A corrective approach to doctors’ illegible handwriting: A pilot course in Italy

Dear Sir

Doctors’ handwriting has always received some attention by media and public because it is usually believed to be qualitatively poor. In fact, sloppy doctors’ handwriting can lead to perilous misinterpretations of medical notes, medical expressions, or even drug dosages. In turn, this can easily lead to malpractice or even to client's death (Sokol & Hettige 2006). An article appeared in Time magazine (Caplan 2007) stated that poor doctors’ handwriting kills about 7000 people each year. This appalling number reminds medical teachers the importance of a legible handwriting in professionalism of medical students and doctors. Besides, although efforts have been made to introduce doctors’ notes directly into electronic tablets, a pilot course for improving doctors’ handwriting was started in Italy. An ad-hoc scale of legibility was used for formative and summative assessment. It was based on a single evaluation of 40 unrelated words that each doctor copied from a pool of 100 randomly extracted. Five independent assessors scored the 40 words by using a five-point Likert scale, scoring from 5 (100% legibility) to 1 (0% legibility). Finally, the scores from the assessors were averaged to obtain the final result for each doctor. The remedy course included practical skills in calligraphy and fast handwriting. Participants were then introduced to theories of personality and handwriting explained by certified graphologists. Furthermore, theories and labs of calligraphy initiated participants to aspects of style and corrective actions in handwriting. Other sections introduced learners to medico-legal aspects of errors in interpretations from poor doctor's handwriting. At the end of the course, the majority of learners felt that it gained insight into risks for malpractice and the potential threat to a client's life from illegible prescriptions and unreadable medical notes in hospital and private practice. The corrective course also generated an improvement of handwriting legibility on the test with a mean entrance score of 1.82 (SD = ±0.80) and with a mean exit score of 4.12 (SD = ±0.71) in 150 participants.