Scientific vs plain

medical English
(Module: Medical Terminology, part 3)

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 Intro
• Thank you for coming!
• I will try not to speak too much today.
– I caught some kind of flu virus, I have a sore
throat, my voice sounds weird, it hurts when I
swallow and my ears are plugged and painful.
– Diagnosis?

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 How you can help
• Pay attention
• Get involved & stay involved
• Raise your hand when you want to speak
• Don’t monopolize / hide away
• Be respectful and supportive of your
colleagues
• Contribute to a climate of care and positive
experience for ALL

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 START
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 Learning objectives
• Be aware of some linguistic sources of
misunderstanding and miscommunication
– When interacting in a foreign language
• Activate and expand your plain English
vocabulary for pain and other symptoms
– How an English-speaking patient would
describe his/her symptoms

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 Learning objectives
• Learn how to obtain accurate and
complete information about symptoms
– The 7+1 questioning protocol
• Ethical professional development
– Understand the significance of adapting your
language to the interlocutor
– Explore links between (in)effective and
(un)ethical medical communication

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 1
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 Activity 1
• Is it enough to master the scientific medical
terminology in order to communicate
successfully as an “international” doctor?
– Let’s discuss 6 situations – method:
1. Individual reflection
– Raise your hand when ready
2. Discuss with people next to you
– Wait to hear my whistle blow and raise hands when ready
3. Whole group discussion
– Wait to hear my whistle blow

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 Situation 1
• A Romanian-born cardiovascular surgeon
working in the UK checks on a patient
scheduled for surgery the next day:
– Doctor: "How are you feeling, Mr. Colby?”
– Mr. Colby: "To tell you the truth, doctor, I think I
am getting cold feet."
• The next day, the doctor postponed the
surgery and ordered vascular tests.

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 Situation 2
• In a hospital in the US, a nervous patient in
need of reassurance expressed his
nervousness by jokingly asked his
Romanian-born surgeon:
– Patient: "Doctor, am I going to kick the bucket?"
– Doctor: “Oh, yes, you are definitely going to
kick the bucket after this!”
• The patient was not reassured.

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 Situation 3
• Kelly is deaf. She comes in for her HIV test
results, but no interpreters for the deaf are
available. Since Kelly is quite proficient at reading
lips, she is given the test results directly. She is
told that her results are positive (meaning, of
course, that she is HIV-positive). Kelly seems
calm and quite relieved, so the doctor does not
discuss it further. Kelly goes home and does not
return to the hospital for follow-up.

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 Situation 4
• Dr. Popescu is explaining to Lin Lee and her
husband, both Chinese, exactly how to take the
medication which Lin is supposed to continue with
after her discharge from hospital. Throughout Dr.
Popescu’s explanation, both nod their heads in
agreement, saying "Yes" repeatedly and smiling
quite nervously. One week later, Lin is once again
admitted to hospital due to complications resulting
from not taking the medication correctly.

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 Situation 5
• Mirela, a Romanian nurse in the UK, is assigned
to care for the 6 patients of Japanese-born Dr.
Kurasawa. During report, the doctor consistently
refers to all the patients as "he", although Mirela
can see that 4 of the patients are female. She
asks the doctor to confirm that there are no male
patients in those beds. Doctor Kurasawa
acknowledges that fact and continues in the same
manner. Mirela is now confused: have 4
transsexuals slipped in?

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 Situation 6
• A Romanian-born doctor in the UK gets a new
resident on his medical team. The resident is
originally from South Africa. When the doctor asks
the resident to do some paperwork, the resident
says: ''I'll get to it just now." One hour later, the
doctor asks for the work, but it hasn’t been done
yet. The doctor is frustrated and now so is the
resident.

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 Conclusion to activity 1
• What do we learn from these situations?

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 2
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 Activity 2
• Talking about PAIN
– How do YOU react to pain?
– In groups of 3, describe the kinds of pain you
have experienced until now
• IN ENGLISH PLEASE !!!
• As you do this, compile a vocabulary list with plain
English words describing different kinds and
intensities of pain
• Time: 3 min, 1 min each

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 Words and expressions
• Pain
– ...
• Other common symptoms
– ...

