Grade Reading Research Articles

Exploring the Role of Coordinating Centre Tutors in Implementing Early Grade Reading Initiatives in Wakiso District, Uganda

The adoption of Early Grade Reading (EGR) Methodology in 2013 in Uganda brought on board different stakeholders to effectively implement it in the education eco-system. With reference to this particular study, we examined the crucial role of Coordinating Center Tutors (CCTs) in Wakiso District, Central Uganda in the effective implementation of EGR methodology. Wakiso District’s socio-economic and cultural diversity necessitates an adaptive approach to EGR, making CCTs indispensable in tailoring instructional methods. Specifically, we set out to scrutinize how CCTs assess EGR instructional practices, and effectiveness of their training programs on effective implementation of EGR in primary schools in Wakiso district. Data was collected from six purposively selected CCTs through face-to-face interviews. Key findings reveal the multidimensional role of CCTs as trainers, mentors, and community engagers. Their instructional practices, range from center-based training to partnered reading, showcasing a holistic strategy. Positive impacts on literacy development, including enhanced comprehension and confidence among learners, under-score the effectiveness of these practices. Continuous professional development initiatives and targeted training contribute significantly to CCT competency, bridging gaps in their earlier college training. In conclusion, the study emphasizes the dynamic role of CCTs in carrying out ongoing support and targeted training programs. The recommendations encompass mentorship programs, collaborative learning environments, diverse instructional methods, continuous professional development, strengthened partnerships, increased community involvement, a structured referral system, and a dynamic learning environment. This study contributes to the understanding of the intricate dynamics surrounding EGR implementation, providing insights for educational policy-makers, practitioners, and researchers aiming to optimize literacy outcomes in diverse contexts.

Persistence and Emergence of Literacy Skills: Long-Term Impacts of an Effective Early Grade Reading Intervention in South Africa

Many countries strongly emphasize enhancing foundational reading skills, with the expectation that such improvements will catalyze the development of new cognitive abilities and lead to improved life outcomes. However, the relationship between early educational gains and later-life achievements remains theoretically complex and evidence is lacking, particularly from low- and middle-income countries (LMICs). This paper examines the long-term impacts of an early grade literacy intervention that was implemented in South Africa in Setswana language from 2015 to 2017. A unique feature of our study is the longitudinal tracking and assessment of the same group of students over a 7-year period, extending up to 4 years post-intervention. We found sustained improvements in Setswana oral reading fluency, indicating a lasting impact of the intervention. Moreover, treated students exhibited enhanced Setswana and English written comprehension skills, signifying the emergence of new skills. Grade progression also improved, potentially reducing dropout rates, and facilitating transitions to secondary education. This study contributes to the limited literature on the long-term causal impacts of early literacy investments in LMICs, suggesting potential for enduring educational benefits and improved later-life outcomes.

Abstract 4116844: Simplifying Cardiology Research Abstracts: Assessing ChatGPT's Readability and Comprehensibility for Non-Medical Audiences

Background: Artificial Intelligence (AI)-powered chatbots like ChatGPT are increasingly used in academic medical settings to help with tasks such as evidence synthesis and manuscript drafting. They have shown potential in simplifying complex medical texts for non-medical audiences like patients and journalists. However, less is known about whether simplified texts may exclude important information or be of interest to patients or other non-medically-trained people such as journalists. Objective: This study aims to assess ChatGPT's capacity to simplify cardiology research abstracts by eliminating jargon and enhancing universal comprehension. Methods: We analyzed all abstracts and scientific statements published from July to November 2023 in Circulation (n=113). These abstracts were processed through ChatGPT with the prompt: "Please rewrite the following text to be comprehensible at a 5th-grade reading level. Retain all original information and exclude nothing". We assessed the readability of both original and simplified texts using Flesch-Kincaid Grade Level (FKGL) and Reading Ease (FKRE) scores. Additionally, a panel of five physicians and five laypeople evaluated these texts for completeness, accuracy, and understandability. Results: ChatGPT transformation or abstracts reduced the required reading level from a college graduate to 8-9th grade by both FKGL (18.3 to 8.6; p<.001) and FKRE (14.6 to 68.5; p<.001). The physician panel generally found that the simplified abstracts retained all essential information without introducing errors. Both physicians and laypeople found the simplified texts more comprehensible. Laypeople appreciated the ease of understanding but did not strongly express a desire for more such simplified texts, and some still worried about the simplified abstracts missing important details. Conclusion: ChatGPT simplifies medical research abstracts to a level understandable by those with less than a high school education without excluding important information. This approach may be useful to communicate new research findings to patients and other non-medically-trained people.

