Authors: Olga Mcheileh, Elissa Abi Fadel, Muhammad Barakat, Issa Awaida, Mirna N. Chahine
Categories: Research, Physician-patient relationship, Health literacy, Arabic language, Lebanon
Source: BMC Medical Education
Authors: Olga Mcheileh, Elissa Abi Fadel, Muhammad Barakat, Issa Awaida, Mirna N. Chahine
Effective communication skills are crucial for strengthening the patient-physician relationship and ensuring high-quality patient care. While Arabic is Lebanon’s official and most widely spoken language, medical education is primarily conducted in English or French. This language barrier may hinder effective communication between doctors and patients from diverse educational backgrounds. This study aims to evaluate how the use of simplified medical terminology and the Arabic mother tongue affects physician-patient communication by assessing physicians’ knowledge of Arabic and simplified terms, as well as their attitude toward communication with patients.
This observational cross-sectional study was conducted among Lebanese patients and physicians from various hospitals across different regions of Lebanon. Data were collected through an anonymous questionnaire designed to assess patient and physician satisfaction with their communication and their familiarity with Arabic medical terminology. The Arabic Usage Tool (AUT) measured physicians’ ability to communicate using simplified medical jargon and Arabic, while the Communication Skills Attitude Scale (CSAS) was used to evaluate physicians’ attitudes toward learning communication skills and the factors influencing them, The Chi-square test was used for associations between nominal variables, while ANOVA and Student’s t-test were used for associations between continuous variables. A p-value of < 0.05 was considered statistically significant.
A total of 938 patients and 388 physicians participated in this study. A significant proportion of physicians (45.12%) demonstrated poor knowledge of Arabic medical terminology. A higher knowledge score was significantly associated with male physicians, older age, higher income, and more advanced academic standing. Additionally, 59.5% of physicians expressed a positive attitude toward learning communication skills. A positive attitude was significantly associated with older physicians, higher income, attending status, graduation after 2020, and specialization in internal medicine (All p values (< 0.05). Arabic communication courses were strongly supported by physicians aged 22–25 (42.6%), ≥ 44 years (36.4%), and recent graduates. Support is higher among those who haven’t previously taken a communication course (All p values (< 0.05).
In Lebanon, where Arabic is the native and predominantly spoken language among patients, most physicians demonstrated limited proficiency in Arabic medical terminology. However, they showed a positive attitude toward enhancing their communication skills. This study underscores the importance of incorporating Arabic language training into medical school curricula in Arabic-speaking countries, as such courses are appreciated by both students and physicians and contribute to better healthcare outcomes.
The online version contains supplementary material available at 10.1186/s12909-026-08871-y.
Effective physician-patient communication is crucial for achieving optimal medical outcomes and enhancing patient’s understanding and satisfaction. However, language barriers are often a significant obstacle to this effective communication [1]. In Lebanon, where Arabic is the official and most commonly spoken language, medical education primarily takes place in English or French. This language discrepancy creates a potential gap in clinical communication between healthcare professionals and patients [2].
The existing research in this area is limited, with only one study from 2016 examining the relationship between medical education in a foreign language and students’ confidence in their native language history-taking skills [3]. However, this study didn’t consider medical students’ knowledge of Arabic medical terminology or the perceptions of specialized doctors. Therefore, it is crucial to investigate the extent to which the use of a simplified medical language and the Arabic language in healthcare settings may pose a barrier in physician-patient communication.
Health literacy, which includes the ability to speak and listen effectively, plays a crucial role in healthcare outcomes [4]. Studies have shown that the lack of health literacy, particularly in cases involving language barriers, can lead to adverse health outcomes and increased healthcare service utilization.
A Saudi Arabian study found that language barriers consistently impact health outcomes, leading to healthcare errors, difficulty understanding patients’ needs, reduced satisfaction, and lower trust in nursing care [5]. Similarly, a U.S. study revealed that children of parents with limited English proficiency have 2.1 times higher odds of adverse events [6]. Patients encountering language barriers also tend to utilize more healthcare services and experience a higher rate of adverse events [7, 8].
To address these challenges, medical schools can consider offering language classes to their students to ensure effective communication with patients from diverse linguistic backgrounds [9]. Some healthcare institutions have also implemented internet translation tools [10] or medical interpretation like MediBabble services to improve healthcare delivery [11]. In certain countries, such as Saudi Arabia, mandated interpreter services enhance patient satisfaction and quality of care [12]. Nevertheless, it’s essential to acknowledge that medical interpretation can be error-prone, with quality varying based on language proficiency [13].
In Lebanon, the linguistic landscape is complex, with most medical schools using foreign languages as the primary medium of instruction. However, most patients in academic and community health clinics primarily speak Arabic [14]. Furthermore, all official medical reports in Lebanon must be written in Arabic [3, 15]. Despite this language mismatch, many Lebanese medical students claim they are comfortable conducting medical histories in Arabic [3].
Nonetheless, there is a lack of research on the knowledge of medical students and doctors in the Arabic language and how it affects their ability to communicate effectively with patients. Therefore, this study aims to assess the impact of using simplified medical jargon and the Arabic language on physician-patient communication. Its primary objectives include evaluating the knowledge of physicians, medical students, and patients in Arabic language and simplified medical terms, as well as assessing physicians’ attitudes toward learning communication skills and incorporating a patient-physician communication course in Arabic and simplified medical jargon into the medical curriculum in the universities in Lebanon. By addressing these issues, the study seeks to contribute to a better patient-centered quality of care in Lebanon, by improving physician-patient communication and increasing patients’ trust and satisfaction.
This study utilized a cross-sectional design, conducted in multiple Lebanese hospitals from July 2021 to May 2022. It was approved by the Institutional Review Board of the hospitals involved but whose names should remain anonymous for confidentiality reasons (see section about ethical approval at the end of article) ensuring patients’ and doctors’ confidentiality. The study was designed to assess the impact of using a simplified medical jargon and the Arabic language on physician-patient communication in Lebanon.
