This is the last in our series
using the
SAM Suitability Assessment
pregnancy and parenting for low skilled readers who may be new
to the healthcare system.
For a good cultural fit
match readers’ LLE
Leonard and Cici Doak, authors
of the SAM,
concluded that most communication errors
in healthcare are caused
by cultural gaps
between patients and providers,particularly
gaps in Logic, Language &
Experience - LLE.
For anyone in health communications
-that’s everyone in healthcare, it’s an acronym
worth remembering.
Logic refers to a way of
thinking about health, illness, treatment.
Because of their
specialized training, healthcare professionals have
a special way of thinking.
For example, to a clinician who sees 30
sick people per day, illness is normal,
another day at work, the usual
routine.
But to those 30 sick people, their illness is exceptional, a
major source of physical, emotional,
spiritual and financial stress for
a whole family, a reason to miss work and
suspend the usual routine.
The clinician’s routine challenge may be the
patient’s life changing
event. Consider, too differences between Western and
Eastern medicine,
between medical specialties, between medicine and public health,
between medicine and
health promotion. A challenge for all health
communicators is to understand and
match the learner’s logic about
your topic.
Language refers to a way
of talking
about health, illness, treatment
Of course, logic and language
overlap.
To a professional the problem
may be hypertension exacerbated by
obesity; to the patient the problem is
bad blood making it hard to walk up the
stairs. In the West, we describe epilepsy
as a disease - abnormalities in brain
cells that cause seizures. Elsewhere,
epilepsy is described as blessing - a sign that the person may be
a shaman;
“the spirit catches you and you fall down”. Other language issues are
less
subtle.
English is the language of the
healthcare system.If you are not proficient in English, you will struggle
at
every level. And even if you are, you may still
struggle when simple English
terms like stool and screen,
minor and routine take on a whole new medical meaning.
Or when simple concepts like walking and pus
or go home
take
on a whole new vocabulary like ambulation
and
discharge.
Latin and Greek are the
language of medicine.
Terms are long and technical, so a natural short hand
emerges. As public relations director for a hospital that
specializes in heart
surgery, I encountered more than
one family who objected to hearing staff refer
their loved one as “the cabbage
in 206”. They were using shorthand for coronary
artery bypass, thinking and
talking about the patient as his procedure and
location.
Experience refers to
participation in events as a basis of knowledge
A clinician lives in the
hospital or clinic. S/he is intimately familiar with
the technology. S/he is in
charge and in control. Everything is organized
for his or her convenience and
efficiency. His or her status comes from
specialized knowledge. In many cases, the patient has no
experience
and very limited knowledge. That means no basis on which to judge
quality, weigh options, or interpret
instructions. At that same hospital,
two patients who had open heart surgery by
the same surgeon on the
same day were re-admitted two weeks later. Their doctor had
told
them to “take it easy.”
Both complied. One ran 3 miles instead of
his usual 5. The other never
got off the couch.
Who is responsible for
bridging the gap?
Federal, state and local laws,
Medicare and Medicaid regulations,
and accrediting bodies clearly state it is
the healthcare providers’
duty to communicate in a way the patient and family
can understand.
SAM says Superior health education materials match the readers
LLE
and present images and examples that are realistic and and positive.
Beginnings Guides are intended for a broad
national audience. It’s
intent is to be as
culture-neutral as possible. We chose cover
art by Laurel Burch in which our testers saw
whatever was important to
them.
Last words on SAM: Only
readers know for sure
SAM is an at-your-desk review. It cannot tell you that your
information
is easy to understand and use. Only the intended learners can tell you
that they learn
easily from your document. SAM helps you get your
materials to the point where
they are ready for Reader Verification
Interviews. More on that next time.
