|Year : 2018 | Volume
| Issue : 1 | Page : 48-53
Is jargon deterrent to effective communication in dental practice? the budding dentists' outlook
Nupur Sharma1, Swati Patnaik2
1 Department of Dentistry, Government Medical College and Hospital, Balangir, India
2 Department of Public Health Dentistry, Institute of Dental Sciences, Bhubaneswar, Odisha, India
|Date of Submission||08-Sep-2017|
|Date of Acceptance||25-Jan-2018|
|Date of Web Publication||23-Mar-2018|
Dr. Nupur Sharma
Department of Dentistry, Government Medical College and Hospital, Balangir - 767 001, Odisha
Source of Support: None, Conflict of Interest: None
Background: Patient–professional communication is a fundamental skill of medical practice. Health-care professionals have to be aware of their own communication practices and need to undergo periodic appraisal of the same. Overzealous and unrepressed use of jargon hinders effective communication between the doctors and patients, leading to a series of misunderstanding. The aim of the study was to assess the use of jargon and its acceptance in clinical history taking among dental students and interns in a dental teaching hospital of Bhubaneswar, Odisha, India. Materials and Methods: A cross-sectional questionnaire-based survey was carried out, consisting of 16 questions on BDS 3rd-year, 4th-year dental students and dental interns. Both descriptive and inferential statistics were computed. Differences between groups were examined using Chi-square test. The level of statistical significance was set at P ≤ 0.05. Results: Two hundred and sixty-seven individuals participated in the present survey, representing an overall response rate of 92.4%. Nearly, 78.9%, 89.6%, and 78% of BDS 3rd-year, 4th-year, and dental interns, respectively, used jargon in case history taking. Almost 61.6% of dental interns admitted that they always used jargon and 22% admitted that they used jargon only when there was a lack of time. Conclusion: This study showed widespread use of jargon/abbreviations in case history taking among the respondents. More medical/dental schools, residency programs, and continuing education programs for practicing physicians need to include training in clinical communication skills to enhance health outcomes.
Keywords: Communication, dental, dentist, jargon
|How to cite this article:|
Sharma N, Patnaik S. Is jargon deterrent to effective communication in dental practice? the budding dentists' outlook. J Indian Assoc Public Health Dent 2018;16:48-53
| Introduction|| |
Language has always been central to the study of man in his environment. Language is a dynamic construct which has social relevance, especially in its environment of usage. The greater value of language lies in its communicability, which is the individual's ability to use the words in a given context. The constant growth of science and technology attracts the entire world. At present, people brief out things, especially in the style of using a language to save their time. The use of SMS lingo, jargons, and abbreviations is becoming more common way of communication. It is hereby observed that the use of jargons and abbreviations is on the rise in both formal as well as informal writing in all fields, and medical profession is no exception.
Jargon can be defined as “the language, especially the vocabulary, peculiar to a particular trade, profession or group.” It serves a dual purpose, one being speeding up communication with people in the know, while on the other hand, it can be used to keep specific knowledge away from the uninitiated. From obtaining the patient's medical history to conveying a treatment plan, the physician's relationship with his patient is built on effective communication. In these encounters, both verbal and nonverbal forms of communication constitute this essential feature of medical practice.
Patients' perceptions of the quality of the health care they received are highly dependent on the quality of their interactions with their health-care clinician and team. The doctor–patient relationship should be two-way and mutually beneficial., It involves developing shared perceptions and feelings regarding the nature of the problem, goals of treatment, and psychosocial support.
Effective communication is an important aspect of patient care, which improves physician–patient relationship and has a profound effect on the patient's perceptions of health-care quality and treatment outcomes. Inappropriate use of medical terms in health-care professional–patient communication has been associated with problems in relation to patient empowerment, patient autonomy, patients' emotional ease, satisfaction, and compliance. Overzealous and unrepressed use of jargon hinders effective communication between the doctors and patients, leading to a series of misunderstandings.
There is a wealth of research data that support the benefits of effective communication and health outcomes for patients and health-care team and very few exploring the communication barriers in health-care settings.,,,, A study done by Subramaniam et al. revealed widespread use of jargon/abbreviations in case history taking among the clinical dental undergraduate students, house surgeons, postgraduate students, and faculty members in dental colleges. The aforementioned literature highlights the lack of knowledge regarding standard medical abbreviations and overzealous use of jargons hindering effective communication.