This study included medical students in their sixth and seventh academic years, residents, general and specialized doctors in internal medicine and surgery, as well as hospitalized patients from internal medicine and surgery departments.
To ensure accurate results, we conducted our study by selecting physicians and residents from a specialized hospital (name kept anonymous) and analyzing their responses alongside patients admitted to that hospital. On the other hand, we also considered physicians from the general population (from any other hospital in Lebanon) and compared their responses with patients from the general population as well. Physicians and patients from the specialized hospital were also considered part of the general population analysis, allowing for a broader comparative assessment.
The total number of physicians in the specialized hospital was 165, distributed as 70 surgeons and 95 internal medicine physicians. Residents and interns were classified into 15 surgery residents, 27 medicine residents, and 36 interns.
To determine the minimum sample size, we used the Slovin formula with a 95% confidence interval and a 5% alpha error, which indicated a minimum of 133 physicians (77 medicine and 60 surgery physicians). Due to their smaller numbers, all 42 residents and 36 interns in this specialized private hospital were targeted for inclusion.
Concerning the sample size needed for the general population, according to the Slovin formula, with 95% confidence interval and 5% alpha error, the minimum number of physicians and patients is 400 for each. However, 938 patients and 388 medical doctors agreed to participate in this cross-section study. Medical doctors were categorized into two surgical and internal medicine specialists.
Included patients were over 18 years of age, hospitalized in internal medicine or surgery departments (more communication is needed with the inpatient compared to the outpatient), COVID-19 negative, with normal mental status, and proficient in Arabic. Excluded were patients under 18 years of age, those hospitalized in other departments, COVID-19 positive (due to infection control measures and isolations at time of data collection, which limited physician-patient interactions), with altered mental status, or primarily speaking a foreign language.
Included were physicians with normal mental status, Med III and Med IV students, residents up to PGY5, general and specialized doctors, working in internal medicine or surgery, dealing with COVID-19 negative patients, primarily speaking Arabic, and studying medicine in a foreign language. Excluded were physicians with altered mental status, medical students below the 6th year, not working in Lebanese hospitals, not working in internal medicine or surgery, dealing with COVID-19 positive patients, or primarily speaking a foreign language.
Data collection took place through self-administered, structured, anonymous Google form questionnaires in Arabic or English (to ensure comprehensive understanding) for both patients and physicians.
+Patients’ questionnaire had 66 questions covering socio-demographics, patients’ trust and satisfaction in their physician, patients’ preferences of the gender and the academic level of their physicians, and well as patients’ ability to understand English-Arabic medical terminology by using the Arabic Unified Medical Dictionary tool (AUT) (more details below).
+Physician questionnaire included additional questions about their specialty, department, income, academic year, and the AUT to evaluate physicians’ ability to communicate using simplified medical jargon and Arabic. It also comprised the Communication Skills Attitude Scale (CSAS) of the physician (more details below).
The CSAS was used to evaluate the attitude of physicians, residents, and Med III and Med IV students towards learning communication skills. This tool has been validated in various regions including Saudi Arabia and Poland [16, 17] It is comprised of 26 items, which are either written as positive or negative statements about communication skills learning, and each item has a corresponding 5-point Likert scale that ranges from strongly disagree to strongly agree, (1 = strongly disagree, 5 = strongly agree) [18]. CSAS scores range from 26 to 130. In this study, we used the median score as a reference a score of 100 or above was considered indicative of a positive attitude toward learning communication skills, while a score below 100 reflected a negative attitude [18]. To assess the reliability and internal consistency of the CSAS, a Cronbach’s alpha test was performed, yielding an alpha coefficient of 0.82, indicating a good level of reliability.
AUT, a tailored tool incorporating simplified medical terminology and the Arabic mother tongue, was employed to assess knowledge of Arabic and basic medical terms (1) physicians, residents, and Med III and Med IV students, to enhance their communication with patients; and (2) patients, to improve their ability to communicate effectively with their healthcare providers. It was based on jargon classification as designed by Pitt and Hendrickson [19] and random selection of 20 English-Arabic validated translated medical terms from The Unified Medical Dictionary of the WHO [20]. The random selection was made by the authors selecting the most encountered medical terms in their practice at the hospitals in Lebanon. We aimed to assess whether patients and physicians could accurately understand medical terminology presented in either English or Arabic, and to determine their ability to identify translation errors. Notably, some questionnaire responses were deliberately incorrect to explore how language barriers might contribute to misunderstandings in clinical settings. For each English-Arabic translated word, participants answer by “Agree”, “disagree” and “I don’t know or not sure”. The total score is the sum of all the correct answers. It included 30 words, thus the total score ranges from 0 to 30. To better categorize AUT knowledge scores, we adopted the frequently used Bloom’s cut-off 80–100% (good AUT knowledge score), 60–79% (moderate AUT knowledge score), and less than 60% (poor AUT knowledge score) [21, 22].
In this study, we used the Median of the scores and a modified Bloom’s cut-off values with the categories ‘’Poor’’ with < 18 correct answers over 30 (< 60.00%), ‘’ Fair’’ with 18 to 20 correct answers over 30, ‘’Good’’ with 21 to 24 correct answers over 30, and ‘’ Excellent’’ with ≥ 25 correct answers over 30.
These cut-off values were also based on our previously published knowledge, attitude and practice studies [23–25]. To evaluate the reliability and internal consistency of the AUT, a Cronbach’s alpha test was conducted. The results showed an alpha coefficient of 0.708 for physicians and 0.906 for patients, indicating a good level of reliability.
The overall data were analyzed using IBM SPSS Version 25. A descriptive analysis was performed, and all results were presented as per their type. Categorical variables (e.g., gender, specialty, residency year) were presented as frequencies and proportions. Continuous variables (e.g., age, income, CSAS and AUT scores) were presented as mean, SD, minimum and maximum. AUT score was computed by adding the score of the items where correct items were coded by “1” and incorrect items were coded by “0”. The CSAS score was computed by considering a 5-point Likert scale where ‘’ strongly disagree’’ [if wrong answer] was given 1 point and ‘’strongly agree ‘’ [if correct answer] was given 5 points.
