Effect of a Clear Communication Training on Medical Residents' Use of Jargon in Written Messages to Patients

Background/Objectives: Despite recommendations to use plain language for better outcomes in clinical care, physicians and other health care professionals frequently use unexplained medical jargon when communicating with patients. Few studies have examined the use of jargon in personalized written communication with patients. We evaluated the effects of a clear communication curriculum on medical residents' use of unexplained jargon in written health-related messages sent to patients through a secure electronic patient portal. Methods: We retrospectively collected messages sent by first-year family medicine residents to patients during the 3 months before and 3 months after completion of a curriculum on health literacy and clear communication. Two researchers independently coded jargon in messages according to Pitt and Hendrickson's taxonomy. Messages with ≥100 words were analyzed for readability using the Flesch-Kincaid Grade Level score. Rates of jargon use and mean readability were compared using t-tests. Results: Nine first-year residents produced a total of 421 messages in the pre- and post-intervention periods. The rate of unexplained jargon decreased from 7.2 to 6.3 jargon terms per 100 words following the training (p = 0.05), a 12.5% reduction, equivalent to nearly one fewer jargon term per message. Jargon rates did not differ by jargon subtype, and average readability did not change. Conclusions: This is the first known study to quantify physicians' use of jargon in personalized messages written to patients. Jargon use was common. Exposure to the curriculum was associated with borderline significantly reduced use of unexplained jargon in the 3 months following training.