Research Study: Use of Jargon in Dental Students

Research Study: Use of Jargon in Dental Students ORIGINAL RESEARCH ARTICLE ‘THE ACCEPTANCE AND USE OF JARGONS IN CASE HISTORY TAKING: A CROSS SECTIONAL QUESTIONNAIRE BASED STUDY AMONG CLINICAL DENTAL STUDENTS AND FACULTY MEMBERS OF DENTAL COLLEGES IN ERNAKULAM AND IDUKKI DISTRICTS, KERALA, INDIA’ ABSTRACT Background: The use of jargons has become very common in health care field, especially in medical/dental records. Although use of standard medical jargons, can be seen as professional, efficient shorthand, the lack of awareness regarding the standard medical abbreviations and incessant and overzealous use of slangs among the health care professionals can act as a barrier in effective communication and understanding among patients and peers. Objective: To assess the acceptance and use of jargons in case history taking among clinical dental students and dental teaching faculty members of dental colleges in Ernakulam and Idukki districts of Kerala. Methodology:  A cross-sectional questionnaire based survey containing 15 questions to assess the objective of the study was done. The study was conducted among clinical dental undergraduate students, house surgeons, post graduate students and teaching faculty members of five dental colleges in Ernakulam and Idukki districts, Kerala. Results were expressed as a number and percentage of response for each question and Chi-square test was performed for inferential statistical analysis. Results:  All the 549 respondents used jargons in case history taking. About 22.4% of the respondents admitted that they always used jargons and 55.8 % admitted of using jargons only when there was a lack of time. Majority of the respondents (71.4%) learnt the jargons from their colleagues. About 50% of respondents admitted of using jargons in history section and about 32% of the respondents in all sections of case history taking. About 74% were of the opinion that abbreviations should be permitted in case history taking. Conclusion: This study points out that there is a widespread use of jargons/abbreviations in case history taking among the respondents. There is a lack of knowledge regarding standard medical abbreviations. Although majority of the respondents are comfortable with the use of jargons, majority of the postgraduates and faculty feel the use of jargons should be stopped. Keywords: Jargon, abbreviations, case history, dental students INTRODUCTION Jargon is defined as the language, esp. thevocabulary, peculiar to a particular trade, profession, or group; medical jargon, plumbers jargon All professions use this linguistic shorthand that serves as a means of communication among members but effectively excludes all others(1). It is very useful in a community sharing a common interest as it removes much information redundancy.At the same time, it represents a barrier to those unfamiliar with it.(2) Communication failures created by jargon are especially plentiful and pernicious in healthcare. Medical/dental records consist of information kept by doctors, health care centres, community health clinics or local hospitals detailing what the doctors or other bodies know about the medical condition and history of patients.(3) They consist of case history, details about medical/dental examinations, treatment planning, treatments done, medications prescribed etc. Like every profession, the use of jargons has become very common in health care field as well, especially in medical/dental records. Although use of standard medical jargons, in its most positive light, can be seen as professional, efficient shorthand, the lack of awareness regarding the standard medical abbreviations and incessant and overzealous use of slangs, mistaking them for jargons, among the health care professions can act as barriers in effective communication and understanding among patients and peers. Moreover, communication barriers often go undetected in health care settings and can have serious effects on the health and safety of patients (4). Hence, this study was conducted with an objective of assessing the acceptance and use of jargons in case history taking among clinical dental students and dental teaching faculty members of dental colleges in Ernakulam and Idukki districts, in Kerala. METHODOLOGY The study was a cross-sectional questionnaire based survey. The target population was the dental students with clinical exposure (third year and final year BDS), house surgeons, post graduate students and the teaching faculty members of five dental colleges in Ernakulam and Idukki districts of Kerala. A prefabricated validity tested questionnaire that was administered to the target population.The questionnaire was divided into two parts. The first part consisted of questions on personal and professional data including age, gender and designation. The second part contained 15 questions on the acceptance and use of jargons in dental case history taking.Two of the 15 questions were open ended. Informed consent was obtained from the respondents. The questionnaires were distributed by the faculty members of Department of Public Health Dentistry and house surgeons posted in the department. The respondents were asked to answer and return the questionnaire immediately. All returned questionnaires were coded and analysed. Results were expressed as number and percentage of response for each question and were analysed using the SPSS Version 17 software. Chi-square test was performed to compare the response in relation to gender and designation and the level of significance was set at p = 0.05. RESULTS Respondent’s profile Among a total of 549 respondents, 24.4% (n=134) were males. About 46.3% (n=254) were undergraduate students, 25.9% (n=142) were house