Bivariate analysis was enrolled to test the factors affecting “AUT” and CSAS Normality test was checked graphically via QQ plot and histogram representation noting that the sample is 382 participants. Chi square test was used to test the association between the dependent variable (nominal) and independent nominal variables (e.g., sex, marital status). ANOVA test and Student t-test were used to test the association between the dependent variable (continuous) and independent (categorical) variables. A p-value of < 0.05 was considered statistically significant.
Between July 2021 and May 2022, 938 patients participated in the study, with a mean age of 47.2 ± 20.61 years. Nearly half of the participants (45.9%) were male, while 54.1% were female, and 51.8% were aged ≥ 45 years. The vast majority were Lebanese (98.2%), predominantly residing in Mount Lebanon (29.3%) and Beirut (26.5%), with 58.7% living in urban areas. Educationally, 46.7% held a university degree. As for the major languages taught in schools, 81.6% of patients reporting Arabic as the most commonly taught language, followed by French (54.3%). then English (28.7%). Conversely, At the university level, 32.2% of patients indicated that English was the primary language of instruction, followed by French at 29.9%, then Arabic at 21.5% (Table 1).
Table 1Demographic characteristics and Languages taught in schools and universities of patients (n = 938)A- Demographic characteristics of patientsFrequencyPercent(%)GenderMale43145.9Female50754.1Age (years)Mean (SD)47.2 (20.61)Median47.0 [27.0–64.0]Min - Max18–102Age (years)≤ 45 years45248.2> 45 years48651.8NationalityLebanese92198.2Other171.8NationalityLebanese92198.2Double Nationalities (Lebanese - Other)70.7GovernorateBeirut24926.5North / Akkar17318.4South / Nabatyeh11211.9Mount Lebanon27529.3Beqaa / Baalbeck - Hermel12913.8AreaRural38741.3Urban55158.7Educational levelIlliterate677.1Primary15816.8Secondary20121.4University43846.7Higher education levels (PhD, MD…)747.9 B- Major languages taught in schools and universities according to patients
Frequency
Percent
(%) What were the major languages in which you were taught in Arabic76581.6English26928.7French50954.3Other404.3I didn’t go to school697.4In what languages were (are) your university classesArabic20221.5English30232.2French28029.9Other40.4I didn’t go to university39642.2
The study included 388 medical doctors, residents, as well as Med III and Med IV students with a mean age of 40.07 ± 15.95 years. Among them, 59.8% were male, 40.2% were female. Most resided in urban areas (76.3%), particularly in Beirut (49.7%) and Mount Lebanon (33.8%). 51.5% were practicing physicians, while 48.5% were medical students. Among students, 33.5% were MedIII and Med IV, and 15% were in their residency year. The residents were at different residency stages (2.3% PGY-1, 2.6% PGY-2, 3.9% PGY-3). About 50% of physicians reported a monthly income of more than $333. As for the major languages taught in schools, 76.5% of physicians reporting French as the most commonly taught language, followed by Arabic (63.7%), then English (59.8%). At the university level, the majority of physicians had their medical education in foreign language (English: 81.4%, French: 65.2%), while only 5.9% were educated in Arabic (Table 2).
Table 2Demographic characteristics and Languages taught in schools and universities of physicians (n = 388)A- Demographic factors of physiciansFrequencyPercent(%)GenderMale23259.8Female15640.2AgeMean (SD)40.07 (15.95)Median36Min - Max22–70NationalityLebanese38398.7Others51.3GovernorateBeirut19349.7North / Akkar256.4South / Nabatyeh215.4Mount Lebanon13133.8Beqaa / Baalbeck - Hermel184.6Living AreaRural9223.7Urban29676.3What is your average monthly salary income (in 4912.6339524.51334311.1> 333$20151.8 B- Major languages taught in schools and universities according to physicians
Frequency
Percent
(%) What were the major languages which you were taught in Arabic24763.7English23259.8French29776.5In what languages were (are) your university classesArabic235.9English31681.4French25365.2*Average rate in 1$ = 15,000 LBP
Understanding the demographic and educational backgrounds, along with the primary language exposure of both patients and physicians, provides essential context for interpreting their language preferences and real-world use in clinical environments. However, while preferences and proficiencies offer insight into linguistic capabilities, the way these skills are applied directly shapes the nature and quality of patient-physician communication.
Almost all patients understood Arabic (96.7%), and more than half understood English (54.7%) and French (52.3%). When asked about their preferred spoken language, the vast majority of patients indicated a preference for Arabic, while only 2.7% and 1.6% preferred English and French, respectively. Most patients (74.7%) preferred their doctors to use more Arabic and fewer foreign language words, and 93.4% reported clear explanations of their diagnoses, using simplified Arabic words (92.6%). Patients’ preferences for physician language use were influenced by age, geography (e.g., Mount Lebanon and urban areas preferred more Arabic), and patients’ language preference (Arabic speakers preferred more Arabic). Patients with lower educational levels preferred more Arabic usage by physicians.
Although Arabic was the native language for 93.6% of physicians, the majority also understood English (97.2%) and French (89.2%). Most doctors reported using more than one language when communicating with patients, with Arabic being the most commonly used (89.5%), followed by English (57.5%) and French (42.5%). Despite this multilingual communication, only 22.9% of physicians consistently asked patients about their preferred language. Meanwhile, 43.8% said they sometimes inquired, and 33.2% never did—highlighting that the majority do not routinely ask about language preference (Fig. 1).
Fig. 1Languages used by physicians in patient communication
Given the central role of language in effective communication, we further examined the extent to which patients and physicians comprehend Arabic medical terms through AUT scores.