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 Conclusion to activity 2
• What do we learn from this activity?

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 3
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 7+1 attributes of symptoms
This is a questioning protocol for doctors:
1. Location, e.g. Where does it hurt?
2. Quality, e.g. How does it hurt?
3. Quantity, e.g. How much does it hurt?...
4. Timing, e.g. When did the pain start? How long does it last?
5. Setting/Context, e.g. What were you doing when you began to feel
worse?
6. Aggravating / alleviating factors, e.g. Does anything make the pain
worse / go away?
7. Associated manifestations, e.g. What else have you been feeling?

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 Activity 3
• Switching from scientific medical English to
plain medical English
– Read the text, clarify unfamiliar vocabulary
– Let’s imagine the following conversations:
• Paul + father + doctor before surgery
– The doctor uses the 7+1 questioning strategy
• Medical staff during surgery
• Paul + doctor after surgery

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 Conclusion to activity 3
• What do we learn from this activity?

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 4
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 Activity 4
• Read and choose between:
– I agree. / I disagree. / It depends. / I don’t know.
1. The doctor should let the patient describe the symptoms using
his/her own words.
2. The doctor should tell the patient about the test results, diagnosis,
treatment and prognosis.
3. The doctor should let the patient decide on the preferred course
of treatment.

What professional values and principles do these

statements refer to?

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 What if…
1. …the patient does not know how to describe
his/her symptoms?
2. … the doctor (is not aware that he/she) does not
understand what the patient is saying?
3. …the patient says that the pain is greater/less
than it really is?
4. …the patient does not understand the test
results, diagnosis, treatment and prognosis?
5. …the patient only pretends to understand/agree?

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 Adopt a patient
• In pairs, choose a photo from the gallery
– Discuss how the person in the photo
• Might react to suffering
• Might describe suffering
• Might be vulnerable to the doctor’s attitude and
approach to communication
– Time:
• 5 min to prepare
• 10 min to share ideas

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 Conclusion to activity 4
• What do we learn from this activity?

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 5
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 Activity 5
• Listen to Dr Finley give results to Ben White
• Does Dr Finley
– Give correct amount and type of information?
– Organize information?
– Include the patient’s perspective?

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 • Giving correct amount and type of information
1. Give information in manageable chunks
2. Check for understanding
3. Ask for the patient’s prior knowledge early on
4. Use the patient’s response as a guide on how to continue
5. Ask the patient what other information would be useful
6. Helping the patient understand and remember new information
• Organize information
1. Use signposting, e.g. First... Second...
2. Use visuals to help explain conditions or procedures
3. Check the patient’s understanding of new information
4. Repeat and summarize to reinforce information
5. Explain in a clear, concise way – avoid jargon
• Including the patient’s perspective
1. Pick up and respond to verbal and non-verbal cues
2. Elicit how the patient is feeling
3. Allow the patient to ask questions and get clarification

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 Conclusion to activity 5
• What do we learn from this activity?

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 Informed consent
• Authentic informed consent requires
– sufficient information, explanations and
examples
– in a way that is understandable to the patient,
– opportunities for the patient to clarify and
discuss,
– as well as enough time for the patient to make
a decision.

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 6
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 Final reflection
• What professional values have you
learned to embrace today, if any?
• trust, respect, altruism, care, compassion,
devotion, responsibility, dignity, honesty,
integrity, fairness, diligence, collegiality,
teamwork, empathy, generosity, confidentiality,
consent + love, perceptiveness, friendliness,
freedom, enthusiasm, imagination, patience,
sincerity, hope, curiosity…

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 Individual learning log
• At the end of each module, I would like you
to fill in this simple form referring to your
personal learning experience in the
classroom and give it to me for safe
keeping
– Fill it in at home and bring it to me next time for
safe keeping
– You will revisit your logs at the final (self-)
evaluation seminar

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 FINISH
& THANK YOU !

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