Hence, this study aimed to assess the use of jargon and its acceptance in clinical history taking among dental students and interns in a dental teaching hospital, Bhubaneswar, Odisha, India.
| Materials and Methods|| |
A cross-sectional study was conducted in one of the private teaching dental hospitals in Bhubaneswar, Odisha, India, and included the BDS 3rd-year, 4th-year dental students and dental interns. A 16-item questionnaire adapted from a study done by Subramaniam et al. was used to collect data in the present study. Test–retest reliability was performed to test the reliability of the questionnaire and was found to be good with Cronbach's alpha (α) 0.75. The participants were informed about the nature of the study and confidentiality was assured. The study was done during April–August in the year 2017.
The research instrument was a self-administered questionnaire in the English language. This survey was completed during regularly scheduled class sessions in an average time of 10 min. The 16-item questionnaire consisted of two sections; the first section consisted of 2 questions included information on sociodemographic characteristics such as gender and year of study and the second section consisted of 14 questions on the acceptance and use of jargon during case history taking in a dental setting. One of these 14 questions was open ended asking the respondents to mention the most commonly used abbreviations by them. The Institutional Review Board approved the research protocol for the study. Informed consent was obtained from all the participants.
The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20 (IBM, Chicago Inc., IL USA). Both descriptive and inferential statistics were computed. Differences between groups were examined using Chi-square test. The level of statistical significance was set at P ≤ 0.05.
| Results|| |
Out of 289 students enrolled in the concerned dental institution, 267 participated in the present survey, representing an overall response rate of 92.4%. Of which, 263 duly filled forms were included for the statistical analysis. The majority (58.6%) of participants were females. Approximately 34.2% were BDS 3rd-year students, 33.1% belonged to BDS 4th-year students, and 32.7% were dental interns.
Acceptance and use of jargon among respondents
Majority of the respondents (78.9%, 89.6%, and 78% of BDS 3rd-year, 4th-year, and dental interns, respectively) used jargon in case history taking. Majority of dental interns (61.6%) admitted that they always used jargon and 22% admitted that they used jargon only when there was a lack of time. There was a statistically significant difference between frequency of use of abbreviations and year of study (P< 0.000) [Table 1].
|Table 1: Response to questions pertaining to the acceptance and use of jargons in case history taking in a clinical dental setting (n=263)|
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Majority of the respondents, that is, 82.2% of BDS 3rd-year, 81.6% of BDS 4th-year, and 88.4% of dental interns used abbreviations for saving time.
Third-year BDS students (68.9%), 4th-year BDS students (67.8%), and dental interns (79%) learned the jargons from their colleagues, whereas 20%, 18.4%, and 8.1% of them, respectively, reported that they learned it from their teachers.
More than half of the respondents of 3rd-year BDS students (57.7%), 4th-year BDS students (55.1%), and dental interns (80.2%) reported that they were aware of the standard medical abbreviations. This difference between groups was statistically significant (P< 0.001).
When asked if the respondents had difficulty in understanding abbreviations written by others, majority of the 3rd-year BDS students (57.7%) reported to have faced difficulty as compared to 51.6% and 31.3% of 4th-year BDS students and dental interns, respectively. This difference between groups was statistically significant (P = 0.004).
A significantly higher percentage of dental interns (80.2%) were aware of standard medical abbreviations as compared to 57.7% of BDS 3rd-year and 55.1% of BDS 4th-year students (P = 0.001).
Almost 78.8% BDS 3rd-year, 85% BDS 4th-year, and 88.3% dental interns hoped that the use of abbreviations should be permitted in case history taking.
The jargons used by the respondents are given in [Table 2].
| Discussion|| |
Communication is essentially the activity of relaying information, expressing emotions, and building relationships in order for trust to develop between health-care providers and their patients/residents; it is important that effective communication is developed and maintained.
Communication is often regarded as an important tool in a health-care setting that when used effectively has the capacity to educate, empower, and de-threaten common health issues, patients present with in practice. Effective communication improves overall satisfaction and contributes toward better long-term health outcomes. However, if it is used ineffectively, it can have detrimental effects creating fear, confusion, and anxiety in patients as well as encouraging resistance to lifestyle changes and healthy behaviors.
Limited literacy skills are one of the strongest predictors of poor health outcomes for patients affecting health status, health-care use, and appropriate health-care decision., Further, the need for health consumers to be “health literate” in today's technologically advanced society is greater than ever before as they are required to participate in more complicated preventative health-care and self-care regimens, understand more complex health information, and navigate more complex health systems.
Often, low health literacy has been regarded as “silent epidemic,” a mismatch between a clinician's level of communication and a patient's level of comprehension. For effective disease management and maintenance of oral health, one must be able to understand, interpret, and act on health information, whether it is communicated verbally or in written form.
