Gist Inference Scores predict gist memory for authentic patient education cancer texts

Abstract

Objectives: Develop a tool to evaluate and improve written medical communication to patients. Determine how effectively Gist Inference Scores (GIS) predict comprehension of patient education texts independently of health literacy. Explicate the text characteristics and psychological mechanism underlying GIS.

Methods: For study 1, a nationally representative sample of older women (N = 61) completed a fill-in-the-blank comprehension task on authentic National Cancer Institute (NCI) texts of varying GIS levels. In study 2, participants (N = 198) read NCI texts (high or low GIS) then recalled what they read.

Results: Study 1 showed that a higher percentage of different words yielding semantically similar sentence meaning were used to correctly fill-the-blanks on high GIS texts and there was no significant interaction with health literacy. In study 2, a greater proportion of decision-relevant information was recalled for high GIS texts.

Conclusions: GIS predicts the likelihood that readers will form gist representations of medical texts on free recall and fill-in-the-blank tasks. High GIS texts allow for more semantic flexibility to mentally represent the same meaning, and more strongly emphasizes gist rather than verbatim representations.

Practical implications: GIS provides medical communicators with an automated and user-friendly method to evaluate medical texts for their ability to convey the bottom-line meaning.

Keywords: Coh-Metrix; Comprehension; Fuzzy-Trace theory; Gist Inference Scores; Written communication.