surgeons, 11.3% (n=62) were students pursuing post-graduation and the rest 16.6% (n=91) were teaching faculty members. The profile of respondents is given in table 1. Acceptance and use of jargons among respondents The response to questions asked regarding the acceptance and use of jargons in dental case history taking are outlined in Table 2. All the respondents used jargons in case history taking. About 22.4% of the respondents admitted that they always used jargons and 55.8 % admitted of using jargons only when there was a lack of time. About 62.6% used abbreviations as it saved time and about 49.2% used it as it was easy. Majority of the respondents (71.4%) learnt the jargons from their colleagues and 38.25% admitted of having learnt them from their teachers. About half the number of respondents used jargons in history section and about 21%, in clinical examination. However, about 32% of the respondents used abbreviations in all sections of case history taking (personal information, history, clinical examination, diagnosis and treatment). Although, only one half of the respondents opined that they were aware of the standard medical abbreviations, about 65% claimed that they used standard abbreviations only. About 60% of the respondents admitted that they were comfortable with case history with abbreviations and only 10.4% had a discomfort in using abbreviations whilst recording case history. More than half the number of respondents felt a difficulty in understanding abbreviations written by others. However a vast majority of the respondents (74%) were of the opinion that abbreviations should be permitted in case history taking. The jargons used by the respondents are given in Table 3 DISCUSSION Clearly, the world has become â€Å"smaller† due to the use of information and communications technologies.Effective communication requires the parties involved sharing a clear understanding of the various definitions and parameters about which information (and data) are being exchanged in other words, are we talking about the same thing? Here, language and, in particular, jargon, plays a key role. Even assuming that all parties have a reasonable command of a common language – for example, International English – the same words may have significantly different meanings to people from different parts of the world.Jargon is an abbreviated form of language that encapsulates tacit knowledge.(2) As medical students, house surgeons, and residents, we pick it up from our peers and from attending physicians who should know better. We hear it at lectures and conferences. We read it in journals and textbooks. Eventually, we become inured to it, and we no longer recognize how ugly it is and how often it impairs effective communication.(5) Medical jargon is often justified on the grounds that it constitutes a kind of medical shorthand, allowing more efficient communication when time is short. These examplesillustrate that jargon is often less informative.(5) Although studies assessing the impact of jargons used by health care providers on the patients have been reported in the literature, not even a single study was found in the available electronic literature that assessed the impact of use of jargons among the health care personnel. As stated above, with the world becoming much smaller and with great developments in the field of communication, there needs to be uniformity in recording and reporting of medical data. Although, there exists a definite set of standard medical jargons, there is a serious lack of awareness regarding the same and there is a prolific use of abbreviations in case history taking, mistaking them for standard medical jargons. This often can result in a lack of effective communications among the colleagues and patients. With case history deserving a great importance as a medical record presently, uniformity needs to exist in documentation of medical records. Hence this study was conducted to assess the use of medic al jargons among dentists and their impact on the peers. A very significant observation in this study was all the 549 respondents of the study used jargons in their case history taking. Moreover, only 56% of the respondents admitted to using jargons only when there was a lack of time. This habit is significantly greater in students compared to house surgeons and faculty. This highlights the fact that use of jargons/shorthand has become an integral component of writing for a significant proportion of the population. The growing and overzealous use of short messaging service and social media may have a significant role to play in this regard. This has in fact become a current topic of concern. Various researches conducted in this regard (6-8) indicate the influence of texting on English language. Although the results are debatable, there is a clear preference for the present generation to use abbreviations over full forms everywhere. Thus the observation that about half the number of respondents use jargons as they find it easy. Over 70% adm it learning these jargons from their colleagues which is again matter of concern. Yet another important observation is that about 65% of the respondents believe that they use standard medical jargons only. However, in reality, as per this study, vast majority of the jargons used are not standard jargons. Moreover, an institution-wise comparison of the jargons used by the respondents, reveals that there a definite variation among the institutions in the same geographical area. Even more important is the fact that there were abbreviations, the use of which was restricted to a single institution, which the respondents in the neighbouring institutions were unaware of, clearly ascertaining the fact that these abbreviations are created according