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How To Improve Your Informed Consent:

[Tool 3A]
Style Guide

For Improving the Informed Consent Form

Collected here are a number of tips for drafting simple and clear consent forms and related educational materials. You may want to photocopy this Style Guide and place a copy inside each of the separate folders you created for each informed consent form undergoing revision.

Download [Tool 3A] Style Guide

Use Plain Language

Word choice and sentence length and structure are critical in creating text that is easy to understand. Here are tips to keep in mind while writing:

Words

• Use simple, common words (avoid medical terminology or jargon)
• Pick strong verbs
• Use “you” to address the reader
• Explain technical terms or use the simpler alternative

   Examples:

   “Chemotherapy is the use of drugs to treat cancer”

   “Noninvasive means without surgery, needles, or cutting skin”

   “arteriovenous fistula (abnormal opening between any artery and vein)”

   “benign (not cancer)”

   “colonoscopy (internal exam of the bowel using a bendable tube (colonoscope) with an attached camera”

   “hypertension (high blood pressure)”

• Avoid long words with many syllables
• Avoid unnecessary adjectives
• Avoid legal jargon
• Avoid abbreviations and acronyms if possible
• Use the same words consistently (ie, don’t use a synonym just to avoid
  repetition, and be careful with use of pronouns)

Sentences

• Keep sentences short (8 to 10 words is good), direct, and succinct
• Use a conversational tone
• Avoid complex sentence structures (e.g., compound sentences, dependent or embedded clauses, lots of commas)
• Consider breaking into a short list when there are more than 3 points to the sentence
• Use concrete nouns and give clear direction

    Don’t say:

    “Following postsurgical safety precautions can reduce the likelihood of wound infections.”

    Do say:

    “After your surgery:
(1) change your bandage daily,
(2) watch for pus or leakage,
(3) call the doctor if there is any change.”



• Use the active voice

    Don’t say:

    “The instrument is inserted by the doctor into the vein”

    Do say:

    “The doctor inserts the instrument into the vein.”

Paragraphs

• Avoid long paragraphs
  (and dense blocks of text)
  (3-4 lines or 2-5 sentences is good)
• Start a new paragraph with a new thought
  
  

Organize the Flow of Ideas

Present one idea at a time

Rule:

If it does not add information or understanding, delete it.

• Sequence the ideas in the order a patient would want them... or...
• Consider using a standardized sequence of categories for all forms
• Add articles, chapters, background with related content or graphics

Example:

The Queensland Government format generally recommends:

    A] Interpreter/Cultural Needs
B] Condition and Procedure
C] Anaesthetic
D] General Risks of a Procedure
E] Risks of Procedure
F] Significant Risks and Relevant Treatment Options
G] Patient Consent
H] Interpreter’s Statement
I] Doctor’s Statement

• Use headings and subheading to “chunk” text together
• Keep these sections short
• Make your heads and subheads work to organize and communicate

    Don’t say:

    “Complications of the Surgery.”

    Do say:

    “Infection is the Most Common Complication.”

• Use vertical lists to highlight a series of items
  

Select a Clear Layout and Design

Type

• Choose a classic and common typeface (e.g., plain serif style like Times New Roman or Garamond are best for print)
• Choose a type size (at least 12 point) that is large enough to read easily
• For visually impaired patients, consider 14 or 16 point text
• Don’t use LONG SECTIONS OF ALL CAPITALIZED TEXT LIKE THIS (this can be difficult to read, especially for visually impaired readers)

Instead, to highlight important points, consider:

• Changing the type size
• Using bold face
• Underlining
• Adding a light background screen

• Don’t over-do the use of boldface because this is annoying
• Use bullets to highlight important points and create lists

White Space and Visual Layout

• Use a lot of white space, around edges and between copy chunks
• Make sure the white space is balanced with words and illustrations
• Use vertical lists to break up text
• Use graphics to break up text
• Use short sections to break up text
• Use shorter rather than longer line lengths
  (less than 65 characters is best)
  (FYI, above line is 65 characters exactly)

Figures, Tables, Graphics

• Use visuals like pictures or diagrams when appropriate
• Make sure figures have a heading, description, or caption

Overall

• Standardize the layout throughout the document (e.g., all same typeface, size, similar copy chunking)

Developed with a grant from the Robert Wood Johnson Foundation

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