The influence of information structuring and health literacy on recall and satisfaction in a simulated discharge communication.

Abstract

We investigated the effects of information structuring and its potential interaction with pre-existing medical knowledge on recall in a simulated discharge communication. 127 proxy-patients (i.e. students) were randomly assigned to one of four conditions. Video vignettes provided identical information, differing in means of information structuring only: The natural conversation (NC) condition was not explicitly structured whereas the structure (S) condition presented information organised by chapter headings. The book metaphor (BM) and the post organizer (PO) conditions also presented structured information but in addition included a synopsis, either at the beginning or at the end of discharge communication, respectively. Proxy-patients' recall, perception of quality and pre-existing medical knowledge were assessed. Information structuring (conditions: S, BM, PO) did not increase recall in comparison to NC, but pre-existing medical knowledge improved recall (p < .01). An interaction between medical knowledge and recall in the BM condition was found (p = .02). In comparison to the NC, proxy-patients in all information structuring conditions more strongly recommended the physician (p < .001). Structured discharge communication complemented by the BM is beneficial in individuals with lower pre-existing medical knowledge. The lower pre-existing medical knowledge, the more recipients will profit from information structuring with the BM.