to one’s convenience. This accounts for the lack of uniformity in the jargons used, as reported. Ironically, only c/o, h/o and w.r.t among the abbreviations reportedly being used by the respondents can be described as standard medical jargo ns (9). It is a noteworthy point that, over 60% of the respondents use jargons in recording patient’s personal information and history section. Guidelines in case history taking indicate that that these sections demand the use of a language which the patient can comprehend. (10) With case history record serving as important legal evidence in medico-legal cases, uniformity needs to be strictly maintained in its recording. Furthermore, in spite of about 55% reporting a difficulty in understanding the abbreviations used by their colleagues/students, a response which is significantly greater among faculty members. About 60% feel they are comfortable regarding case history with abbreviations. This is significantly higher among undergraduate students. However, majority of the post graduate students and faculty members opined that they were comfortable with case history without abbreviations. Although about 50% of the respondents claim that they are aware of the standard medical abbreviations, it was found to be false. This indicates that there is lack of adequate knowledge regarding the same. Most importantly, with about 85% opining that there is no need to stop the use of abbreviations, there is a clear reflection of the attitude of the respondents towards the same. A statistically significant difference in this regard between students and faculty members reveal that faculty members opined regarding the s top of use of abbreviations. This study thus throws a light on an issue which demands a serious action. Furthermore this study warns us that this practice is leading to damage to the use and purpose of medical recordkeeping, which can have a serious impact in the long run. Recommendations With lack of awareness being one of the most common reason for this observation, efforts to improve the awareness by incorporating the same in the curriculum can be recommended. The faculty members have a major role of play in this regard by ensuring that the students record the case history without abbreviations/jargons. CONCLUSION This study points out that there is a widespread use of jargons/abbreviations in case history taking among the clinical dental undergraduate students, house surgeons, post graduate students and faculty members in dental colleges in Ernakulam and Idukki districts. There is a lack of knowledge regarding standard medical abbreviations. Although majority of the respondents are comfortable with the use of jargons, majority of the postgraduates and faculty feel the use of jargons should be stopped. REFERENCES Fenske RE. The Use of Jargon in Medical School Libraries. Bull. Med. Libr. Assoc. 1986;74(1):12-15. Baldi S, Gelbstein E. Jargon, protocols and uniforms as barriers to effective communication. Intercultural Communication and Diplomacy 225-40, assessed online on 25-01-2015. McQuoid-Mason D, Pillemer B, Friedman C, Dada M. Medical records, reports and evidence in court. Crimes against women and children – a medicolegal guide. 2002. Published by Independent medicolegan unit, University of Natal, accessed online on 28-01-15. Graham S, Brookey J. Do patients understand? The Permanente Journal 2008;12(3):67-9. Ronal PM. A bad case of medical jargon. Pitfalls in medical writing. American Journal of Roentegenology 1993;161:592. Aziz S, Shamim M, Aziz MF, Avais P.The Impact of Texting/SMS Language on Academic Writing of Students- What do we need to panic about? Elixir Ling. Trans. 2013;55:12884-12890 Mahmoud SS. The Effect of Using English SMS on KAU Foundation Year Students’ Speaking and Writing Performance. American International Journal of Social Science 2013;2(2):13-22. Ochonogor WC, Alakpodia NO, Achugbue IE.The Impact of Text Message Slang (Tms) or Chartroom Slang on Students Academic Performance. International Journal of Internet of Things 2012;1(2):1-4. Common medical jargons. Assessed online stedmansonline.com/webFiles/Dict-Stedmans28/APP06.pdf on 23/01/15. Ghom AG. Textbook of Oral Medicine. 2014, third edition, Jaypee brothers Publishing. Case Study: Nestle Case Study: Nestle Case Study Report – Nestle Introduction: The case study on the multinational company – Nestle, which happens to be a FMCG global giant reveals the strategies and the well designed plans of the company wherein it tries to shift its image from a food company to that of a nutrition health and welfare company. The moto of the company which has been that of good food, good life is further extended where the company looks forward to enter the arena of health and nutrition products that will encompass products such as infant food, diet food and also that of healthcare products. In the process we see that the company in its process of diversification of its products have also at times failed to achieve its targets. However the general structure of the company happens to be large enough to help the company maintain its position as the leading healthcare company in world with some of the most noted and successful brands. Main Discussion: The case study reveals the well calculated plans of he company Nestle where it had made conscious efforts which would change its very image in the market. It has been reflected through the case study that the then ongoing image where Nestle happened to be a leading brand worldwide in the field of food products looked forward to enter the field of the healthcare food products and also dominate the market in the coming span of time. Hence Nestle soon embarked upon a marketing strategy through it could extensively change its image and develop an