Artificial intelligence as a modality to enhance the readability of neurosurgical literature for patients.

In this study the authors assessed the ability of Chat Generative Pretrained Transformer (ChatGPT) 3.5 and ChatGPT4 to generate readable and accurate summaries of published neurosurgical literature. Abstracts published in journal issues released between June 2023 and August 2023 (n = 150) were randomly selected from the top 5 ranked neurosurgical journals according to Google Scholar. ChatGPT models were instructed to generate a readable layperson summary of the original abstract from a statistically validated prompt. Readability results and grade-level indicators (RR-GLIs) scores were calculated for GPT3.5- and GPT4-generated summaries and original abstracts. Two physicians independently rated the accuracy of ChatGPT-generated layperson summaries to assess scientific validity. One-way ANOVA followed by pairwise t-test with Bonferroni correction were performed to compare readability scores. Cohen's kappa was used to assess interrater agreement between the two rater physicians. Analysis of 150 original abstracts showed a statistically significant difference for all RR-GLIs between the ChatGPT-generated summaries and original abstracts. The readability scores are formatted as follows (original abstract mean, GPT3.5 summary mean, GPT4 summary mean, p value): Flesch-Kincaid reading grade (12.55, 7.80, 7.70, p < 0.0001); Gunning fog score (15.46, 10.00, 9.00, p < 0.0001); Simple Measure of Gobbledygook (SMOG) index (11.30, 7.13, 6.60, p < 0.0001); Coleman-Liau index (14.67, 11.32, 10.26, p < 0.0001); automated readability index (10.87, 8.50, 7.75, p < 0.0001); and Flesch-Kincaid reading ease (33.29, 68.45, 69.55, p < 0.0001). GPT4-generated summaries demonstrated higher RR-GLIs than GPT3.5-generated summaries in the following categories: Gunning fog score (0.0003); SMOG index (0.027); Coleman-Liau index (< 0.0001); sentences (< 0.0001); complex words (< 0.0001); and % complex words (0.0035). A total of 68.4% and 84.2% of GPT3.5- and GPT4-generated summaries, respectively, maintained moderate scientific accuracy according to the two physician-reviewers. The findings demonstrate promising potential for application of the ChatGPT in patient education. GPT4 is an accessible tool that can be an immediate solution to enhancing the readability of current neurosurgical literature. Layperson summaries generated by GPT4 would be a valuable addition to a neurosurgical journal and would be likely to improve comprehension for patients using internet resources like PubMed.

Construction and content validity of the Brazilian Portuguese Reading and Writing Neuropsychological Instruction program for early grades.

Construction and content validity of the Brazilian Portuguese Reading and Writing Neuropsychological Instruction program for early grades.

Formation of personal and meta-subject results in the context of the development of reading and digital literacy in 7th grade at informatics lessons using case technology

Formation of personal and meta-subject results in the context of the development of reading and digital literacy in 7th grade at informatics lessons using case technology

How teachers in Tanzania understand and implement phonics instructional approach for the teaching of reading in early grades

How teachers in Tanzania understand and implement phonics instructional approach for the teaching of reading in early grades

Utilization of Artificial Intelligence in the Creation of Patient Information on Laryngology Topics.

To evaluate and compare the readability and quality of patient information generated by Chat-Generative Pre-Trained Transformer-3.5 (ChatGPT) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) using validated instruments including Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease, DISCERN, and Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P). ENTHealth.org and ChatGPT-3.5 were queried for patient information on laryngology topics. ChatGPT-3.5 was queried twice for a given topic to evaluate for reliability. This generated three de-identified text documents for each topic: one from AAO-HNS and two from ChatGPT (ChatGPT Output 1, ChatGPT Output 2). Grade level and reading ease were compared between the three sources using a one-way analysis of variance and Tukey's post hoc test. Independent t-tests were used to compare DISCERN and PEMAT understandability and actionability scores between AAO-HNS and ChatGPT Output 1. Material generated from ChatGPT Output 1 and ChatGPT Output 2 were at least two reading grade levels higher than that of material from AAO-HNS (p < 0.001). Regarding reading ease, ChatGPT Output 1 and ChatGPT Output 2 documents had significantly lower mean scores compared to AAO-HNS (p < 0.001). Moreover, ChatGPT Output 1 material on vocal cord paralysis had a lower PEMAT-P understandability compared to that of AAO-HNS material (p > 0.05). Patient information on the ENTHealth.org website for select laryngology topics was, on average, of a lower grade level and higher reading ease compared to that produced by ChatGPT, but interestingly with largely no difference in the quality of information provided. NA Laryngoscope, 2024.

