157 - Jargon Jumble: Teenagers’ Understanding of Medicalized English

Poster Number: 157
Publication Number: 157.157

Background: Despite recognizing the importance of minimizing jargon, it is still overused with patients. A 2021 study demonstrated how poorly adults understood a subset of jargon called “medicalized English” – terms or phrases that have different meanings in a medical context than everyday use.

Objective: We aimed to repeat this study with teenagers, characterizing their understanding and comparing it to adults.

Design/Methods: We recruited 13- to 17-year-old volunteers at the 2023 Minnesota State Fair, representing a cross-section of the population, to take an anonymous, validated survey and assess their understanding of common phrases a doctor might say or write. The same survey was previously used by members of this author group with adult volunteers. Prompts included both multiple choice and free text options. Responses were coded as correct, partially correct, or incorrect by two independent researchers, with a third researcher reconciling discrepancies. Fisher’s exact tests were used to compare the proportion correct between teens and adults.

Results: 71 teens volunteered (55% female, 42% male, and 3% non-binary; mean age of 15 years). Like adults, teens demonstrated a poor understanding of many of the phrases evaluated, with teens having statistically lower understanding than adults on 5 of 13 questions (38%) (Table 1). While 97% knew that “negative” cancer screening results meant they did not have cancer, fewer understood that “the tumor is progressing” or having “positive nodes” in the context of cancer was bad news (69% and 53%, respectively). While most understood that an “unremarkable” chest X-ray was good news (65%), few (17%) realized that having an “impressive” chest X-ray was usually a bad thing. When phrased in lay terms, more teens understood “your blood test shows me you do not have an infection in your blood” (89%) rather than “your blood culture was negative” (52%), and “you are to have nothing by mouth after 4 PM” (48%), rather than “ you will need to be NPO at 8 AM” (0%). Only 10% of teens understood that “bugs in the urine” conveyed a urinary tract infection, with 37% expressing a literal interpretation of insects. None of the teenagers knew what an occult infection meant. Similarly, none knew the meaning of “febrile,” with 10% believing that it was related to fertility or sexual activity.

Conclusion(s): Many common phrases within a medical context are misunderstood by teenagers, with many interpretations being the exact opposite of what the healthcare provider intends.