When Life Depends on Clear Instructions

Home/Publications/CIDM eNews/Information Management News 12.05/When Life Depends on Clear Instructions

Irene Etzkorn
Siegel & Gale, LLC

You are in a 25th floor hotel room and the fire alarm goes off in the middle of the night. You study the “you are here” diagram on the back of the door to find out where the nearest exit is. If it is like most of these diagrams, it looks more like a maze than an escape map. Just as your panic rises, the all-clear signal rings and disaster is averted, but no thanks to the information card. Still anxious on your trip home, you examine the escape procedures card in the seatback of the airplane and realize that it, too, is useless.

And how about your last doctor’s visit? Unless you are quite young or remarkably healthy, you probably can’t accurately recall the medications you take regularly-pronounce them, recite the dosage, describe what they are treating, remember their contra-indications. Certainly not if you are among the half of the US population who is either functionally illiterate or marginally illiterate1. Don’t feel too smug if you are better educated; education alone won’t insulate you from the arcane language of certain fields. Did you really understand that medical consent form you signed for your recent surgery? One study showed that patients with average reading levels were unable to understand most of the consent forms used for research studies of cancer drugs2.

Don’t think old age will bring relief. When you turn age 65, you have the Medicare Handbook to read. “Today’s Medicare is about choice” according to the official, 90-page “Medicare & You,” but they might as well say today’s Medicare is about confusion.

The first substantive information does not appear until page 9. Before that, there is an extended Table of Contents, an Index of Topics, and a self-congratulatory letter from Tommy Thompson. Most readers will have given up by page 4. The very first paragraph begins, “If there are words in this handbook you don’t understand…” This is not a good omen. If you do plow through, you’ll confront “lifetime reserve days” and “durable medical equipment regional carrier.” In response, AARP has come up with their own “plain English” guide to explain the new Medicare Prescription Drug coverage. While a noble attempt, it points up how the underlying legislation is so convoluted that it defies explanation. Twisted thinking cannot be untangled by clear writing.

Actually, inadequate instructions affect us from birth. According to a study conducted in 2003 at the Uniformed Services University of the Health Sciences in Maryland, 80% of child safety seats are improperly installed or misused and the instructions for installing them are the root of the problem3. The instructions are written at a 10th grade reading level while at least 50% of US adults read at a significantly lower level.

Did you complain to the hotel when you checked out? Did you contact the airline after you landed? Send an e-mail to the car seat manufacturer? Probably not, because there is a pervasive and dangerous acceptance that “official” or ֻimportant” information is usually impenetrable.

A perfect example of “governmentspeak” is the civil defense web site for Honolulu, Hawaii. Three pages, accessible on the Internet are titled, Emergency Instructions. They explain what to do if you hear the Civil Defense Warning Sirens and/or the Emergency Alert System. First of all, they ask you to distinguish between a steady 3-minute siren and a wailing 3-minute siren (the latter indicating that an enemy attack is already in progress or imminent). After making the distinction, it turns out the instructions are exactly the same for either circumstance, except that they tell you to seek shelter immediately for a wailing siren. You’ve obviously already lost at least 3 minutes listening to nuances in the siren tone. The 3 pages of instructions could have been boiled down to one sentence: “If you hear an air raid siren, seek shelter and turn on a radio or television for instructions.”

What can we do about this? Complain. Send emails and letters to companies who issue unclear instructions telling them that you won’t buy more from them because you couldn’t understand how to use the last item you purchased from them. Companies have time and money to advertise products; equal attention needs to be paid to making sure we can use them after we buy them.

A few years ago, The European Union paved the way for consumers to seek refunds and even file lawsuits if they bought unassembled furniture and could not put it together based on the instructions provided by the seller. Until we, as buyers, users and citizens, declare unclear information unacceptable and dangerous, companies and legislators will continue to take the easy way out. Shorter, clearer writing is much harder to achieve than verbosity. Companies and government agencies must stop treating information as a label to be slapped on as a product or service goes out the door. Treated as an afterthought, rather than as an integral part of the development process, communication suffers.

However, there is an exception to every rule. There is one instruction writer we should thank. His unclear writing inadvertently saved lives. When police found the undetonated bomb that proved the Al Qaida connection in the recent Madrid terrorist attack, they discovered that it didn’t go off because the bomber programmed his cell phone alarm as the trigger for 7 pm rather than 7 am. For once, unclear instructions saved lives.

So when does life depend on clear instructions?—almost always.

1 “Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey”. Irwin S. Kirsch, Ann Jungeblut, Lynn Jenkins, and Andrew Kolstad. September 1993. National Center for Education Statistics, US Department of Education. Washington, DC.

2 “Informed consent for clinical trials: A comparative study of standard versus simplified forms.”. TC Davis, RF Holcombe, HJ Berkel, S Pramanik, and SG Divers. May 6, 1998. Journal of the National Cancer Institute. Vol 90, No 9.

3 “How Readable Are Child Safety Seat Installation Instructions?”. Mark V. Wegner and Deborah C. Girasek. March, 2003. Pediatrics.

This article originally appeared in IBM’s Ease of Use Journal. Used with author’s permission.

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