Language and Literature Education Field: Some Aspects of Teaching in Primary Schools of National Minorities

The article explores teaching tools and certain aspects of teaching the Ukrainian language in primary grades, focusing on the instruction in the language of indigenous peoples/national minorities in general secondary education institutions in Ukraine and abroad. It presents the experiences of teachers, methodologists, authors of educational and methodological materials, and contemporary domestic and foreign scholars, based on a comparative analysis. Current trends in publishing textbooks and teaching aids are examined. The article highlights the experiences of Ukrainian and foreign educators regarding the relevance of educational support and the potential for engaging each child in meaningful individual and socially significant educational, research, and inquiry activities. It is determined that in textbooks and aids for the Ukrainian language and reading for grades 1-4, a concept has been pre-planned that considers the specifics of all sections and topics of the language and reading curriculum. The article proves that independent work effectively integrates the content of the studied material from language and literature, allowing for quick comprehension of the textbook, section, or topic, as well as enabling students to read and provide correct answers, with appropriate recommendations formulated. It is noted that modern realities require working with digital textbooks, necessitating additional teacher training to utilize them effectively. The article identifies the problems and prospects for further research, which include the development of digital skills for students and teachers, the need for educational institutions to be equipped with digital devices, and the formation of motivation among students, teachers, and parents for learning the Ukrainian language both in Ukraine and abroad.

Readability Metrics in Patient Education: Where Do We Innovate?

The increasing use of digital applications in healthcare has led to a greater need for patient education materials. These materials, often in the form of pamphlets, booklets, and handouts, are designed to supplement physician–patient communication and aim to improve patient outcomes. However, the effectiveness of these materials can be hindered by variations in patient health literacy. Readability, a measure of text comprehension, is a key factor influencing how well patients understand these educational materials. While there has been growing interest in readability assessment in medicine, many studies have demonstrated that digital texts do not frequently meet the recommended sixth-to-eighth grade reading level. The purpose of this opinion article is to review readability from the perspective of studies in pediatric medicine, internal medicine, preventative medicine, and surgery. This article aims to communicate that while readability is important, it tends to not fully capture the complexity of health literacy or effective patient communication. Moreover, a promising avenue to improve readability may be in generative artificial intelligence, as there are currently limited tools with similar effectiveness.

Physical Fitness, Executive Functions, and Academic Performance in Children and Youth: A Cross-Sectional Study

The aim of this cross-sectional study was to investigate the relationship between physical fitness, executive function, and academic performance in children and adolescents. A total of 131 students (49% female) aged 10–15 years from a public school in Rio de Janeiro were assessed in executive functions (hearts and flowers, Corsi’s block, and digit span tasks), academic performance (Portuguese, reading, math, and overall school grade), physical tests (touch test disc, agility, lower limb and upper limb explosive strength), and anthropometric measurements. Regression results showed that the composite of sports-related fitness measures was the best predictor of executive functions (β = 0.472; t = −6.075 p &lt; 0.001). Decision tree classifier analysis showed that the combination of factors that discriminated better and worse executive function groups were better performance in hand–eye coordination (TTD), math, and upper limb strength (ULEST). Sports-related fitness is significantly correlated with executive function. Hand–eye motor coordination has been identified as the most important predictor of improved cognitive outcomes, surpassing even academic skills. These findings should be considered in the design of physical activity programs in school settings, which may have a positive impact on child development, reflected in the reduction of academic and socioeconomic disparities.

Validity and reliability of a physical literacy knowledge, attitudes, self-efficacy and behaviors questionnaire for early childhood educators (PLKASB-ECE): An exploratory factor analysis.

