The Bermuda Triangle of guideline presentation: What are our readers missing?

Aim: To discuss how graphical design, language and text complexity can impact upon the end users ability to implement a guideline. Background/Importance: Guideline development often focuses on the evidence base to make clinical decisions, with less emphasis upon the final design layout or use of language and design for the end user. Methods/Process: This was a study which used grounded theory methodology. Methods used semi structured interviews with participants as well as a discourse analysis on Paramedic guidelines. Results/Lessons Learnt: In an effort to create fast and efficient-to-use guidelines, many shortcuts are taken within the presentation of the paramedic guideline. These guideline shortcuts may challenge paramedics to understand the expectations of care for patients and additionally they are created without acknowledging their heterogeneous education and training background. Conclusion: Readability of a guideline should be emphasised during guideline conception stage. Attention to language level and text complexity need to be suited to the intended audience.