S638 Complication Rates for Esophagogastroduodenoscopy and Colonoscopy Procedures Performed by GI Trainees at a Tertiary Care Center

Abstract

Introduction: High-quality screening colonoscopy is dependent on adequate colonoscopy preparation (prep). Despite many new formulations including low-volume laxative preps and split-prep schedules, inadequate colon preps are not uncommon. One important factor in improving the quality of colon prep is ensuring that patients understand the prep instructions. Apart from verbal communication, many hospitals post colonoscopy prep instructions on their website. In this study, we evaluated the readability, understandability, and actionability of online colonoscopy prep instructions. Methods: The top 75 hospitals in gastroenterology as ranked by 2021-22 US News and World Report were selected. These hospitals were entered into the Google search engine using the hospital's name followed by "bowel preparation." Each hospitals' bowel preparation information was evaluated independently by four reviewers using a total of 21 website criteria including readability, understandability, and actionability. Readability of each website was evaluated by assessing the approximate reading grade level of the materials using the Flesch Kincaid Grade Level Calculator with a preferred reading grade level below 6. Understandability and actionability were measured with the Patient Education Materials Assessment Tool (PEMAT) with recommended scores above 70% for both. Materials were excluded from review if no standardized document was listed on the hospital website or if duplicate materials were listed among two websites. Results: After exclusion, a total of 51 out of 75 web pages were evaluated. Average reading grade level of the materials assessed was 9.1 6 2.3. Overall understandability score was 78.1% 6 9.7%, and overall actionability score was 74.7% 6 30.1%. Of the websites assessed, 6% of hospitals included images to support text and 20% included videos in addition to text. 18% of the hospitals linked resources in different languages. 59% of materials did not include side effect warnings, and only one website listed an allergic reaction statement. Conclusion:The readability, understandability, and actionability of the written materials for bowel preparation among hospital websites are quite variable and do not meet the recommended standards. In addition, materials often lack key information. The educational content provided by physicians can be improved by further identifying what constitutes effective communication and using online tools to assess and improve readability and display.