This mismatch in communication is further accentuated by the use of jargons in the medical profession. Jargon usually means the specialized language or code used by people in the same work or profession that is difficult for others to understand. In professions that deal with life and death situations on a daily basis, talking in code may not be the best idea.
Health communication research and guidelines often recommend that medical terminology be avoided when communicating with patients due to their limited understanding of medical terms. The use of medical jargon in case history taking is often justified on the grounds that it constitutes a kind of medical shorthand, allowing more efficient communication when the time is short.
Time management in the medical office is essential if the practice is to achieve any level of success and survive in today's health-care market. With the ongoing changes occurring in health care, efficient time management is more important today than ever before. It is a priority in delivering excellent patient care. Most of the respondents in our study also justified the use of jargons to save time. Similar findings were reported in a study done by Subramaniam et al., LeBlanc et al., and Lerner.,,
Although it has become common practice to use abbreviations and acronyms in medical records, their overuse has been highlighted as a concern for patient safety. Certain abbreviations have been noted to cause an increase in misinterpretations and consequently medication errors., In the present study, it was surprising to note that majority of the dental interns (61.6%) always used jargons during communication. This is a cause for concern as ambiguity arising from multiple interpretations of abbreviations can be potentially detrimental to patient care.
The medical profession is well known for offering effective mutual support to its members. Understanding the nature, magnitude, significance, and implication of peer group influence in education is very crucial and important for the “productivity” of educational processes. Peer group is an important influence throughout one's life, but they are more critical in relation to academic performance. It was interesting to note that most of the respondents were influenced by their colleagues as well as peers and reported to have learned the use of jargons from them. Similar findings were reported by Subramaniam et al.
Doctors and other health-care professionals commonly use a list of abbreviations, acronyms, and other medical terminology as a reference to rapidly search and accurately record information about and give instructions to their patients. Its use eases clinical proceedings and enables everyone involved in the process of treatment and care to perform more efficiently for the patient's benefit. Many agencies and authors have attempted to come up with a comprehensive list of English language medical abbreviations, but it is a cause for the disappointment that there is no standard or approved list used by health-care professionals to search for medical acronyms or abbreviations.,, Therefore, it is important to understand the context in which the abbreviation or term has been used.
The findings of the present study indicated that as compared to the dental interns, majority of the BDS 3rd-year and 4th-year students faced difficulty in understanding abbreviations used by others which is in agreement with a previous study conducted by Subramaniam et al. This may be explained by the fact that dental interns have greater clinical exposure and are well trained as compared to a undergraduate dental student.
This also calls for a need to have a standardized guideline for the use of medical as well as dental abbreviations or jargons to avoid miscommunication in interpreting medical records leading to medicolegal issues.
The process of curing a patient requires a holistic approach which involves considerations beyond treating a disease. It warrants several skills in a doctor along with technical expertise. Good communication skills among the doctors are crucial in building a trustworthy doctor–patient relationship that not only helps in therapeutic success by providing holistic care to the patient but also leads to job satisfaction among the doctors. Not many doctors are naturally blessed to have good communication skills, and there is a necessity of formal training in this study.
While the curriculums of most medical schools now include some form of training in communications skills, this is a fairly recent phenomenon. Conventionally, medical education in India has paid little attention to the skills that promote effective interactions with patients. Most practicing physicians have not been taught to appreciate the patient's experience of illness; nor do they learn how to partner with patients and serve as a coach or guide. As a result, they typically do not know how to communicate with patients in a way that maximizes understanding and involvement in decision-making.
A plethora of work is dedicated to lack of communication in health care, but not many have highlighted the effects of using jargon on health care.,, Uncontrolled and unchecked use of jargon instead of standard medical terminology can be dangerous. The current study is pristine and novel in nature and adds to a very limited body of literature which evaluates the use of jargon and its acceptance in clinical history taking among dental students in a dental teaching hospital, Bhubaneswar, Odisha, India. However, our study had certain limitations. The data for the study relied heavily on the information received from the respondents so may be biased by social desirability.
The current study with a sample size of 267 provides an insight to the use of jargon and its acceptance in clinical history in a single institution. Studies with a larger sample size in multiple health centers are recommended to provide more accurate understanding of jargon use in a wider population.
| Conclusion|| |
Medical terminology is the standardized means of communication within the health-care industry. The importance of fluency in medical terminology, which applies to all hospital personnel, including allied health-care professionals, cannot be overstated. This study revealed a widespread use of jargon/abbreviations in case history taking among the dental undergraduate students and dental interns. More medical/dental schools, residency programs and continuing education programs for practicing physicians need to include training in clinical communication skills to enhance health outcomes.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]