We have discussed applying Pulitzer’s advice to make your instructions and information brief,
clear and picturesque. So chances are good that the learner will read, understand and remember
them and act accordingly. So ethical duty requires that accuracy be checked and double-checked.
Here we are talking about content accuracy. We want to confirm that the recommended behaviors
will indeed enable the learner to fulfill the stated purpose of the information. So the first step
is to review the purpose.
To confirm content accuracy, it is imperative to go beyond internal expert reviews, which tend
to reinforce “what we already know” and “the way we always do it”. Internal reviews are
subject to personal opinion, groupthink and petty politics, all of which are unreliable. That is
not to say that internal reviews are not important and necessary. But before you send out those
new and improved materials for review, check their accuracy against the scientific evidence in
published journals, national guidelines and professional standards. That way, when a reviewer
whose knowledge or clinical judgment is not quite up-to-date demands a questionable change,
you are ready to defend your content and serve your reviewers at the same time.
Example: In a last-minute review of the Beginnings Parents Guide, a state department of health
medical director halted well-advanced plans to introduce the Parents Guide into several home
visitation programs because, he said, the section on night terrors is inaccurate. He knew that
“any child having night terrors has a parent who is abusing him or drugs, usually both”. I was
able to present the research base for the information along with current guidelines from the
American Academy of Pediatrics. I noted that I found in the literature no indication of physical
or substance abuse as a cause of night terrors, and asked, “What am I missing?” Now we know
that we are both up-to-date and the materials are accurate.
With a computer and public resources, it is easy and usually quick to find the current literature
on almost any health or medical topic. Back to our example: A Google search on “night terrors”
brings up: MedlinePlus Medical Encyclopedia: Night terror
Night terror (sleep terror) occurs during Stage 3 and Stage 4 sleep (deep sleep). The cause is
unknown but night terrors are commonly associated with ...
Of course, you bypassed Wikipedia and consumer sites you have not thoroughly evaluated.
Then you bookmarked MedlinePlus, www.nlm.nih.gov/medlineplus as a rich and reliable
resource that you will use often. MedlinePlus brings together authoritative information from
the National Library of Medicine, the National Institutes of Health (NIH), and other government
agencies and health-related organizations. Preformulated MEDLINE searches are included in
MedlinePlus and give easy access to medical journal articles. MedlinePlus also has extensive
information about drugs, an illustrated medical encyclopedia, interactive patient tutorials,
and latest health news.
Also add to your Internet Favorites the National Guidelines Clearinghouse www.guidelines.gov.
This site is a treasure trove of evaluated medical guidelines from multiple sources. Other
excellent resources are the websites of medical specialty associations, such as the American
Academy of Pediatrics, American Diabetes Association, et al. Can’t find it on your own? Call
the medical librarian at your hospital or your local university health services library.
To speed up your reviews, distribute the material in press-ready form, rather than as a typed
manuscript. State the purpose of the information and indicate that you are requesting
confirmation of the clinical accuracy and medical reliability of highlighted text. Since an invitation
to review typically is seen as an imperative to make changes, add a note like this: If this information
is accurate, no action is necessary. Absent a response by Date at Time, we will assume no changes
Keep in mind that clinicians and practitioners are content experts. They are not writers, graphic
designers or layout artists. It is not their job to say where the commas go. The grammar, cultural
and linguistic appropriateness, readability, legibility and reading gravity warrant separate review
by those with the appropriate expertise.
Since we see what we expect, typos hide easily from the most attentive eyes. They ooze up out
of perfect lines of type to cast doubt on accuracy and attention to detail. Take the time for
proofing by several readers who are not familiar with the information or the subject; that means
neither the author(s) nor the content experts can be proofreaders. Good proofreaders have advanced
literacy skills, meticulous attention to detail, a good method and lots of practice. There are classes
in proofreading; I highly recommend that any organization that produces health information have
several trained proofreaders on staff, and that they are well-rewarded for their efforts.
Here is the (nearly) fool-proof proofing process:
1. Working in sections, read slowly through the text as usual. At this point, you are looking for
obvious errors: missing or repeated words or lines, missing punctuation, overly long sentences
and paragraphs, photos without captions, usage errors such as their instead of there, and problems
with subject-verb agreement. For example, “The cause of night terrors are not known.” Here
the subject is cause – singular and the verb is are – plural. Change one of them for agreement:
“the cause ... is not known” OR “the causes ... are not known.”
2. Now to catch the typos, start at the end and work backward word by word. This forces you to
look at each word and see those pesky typos. Remember, your eye will see what it expects to be
there, so give special attention to familiar text such as names and addresses.
3. Always reward those who find typos and other errors.