Nurturing physical literacy in young children offers a unique opportunity to address global physical inactivity trend. Early childhood education and care (ECEC) environments, with their extensive reach into this age group, and early childhood educators, through their daily interactions with children, are strategically positioned to influence children's physical literacy development. However, enhancing educators' ability to foster physical literacy requires valid and reliable assessment tools to measure holistic physical literacy constructs (i.e., cognitive, affective, behavioral) to assess the impact of physical literacy educational interventions. The purpose of this study was to develop a holistic digital tool to measure physical literacy knowledge, attitudes, self-efficacy, and behaviors of early childhood educators (PLKASB-ECE) for both their professional teaching context as well as the educator's own personal physical literacy behaviours. This study was conducted in two phases. Phase 1 involved item generation and content validation. Phase 2 employed a cross-sectional validation study design to assess the psychometric properties of the PLKASB-ECE tool. Based on a literature review an initial 19-item instrument was developed that subsequently underwent three rounds of expert content validation. Six additional items were added, resulting in a final 25-item self-report measure with a readability score equivalent to an 8th grade reading level (Flesch-Kincaid Grade Level: 8.7). This included 1 global rating item, 2 qualitative response items, 7 knowledge items, and 15 items addressing physical literacy attitudes, self-efficacy and behaviors using a 7-point Likert response scale. The PLKASB-ECE tool was administered to 470 educators in Alberta, Canada between 2019 to 2022. The 15 items were subjected to exploratory factor analysis and resulted in a five-factor scale with one item not loading. The five-factor scale held with the final 14 items with loadings ranging from 0.481 to 0.886, Cronbach's alpha ranging from 0.70 to 0.82, with ordinal omega ranging from 0.72 to 0.82. Usability, as assessed by completion time, was 8.15 minutes. These findings demonstrate good indices of reliability and validity for the PLKASB-ECE tool. This tool will be valuable as a research outcome measure for assessing educational interventions aimed at enhancing educators' understanding, confidence, and strategies for fostering holistic concepts of physical literacy in young children within ECECs.

Accuracy of natural language processors for patients seeking inguinal hernia information.

NLPs such as ChatGPT are novel sources of online healthcare information that are readily accessible and integrated into internet search tools. The accuracy of NLP-generated responses to health information questions is unknown. We queried four NLPs (ChatGPT 3.5 and 4, Bard, and Claude 2.0) for responses to simulated patient questions about inguinal hernias and their management. Responses were graded on a Likert scale (1 poor to 5 excellent) for relevance, completeness, and accuracy. Responses were compiled and scored collectively for readability using the Flesch-Kincaid score and for educational quality using the DISCERN instrument, a validated tool for evaluating patient information materials. Responses were also compared to two gold-standard educational materials provided by SAGES and the ACS. Evaluations were performed by six hernia surgeons. The average NLP response scores for relevance, completeness, and accuracy were 4.76 (95% CI 4.70-4.80), 4.11 (95% CI 4.02-4.20), and 4.14 (95% CI 4.03-4.24), respectively. ChatGPT4 received higher accuracy scores (mean 4.43 [95% CI 4.37-4.50]) than Bard (mean 4.06 [95% CI 3.88-4.26]) and Claude 2.0 (mean 3.85 [95% CI 3.63-4.08]). The ACS document received the best scores for reading ease (55.2) and grade level (9.2); however, none of the documents achieved the readibility thresholds recommended by the American Medical Association. The ACS document also received the highest DISCERN score of 63.5 (57.0-70.1), and this was significantly higher compared to ChatGPT 4 (50.8 [95% CI 46.2-55.4]) and Claude 2.0 (48 [95% CI 41.6-54.4]). The evaluated NLPs provided relevant responses of reasonable accuracy to questions about inguinal hernia. Compiled NLP responses received relatively low readability and DISCERN scores, although results may improve as NLPs evolve or with adjustments in question wording. As surgical patients expand their use of NLPs for healthcare information, surgeons should be aware of the benefits and limitations of NLPs as patient education tools.

Readability of Patient-Reported Outcome Measures Used in Voice Disorders

ObjectivesThis study aims to evaluate Turkish patient-reported outcome measures (PROM) used in voice disorders using different readability formulas and to examine the relationship between text-based features and readability values. Study DesignA search was conducted to identify published Turkish PRO questionnaires related to dysphonia that are completed by patients. MethodsSearch was conducted to identify published PROM related to dysphonia that are completed by patients in a self-administered format. Reading grade levels were analyzed for voice-related PROM using the Ateşman readability and the Bezirci-Yılmaz new readability formulas as computed by a readability calculations software package. Text-based quantitative features are obtained. Descriptive statistics were also computed across the questionnaires. ResultsA total of 14 PROMs were found. In the analysis, the mean of the Ateşman readability values of the PROM was calculated as 70.66 (±5.55). This value is defined as 'easy', according to the Ateşman readability measures. The average Bezirci-Yılmaz new readability value is 6,03 (±1,07). This value corresponds to the 6th grade reading level in the Turkish education system. ConclusionsResults show that more than half of the PROMs in the Turkish language have the recommended reading level. PROMs allow healthcare professionals to objectively understand the patient's symptoms, both qualitatively and quantitatively. Therefore, it is critical that patients accurately understand and respond to these outcome measures. This is why developers should consider reading as a testable structure. Speech and language therapists should consider the reading level required to understand a specific PROMs in order to obtain the most useful information for treatment planning and outcome assessments.

