The readability of teaching and learning text books used for Health training programmes in the Ministry of Health in Kenya
Mwamisi, Joseph Musyoka
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Teaching and learning text books that are difficult to read are a hindrance to the delivery of health care services that are vital to a healthy nation. These teaching and learning text books pose problems and difficulties to the reader who is expected to acquire skills. The problems may come as a result of unsuitable teaching and learning text books used by health workers during their training. The teaching and learning text books may be defective or bad because they may not be written well and may have difficult vocabulary, long sentences or unclear illustrations. This study hoped to identify the reading problems in the teaching and learning text books used in the training of health workers under the Ministry of Health in Kenya. In order to identify these reading problems it was important to determine the readability of these text books. From the review of the literature it is clear that there are several factors that can contribute to readability problems in teaching and learning text books. The study adopted the survey design. The population of the study comprised the Kenya Medical Training College and the Medical Training Centers in the six provinces (Coast, Eastern, Nairobi, Central, Rift Valley, Nyanza and Western) namely: Mombasa, Medical Training Center, Machakos, Medical Training Center, Kenya Medical Training College, Nakuru, Medical Training Center, Kisumu, Medical Training Center and Kakamega, Medical Training Center. The number of respondents for the study was 139. Data were collected through questionnaires and from text books used during health training programs under the Ministry of Health in Kenya. The questionnaires were administered by the researcher and extracts from the teaching and learning text books collected for analysis. Quantitative data was analyzed using descriptive statistics and results presented in percentages. A total of 26,000 words from two hundred and sixty (260) extracts of the teaching and learning text books were analyzed using Flesch Formula Nomogram. This formula helped the researcher to use the criteria of syllables per words for lexical difficulty and words per sentence for syntactic complexity as criteria for overall readability of text. Comparisons were done among the 26 textbooks analyzed and the research revealed that some of the extracts were of standard level. In addition some extracts within a text book comprised standard and difficult levels. In summary results from the application of the Flesch formula suggested that the text books' heading passages are pitched at a very difficult readability level. The average Reading Ease Score (RES) is within the 30 - 50 range, which are (36.) "difficult". The researcher also used a content analysis approach known as Personal Judgment to assess the readability of teaching and learning text books by examining several factors that contribute to the readability of the text books, namely: lexis, syntax, text organization, coherence, cohesion, punctuation, headings, text and art work interaction and reader involvement. The number of textbooks used was 26. The research has revealed that the most readable teaching and learning text books have the following characteristics: The text book is characterized by:-fewer latences, shorter sentences, comparatively normal (25 words and below) sentences inVG length, comparatively low syllables /100 words ratio, high proportion of simple words, It also has discourse markers or sign posts such as then, however, but..... In conclusion the study indicated that the analysis of the Teaching and Learning Text books used during health training program under the Ministry of Health in section 4.4 has revealed that readability in the writing of the Text books has not been given top priority. This is proved by the fact that the findings, based on data analysis, measurement by formula, evaluation by students and trainers, variables contributing to readability, etc., place the Teaching and Learning Text books at a difficult reading level. Another problem includes some typing errors in some text books. This implies that some of these text books are not adequately proof - read. Perhaps an good editor needs to be appointed. Evaluation by students and trainers show several short comings, such as illustrations lack gender balance and are insensitive to cultures. Some illustrations are also confusing. Sentences are rather long with complicated vocabulary. Most of the text books are outdated and therefore, require review/revision. The study recommends that in order to improve the readability of teaching and learning text books used for training students under the Ministry of Health in Kenya it would be necessary to initiate or improve an existing program by developing a program for teaching the development of readable teaching and learning text books.