Majority of physicians correctly identified Arabic medical terms, except for specific words like phlebitis (26.3% correct), glaucoma (10.8%), depression (31.2%), and others (Table 3). The medical terminology knowledge score (AUT score) among physicians was poor with a mean of 17.66 ± 3.585 over 30. We observed that 45.12% had poor knowledge (less than 18 correct Arabic words out of 30), 26.8% had fair knowledge (18–20 correct Arabic words out of 30) and 18.56% had good knowledge (21–24 correct Arabic words out of 30). Very few (0.52%) had excellent knowledge (≥ 25 correct Arabic words out of 30) (Fig. 2). Physicians working in specialized hospitals had significantly lower average Arabic medical term knowledge compared to those in other hospitals (AUT mean score 17.04 vs. 17.90 over 30, p-value = 0.035). Internal medicine doctors performed better than surgeons (AUT mean score 10.85 vs. 8.31 over 30, respectively, p value < 0.001). The bivariate analysis showed significant associations between AUT levels and gender (p = 0.018), age (p < 0.001), monthly income (p < 0.001), academic year (p < 0.001), and graduation year (p < 0.001). Male physicians had better knowledge, with 68.3% showing fair to very good knowledge compared to 31.7% of females. Older physicians performed better; 56.7% of those aged 44 + had excellent knowledge versus 20.2% of those aged 26–32, and many in the 22–25 age group had poor knowledge. Lebanese physicians (98.1%) had better knowledge compared to 1.4% of other nationalities. Physicians earning over 33; similarly, 68.3% of attending physicians scored better compared to 12.5% of PGY physicians (Table 4).
Table 3Distribution of patients AND Physicians according to their ability to use and understand a number of English-Arabic validated translated words chosen randomly from the Unified Medical Dictionary of the WHO, as reported in the questionnaire to patients and physicians with correct answers and correct meaningEnglish term proposed in the questionnaireArabic term proposed in the questionnaireCorrect answerCorrect meaning in Arabic of the proposed English termCorrect meaning in Englishof the proposed Arabic termFrequency & percentage of patients who provided the correct answer.Frequency & percentage of physicians who provided the correct answer.FrequencyPercent(%)FrequencyPercent(%)Cholangitisالتهاب المرارة أو الصفيريّةFALSEالتهاب الاقنية الصفراويةCholecystitis727.721154.4Pulmonary Atelctasisانخماص رئويTRUE12213.024262.4Duodenal Ulcerقرحة الاثني عشرTRUE17118.231280.4Vaginomycosisفطر مهبليّTRUE23424.931581.2Phlebitisالتهاب الوريدTRUE12513.332784.3Cataractالمياه الزرقاءFALSEاعتمام عدسة العين او ساد او ماء بيضاء او ماء سوداءGlaucoma717.610226.3Glaucomaالماء السوداءFALSEالزرقاء الزرق او الماءCataract869.24210.8DepressionأرقFALSEاكتئاب26828.612131.2Myocardial Infarctusاو احتشاء عضلة القلبالذبحة القلبيةTRUE28230.136493.8PsoriasisبهاقFALSEالصدفيةVitiligo11111.816241.8PancreasطحالFALSEالبنكراسSpleen30432.430578.6AtriumالاذينTRUE22624.127069.6Meniscusالغضروف المفصلTRUE19520.832784.3RectumالمستقيمTRUE16617.720051.5CervixالرحمFALSEالعنقUterus24426.011629.9Basal GangliaالمخيخFALSEالنوى القاعديةCerebellum9610.230578.6Arteryشريان اوعرقTRUE46349.410025.8TesticleالخصيةTRUE44046.928874.2PharynxالحنجرةFALSEالبلعومLarynx9510.1256.4Urethraالاحليل او مجرى البولTRUE29531.435691.8FeverحمىTRUE52556.036393.6StrabismusرأرأةFALSEالحولNystagmus606.411529.6Ataxiaاختلاج الحركة أو رنح أو الانتظام فقدTRUE11011.726468Colicky PainتشنجاتFALSEمغصCramps778.212331.7ComplicationsمضاعفاتTRUE46749.837797.2White Blood Cellsالصفيحات البيضاءFALSEالبيضاء الدم خلاياPlatelets849.012131.2Uric AcidزلالFALSEحمض اليوريكCreatinine15616.629676.3CT Scanالاشعة الصوتية المقطعيةFALSEمقطعيةصورةUltrasound10411.120653.1Lumpectomyاستئصال الكتلة الورميةTRUE19120.427169.8EMGمخطط كهربية الدماغFALSEكهربية مخطط العضلEEG879.322758.5
Fig. 2Distribution of physicians according to their knowledge of Arabic medical terms. AUT score :< 18 over poor knowledge of medical Arabic term; 18 to 20 words over fair knowledge of medical Arabic term; 21to 24 words over good knowledge of medical Arabic term; and ≥ 25 OVER excellent knowledge of medical Arabic term
