Specialised vocabulary research and the professions
Specialised vocabulary in Medical English has been the subject of a range of research in EAP to identify this vocabulary to support language learners and teachers (see Chapter 6), however, it is vital to also consider the use of this lexis in health communication. That is, how complex medical concepts and procedures are communicated between medical professionals and patients, as well as between members of the profession. Franken and Hunter (2012) report that the choice of language by practitioners had an impact on communication effectiveness with patients in a study carried out in Aotearoa/New Zealand. In particular, Franken and Hunter (2012) note examples of when vocabulary use was problematic, such as unfamiliar vocabulary, ’They use words that you’ve never heard before’ (p. 15) and the need to take the audience into account:
The doctors also need to simplify their medical terms to patients. I understand a lot of it but I have been in with doctors with my parents they used medical terms where my mother wouldn’t understand. If they could simplify that, make it simple and understandable for people, maybe we would know then what they are talking about and… this is your job. But they’re all using big medical words.
(Franken and Hunter, 2012, pp. 15—16)
Compare these problems with communication with a definition of successful communication through considerate language use, ’She [the nurse] was so good because she would talk in the language that I understand’ (Franken & Hunter, 2012, p. 16).
Ferguson (2013) notes that for learners in English for Medical Purposes (EMP) there are many variables such as the first language background of learners and their existing medical knowledge. Having existing medical training in a first language should facilitate learning specialised vocabulary in the same field in a second language such as English. Dahm (2011) looked into everyday and medical terminology among international medical graduates in Australia to support the development of a medical professional ESP course. Dahm’s (2011) study showed that Medical language is known by medical students but medical communication needs attention because of ’divergences in the meaning and perception of medical terms’ (p. 187) between medical staff and patients.
A feature EMP of communication between doctors and patients is idiom-atic language. Basturkmen (2010) reports on two ways in which idiomatic expressions were used in medical consultations, in a data set gathered by an ESP teacher through observations. One use of idiomatic language was to describe pain (for example, the odd pain, shooting pains), and the other use was to describe symptoms (for example, be under the weather and broke out in this red rash). Basturkmen (2006) states that such lexical choices (using unmedical vocabulary instead of medical vocabulary) are an attempt to lessen the distance between medical professionals and patients. Multiword units were another feature that the ESP teacher noticed in the observations, including expressions doctors might use when offering suggestions or options to patients, such as it would be a good idea to and what I’d like to suggest is…. (p. 104).
Case studies are another important area of Medical English. Canziani and Mungra (2013) undertook a study of the vocabulary in clinical case studies, based on a small corpus of 200 case histories, making the total number of words in the corpus just under 250,000, with the aim of developing a word list. Examples of the areas of Medicine in the corpus include Infectious Diseases, Medicine and Dentistry (General), Nephrology, Obstetrics, Gynecology and Women’s Health and Oncology. The texts in the corpus had very different lengths but the average number of words in a case history was just over 1200 words. Case histories are possibly not very familiar publications for people outside the field. All the case histories in the corpus contained these parts: abstract/introduction/presentation, diagnostic procedure, management of the patient and outcome and discussion/conclusion. The study included comparing the results with some existing specialised word lists such as Coxhead’s (2000) AWL and Wang, Liang, and Ge’s (2008) Medical Academic Word List. Some of the most frequent items in Canziani and Mungra’s (2013) academic word list for clinical case studies were patient, diagnose/diagnosis, symptom/symptomatic/asymptomatic, clinic/clinically, infect/infected/infections/infectious, artery/arteritis/arteries, surgery and cardiac/cardiovascular/endocarditis. These words include both Medical words which might be in general usage as well as highly technical words which might not be well known outside the field of Medicine (for example, endocarditis).
A final point to make about specialised vocabulary in medical communication is the presence of proper nouns, such as Parkinson’s, which are used for diseases and conditions. A wealth of medical information stands behind proper nouns such as Stevens-Johnson, which is a form of toxic epidermal necrolysis, as Quero (2015) found in the course of her analysis of Medical textbooks. Abbreviations are also present in large amounts in Medical English. Some of these items could be readily mistaken for another word, such as in the cases of TEN (toxic epidermal necrolysis) and FISH (fluorescence in situ hybridisation). This section has highlighted that different aspects of specialised vocabulary in health-care communication have been investigated in several ways. The next section focuses on Nursing.