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How clinical features are presented matters to weaker diagnosticians
Author(s) -
Eva Kevin W,
Wood Timothy J,
Riddle Janet,
Touchie Claire,
Bordage Georges
Publication year - 2010
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/j.1365-2923.2010.03705.x
Subject(s) - terminology , medical diagnosis , test (biology) , context (archaeology) , medical terminology , psychology , unified medical language system , language assessment , sample (material) , medical education , medicine , family medicine , linguistics , computer science , artificial intelligence , nursing , mathematics education , radiology , paleontology , philosophy , chemistry , chromatography , biology
Medical Education 2010: 44 : 775–785Objectives  This study aimed to test the extent to which the use of medicalese (i.e. formal medical terminology and semantic qualifiers) alters the test performance of medical graduates; to tease apart the extent to which any observed differences are driven by language difficulties versus differences in medical knowledge; and to assess the impact of varying the language used to present clinical features on the ability of the test to consistently discriminate between candidates. Methods  Six clinical cases were manipulated in the context of pilot items on the Canadian national qualifying examination. Features indicative of two diagnoses were presented uniformly in lay terms, medical terminology and semantic qualifiers, respectively, and in mixed combinations (e.g. features of one diagnosis were presented using lay terminology and features of the other using medicalese). The rate at which the indicated diagnoses were named was considered as a function of language used, site of training, birthplace and medical knowledge (as measured by overall performance on the examination). Results  In the mixed conditions, Canadian medical graduates were not influenced by the language used to present the cases, whereas international medical graduates (IMGs) were more likely to favour the diagnosis associated with medical terminology relative to that associated with lay terms. This was true regardless of whether the entire sample or only North American‐born candidates were considered. Within the IMG cohort, high performers were not influenced by the language manipulation, whereas low performers were. Uniform use of lay terminology resulted in the highest test reliability compared with the other experimental conditions. Conclusions  The results indicate that the influence of medical terminology is driven more by substandard medical knowledge than by the language issues that challenge some candidates. Implications for both the assessment and education of medical professionals are discussed.

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