Table 4Bivariate analysis showing the association between socio-demographic variables and educational level & AUT scores of physiciansAUT scoreP.valuePoor(< 18 / 30)Fair(18–20)Good(21–24)Excellent(≥ 25)GenderMale111714820.01852.9%68.3%66.7%100.0%Female993324047.1%31.7%33.3%0.0%Age22–259621150< 0.00145.7%20.2%20.8%0.0%26–32331311115.7%12.5%15.3%50.0%33–43811503.8%10.6%6.9%0.0%≥ 44735941134.8%56.7%56.9%50.0%NationalityLebanese2061047120.56998.1%100.0%98.6%100.0%Others40101.9%0.0%1.4%0.0%Where do you live?Beirut94564210.64744.8%53.8%58.3%50.0%North / Akkar167207.6%6.7%2.8%0.0%South / Nabatyeh105604.8%4.8%8.3%0.0%Mount Lebanon803218138.1%30.8%25.0%50.0%Beqaa / Baalbeck - Hermel104404.8%3.8%5.6%0.0%Where do you live?Beirut94564210.17944.8%53.8%58.3%50.0%Other1164830155.2%46.2%41.7%50.0%Where do you live?Mount Lebanon80321810.18038.1%30.8%25.0%50.0%Other1307254161.9%69.2%75.0%50.0%In which area do you live?Rural51261500.78124.3%25.0%20.8%0.0%Urban1597857275.7%75.0%79.2%100.0%Monthly Income < 33 817148138.6%68.3%66.7%50.0%What is your academic year?6-7th year medicine9520150< 0.00145.2%19.2%20.8%0.0%PGY341310116.2%12.5%13.9%50.0%Attending817147138.6%68.3%65.3%50.0%Year of graduation≤ 19903633200< 0.00117.1%31.7%27.8%0.0%1991–2000312112114.8%20.2%16.7%50.0%2001–201013151406.2%14.4%19.4%0.0%2011–2020331511115.7%14.4%15.3%50.0%> 2020972015046.2%19.2%20.8%0.0%Do you work at the Hospital “X”?yes66221800.19331.4%21.2%25.0%0.0%Other1448254268.6%78.8%75.0%100.0%In what department are you?Internal medicine154754910.74973.3%72.1%68.1%50.0%Surgery562923126.7%27.9%31.9%50.0%
Patients were asked to assess their understanding of a selection of randomly chosen, English-Arabic translated medical terms, validated and sourced from the WHO’s Unified Medical Dictionary. The results showed that, for the majority of terms, over half of the patients responded with “I don’t know” or “Not sure’’, except for the term “depression,” for which 44.3% of patients selected “I don’t know” or “Not sure,” 28.6% responded incorrectly, and 27.6% answered correctly. For “artery,” 44.2% responded with uncertainty, while 49.4% provided a correct answer and 6.4% answered incorrectly. In the case of “white blood cells,” 37% were unsure, 54.1% gave incorrect responses, and only 9% answered correctly (Table 3). Consequently, the medical jargon knowledge score (AUT) of patients was extremely poor with a mean of 6.30 ± 6.009 over 30 such as more than 75% of them scoring less than 11 over 30 and more than 25% of patients scored 0 over 30. Patients’ ability to use and understand Arabic medical terms (AUT) was significantly associated with education level (p < 0.001); those with higher education had a mean AUT of 11.27 ± 6.22, compared to 0.54 ± 1.72 among illiterate patients. The language of instruction in both school and university significantly influenced patients’ AUT those who reported Arabic as their primary language of instruction scored significantly higher than those taught in other languages, and similarly, patients taught in English also achieved significantly higher scores compared to their peers educated in other languages. No significant difference was found for French (p = 0.134). The AUT score was also associated with patients’ age; those under 45 years had significantly higher AUT scores than those over 45 (7.99 ± 6.16 vs 4.73 ± 5.40, respectively) (p < 0.001).
Based on these results, physicians showed limited knowledge of Arabic medical terminology (AUT scores), with patients performing even worse. Addressing these gaps—particularly on the physicians’ side—is essential to better understand patients’ needs, enhance satisfaction, build trust, and ultimately improved health outcomes.
Examining physicians’ attitudes toward enhancing their communication skills—measured by the Communication Skills Attitude Scale (CSAS) — highlights their willingness to address existing gaps, particularly in Arabic.
The majority of physicians reported that they agree or strongly agree with all the items of the positive attitude statement (PAS) except for item 12 “Learning communication skills is fun” with 42% of physicians answering strongly agree or agree (mean (SD) = 3.32 (1.07)). Among the PAS items, the statements on which physicians scored the highest were statement 1 “In order to be a good doctor I must have good communication skills” with 95.3% of physicians answering strongly agree or agree (mean (SD) = 4.66 (0.64)), and statement 10 “Learning communication skills has improved or will improve my ability to communicate with patients” with 90.3% of doctors answering strongly agree or agree (mean (SD) = 4.46 (0.77)). Among the negative attitude statements (NAS) on which physicians scored the highest with 82% and 80.4%, respectively, answering strongly disagree or disagree were statement 19 (mean (SD) = 4.25 (1.10)) “I don’t need good communication skills to be a doctor” and statement 2 (mean (SD) = 4.20 (1.22)) “I can’t see the point in learning communication skills” respectively (Table 5). The average physician attitude score (CSAS) was 99.87 ± 11.85 out of 130 (76.82%), with the majority (59.5%) demonstrating a positive attitude (score ≥ 100 over 130) toward learning medical communication skills.
