By Bhaval Shah, Ph.D., Partner, Infograph-ed, and Karen Roy, MSc, Partner, Infograph-ed
In this age of Web 2.0, we are at an all-time high of ready-access information and overload. A study by Martin Hilbert and colleagues in 2011 showed that we take in the equivalent of 174 newspaper’s worth of information daily. Compare that number to “only” 40 newspaper’s worth taken in daily in 1984 and you soon start to see how information overload is only going to increase over time. This is especially important to consider for healthcare professionals as they seek to find the most relevant information or CME content to support their lifelong learning goals and address their self-identified needs.
To make our content stand out from everything else that is vying for their attention, it is imperative that we differentiate our information with thoughtfully designed visual elements that are quick and easy to understand.
Combining data with effective design to facilitate visual consumption is an effective way to ensure our content is more quickly and easily understood. In fact, 50 percent of the human brain is dedicated to visual functions, and images are processed faster than text (Merieb and Hoehn, 2007). Because visual literacy precedes verbal literacy in human development, it is the basis of thought processes that are the foundations for reading and writing (Berger, 1972).
There are practical implications to this neuroscience. For example, Turck et al (2014) studied healthcare professionals’ preference for infographic versus conventional, text-based abstracts for communicating results of clinical research. The researchers found that clinicians preferred infographic abstracts to text for a quicker, more efficient read, and that the infographics more likely facilitated long-term factual retention.
The 4-Step Plan to Presenting Information with Impact
In cognitive psychology, cognitive load refers to the total amount of mental effort being used in the working memory. Cognitive load theory, developed by Sweller in the late 1980s (Sweller 1994), differentiates cognitive load into three types: intrinsic, extraneous and germane. Intrinsic load is defined as the inherent level of difficulty in any given topic; germane load fosters learning; and extraneous load impedes learning.
This framework led us to develop a simple and practical approach to designing information with impact. At the heart of it, our process aims to reduce extraneous cognitive load and increase the germane load of information and education.
Our four-step process can be applied to any form of information including medical education slides, internal communication reports, outcomes reports and more. Using this stepwise approach and examples outlined, you will have the tools you need be able to apply this process in your own materials, having completed the case study below.
Step 1: Cut and Categorize
The first step of the process begins with minimizing any unnecessary mental work on the reader. By removing excessive complexity, you will remove some of the extraneous cognitive load. Mayer and Moreno (2003) call this approach weeding. It involves eliminating all extraneous content that embellishes the learning, even when it is interesting in its own right. The goal is to avoid promoting incidental processing that is not relevant to the learning task.
Consider words that are redundant and can be removed. How much text do you need to relay the point you are trying to make? Prune your information down to succinct bullets. In the process of condensing the information, it will become easier to pull out and assign any applicable categories within it.
Most information can be organized in such a way as to help readers quickly align with the content and help them find relevant material, faster. Additionally, this step makes similarities and differences among categories of content more explicit (Clarke 2010). When categorizing your information, look for meaningful sections or repeating patterns. An example of categorizing information is shown below:
Step 2: Define Messages
A message is the one main point you want your reader to take away from each section. Work with a rule of one message per section or slide. By applying this rule, you will keep your reader focused only on the main key takeaway for each section. Once you have defined a message, create a “message title” for that section.
Clear and succinct message (or sentence) titles have been shown to be more effective than passive phrase titles in conveying technical information (Alley and Neeley, 2005) and aiding retention (Alley et al, 2006) in various audiences.
Examples of passive phrase titles versus message titles are shown below:
Step 3: Determine Visuals
Multiple studies (Verdi et al ,1997; Patton, 1991) over many years have pointed to the effectiveness of the use of visuals in learning and retention. Of note, the use of illustrations or graphics presented together with short pieces of text are found to be most effective in learning. In the third step of our process, we consider which types of visuals are optimal in the delivery of our information. Visuals should aid, and not deter, from the information being presented. Specifically, if you were to remove any text accompanying the visual, the reader should still be able to get a sense of the information being conveyed.
