Doctor Talk: Physicians' Use of Clear Verbal Communication

Low health literacy negatively affects processes and outcomes of care. Physicians do not routinely use communication techniques recommended for use with low health literate patients. This study was conducted to compare the self-reported and actual use of clear verbal communication among medical residents and to identify characteristics associated with clear communication. Residents self-assessed their communication behaviors and then completed a low health literacy standardized patient encounter. Answers on the self-assessment were compared with behaviors observed in the standardized patient encounter. Residents (N = 82) reported frequent use of techniques recommended for clear verbal communication, including plain language (88%) and teach-back (48%). However, during the standardized patient encounter, they used an average of 2 jargon terms per minute, and only 22% used teach-back. No resident characteristics consistently predicted better communication. In conclusion, the study found that medical residents used clear communication techniques infrequently and tended to overestimate the clarity with which they communicate.