Table 5Physicians’ responses for each statement of the CSASStrongly disagreeDisagreeNeutralAgreeStrongly agreeMean (SD)Items of PAS 1. In order to be a good doctor I must have good communication skills.3 (0.8%)1 (0.3%)14 (3.6%)89 (22.9%)281 (72.4%)4.66 (0.64) 4. Developing my communication skills is just as important as developing my knowledge of medicine5 (1.3%)15 (3.9%)50 (12.9%)168 (43.3%)150 (38.7%)4.14 (0.88) 5. Learning communication skills has helped or will help me respect patients4 (1.0%)8 (2.1%)40 (10.3%)140 (36.1%)196 (50.5%)4.33 (0.82) 7. Learning communication skills is interesting20 (5.2%)41 (10.6%)88 (22.7%)128 (33.0%)111 (28.6%)3.69 (1.14) 9. Learning communication skills has helped or will help facilitate my team-working skills5 (1.3%)4 (1.0%)60 (15.5%)155 (39.9%)164 (42.3%)4.21 (0.83) 10. Learning communication skills has improved or will improve my ability to communicate with patients4 (1.0%)4 (1.0%)30 (7.7%)120 (30.9%)230 (59.3%)4.46 (0.77) 12. Learning communication skills is fun20 (5.2%)57 (14.7%)148 (38.1%)103 (26.5%)60 (15.5%)3.32 (1.07) 14.Learning communication skills has helped or will help me respect my colleagues4 (1.0%)10 (2.6%)57 (14.7%)155 (39.9%)162 (41.8%)4.19 (0.85) 16. Learning communication skills has helped or will help me recognize patients’ rights regarding confidentiality and informed consent4 (1.0%)21 (5.4%)70 (18.0%)153 (39.4%)140 (36.1%)4.04 (0.92) 18. When applying to medicine, I thought it was really a good idea to learn communication skills14 (3.6%)41 (10.6%)102 (26.3%)141 (36.3%)90 (23.2%)3.65 (1.06) 21. I think it is really useful to learn communication skills on the medical degree9 (2.3%)7 (1.8%)56 (14.4%)192 (49.5%)124 (32.0%)4.07 (0.86) 23. Learning communication skills is applicable to learning medicine3 (0.8%)10 (2.6%)70 (18.0%)192 (49.5%)113 (29.1%)4.04 (0.80) 25. Learning communication skills is important because my ability to communicate is a lifelong skill3 (0.8%)6 (1.5%)62 (16.0%)162 (41.8%)155 (39.9%)4.19 (0.81)Items of NAS 2. I can’t see the point in learning communication skills231 (59.5%)81 (20.9%)28 (7.2%)19 (4.9%)29 (7.5%)4.20 (1.22) 3. Nobody is going to fail their medical degree for having poor communication skills112 (28.9%)96 (24.7%)93 (24.0%)56 (14.4%)31 (8.0%)3.52 (1.26) 6. I haven’t got time to learn communication skills113 (29.1%)86 (22.2%)108 (27.8%)49 (12.6%)32 (8.2%)3.51 (1.26) 8. I can’t be bothered to turn up to sessions on communication skills89 (22.9%)110 (28.4%)96 (24.7%)62 (16.0%)31 (8.0%)3.42 (1.23) 11. Teaching communication skills between physician and patients would complicate things168 (43.3%)123 (31.7%)45 (11.6%)23 (5.9%)29 (7.5%)3.97 (1.21) 13. Learning communication skills is too easy31 (8.0%)106 (27.3%)162 (41.8%)63 (16.2%)26 (6.7%)3.14 (1.00) 15. I find it difficult to trust information about communication skills given to me by non-clinical lecturers75 (19.3%)60 (15.5%)112 (28.9%)70 (18.0%)71 (18.3%)2.99 (1.36) 17. Communication skills teaching would have a better image if it sounded more like a science object99 (25.5%)79 (20.4%)104 (26.8%)57 (14.7%)49 (12.6%)3.31 (1.33) 19. I don’t need good communication skills to be a doctor221 (57.0%)97 (25.0%)31 (8.0%)23 (5.9%)16 (4.1%)4.25 (1.10) 20. I find it hard to admit having some problems with my communication skills99 (25.5%)125 (32.2%)108 (27.8%)39 (10.1%)17 (4.4%)3.64 (1.10) 22. My ability to pass exams will get me through medical school rather than my ability to communicate69 (17.8%)96 (24.7%)91 (23.5%)84 (21.6%)48 (12.4%)2.86 (1.29) 24. I find it difficult to take communication skills learning seriously139 (35.8%)122 (31.4%)63 (16.2%)54 (13.9%)10 (2.6%)3.84 (1.13) 26. Communication skills learning should be left to psychology students not medical students208 (53.6%)111 (28.6%)24 (6.2%)30 (7.7%)15 (3.9%)4.20 (1.10)PAS Positive attitude statements, NAS Negative Attitude Statements
Positive attitude was associated with physicians of older age (p-value = 0.006), higher monthly income (p-value = 0.005), attending status (p-value = 0.001), graduation year after 2020 (p-value = 0.01), and specialization in internal medicine (p-value = 0.023). Indeed, CSAS was significantly higher among physicians who earn more than . Older physicians (≥ 44 years, 48.5%) had significantly higher CSAS than younger ones (22–43 years). Similarly, attending physicians (57.1%) had higher CSAS than Med III and MED IV medical students (32.9%) and residents (10.0%). CSAS was significantly higher among physicians who graduated after 2020 (33.3%) compared to those who graduated before 1990 (23.8%), between 1991 and 2000 (18.6%), 2001–2010 (13.4%), and 2011–2020 (10.8%). Finally, CSAS was significantly higher among Internal medical physicians (76.2%) compared to surgery physicians (23.8%) (Table 6).
Table 6Bivariate analysis showing the association between attitude scale and sociodemographic variables, communication status, preferred languages, and languages taught in school. (merge)AttitudeP.valuePositive (≥ 100 / 130)Negative (< 100 / 130)GenderMale136960.65458.9%41.1%Female956141.1%38.9%Age22–257557 0.006 32.5%36.3%26–32253310.8%21.0%33–431958.2%3.2%≥ 441126248.5%39.5%Where do you live?Beirut120730.29251.9%46.5%others1118448.1%53.5%In which area do you live?Rural54380.85123.4%24.2%Urban17711976.6%75.8%Monthly Income< 331366558.9%41.4%What is your academic year?6-7th year medicine7654 0.001 32.9%34.4%PGY233510.0%22.3%Attending1326857.1%43.3%Year of graduation≤ 19905534 0.01 23.8%21.7%1991–2000432218.6%14.0%2001–2010311113.4%7.0%2011–2020253510.8%22.3%> 2020775533.3%35.0%Do you work at the Hospital “X”?Hospital “X”56500.09924.2%31.8%Other17510775.8%68.2%In what department are you?Internal medicine1761030.02376.2%65.6%Surgery555423.8%34.4%Did you take any course regarding physician-patient communication (at university, online…)?No138960.78159.7%61.1%Yes936140.3%38.9%Do you ask your patients what language do they prefer to be talked to?No4683 < 0.001 19.9%52.9%Sometimes1165450.2%34.4%Yes692029.9%12.7%Do you give to your patient enough explanation about the initiation of a new treatment or the prescription of home medications (use, benefits, side effects)?No1521 0.020 6.5%13.4%Yes20512388.7%78.3%Not applicable11134.8%8.3%Do you give your patient wrong diagnosis?No2081360.31490.0%86.6%Yes953.9%3.2%Not applicable14166.1%10.2%Do you explain to your