Reading scores rise with difficult medical terms

For easy to read text, use med terms sparingly

When difficult medical terms are used in a text the reading grade level is higher.

"Many people think that medical terms will skew results on readability formulas. What they really do is accurately reflect the difficulty of the text. If "laparoscopy" is in a document 10 times, that means the inexperienced readers who have to sound it out' each time they come to it, will have to do so 10 times. That means 10 interruptions in their reading flow," says Audrey Riffenburgh, MA, president of based Plain Language Works Albuquerque, NM, and a specialist in health literacy and plain language.

How do adults with weak reading skills make their way through text with unfamiliar, difficult-to-pronounce medical terms? Riffenburgh says every time they come to a word that's not in their sight word vocabulary (meaning they know it on sight' without needing to sound it out), they have to stop and begin sounding out the unfamiliar word.

For example, laparoscopy has 11 letters which make up five syllables that readers have to figure out, put together in the proper sequence, and then say correctly to compare it with words they know in their heads to determine if they can understand it.

When readers don't know what the word means or have never heard it pronounced, they don't have an auditory memory of it to which they can link a visual image. Therefore, they must remember the 11 letters and five syllables, their order in the word, and what the word means if they are able to determine its meaning from the context. However, they are very likely to have lost track of the context by that time, explains Riffenburgh.

"Let's assume they do figure out the pronunciation and the meaning. By then, they probably have forgotten the other information in the sentence in which the word appears, so they may need to backtrack," adds Riffenburgh.

Should readers find the word "laparoscopy" again in a sentence, the fact they have sounded it out one time does not mean they now have it in their sight word vocabulary. Most new readers have to see a word in context many, many times before they are able to recognize it quickly enough that it doesn't interrupt the flow of their reading.

The flow or fluency of reading is directly linked to comprehension. If a reader is busy stopping to sound out words in a sentence, then fluency doesn't occur, and comprehension of the information doesn't occur either. A higher reading score on a document because of one repeated hard word is an accurate reflection of how challenging that document will be for someone who doesn't know the difficult word on sight.

Removing obstacles to comprehension

To make documents that contain difficult medical terms easier to read, first and foremost — don't use the word over and over again, says Riffenburgh.

The author's priority is most likely to make sure the reader understands all the concepts in the document. For example, if the document is describing a laparoscopy to enable the reader to make an informed decision about whether to have one, the most important information is not the name of the procedure. The reader needs to know what will happen during the procedure and the benefits and risks. Therefore, to get the necessary information, the reader does not need to see the word laparoscopy again and again.

A writer might describe how doctors can make very small cuts in a person's stomach and put a long tube with a light and camera inside to look around, explains Riffenburgh. Then he or she might state, "This kind of surgery is called a laparoscopy" and include a pronunciation guide. The author can then continue to describe the procedure as necessary.

It's more important to make sure readers get the concepts tied to the word — even if they don't learn the word. Patients can always talk to their doctor about the surgery where tiny cuts are made and a tube with a camera on the end is inserted. The health care provider will know what the patient is talking about, states Riffenburgh.

"Patients can learn about processes, procedures, benefits, and risks without knowing the hard, long medical words that more educated people use to describe them. Just give them the concepts in plain language, and the reading level will come down as comprehension goes up," she explains.


For more information about writing in plain language, contact:

• Audrey Riffenburgh, MA, President, Plain Language Works, Albuquerque, New Mexico. Telephone: (505) 345-1107. E-mail: