Purpose To compare handwriting legibility among professions.
Methods A convenience sample, stratified by gender, of 20 right-handed volunteers each from 7 occupations rapidly wrote the sentence “The quick brown fox jumps over the lazy dog” in < 17 seconds. Legibility was scored by two methods. The number of malformed individual letters was visually judged by a single blinded investigator. Four investigators, blinded to subject characteristics, independently rated the global legibility of the writing samples on a 4-point scale: poor, fair, good, excellent. Raters were tested with the kappa statistic. Characteristics and scores were compared using logit regression and post hoc Wilcoxon rank sum test. Scoring methods were compared by Spearman's correlation. The study was powered to detect a difference of 25% across occupations.
Results Among 70 males and 70 females, with ages 18 to 64 years and 12 to 28 years of education, only education differed among groups. Legibility scores did not differ significantly by occupation, age, or education, but legibility was significantly and consistently better in women.
There was good intra- and interrater agreement (kappa 0.35-0.56 and 0.23, respectively, p < .001) and good correlation between scoring methods (rho -0.75, p < .001). Conclusion: Physician handwriting legibility is not different from other occupations, although illegibility, which has been demonstrated to compromise patient care, is nonetheless prevalent. Legibility is consistently better in women.
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