Use plain and inclusive language to prevent misunderstandings
Patient activation may yield important health benefits[1], but when reading their doctor's notes patients often encounter medical jargon and terminology that is not familiar to them, and may even, in some cases, anger or upset them. In a recent N.Y. Times article, the author Tara Parker-Pope cautions that common medical jargon could confuse patients or make them feel judged. Common expressions that may lead to misunderstandings or negative feelings include:
“the patient is a poor historian”
“the patient failed treatment with...”
“patient denies recreational drug use”.
Examples for abbreviations that could be problematic include
SOB (shortness of breath)
F/U (follow-up)
OD (oculus dextrus = right eye)
A recent commentary in the American Journal of Medicine gives providers practical suggestions and advice on how to write clear and effective patient notes. The PEHL website links to plain language dictionaries and inclusive language guidelines to help providers find alternatives for medical jargon and terminology that may be confusing or upsetting for patients.
[1] Dendere R, Slade C, Burton-Jones A, Sullivan C, Staib A, Janda M. Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review. J Med Internet Res. 2019;21(4):e12779. Published 2019 Apr 11. doi:10.2196/12779
Using Icon Arrays to Communicate Risk
Pictographs and icon arrays are two names for a type of risk communication graphic. Pictographs are made up of a matrix of unique elements representing individual units (people) within the at-risk population. Icon arrays are inherently a frequency-based representation of risk. Research has shown that for many people, especially the less numerate, frequency representations of risk are more understandable than percentages. Researchers at the Center for Bioethics and Social Sciences in Medicine (CBSSM), University of Michigan have studied pictographs extensively and concluded that pictographs effectively communicate the incremental benefit of risk-reducing treatments and the risk of developing side effects from medications. Studies have shown that static pictographs are more effective than more complex animated or interactive versions, perhaps because these elements distract attention.
55 Michigan Medicine faculty and staff have already completed a Plain Pledge to affirm their commitment to use plain language when communicating with patients. PEHL captures definitions created through this activity in the new Go Blue Glossary of plain language. If you want to receive the nametag pin to signal your commitment to plain language to your patients, take a few minutes to take a Plain Pledge on the PEHL website.
Clearinghouse News
165 new materials have been added to the Clearinghouse between August 1, 2021 - November 31, 2021. This includes 160 materials created in-house and 5 materials from external organizations that have been reviewed and approved by Michigan Medicine content experts. Notable additions include:
Receiving a kidney from an HCV+ donorscreencast videos. PEHL worked with transplant center pharmacist Sarah Tischer to create an overviewand Q&A videos to help patients understand the pros and cons of this complex and difficult decision, so they can give an informed consent.
Family Crisis Plan (Suicide Prevention) and 10 Helpful Responses to Self Harm Behavior. Authored by social workers these handouts give parents and caregivers appropriate verbal responses to use with at-risk children and adolescents. Both handouts are also available in Spanish and Arabic. The English versions have been uploaded to MiChart patient Instructions.
Check out the new Clearinghouse pages we added for:
Over-reliance on readability formulas and readability scores is a common mistake healthcare professionals make when writing materials for patients. Attend our next class: Beyond Readability Formulas: Writing Clear and Effective Patient-Centered Educational Materials and learn proven, evidence-based principles of plain language writing. The class schedule for 2022 will be posted on the PEHL websitelater in December. Classes are taught by zoom .
This class is also available as an online training module via MLearning. The activity code is UMHS-52601.
Michigan Medicine - Patient Education and Health Literacy Program (PEHL)