This piece is intended for a medical education booklet distributed to a general patient audience. The goal of the piece is to provide a brief but comprehensive overview of the autonomic nervous system (ANS) before exploring the symptoms of POTS, a condition involving autonomic system dysfunction that is currently growing in prevalence.
Media and software: Procreate, Adobe Illustrator
Client: Shelley Wall
My reason for selecting this topic was that many laypeople lack an understanding of the autonomic nervous system (ANS), despite the fact that autonomic system disorders are becoming more common. Currently, developing research suggests a link between COVID infection and autonomic dysfunction, and diagnoses of autonomic disorders, collectively falling under the category of dysautonomia, have become more common in the past few years. I wanted this piece to provide patients with a basic understanding of the ANS before discussing what may occur if they have a form of autonomic dysfunction.
Because of the complexity of this topic and the breadth of information I wanted to include, this piece went through several stages and iterations. With each one, my goal was to refine the scope of the topic and improve both the verbal and visual communication to the target audience:
This piece is part of a series created by myself and my classmates in the MSc in Biomedical Communications program at the University of Toronto. We collaboratively developed a style sheet to guide our design choices and ensure consistency between each of our individual pieces.
Before beginning my piece, I conducted a brief media audit of existing educational resources on the ANS.
Sources (left to right): Labster Theory Pages, Autonomic Nervous System; Merck Manual Consumer Version, Overview of the Autonomic Nervous System; Grow Psychological, LLC, The Brain is Knowledge, the Body is Wisdom; Cleveland Clinic, Autonomic Nervous System
I repeated the process for patient education on dysautonomia.
Sources (left to right): Yoga U, When the Nervous System Goes Haywire; The Dysautonomia Project; Chirn Park Health Group, Dysauatonomia
My most important findings from the media audit:
- Few illustrations of the autonomic NS include a depiction of a full, realistic, person, with most including disembodied organs and body parts; a few resources use silhouettes.
- There is a significant focus on the sympathetic and parasympathetic divisions of the autonomic system, with few resources generalizing or simplifying this information.
- Many ANS resources are advanced (they use technical language and require background knowledge to understand), with few resources specifically designed for patients.
- Dysautonomia resources are overall more patient-friendly than general ANS resources, but few resources include comprehensive information about the ANS.
My conclusions:
- Including an illustration of a full person rather than disembodied parts can help make this topic approachable and patient-friendly.
- While important to medical education, a discussion of the sympathetic and parasympathetic divisions may not be necessary for a patient-centered overview of the ANS.
- Patient-appropriate resources for this topic are lacking, and the design of resources targeted to patients is needed, especially to promote understanding of what the ANS is and why it’s so important for our health.
With the media audit completed, I began by writing a draft of the text to include in the piece. From the beginning, I decided to structure this piece by first introducing the basics of the autonomic nervous system before moving into the specifics of dysautonomia. At this point, the draft text had a reading level of grade 9, which was higher than my goal of a grade 6 reading level and required further editing.
I then placed the text into a preliminary draft layout.
For the second draft, I spent time simplifying and reducing the amount of text I included. While the initial draft included information about the two divisions of the ANS, I decided to omit this information and focus more on the basics. With my goal of making the piece patient-friendly, I thought it was more important to limit the information to what was absolutely necessary and avoid overwhelming readers. For this draft, I also completed preliminary versions of the intended illustrations.
For this draft, I received feedback that the page on dysautonomia was confusing, as some people thought that dysautonomia referred to a singular condition rather than a category of diseases. One suggestion I received was to narrow my focus to just one condition that falls under the category of dysautonomia, and I decided to narrow my scope to focus on POTS (postural orthostatic tachycardia syndrome), a common type of dysautonomia.
Because of this big structural change, I created more rough sketches to plan out the final layout. I decided to go forward with the final sketch here, though it was still to undergo further changes for the final version.
I also worked to further condense and simplify the text to achieve the goal of a grade 6 reading level according to the Flesch-Kincaid readability test. The first draft of the text contained 591 words at a grade 9 reading level; this was reduced to 375 words and a grade 5 reading level for the final version.
For the final illustrations, I decided to directly compare an image of a healthy person and an image of someone experiencing POTS symptoms. I also improved understandability by translating the symptoms I mentioned into vector icons rather than associating them with rendered images of the organs involved.
The final version of the piece differed quite drastically from the original, and I had to rethink many of my initial ideas to make this piece appropriate and understandable for a patient audience.
Potential future work on this project includes clarifying the generalized nature of the nerves in the first image by replacing the rendered spinal cord and nerves with a simplified, diagrammatic style; improving the didactic value of the second image; and potentially reversing the page order and rewriting some sections to support this reversal.