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Fostering translation and communication in medicine and beyond

In this Stanford Medicine Unplugged post, medical student Yoo Jung Kim discusses the importance of effectively communicating with patients.

Back in college, my buddies and I wrote a book called What Every Science Student Should Know, a how-to guide for science college majors, published by the University of Chicago Press in 2016. Last month, our book was published in China, titled 理工生必须知道的那些事儿 (Google Translate: Those Things that Science and Engineering Students Must Know.)

When our international rights manager informed us that the Simplified Chinese translation rights had been snapped up by an academic publisher, I was ecstatic but also somewhat flummoxed. Much of the information in our book is relevant to college students across the world, but there were bits and pieces of advice that were specific to the American higher education system.

We asked our editors in China whether we needed to remove or revise parts of the book to provide a better localization for Chinese readers, but they assured that this wouldn't be necessary. And in the end, the book was translated precisely how we had written it.

This was when I was reminded of the difference between translation and communication. There is much of both in medicine, and I don’t mean taking care of non-English speaking patients — although there’s plenty of that too. Medicine has a particular language of its own, one that is accessible only to people who have dedicated years of their lives in studying its use. There is a vast knowledge gap between a typical practitioner and patient, so even when taking care of a native English speaker, it’s not enough to “translate” medical jargon in the vernacular. Instead, optimal communication requires tailoring the information to suit the patient’s needs and background.

During the preclinical years, medical students are taught to speak to our patient-models with everyday words. For instance, when carrying out a structured physical exam, “Percussing the costovertebral angle” becomes "Ma'am, I'm going to tap on your back,” and “Auscultating the lung fields” becomes “Sir, I’m going to listen to your chest with my stethoscope.”

When we talk with patients or patient-models off-the-script to reassure or inform them of what they have, translating becomes more difficult because words embody the ideas themselves. For this reason, translation requires knowing a concept well enough to come up with multiple word detours that patients can follow. Once the students start interacting with real patients in the wards and the clinics, the challenge is to grow from being a translator to a communicator.

Communication involves the extra step of providing just the right amount of information with the right combination words so that the patients can apply the knowledge as part of their post-visit care. To prevent patients from being confused or overwhelmed with medical information, students are taught to ask patients what they want to know, which ensures that the patients’ most important concerns are addressed. Students are also taught to check patients’ understanding by asking them to repeat, in their own words, what was discussed about their care. This practice accomplishes two things at once: It encodes the information in the patients’ minds and provides student and physicians concrete evidence of patients’ level of understanding.

Communication is still a skill that I’m still working on. When I write, I take my sweet time ruminating over each word by considering its nuance and sorting through synonyms. But when I speak and then sense my patient’s discomfort, I can’t take my words back from the air. I need to be fast, precise, and accurate, but also mindful of how my patient is handling the information.

Now that our book is out in China, I wonder what our readers will think of it. Will they be flummoxed by the presence of a few pieces of advice that don't mesh with their own view of the academic world? Sitting in California, I can’t gauge their reaction or test their understanding. Still, I hope that even in another language, my co-authors and I are able to communicate our ideas and feelings, just as I hope to do in medicine.

Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unplugged category.

Yoo Jung Kim is a fourth-year Stanford medical student and the co-author of What Every Science Student Should Know, a guide for aspiring college STEM students. She also writes for Doximity and U.S. News and World Report.

Photo by Shutterstock

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