The analysis of the interview data yielded several important findings that residency programs should consider when designing orientations, training curricula, and communication interventions. Programs may need to address challenges related to regional dialect and "informal" English use, as well as communication barriers associated with cross-cultural differences in norms, values, and beliefs. Programs also need to draw on multilayered interventions to address the multidimensional challenges of cross-cultural physician-patient communication.

Purpose: The goal of this study was to determine which approach to assessing understanding of medical information patients most prefer and perceive to be most effective.Methods: Two videos were shown to participants: (1) a physician explaining a medical condition and its treatment and (2) a physician inquiring about patient understanding of the medical information the patient had been given using There is considerable evidence that many patients leave medical encounters with a poor understanding of their disease and the recommended treatment. Hewson 1 found that, when patients were asked to explain what had been told them, their explanations included so many gaps and errors that half of the information they had been given was lost. Several early studies substantiated poor understanding of medical information, with reports of lost information ranging from 46% to 63%. 2-7More recently, a study of 20 general practices in England reported that misunderstandings associated with actual or potential adverse outcomes occurred in 80% of consultations.8 A study of patient retention of information given during consent for mammoplasty found that patients were able to recollect on average 3 of 12 pieces of the information given them, or only 25%. 9 In another study, patients were asked immediately after discharge from the emergency department about diagnosis and treatment recommendations; although 79% of patients gave the correct diagnosis, correct treatment information was given by only 49% of patients.