Consider the complexity of your visuals. How complex is your visual, and can you simplify it? Butcher (2006) compared the understanding of heart circulation presented in three formats: text, text plus simple line drawing, or text plus a more accurate three-dimensional drawing. Both visual formats led to more learning than text alone. However, perhaps surprisingly, the simpler line drawing was more effective than the 3-D version.
When determining the use of visuals in designing your information, consider the following visual types:
Step 4: Apply Style
The goal of this step is to remove any remaining extraneous load within your information.
Using inconsistent fonts, sizes and image types all increase distraction and “noise” as your reader subconsciously tries to assign a relevance to these inconsistencies, thereby contributing to extraneous load. The key to successfully applied style is consistency.
In addition to using a consistent style, special consideration should to paid to your color palette. Kleinman and Dwyer (1999) found that the use of color graphics in instructional modules as opposed to black and white graphics promoted achievement, particularly when educating on concepts. Consider a specific color to highlight main points and assign colors consistently throughout.
Some style considerations are outlined below:
By applying this 4-step process to your content, you will be able to improve legibility, decrease the time to convey your information clearly and ultimately have greater impact on the reader.
A Worked Case Study
The example below will be transformed using the four-step process.
Step 1: Cut and Categorize
We cut down much of the verbiage in the paragraph above, created bullets, and categorized each of the adverse events into body areas.
Step 2: Define Messages
After categorizing the content, we determined that there were in fact two discreet messages evident in the information above and therefore created two message titles:
Step 3: Determine Visuals
We decided to use icons to quickly convey each AE body area category. For the AE data, we used a “reflected” bar chart that effectively highlights the differences between the two data groups:
For Part B, we decided to use an image to show the process of receptor internalization.
Step 4: Apply Style
In the final step, in Part A, we used different colors for each body area, and orange to emphasize the adverse event of constipation, delineating it from the other AEs.
The image used in Part B shows a temporal sequence of events. To further clarify this sequence, we decided to break up the image into three “small multiples” showing the events taking place at each time point.
Finally, the “before” in comparison to the transformed “after” examples are shown below.
Alley M and Neeley KA. Rethinking the Design of Presentation Slides: A Case for Sentence Headlines and Visual Evidence. Technical Communication. 2005;52:417-426
Alley M, Schreibe M, Ramsdell, K, and Muffo J. How the Design of Headlines in Presentation Slides Affects Audience Retention. Technical Communication. 2006;53:225-234
Berger J (1972). Ways of seeing. London: Britain Broadcasting Corp.
Butcher KR. Learning from text with diagrams: Promoting mental model development and inference generation. Journal of Educational Psychology. 2006; 98:182–197.
Clarke RC Graphics for Learning: Proven Guidelines for Planning, Designing, and Evaluating Visuals in Training Materials, Edition 2. 2010 John Wiley & Sons
Hilbert M and Lopez P. The world's technological capacity to store, communicate, and compute information. Science. 2011;332:60-65
Kleinman EB and Dwyer FM. Analysis of Computerized Visual Skills: Relationships to Intellectual Skills and Achievement. International Journal of Instructional Media. 1999;26:53-69.
Mayer RE and Moreno R. Nine Ways to Reduce Cognitive Load in Multimedia Learning Educational Psychologist. 2003;38,43-52
Merieb, EN and Hoehn K (2007). Human Anatomy & Physiology 7th Edition, Pearson International Edition.
Patton WW. Opening students’ eyes: Visual learning theory in the Socratic classroom. Law and Psychology Review. 1991;15:1-18.
Sweller J. Cognitive load theory, learning difficulty, and instructional design. Learning and Instruction. 1994;4:295-312
Turck CJ, Silva MA, Tremblay SR and Sachse SL A Preliminary Study of Health Care Professionals’ Preferences for Infographics Versus Conventional Abstracts for Communicating the Results of Clinical Research. Journal of Continuing Education in the Health Professions. 2014;34: S36–S38
Verdi MP, Johnson JT, Stock AW, Kulhavy RW and Whitman-Ahern P. Organized Spatial Displays and Texts: Effects of Presentation Order and Display Type on Learning Outcomes. The Journal of Experimental Education. 1997;65:303-317