best practices, and to make recommendations to the field for improvement. METHODS: A sample of 77 patient education documents were downloaded from the American Society for Surgery of the Hand Web site, handcare.org, and assessed for readability using 4 readability tools. Mean readability grade-level scores were derived. Best practices for plain language for written health materials were compiled from 3 government agency sources. RESULTS: The mean readability of the 77 patient education documents in the study was 9.3 grade level. This reading level is reduced from the previous study in 2008 in which the overall mean was 10.6; however, the current sample grade level still exceeds recommended readability according to best practices. CONCLUSIONS: Despite a small body of literature on the readability of patient education materials related to hand surgery and other orthopedic issues over the last 7 years, readability was not dramatically improved in our current sample. Using health literacy as a framework, improvements in hand surgery patient education may result in better understanding and better outcomes for patients seeing hand surgeons. CLINICAL RELEVANCE: Improved understanding of patient education materials related to hand surgery may improve preventable negative outcomes that are clinically significant as well as contribute to improved quality of life for patients.