Information design for effective instructions

The design of health information is a particular interest and we have some fascinating precedents to modern health communication in an archive of materials produced by the Isotype Institute in the 1940s and 50s (the Institute developed public information and education campaigns, including war effort posters and films for the UK Government in WW2).

Illustration 1 shows an Isotype poster, created for the American TB Association in the 1940s to explain TB infection and transmission. Although the work is a little dated, you can see many of the hallmarks of good information design: a limited amount of information per poster; titling to orient the reader; clear illustration combined with simple language; systematic use of a colour code throughout the campaign’s posters; and strong cues to reading order.

The striking imagery used in the Isotype Institute’s materials demonstrates awareness of the challenge of engaging and maintaining people’s attention. In one poster, diagrammatic illustration is combined with photographs to help connect technical presentation to people’s everyday experience. For modern information designers there is often a tension between using realistic photographs and more focused, diagrammatic representations, which some people find difficult to understand.

The striking imagery used in the Isotype Institute’s materials demonstrates awareness of the challenge of engaging and maintaining people’s attention

What is clear, however, is that presenting information in different ways, including well written text and focused illustration, increases the accessibility of information. In a recent project to design a questionnaire to help the relatives of people with dementia inform nursing staff about a patient’s symptoms, we made sure we used both verbal and graphic tools to maximise communication.

When it comes to reading instructions, research by Sullivan and Flower reveals that people rarely read two sentences of an instruction manual consecutively, often ignore introductory text and start using a product before finishing reading. Furthermore, the more familiar people feel with a product, the less likely they are to read instructions. (and most readers of this article will probably recognise their own behaviour here). But it is sometimes hard to imagine that a person using a medical product or device would not check the accompanying information first.

When a new medical product is developed, regulators require that accompanying information leaflets are tested for the accuracy and speed with which people can find information in them. These requirements focus on comprehension of leaflet text but research by Dickinson has shown that improving the design of typical patient information, such as the constructed leaflet for an imaginary medication ‘Atenofen’ shown in illustration 2, can improve performance on these tasks. That’s a start. People respond positively to information that looks attractive and signals content clearly. But such tests only tell us a limited amount about people’s every day experience of taking medicines and using medical devices. Often an individual has a regime of several interventions and relies on a mix of memory of the prescribing doctor’s instructions, packaging inserts (if they read them), and, in the case of devices, cues from the design of the device itself. It’s small wonder, therefore, that there can be slip ups in use.

So we have to look for innovative ways to engage people with the detail of how to use their medications and devices.

One way forward is to think of a coordinated information experience, from consultations with doctors (who are known to overestimate their patients’ literacy levels), through interactions with pharmacists and family members, to access to web tools and mobile phone apps, and finally to packaging and information leaflets, and to the product itself.

The critical action at each stage is to tailor the information to user needs, engaging people but not overwhelming them. A rapid project by two of our undergraduate students (illustration 3) shows what can be done. They refined a lengthy explanation for school students about a new mobile phone-based service for contacting their school nurse, into an eye-catching poster and information card. While information designers have less freedom to ‘play’ with popular culture in patient information leaflets, experimenting with and testing alternative graphic forms to attract and focus readers’ attention, to encourage them to keep reading and remember content afterwards, is key to design that helps people simply ‘get things done’.