The design of an orthodontic patient information leaflet: a cross-sectional, mixed methods study involving surveys, a knowledge test and eye-tracking
- 1Cardiff University
Abstract
BackgroundPatient Information Leaflets (PILs) are widely used to support verbal communication during orthodontic consent. For a PIL to be effective, it must present information clearly and support patient understanding and recall. A commonly used orthodontic PIL in the UK is the British Orthodontic Societys (BOS) PIL "Orthodontic Treatment: What are the risks?".
Aim and objectivesTo evaluate this orthodontic PIL, compared to a simpler Designed to Smile PIL, with regards to: 1) Design clarity; 2) Free text comments on the design and content; 3) Knowledge after reading the PIL; 4) Time spent looking at various aspects of the PIL.
MethodsStudents of non-medicine or dentistry programmes viewed the orthodontic PIL electronically with simultaneous eye-tracking. Immediately afterwards, they completed a survey capturing their clarity of design rating, feedback on the design and content, and knowledge of the PIL content. This was repeated for a simpler Designed to Smile PIL.
Results36.8% rated the orthodontic PIL as "very clear" compared to 66% for the Designed to Smile PIL. Suggested improvements included breaking-up large blocks of text, using more images, and including descriptions of patient experience. 48.9% (SD = 9.0) of questions were answered correctly regarding content in the orthodontic PIL; significantly lower than the simpler Designed to Smile PIL (80%; SD = 11.3%) (P < 0.001). Eye-tracking indicated that participants spent more time looking at images in the orthodontic PIL (median = 22.2% of time) compared to the Designed to Smile PIL (median = 8.2%) (P < 0.001).
ConclusionsO_LIThe Designed to Smile PIL was deemed clearer than the orthodontic PIL. C_LIO_LISuggestions for improvement included using more images and breaking-up large sections of text. C_LIO_LIKnowledge was relatively poor after reading the orthodontic PIL. C_LIO_LIParticipants spent longer looking at the images in the orthodontic PIL compared to the Designed to Smile PIL. C_LI
Related
- Nutrition Knowledge, Information Sources, and Self-Perceived Ability to Provide Nutrition Counseling Among Medical Students: A Cross-Sectional Study
- Theoretical Knowledge, Self-Assessed Competence, and Information-Seeking Behaviors in Evidence-Based Medicine Among Polish Medical Students: A Cross-Sectional Study
- Knowledge, attitudes, and information needs regarding norovirus infection among parents of primary school students directly affected by outbreaks: a cross-sectional study in Hangzhou, China
- Knowledge, Practice, and Attitude of Healthcare Providers Concerning the Use of Information Technology in Healthcare Units: A Cross-Sectional Study
- Assessment of food safety knowledge, attitudes, and self-reported practices among secondary school students in Bangladesh: A geographic information system-based cross-sectional study
BibTeX
@misc{farnell2026design,
title = {{The design of an orthodontic patient information leaflet: a cross-sectional, mixed methods study involving surveys, a knowledge test and eye-tracking}},
author = {D. J. J. Farnell and J. Galloway and A. J. Kho},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.25.26366089},
url = {https://www.medrxiv.org/content/10.64898/2026.10.25.26366089v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - The design of an orthodontic patient information leaflet: a cross-sectional, mixed methods study involving surveys, a knowledge test and eye-tracking
AU - D. J. J. Farnell
AU - J. Galloway
AU - A. J. Kho
PY - 2026
DA - 2026/10/25
PB - medRxiv
DO - 10.64898/2026.10.25.26366089
UR - https://www.medrxiv.org/content/10.64898/2026.10.25.26366089v1
AB - BackgroundPatient Information Leaflets (PILs) are widely used to support verbal communication during orthodontic consent. For a PIL to be effective, it must present information clearly and support patient understanding and recall. A commonly used orthodontic PIL in the UK is the British Orthodontic Societys (BOS) PIL "Orthodontic Treatment: What are the risks?". Aim and objectivesTo evaluate this orthodontic PIL, compared to a simpler Designed to Smile PIL, with regards to: 1) Design clarity; 2) Free text comments on the design and content; 3) Knowledge after reading the PIL; 4) Time spent looking at various aspects of the PIL. MethodsStudents of non-medicine or dentistry programmes viewed the orthodontic PIL electronically with simultaneous eye-tracking. Immediately afterwards, they completed a survey capturing their clarity of design rating, feedback on the design and content, and knowledge of the PIL content. This was repeated for a simpler Designed to Smile PIL. Results36.8% rated the orthodontic PIL as "very clear" compared to 66% for the Designed to Smile PIL. Suggested improvements included breaking-up large blocks of text, using more images, and including descriptions of patient experience. 48.9% (SD = 9.0) of questions were answered correctly regarding content in the orthodontic PIL; significantly lower than the simpler Designed to Smile PIL (80%; SD = 11.3%) (P < 0.001). Eye-tracking indicated that participants spent more time looking at images in the orthodontic PIL (median = 22.2% of time) compared to the Designed to Smile PIL (median = 8.2%) (P < 0.001). ConclusionsO_LIThe Designed to Smile PIL was deemed clearer than the orthodontic PIL. C_LIO_LISuggestions for improvement included using more images and breaking-up large sections of text. C_LIO_LIKnowledge was relatively poor after reading the orthodontic PIL. C_LIO_LIParticipants spent longer looking at the images in the orthodontic PIL compared to the Designed to Smile PIL. C_LI
ER -