Researchers determine common ambiguous language in surgery

The language used in operating rooms is not always as precise as it should be and contains ambiguities that researchers want to resolve, according to a new study.

“The surgery is too precise to use imprecise language,” said Gary Sutkin, professor of obstetrics and gynecology at the University of Missouri-Kansas City and one of the study’s authors.

Researchers found nearly 4,000 potentially ambiguous sentences in six videotaped teaching surgeries at an academic medical center in Pennsylvania, or about 12 per minute of surgery.

“The language people use in everyday life is very ambiguous. It’s very vague, and we kind of live with it. . . But it turns out that’s also the case in a surgical education setting, ”said Andrew McKenzie, associate professor of linguistics at the University of Kansas and one of the study’s authors. “Language [surgeons] the use is not more precise than the language we would use in an informal conversation.

None of the sentences resulted in a medical error, but the study documented 131 “near misses” or cases that could have led to an error.

“The interest of this [study] By no means should be that, ‘Oh my God, the doctors don’t know how to talk to each other, and we run a risk every time we go to the [operating room]Said Tina Foster, professor of obstetrics and gynecology and community and family medicine at Geisel School of Medicine in Dartmouth, who was not involved in the study. “This is just one example of the possibility of improving the way we communicate. “

Sutkin gave an example from video recordings of a resident performing surgery that cut too close to the bladder. The attending surgeon saw it and said “it’s terribly close to the bladder.”

“It would be a lot better if the attendant said, ‘Stop, your scissors are pointed at the bladder. If you keep going, you’re about to cut the bladder, ”Sutkin said.

Although studies on communication issues between medical professionals have already been conducted, Sutkin said this study was the first to look specifically at surgeons.

“We know that poor communication is the number one cause of error in the operating room, but it has been studied among members of the internal professional team like surgeons and nurses,” he said. “No one before has really ever studied the language two surgeons use when talking to each other, and especially examines it at the semantic level.”

To reduce ambiguities and make sure they don’t lead to medical errors, the researchers suggested more standardized language in the operating room. For example, operating rooms might have colored signs on the wall so that surgeons can say “move a little blue” rather than “move a little left,” which depends on the surgeon’s perspective.

Standardized language is what the airline industry has done to reduce communication problems and this is how Sutkin became interested in the subject. He heard of Indonesia AirAsia flight 8501, which crashed in part because the co-pilot misinterpreted what the pilot meant by “pull down”.

“I read this story and I was like, ‘You know, we’re so dangerous in the operating room, we could absolutely do it,'” he said.

The research team’s future work will allow treating surgeons and residents to view recordings of their surgeries separately, where the treating surgeon used ambiguous language and compare their interpretations.

“We want to see how much of this work can we get out of because the people involved are busy doing something,” McKenzie said.

The results of such studies could help surgeons notice where they have been misinterpreted and use more precise language in the future.

“There is a little mental energy to trying to ask yourself what you are really being asked to do, and if you had that mental energy better able to focus on the task itself, that would be great,” Foster said.

Although such studies take place in the operating room, there are still lessons that can be applied in everyday life, according to McKenzie.

“I think it’s important for people to be aware of the work they are doing to their listeners with ordinary language. We work a lot when we listen, ”he said.

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