How Prepared are Ethiopian English Teachers to Teach Early Grade Reading?

Purpose. This paper examines how prepared Ethiopian public primary school English teachers are to teach early grade reading. Methodology. A descriptive research design of mixed methods was employed. A sample of 125 English teachers in 20 randomly selected primary schools in Hawassa City Administration was the source of data. The researchers employed a knowledge assessment test, focus group discussions, and questionnaires to gather the necessary data. The analysis of quantitative data was carried out by using Statistical Package for Social Sciences (SPSS version 25.0). Results. It has been learned from the findings that primary English teacher preparation paid little attention to coursework and practicum to teach early reading. The results also revealed that English teachers felt somewhat prepared to teach early grade reading. There is serious knowledge limitation among English teachers that (12)9.6% of primary English teachers scored 50% and above, whereas (113)90.4% of teachers scored below 50%; the teachers’ average knowledge test score was 36.4%. The results have clearly indicated that it is statistically significant, the direct relationship among teacher preparation coursework emphasis, practicum attention statistically significant, direct relationship among teacher preparation coursework emphasis, practicum attention, and teachers’ felt preparedness at (p=0.001). Conclusions. The results have led to the conclusion that teacher preparation, both in its coursework and practicum, did not pay due attention to teaching early grade reading. That is, primary English teachers were inadequately prepared to teach early grade reading. Based on the results of this study, to improve the practice of early literacy instruction, English teachers’ knowledge and skills gaps need to be duly addressed. Further studies that investigate the current practice of early literacy teacher preparation and professional development should be conducted with a larger sample size and diverse contexts.

Utilization of Artificial Intelligence to Improve Equitable Healthcare Access for Breast Implant Patients

Abstract The recently mandated US Food and Drug Administration (FDA) patient decision checklists were developed with the goal of improving the informed decision-making process for patients considering breast implants. Yet, prior research has demonstrated that these checklists are written at reading levels far in excess of that recommended by the National Institutes of Health and the American Medical Association. Patients considering breast implants are required to sign these forms prior to surgery, even if they have little to no comprehension of their contents. This study aims to improve the accessibility, and therefore the utility, of the mandated FDA patient literature using the assistance of artificial intelligence (AI). Patient decision checklists were obtained from the three most utilized breast implant manufacturers in the United States– Allergan, Mentor, and Sientra. AI was then asked to synthesize a novel patient decision checklist, written at the 6th grade reading level, using these checklists as source material. The AI-assisted checklist was edited by plastic surgeons for both formatting and content. Readability analysis of all documents was performed using the Flesch Reading-Ease Score, Flesch-Kincaid Grade Level, Gunning-Fog Index, Coleman-Liau Index, Simplified Measure of Gobbledygook, and Automated Readability Index. Textual analysis included sentence count, word count, number and percentage of complex words, average number of words per sentence, and average number of syllables per word. The overall readability of Allergan, Mentor, and Sientra patient checklists correlated with the college reading level. These documents were of a statistically significantly higher reading level the AI-assisted checklist, which was written at the recommended 6th grade level. Text composition analysis similarly demonstrated substantial differences between the AI-assisted and FDA mandated literature. The currently mandated breast implant patient checklists are written at a college reading level and are inaccessible to the average patient. We propose a new patient decision checklist, generated with the assistance of artificial intelligence, in order to improve healthcare access within plastic surgery. This simplified material can be used as an adjunct to the current checklists in order to improve shared decision making.

Standard HIPAA Authorization Forms Decreased Response Rates for a Multi-site Pragmatic Trial.