patient the informed consent (benefits, risks)?No24250.26810.4%15.9%Yes19412384.0%78.3%Not applicable1395.6%5.7%Do you tell the patient that his problem needs to be referred to another doctor of different specialty without giving him preliminary results, explaining to him about his case or helping him reaching to the new doctor?No146940.55963.2%59.9%Yes584725.1%29.9%Not applicable271611.7%10.2%Do you feel that charge of consultations is appropriate to time and explanations (before the crisis and the pandemic)No116790.20350.2%50.3%Yes955641.1%35.7%Not applicable20228.7%14.0%Do the physicians and medical students prove to be team effective?No19130.8508.2%8.3%Yes20313687.9%86.6%Not applicable983.9%5.1%Have you had any practice in history taking/communication skills between physicians and patients in Arabic during your clinical skills courses in the pre-clinical years, before you began working in a hospital?No1621050.49770.1%66.9%Yes695229.9%33.1%Do you feel confident in taking a history and explaining to your patient in Arabic?Strongly disagree50 0.028 2.2%0.0%Disagree1968.2%3.8%Neutral282712.1%17.2%Agree514722.1%29.9%Strongly agree1287755.4%49.0%What languages do you understand? ArabicNo790.1893.0%5.7%Yes22414897.0%94.3%Languages in which you were taught in ArabicNo9447 0.031 40.7%29.9%Yes13711059.3%70.1%Languages in which you were taught in University: ArabicNo2141510.14892.6%96.2%Yes1767.4%3.8%
CSAS score was significantly higher among physicians who reported inquiring about their patients’ preferred language of communication (CSAS ≥ 100/ 69 (29.9%) vs. CSAS < 100/ 20 (12.7%); p < 0.001), and those who reported giving patients enough explanation about the initiation of a new treatment or the prescription of home medications. Furthermore, most physicians strongly agree about feeling confident in taking a history and explaining to their patient in French or English (56.4%), with significant higher CSAS among physicians who do not report Arabic language as the language taught in School (40.7% with CSAS ≥ 100 vs. 47, 29.9% with CSAS < 100, p = 0.031) (Table 6).
Exploring physicians’ communication attitudes naturally leads to the question of how willing physicians are to support structural changes—such as integrating Arabic communication courses—within medical education.
Most physicians (68.8%) reported not practicing communication skills with their patients in Arabic during their pre-clinical years oy before beginning work in a hospital.
Physicians generally felt confident in taking a history and explaining in French or English (87.6% agreed), as well as in Arabic (78.1% agreed). The majority believed introducing a communication course in Arabic before working in a hospital setting would be beneficial (70.4% agreed). The majority (81.7%) assumed that future patients would speak Arabic (Table 7).
Table 7Physicians’ confidence in medical communication and perceived need for Arabic trainingFrequencyPercent(%)Have you had any practice in history taking/communication skills between physicians and patients in Arabic during your clinical skills courses in the pre-clinical years, before you began working in a hospital?No26768.8Yes12131.2Do you feel confident in taking a history and explaining to your patient in French or English?Strongly disagree30.8Disagree123.1Neutral379.5Agree11730.2Strongly agree21956.4Do you feel confident taking a history and explaining to your patient in Arabic?Strongly disagree51.3Disagree256.4Neutral5514.2Agree9825.3Strongly agree20552.8Will most of the patients you will see in the future speak?Arabic31781.7English4912.6French153.9Others71.8Do you think it would be beneficial to introduce a communication course in Arabic before you begin working in a hospital setting?Strongly disagree30.8Disagree307.7Neutral8221.1Agree11128.6Strongly agree16241.8
Bivariate analyses showed that the physicians’ age group most strongly in favor of introducing Arabic communication courses comprises physicians aged 22–25 years (42.6%), followed by those aged 44 and above (36.4%). When considering the year of graduation, support for such courses tends to increase among more recent graduates, indicating that newly trained physicians may be more aware of the benefits of Arabic communication training. Furthermore, our findings reveal that physicians who have not previously taken a patient-physician communication course are more likely to support the introduction of one in Arabic compared to those who have (63.1% vs. 36.9%, respectively) (Table 8).
Table 8Bivariate analysis showing the association between introduction of communication course in Arabic and different variablesDo you think it would be beneficial to introduce a communication course in Arabic before you begin working in a hospital setting?p-valueStrongly disagreeDisagreeNeutralAgreeStrongly agreeGenderMale3234569920.129100.0%76.7%54.9%62.2%56.8%Female073742700.0%23.3%45.1%37.8%43.2%Age (years)22–25032238690.0010.0%10.0%26.8%34.2%42.6%26–32011618230.0%3.3%19.5%16.2%14.2%33–430373110.0%10.0%8.5%2.7%6.8%≥ 44323375259100.0%76.7%45.1%46.8%36.4%Year of graduation≤ 1990192027320.00233.3%30.0%24.4%24.3%19.8%1991–200021014172266.7%33.3%17.1%15.3%13.6%2001–2010071110140.0%23.3%13.4%9.0%8.6%2011–2020001818240.0%0.0%22.0%16.2%14.8%> 2020041939700.0%13.3%23.2%35.1%43.2%SpecialtiesIM02460751200.0620.0%80.0%73.2%67.6%74.1%Surgery36223642100.0%20.0%26.8%32.4%25.9%Understanding Arabic languageNo013390.7590.0%3.3%3.7%2.7%5.6%yes32979108153100.0%96.7%96.3%97.3%94.4%Understanding English languageNo011180.2520.0%3.3%1.2%0.9%4.9%yes32981110154100.0%96.7%98.8%99.1%95.1%Understanding French languageNo0178260.0970.0%3.3%8.5%7.2%16.0%yes32975103136100.0%96.7%91.5%92.8%84.0%Arabic as a language taught in schoolNo126394530< 0.00133.3%86.7%47.6%40.5%18.5%yes24436613266.7%13.3%52.4%59.5%81.5%English as a language taught in schoolNo24234681< 0.00166.7%13.3%28.0%41.4%50.0%yes12659658133.3%86.7%72.0%58.6%50.0%French as a language taught in school No 031919500.0250.0%10.0%23.2%17.1%30.9%yes3276392112100.0%90.0%76.8%82.9%69.1%Taking patient-physician communication courseNo2245670820.00566.7%80.0%68.3%63.1%50.6%yes1626418033.3%20.0%31.7%36.9%49.4%
These findings underscore the need for curriculum enhancements and institutional support to bridge language gaps and improve communication outcomes in Arabic-speaking healthcare contexts.
