title: Discharge instructions: do illustrations help our patients understand them?
abstract: OBJECTIVE
  To determine whether the addition of illustrations to discharge instructions improves patient comprehension.
  
  
  METHODS
  Randomized, blinded, prospective study. A blinded investigator asked a series of questions designed to test the participant's comprehension of the discharge instructions. There were 10 possible correct responses.
  
  
  METHODS
  Emergency department of a rural Level I trauma center.
  
  
  METHODS
  Convenience sample of 101 patients discharged with the diagnosis of laceration.
  
  
  METHODS
  Patients were randomly assigned to receive discharge instructions with (n = 54) or without (n = 47) illustrations.
  
  
  RESULTS
  The median number of correct responses was five. Patients with illustrations were 1.5 times more likely to choose five or more correct responses than those without illustrations (65% versus 43%; P = .033). The effect of illustrations varied by demographic group. Among nonwhites (n = 51), patients with illustrations were more than twice as likely to choose five or more correct responses (P = .032). Among patients with no more than a high school education (n = 71), patients with illustrations were 1.8 times more likely to choose five or more correct responses (P = .038). Among women (n = 48), patients with illustrations were 1.7 times more likely to chose five or more correct responses (P = .006).
  
  
  CONCLUSIONS
  The addition of illustrations to discharge instructions for patients who have sustained lacerations improves patient comprehension. There is a large effect among patients who are nonwhite, female, or have no more than a high school education.
authors.affiliation: Department of Emergency Medicine, East Carolina University School of Medicine, Greenville, NC.
authors.forename: P E
authors.initials: PE
authors.lastname: Austin
authors.forename: R
authors.initials: R
authors.lastname: Matlack
authors.forename: K A
authors.initials: KA
authors.lastname: Dunn
authors.forename: C
authors.initials: C
authors.lastname: Kesler
authors.forename: C K
authors.initials: CK
authors.lastname: Brown
mesh_terms: D001296:Audiovisual Aids; D004522:Educational Status; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D044469:Racial Groups; D012737:Sex Factors; D016037:Single-Blind Method; D012867:Skin / Q000293:injuries