P <0.0001) in their definitions compared to those without college degrees. Patients without college education also overestimated more frequently (47% vs 44% with a college degree, P=0.04). Patients over 60 were more confident (4.02 ± 0.66 vs 3.77 ± 0.67, P<0.0001) and accurate (3.33 ± 0.92 vs 3.17 ± 0.97, P=0.0184) when compared to younger patients. Patients with previous medical experience were more confident (4.13 ± 0.55 vs 3.82 ± 0.71, P<0.0001) and more accurate (3.48 ±0.94 vs 3.18 ± 0.94, P<0.001) compared to those without. Patients who previously underwent Mohs surgery were more confident (4.06 ± 0.62 vs 3.77 ± 0.76, P<0.0001), accurate (3.58 ± 0.89 vs 2.98 ± 0.99, P<0.0001), and less likely to overestimate (39% of the time vs 49%, P<0.0001) compared to those who had not.
DISCUSSION
This study is limited in diversity as a single institution sample; however, it illustrates the frequent lack of comprehension with Mohs surgery terms. Patients overestimated their knowledge nearly half of the time which reinforces the need to discuss with patients in non-medical terms to prevent instances of miscommunication and uncertainty.4,5 We suggest using alternate terms or descriptive phrases patients are more familiar with, as demonstrated in table 2 under “Common Accurate Definitions.” Further research can evaluate patient satisfaction and surgical complication rates when using simplified terminology.
DISCLOSURES
All authors listed above have no conflict of interest.
REFERENCES
1. Kutner, M, Greenberg E. and Baer J. (2006). A first look at the literacy of Americas adults in the 21st century. NCES 2006-470. Washington, DC: National Center for Education Statistics.
2. Graham S, Brookey J. Do patients understand? Perm J. 2008 Summer;12(3):67-9. doi: 10.7812/tpp/07-144. PMID: 21331214; PMCID:
3. Neill BC, Golda N, Seger EW, Wick J, Whitsitt J, Huber A, Chu T, Potts GA, Chow P, Moore S, Fakhoury JW, Rajpara A, Hocker TLH. Determining patient understanding of commonly used dermatology terms: A multicenter crosssectional survey. J Am Acad Dermatol. 2020 Sep;83(3):933-935
4. Neill BC, Seger EW, Rickstrew JJ, Rajpara A. Reply to: "Missing the mark on patient comprehension". J Am Acad Dermatol. 2021;84(2):e117-e118. doi:10.1016/j.jaad.2020.10.022
5. Kelly PA, Haidet P. Physician overestimation of patient literacy: a potential source of health care disparities. Patient Educ Couns. 2007;66(1):119-122. doi:10.1016/j.pec.2006.10.007
2. Graham S, Brookey J. Do patients understand? Perm J. 2008 Summer;12(3):67-9. doi: 10.7812/tpp/07-144. PMID: 21331214; PMCID:
3. Neill BC, Golda N, Seger EW, Wick J, Whitsitt J, Huber A, Chu T, Potts GA, Chow P, Moore S, Fakhoury JW, Rajpara A, Hocker TLH. Determining patient understanding of commonly used dermatology terms: A multicenter crosssectional survey. J Am Acad Dermatol. 2020 Sep;83(3):933-935
4. Neill BC, Seger EW, Rickstrew JJ, Rajpara A. Reply to: "Missing the mark on patient comprehension". J Am Acad Dermatol. 2021;84(2):e117-e118. doi:10.1016/j.jaad.2020.10.022
5. Kelly PA, Haidet P. Physician overestimation of patient literacy: a potential source of health care disparities. Patient Educ Couns. 2007;66(1):119-122. doi:10.1016/j.pec.2006.10.007
AUTHOR CORRESPONDENCE
Brett C. Neill MD bcneill6@gmail.com
