A method to quantify residents' jargon use during counseling of standardized patients about cancer screening.
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.


METHODS
Primary care internal medicine residents.


METHODS
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.
Deuster
Lindsay
L
Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee, WI 53226-0509, USA.
Christopher
Stephanie
S
Donovan
Jodi
J
Farrell
Michael
M
D000328:Adult; D002983:Clinical Competence / Q000592:standards; D037001:Directive Counseling / Q000379:methods* / Q000592:standards; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards; D010817:Physician-Patient Relations; D010820:Physicians / Q000592:standards