Reading grade levels rise with difficult medical terms
For easy-to-read text, use med terms sparingly
When difficult medical terms are used in a text, the reading grade level is higher.
Many think that medical terms will skew results on readability formulas, says Audrey Riffenburgh, MA, president of Plain Language Works based in Albuquerque, NM, and a specialist in health literacy and plain language. What they actually do is accurately reflect the difficulty of the text, Riffenburgh says.
"If 'laparoscopy' is in a document 10 times, that means the inexperienced readers who have to sound it out each time they come to it, will have to do so 10 times," she says.
How do adults with weak reading skills make their way through text with unfamiliar, difficult-to-pronounce medical terms? Riffenburgh says every time they come to a word that's not in their sight word vocabulary, which means they know it on sight without needing to sound it out, they have to stop and begin sounding out the unfamiliar word. For example, laparoscopy has 11 letters that make up five syllables that readers have to figure out, put together in the proper sequence, and then say correctly to compare it with words they know in their heads to determine if they can understand it.
When readers don't know what the word means or have never heard it pronounced, they don't have an auditory memory of it to which they can link a visual image. Therefore, they must remember the 11 letters and five syllables, their order in the word, and what the word means if they are able to determine its meaning from the context. However, they are very likely to have lost track of the context by that time, explains Riffenburgh.
Should readers find the word "laparoscopy" again in a sentence, the fact they have sounded it out one time does not mean they now have it in their sight word vocabulary. Most new readers have to see a word in context many, many times before they are able to recognize it quickly enough that it doesn't interrupt the flow of their reading.
The author's priority is most likely to make sure the reader understands all the concepts in the document. For example, if the document is describing a laparoscopy to enable the reader to make an informed decision about whether to have one, the most important information is not the name of the procedure. The reader needs to know what will happen during the procedure and the benefits and risks. Therefore, to get the necessary information, the reader does not need to see the word laparoscopy again and again.
A writer might describe how doctors can make very small cuts in a person's stomach and put a long tube with a light and camera inside to look around, explains Riffenburgh. Then he or she might state, "This kind of surgery is called a laparoscopy," and include a pronunciation guide. The author can then continue to describe the procedure as necessary.
It's more important to make sure readers get the concepts tied to the word, even if they don't learn the word. Patients always can talk to their doctors about the surgery where tiny cuts are made and a tube with a camera on the end is inserted. The health care provider will know what the patient is talking about, states Riffenburgh.
Resources for producing clear language documents
Many resources are available to help patient education managers produce clear, readable patient handouts. To write documents in plain language, Doug Seubert, guideline editor in Quality Improvement and Care Management at Marshfield (WI) Clinic, frequently uses the following resources:
- The Health Literacy Style Manual. Web: coveringkidsandfamilies.org/resources/docs/stylemanual.pdf.
- Scientific and Technical Information Simply Put (Centers for Disease Control and Prevention). Web: www.cdc.gov/od/oc/simpput.pdf.
- Pfizer Principles for Clear Health Communication, Second Edition. Web: www.ihconline.org/toolkits.
- Readability Toolkit from the Group Health Center for Health Studies. Web: www.uams.edu/irb.
For alternative word lists, go to these sources:
- "Simple Words and Phrases" from Plain Language gov. Web: www.plainlanguage.gov/howto/wordsuggestions/simplewords.cfm.
- Words to Watch — Fact Sheet from Partnership for Clear Health Communication. Web: www.npsf.org/askme3/pdfs/words_to_watch.pdf.
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