Writing Tips: Understandability

When writing patient materials, the concept of understandability is of the utmost importance. Patient brochures are not effective if the intended audience cannot understand them.

Plain Language

A communication is in plain language if its wording, structure, and design are so clear that the intended readers can easily find what they need, understand what they find, and use that information.

International Plain Language Federation

Some words we use in the healthcare setting may seem simple, but in reality, they are harder for people to understand. Consider using a plain language thesaurus to make it easier for people to understand the concepts you are trying to explain.

Plain language thesaurus for health communications
by Centers for Diseases Control and Prevention

Everyday words for public health communication
by Centers for Diseases Control and Prevention


adverse = bad, dangerous, hurtful, harmful

exhale = breathe out

migration = moving from one place to another

peritoneum = lining of your stomach, belly, tummy


Adverse event: possible side effect or reaction after getting a shot or taking medicine

Plain Language Sentence
You should report any reactions that happen after getting the smallpox shot to state public health authorities and the national Vaccine Adverse Events Reporting System (VAERS).


Being mindful of word choice and using the tools above are a great start. However, it’s also important to write at a reading level that most people will be able to understand. Not everyone can read at the same level, as demonstrated by the statistics below from Life Literacy Canada.

There are different ways to calculate a readability score, but the most common and accessible are the Flesch Reading Ease Score and the Flesch-Kincaid Grade Level Score. Both scores use a formula to calculate overall readability based on the number of syllables, words and sentences, and sentence and word lengths. The Flesch Reading Ease Score is scored from 0 to 100. The closer your text is to 100, the more readable it is. To learn more about how these formulas are calculated, please click here.

The important thing to remember is to keep your material at a simpler grade level to make it more accessible. Aim for an 8th-grade level, as indicated in the figure below.

Everyone with access to Microsoft Word has access to the Flesch Reading Ease Score and the Flesch-Kincaid Grade Level score. In the example below, two texts about rheumatoid arthritis were written in Word and analyzed for readability. The first text, aimed towards healthcare professionals, has a lower Reading Ease Score and a higher grade level. We modified the second text with patients in mind. The Reading Ease Score is much higher, and the grade level has come down considerably.

Keep in mind that sometimes, in the medical field, the nature of the words we use can alter these scores. For example, there is no easy way to say ankylosing spondylitis, and the number of syllables in these two words will decrease your reading ease score. Don’t worry about that! A big part of editing is knowing when to stop. Focus on the parts that will actually make a difference and improve the document.

Tips for Improving Readability Scores

  • Cut out unnecessary filler words sentences: Get straight to the point. All words and sentences in your document should serve a purpose. Remember that you have a limited amount of time and words to capture your reader’s attention. Make it count!
  • Reduce the length of your sentences: This is not an academic paper. Short sentences with a point get the job done.
  • Use active voice, not passive: Be direct. Instead of saying “lung cancer is caused by smoking,” you should say, “smoking causes lung cancer.”
  • Use a thesaurus: use both a plain-language thesaurus (like the ones mentioned above) and a regular thesaurus if you feel like a word might be too complicated and there is a simpler alternative.
  • Think about the information critically: Before adding something that will require you to explain additional concepts, think about what this information brings to the overall document. Is it really necessary?

If you would like to request a review of your patient materials, please click here to view the services we provide and submit a request.

Sinai Patient Education Pavilion

The SinaiPEP website was created by the librarians at the Mount Sinai Hospital and Bridgepoint Active Healthcare to help patients and their families find reliable and relevant health information.

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