The Health Insurance Portability and Accountability Act (HIPAA) aims to safeguard patient information; however, complex legal language may lead to confusion and mistrust, and hinder enrollment in clinical trials. To evaluate the effect of a standard HIPAA authorization included in mailed survey packets on study enrollment for a multi-site pragmatic trial. This study is nested within an advance care planning pragmatic trial at 50 primary care clinics across three University of California (UC) Health Systems. We included English and Spanish-speaking seriously ill patients. One third of eligible patients received and 2/3 did not receive the HIPAA authorization in their enrollment packet. We compared enrollment rates at 3months and assessed the readability, understandability, and actionability of the standard HIPAA form using the Federal Plain Language Guidelines Checklist for Plain Language, the Automatic Readability Checker consensus calculator (grade 8 is the average reading level for US adults), and the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P, 0-100%, 70% considered the minimum). Of 4632 eligible patients (mean age 71, 48% women, 11% Spanish-speaking, 40% racial/ethnic minority); 1543 received a mailed enrollment packet with a HIPAA form and 3089 did not. Patients mailed the HIPAA form were less likely to enroll (10.2% vs. 14.8%, p < 0.001). The standard HIPAA form scored at the 12th grade reading level, had a PEMAT-P Understandability score of 42%, had an Actionability score of 40%, and only met 50% of Federal Plain Language Guideline Checklist items. The inclusion of a standard HIPAA authorization in mailed enrollment packets for a large pragmatic trial led to lower rates of study enrollment. This study informs how HIPAA authorization forms should be redesigned to be more accessible to patients to prevent unnecessary barriers to research enrollment.

Millions of Students are (Still) Above Grade Level: Achievement and Achievement Variability in Mathematics and Reading Before and During COVID-19 in the United States

According to a 2017 article by Peters and colleagues, millions of students have already demonstrated they know the material slated to be taught that year. Consequently, grade-level standards are unlikely to be appropriately challenging for these students. In this paper, we conceptually replicated and extended this prior study. Using data from schools that administered the Renaissance Star assessment in Fall 2018 and Fall 2021, we quantified pre-COVID and mid-COVID average achievement and variance in achievement in mathematics and reading in fifth grade and estimated the grade level of instruction needed for students. Our results indicate that (a) achievement dropped during COVID-19 relative to pre-COVID, but the drop in mathematics was larger, and (b) achievement variability increased during COVID-19, but the variability in reading was slightly more pronounced. Further, our results replicated Peters et al.’s (2017) results showing that large numbers of students still performed above grade level, and substantial variability in achievement was present within schools.

Online Patient Resources for Birdshot Uveitis: How Readable are These Resources?

ABSTRACT Purpose Birdshot uveitis is a rare ophthalmic condition that can be challenging to control. The readability of online patient resources may impact the management of patients with birdshot. Thus, we examined the readability of online patient resources and identified differences in readability among sources and sections of websites. Methods We queried 3 search engines (Google, Yahoo, Bing) for search results based on a series of terms related to birdshot uveitis. One hundred and twenty results were retrieved and 17 articles were assessed for readability analysis using validated readability and grade-level metrics. Articles were scored based on their entire textual content and, when feasible, also based on sections (e.g. background, diagnosis, treatment). Statistical analyses were conducted using ANOVA and Tukey’s honestly significant difference. Results The websites analyzed were from hospitals and academic centers (5), private practices (3), patient advocacy organizations (4), and other non-profits (5). On average, online patient resources are too difficult to read according to readability scores and grade levels ranging from late high school to college graduate. Articles written by non-profits other than advocacy organizations had an average of 6.5% more complex words than articles written by hospitals and academic centers (p < 0.05). Multiple metrics revealed that the treatment sections were less readable than the causes and symptoms sections. Conclusion The readability of online patient resources for birdshot far exceeds reading levels recommended by the AMA, NIH, and patient safety organizations. Efforts should be made to improve the readability of patient education materials and patient understanding of their disease.

Teachers' strategies for training students' literacy and numeracy through media-based learning in Pansor Village

This community service is entitled teacher strategies in training students' literacy and numeracy through media-based learning at SDN 5 in Pansor village, Kayangan sub-district, North Lombok district. This service is carried out with several objectives, first, to increase awareness about the importance of learning numeracy literacy from an early age, second, to provide knowledge to the students of SDN 5 Sesait that learning numeracy literacy is not just by reading books but can use several tools. apart from books such as drawing media and ice cream sticks and so on. The method used is a face-to-face and direct practice method of learning literacy and numeracy using image-based media or using ice cream sticks by constructing a framework. The results obtained from this service or socialization are to outline the methods used by teachers to teach students mathematics and literacy using media-based learning. Numeracy literacy is one of the first steps or stages that must be trained in school. One of the factors causing media-based Literacy and Numeracy training to be held in Pansor Village, especially at SDN 5 Sesait, is the low ability in reading and arithmetic in grades 5 and 6 which is caused by contemporary factors, namely playing online games and playing social media, especially for children. elementary school children who are continuously without parental supervision.