image of a nutrition, health and welfare fostering company through the tool of its products. Hence quite clearly Nestle set forward to ake up various measures to effect the same. In the process Nestle did and tried a number of different tactuc to achiev the same. It changed the composition of its products by eliminating excess of sugar and salts and fats and by incorporating more healthier nutrients in its products. Once again we also see that N estle embarked upon a method or business pattern of a large number of acquisitions. Through these acquisitions Nestle tried to buy over certain reputed names of the healthcare product industry and enter the arena on a global scale. It made some of very huge investments in the process of these mergers and acquisitions. In this context one point that can be mentioned which could have been a pressing concern for the company especially during the years that immediately preceded the financial crisis era. The case study reveals that in the year 2005 Nestle did make a drive for the market of the healthcare products nutrition food, which was when the company had to make some huge investments. However as even mentioned by the experts the company could not expect any immediate returns or profits from these investments. In fact the company had to struggle considerably to push the volume of its sales and face a stiff competition from the already existing big layers of the said industry. Another point that happens to be an addition to the mentioned point is that in the effort of being a world player in the NHW segment the company did make huge and well diversified investments. This also could have posed a challenge to the company especially during the recession period. In fact we also see that as mentioned by the then CEO Bulcke, maintaining the company position in those challenging times happened to be quite critical. In those time we see that the company had taken a strategy that tried to maintain its market index and also increase the sales and business volume as far as possible. In fact we do see that in the strive of being a world renowned NHW segment company and of changing the brand image of the company, the management of the company had invested heavily on various measures of entering the industry of NHW and of fortifying the market position of the company in the said industry segment. In comparison to the same not as an aggressive stand was taken by the comp any in boosting its sales vigor and of taking an equally dynamic marketing endeavors. As result we see that the company even failed to achieve its said initial targets which it had set for itself when it entered the NHW sector. Once again we also see that the company at least to some extent did digress away from its path of being a NHW company, when it also bought over some fast food chain. This is company said was a calculated measure since it could not do away with the strategy of being a diversified company. However the company did induce certain health measures in to the fast food items and did incorporate some healthy items into the menu preparations. It can be said that the mission of the company happened to be of providing its customers with a good taste and a healthy life style through its products. To implement the same to an excelled level and to make mark in the market in the longer run the company did embark upon this journey of entering the health and nutrition products. In doing so we see that the company was faced with a serial of advantages that arose from its strengths and also disadvantages that arose from its weaknesses. In the following part of the discussion we take a look at both of the considerations: Strengths: The company that is Nestle happens to be a big name which ensures that the brand already has an acknowledgment in the market and the consumers or the retailers does not need to be briefed regarding the profile of the company. This facet was a particular strength of the company that enabled certain percentage of market penetration. The company had enough capital power which could enable the company to indulge into strategies of acquisition and of elaborate RD endeavors. Nestle was already into the food industry, which gave it considerable leverage. Weaknesses: The company went into a very elaborate process and method of acquisition and mergers which definitely ate into a considerable amount of the financial resources of the company. This could have posed a challenge during the financial crunch period. Nestle in its strive to be a world leader in the arena of the NHW sector did not put enough stress on the marketing part, which led to loos of target achievement. It did pose a contradictory figure when the brand bought over fast food item chains. It helped its critics criticize its image as a NHW company. Conclusion: Quite surely the strategy of Nestle to enter the NHW sector was a well tailored plan that will yield high returns in the future, nevertheless a more profit oriented endeavor could have helped the company overcome its revenue issues that did surface during its transition phase. Recommendation: It could be recommended to the company that the brand instead of trying various products in the NHW field could single out a more streamlined array of products in which the company will try concentrate during its initial period of entering the NHW industry or market segment. This would also help the company streamline its marketing procedure and the company can adopt more aggressive marketing endeavors that will help the company achieve better sales volumes. With time these returns could again be profitably used in the RD endeavors that will help the company come up with better and improved brands and also at the same point establish itself as a global ,market leader.