Semantically Ambiguous Language in the Teaching Operating Room
| Autor: | Gary Sutkin, Andrew McKenzie, Cynthia Y. Liu |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Surgeons
Typology Operating Rooms Semantic analysis (linguistics) Communication Teaching Anaphora (linguistics) Internship and Residency Cognitive reframing Near miss Deixis Semantics Education 03 medical and health sciences 0302 clinical medicine Ambiguous grammar 030220 oncology & carcinogenesis Humans Surgery 030212 general & internal medicine Psychology Language Cognitive psychology |
| Zdroj: | Journal of Surgical Education. 78:1938-1947 |
| ISSN: | 1931-7204 |
| Popis: | OBJECTIVE Teaching and training surgeons work hard in the OR to understand each other, yet miscommunication is an important cause of preventable adverse events in surgery. Our objective was to perform a formal semantic analysis of language in authentic teaching surgical cases, identify the prevalence and typology of ambiguous or potentially ambiguous language, and describe their potential for miscommunication. DESIGN In this secondary analysis of qualitative data, we collaborated with a semanticist, categorizing linguistic phenomena often associated with miscommunication. We defined an ambiguous phenomenon as a string of language that could be reasonably interpreted in more than one way. We analyzed transcripts of 319 minutes of surgery, coding for 14 linguistic categories. Cohen's kappa was calculated. We determined the prevalence and rate of each linguistic category and chose illustrative examples. PARTICIPANTS AND SETTING Six surgical attendings, four fellows, and six residents, ranging from PGY1 to PGY4, at the University of Pittsburgh Medical Center, a tertiary medical center in Pittsburgh, Pennsylvania. RESULTS We found 3912 examples of potentially ambiguous language, 12.3 per minute. Percentage agreement between two expert raters was 76.3%. The most common phenomena were deixis (3.1 per minute), directional (2.6), anaphora (1.3), implicit instruction (1.3), and degree modifiers (0.7). Restatements/reframing occurred 1.4 times per minute. We identified 131 near misses associated with potentially ambiguous language. Cohen's kappa was 0.70 among expert semanticists. CONCLUSIONS Potentially ambiguous language is common and has the potential to jeopardize safe teaching surgery. We postulate that the high amount of potentially ambiguous language use in the operating room places a burden on the training surgeon to comprehend surgical instruction. |
| Databáze: | OpenAIRE |
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