{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:05:11Z","timestamp":1785337511257,"version":"3.55.0"},"reference-count":16,"publisher":"University of Toronto Press Inc. (UTPress)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Veterinary Medical Education"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Readability, or the ability to comprehend written text, may directly influence client understanding and adherence to post-operative (PO) care instructions. Previous work at Ross University School of Veterinary Medicine demonstrated that higher reading grade levels in discharge instructions were associated with increased PO complication rates in dogs undergoing elective sterilization. Subsequently, a readability maximum was implemented, requiring all third-year veterinary students to create discharge instructions with a Flesch\u2013Kincaid Grade Level (FKGL) of 6 or below. This study evaluated the impact of this intervention on PO complication rates within the student-run community spay\/neuter program. Readability scores and PO outcomes were analyzed in 175 cases (114 dogs, 61 cats). Mean FKGL was 5.45 \u00b1 0.89, and mean Flesch Reading Ease score was 75.57 \u00b1 6.53, indicating materials were written at or below the recommended Grade 6 literacy level. The overall complication rate was 34.3%, but there was no association observed between complication occurrence and readability scores (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &gt; .05).\n                  <\/jats:p>","DOI":"10.3138\/jvme-2025-0177","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T14:21:41Z","timestamp":1785334901000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of Mandatory Maximum Readability Scores in Client Discharge Instructions on Postoperative Sterilization Complications"],"prefix":"10.3138","author":[{"given":"Faith M.","family":"Cournoyer","sequence":"first","affiliation":[{"name":"Ross University School of Veterinary Medicine, PO Box 334, Basseterre, 00265, St. Kitts, West Indies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Rolph","sequence":"additional","affiliation":[{"name":"Ross University School of Veterinary Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3679-8859","authenticated-orcid":true,"given":"Christopher M.","family":"Biancaniello","sequence":"additional","affiliation":[{"name":"Veterinary Specialty Hospital of San Diego Sorrento Valley, 10435 Sorrento Valley Rd, San Diego, CA 92121, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Peda","sequence":"additional","affiliation":[{"name":"Ross University School of Veterinary Medicine with no other research affiliation. P.O. Box 334, Basseterre, St. Kitts, West Indies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Davis","sequence":"additional","affiliation":[{"name":"Ross University School of Veterinary Medicine, PO Box 334, Basseterre, 00265, St. Kitts, West Indies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0406-2631","authenticated-orcid":true,"given":"Sarah M.","family":"Cavanaugh","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Ross University School of Veterinary Medicine, PO Box 334, Basseterre, 00265, St. Kitts, West Indies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priti S.","family":"Karnik","sequence":"additional","affiliation":[{"name":"Ross University School of Veterinay Medicine and has no other research affiliation. PO Box 334 Basseterre, St Kitts, West Indies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Ross University School of Veterinary Medicine, and have no other research affiliation. Saint Kitts, West Indies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela S.","family":"Witcher","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Ross University School of Veterinary Medicine, P.O. Box 334, Basseterre, 00265, St. Kitts, West Indies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1064-3785","authenticated-orcid":true,"given":"Ryan P.","family":"Cavanaugh","sequence":"additional","affiliation":[{"name":"Ross University School of Veterinary Medicine, P.O. Box 334, Basseterre, Saint Kitts and Nevis, West Indies"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1696","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_3_8_2_2","first-page":"43","article-title":"Readability of texts: state of the art","volume":"2","author":"Zamamian M","year":"2012","unstructured":"Zamamian M, Heydari P. Readability of texts: state of the art. Theory Pract Lang Stud. 2012;2:43\u201353. https:\/\/doi.org\/10.4304\/tpls.2.1.43-53","journal-title":"Theory Pract Lang Stud"},{"issue":"9","key":"e_1_3_8_3_2","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1007\/s11606-012-2046-0","article-title":"Readability of patient education materials available at the point of care","volume":"27","author":"Stossel LM","year":"2012","unstructured":"Stossel LM, Segar N, Gliatto P, Fallar R, Karani R. Readability of patient education materials available at the point of care. J Gen Intern Med. 2012;27(9):1165\u201370. https:\/\/doi.org\/10.1007\/s11606-012-2046-0. Medline: 22528620","journal-title":"J Gen Intern Med"},{"key":"e_1_3_8_4_2","doi-asserted-by":"crossref","first-page":"84","DOI":"10.4103\/1357-6283.210517","article-title":"Assessing reading levels of health information: uses and limitations of Flesch formula","volume":"30","author":"Jindal P","year":"2017","unstructured":"Jindal P, MacDermid JC. Assessing reading levels of health information: uses and limitations of Flesch formula. Educ Health (Abingdon). 2017;30:84\u20138. https:\/\/doi.org\/10.4103\/1357-6283.210517. Medline: 28707643","journal-title":"Educ Health (Abingdon)"},{"key":"e_1_3_8_5_2","doi-asserted-by":"crossref","first-page":"e18161","DOI":"10.5812\/atr.18161","article-title":"Readability of patient education materials on the American Association for Surgery of Trauma website","volume":"3","author":"Eltorai AE","year":"2014","unstructured":"Eltorai AE, Ghanian S, Adams CAJ, Born CT, Daniels AH. Readability of patient education materials on the American Association for Surgery of Trauma website. Arch Trauma Res. 2014;3:e18161. https:\/\/doi.org\/10.5812\/atr.18161. Medline: 25147778","journal-title":"Arch Trauma Res"},{"key":"e_1_3_8_6_2","doi-asserted-by":"crossref","unstructured":"Lopez C Kim B Sacks K. Health Literacy in the United States: Enhancing Assessments and Reducing Disparities (May 20 2022). 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Evaluating the readability of recruitment materials in veterinary clinical research. J Vet Intern Med. 2023;37:2125\u201330. https:\/\/doi.org\/10.1111\/jvim.16857. Medline: 37759419","journal-title":"J Vet Intern Med"},{"key":"e_1_3_8_13_2","doi-asserted-by":"crossref","first-page":"e3796","DOI":"10.1002\/vetr.3796","article-title":"Readability of postoperative discharge instructions is associated with complication rate in companion animals undergoing sterilisation","volume":"194","author":"Biancaniello C","year":"2024","unstructured":"Biancaniello C, Rolph KE, Cavanaugh SM, Karnik P, Peda A, Cavanaugh RP. Readability of postoperative discharge instructions is associated with complication rate in companion animals undergoing sterilisation. Vet Rec. 2024;194:e3796. https:\/\/doi.org\/10.1002\/vetr.3796. 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