A method to quantify residents' jargon use during counseling of standardized patients about cancer screening. J Gen Intern Med 2008 Dec;23(12):1947-52
Date
08/02/2008Pubmed ID
18670828Pubmed Central ID
PMC2596518DOI
10.1007/s11606-008-0729-3Scopus ID
2-s2.0-57249115151 (requires institutional sign-in at Scopus site) 49 CitationsAbstract
BACKGROUND: Jargon is a barrier to effective patient-physician communication, especially when health literacy is low or the topic is complicated. Jargon is addressed by medical schools and residency programs, but reducing jargon usage by the many physicians already in practice may require the population-scale methods used in Quality Improvement.
OBJECTIVE: To assess the amount of jargon used and explained during discussions about prostate or breast cancer screening. Effective communication is recommended before screening for prostate or breast cancer because of the large number of false-positive results and the possible complications from evaluation or treatment.
PARTICIPANTS: Primary care internal medicine residents.
MEASUREMENTS: Transcripts of 86 conversations between residents and standardized patients were abstracted using an explicit-criteria data dictionary. Time lag from jargon words to explanations was measured using "statements," each of which contains one subject and one predicate.
RESULTS: Duplicate abstraction revealed reliability kappa = 0.92. The average number of unique jargon words per transcript was 19.6 (SD = 6.1); the total jargon count was 53.6 (SD = 27.2). There was an average of 4.5 jargon-explanations per transcript (SD = 2.3). The ratio of explained to total jargon was 0.15. When jargon was explained, the average time lag from the first usage to the explanation was 8.4 statements (SD = 13.4).
CONCLUSIONS: The large number of jargon words and low number of explanations suggest that many patients may not understand counseling about cancer screening tests. Educational programs and faculty development courses should continue to discourage jargon usage. The methods presented here may be useful for feedback and quality improvement efforts.
Author List
Deuster L, Christopher S, Donovan J, Farrell MMESH terms used to index this publication - Major topics in bold
AdultClinical Competence
Directive Counseling
Early Detection of Cancer
Female
Humans
Internship and Residency
Male
Middle Aged
Patient Education as Topic
Physician-Patient Relations
Physicians