Physicians’ education now includes not only medical courses and technical expertise but also communication skills which are essential for effective patient interactions. This study aimed to evaluate the knowledge of physicians, medical students and patients in Arabic language and simplified medical terms, as well as assessing physicians’ attitudes toward learning communication skills and incorporating a patient-physician communication course in Arabic and simplified medical jargon into the medical curriculum in the universities in Lebanon.
Our study demonstrated that specialized physicians and medical students generally hold positive overall attitudes towards learning communication skills, with 59.5% expressing a favorable reaction. Similar results were reported by other studies, such as the one conducted by Anjali Choudhary and Vineeta Gupta [26] among medical students in India, where 78.1% of students showed a positive attitude toward learning communication skills. The discrepancy in percentages may be attributed to differences in medical curricula, cultural influences, and the extent to which communication skills are emphasized during training. Additionally, age was significantly associated with a positive attitude toward learning communication skills, with older physicians displaying more enthusiasm for acquiring these skills. This finding aligns with previous research indicating that older medical students were more positive about learning communication skills [27]. Education year also played a role, with attending having significantly more positive attitudes than their younger counterparts, likely due to their increased clinical experience and direct patient interactions. These findings are consistent with studies conducted in Egypt by Khashab [28] and in Zimbabwe by Kahari and Takavarasha [29], which highlighted the role of clinical exposure in shaping attitudes toward communications training.
This study showed that internal medicine physicians had a greater positive attitude toward learning communication skills compared to surgery doctors. This difference may be due to many factors related to the nature of each specialty and the type of patient interactions they engage in.
Internal medicine physicians deal with diseases that require long term relations with patients and regular follow up visits, especially while managing chronic illnesses, which needs continuous patient education and involvement, along with strong communication skills to explain the diagnosis, discuss the treatment plan effectively.
On the other hand, surgeons interact with patients at short term, where they only communicate preoperatively and postoperatively [30]. Surgery is a more technical and hands-on specialty, which can lead to a greater emphasis on developing technical skills over communication skills among surgery doctors. However, complications encountered post-operatively and patient dissatisfaction emphasize the importance of communication courses for all doctors [31].
Jargon and technical language are frequently used in clinical settings, often creating communication barriers for patients with low literacy [32]. A study found that medical residents used two jargon words per minute on average when interacting with a standardized patient who has limited health literacy [33]. Our study revealed that 45.12% of physicians had poor knowledge in Arabic medical terms, recognizing fewer than 18 correct words out of 30. This may be due to the predominant use of foreign languages (English or French) in medical schools. Additionally, patients scored extremely poorly by barely recognizing six words out of 30 on average. They frequently responded with uncertainty (“I don’t know” or “I’m not sure”) when asked about their ability to use and understand translated English-Arabic medical terms. This highlights the mismatch between physicians’ ways of communication and patient language preferences, therefore the need for improved verbal communication in healthcare settings.
In Lebanon, English and French are the main languages of medical education. Despite this, most patients in our study reported high levels of trust in their doctors and satisfaction with communication, even when consultations were conducted in foreign languages. This contrasts with a study conducted in Egypt, where the use of a foreign language negatively affected patients’ understanding of instructions [34].
These discrepancies may be influenced by patients’ expectations, familiarity with foreign medical terminology, and differences in health literacy. Or these results may be influenced by social desirability bias; respect for doctors and cultural norms. However, social desirability can be of two extremes; either the patient is very satisfied of his doctor, or unsatisfied at all. Therefore, in this matter, the answers were expected to be balanced because patients who participated might have been very unsatisfied as well.
On the other side, many countries have added native language communication courses to overcome similar obstacles and improve healthcare outcomes. For example, in Germany, international medical students undergo specialized German medical communication courses to prepare for hospital settings, and all healthcare workers must be knowledgeable of the native language.
Also in China, international students must pass a medical communication exam before starting clinical practice. Implementing a similar approach in Lebanon and in the Arabic speaking countries — through Arabic medical language training — could highly improve patient-centered care, satisfaction, and trust.
Studies on the use of medical term in healthcare interactions, suggested that physicians and patients influence each other’s speaking style, with physicians using more medical terminology when interacting with patients who also use terms [35].
Despite the low AUT score among physicians, patients still preferred their doctors to use more Arabic, which could suggest that the difficulty lies in the use of foreign medical terms, which patients may struggle to understand. These findings highlight the need to adjust communication to patients’ understanding ability and preferred language.
Only 52.8% of physicians in our study reported confidence in taking medical histories in Arabic. This proportion was lower than the reported confidence levels among medical students in a previous study [3]. The gap may be due to increased use of foreign-language medical terms and limited emphasis on Arabic medical jargon. Further studies are needed to understand this discrepancy and the factors contributing to differences in physicians’ confidence levels in taking medical history in Arabic.
The majority of physicians in our study believed that introducing communication courses in Arabic before entering hospital-based training is crucial. There have been several studies conducted on the introduction of communication courses in medical schools worldwide and could provide essential skills for improving patient-centered communication and care [36]. Some barriers to improving Arabic medical terminology knowledge are the dominance of English and French in medical schools, and the lack of standardized Arabic medical terms [37]. Addressing these challenges, Arabic language communication courses should cover topics such as history taking, explaining diagnosis, and handling conversations using medical terminology. Implementing such courses could bridge communication gaps, improve patient satisfaction, and overall healthcare delivery in Arabic speaking regions (Table 9).
Table 9Summary of our findings and recommendationsKnowledge of Arabic medical termsMajority of doctors have poor knowledge in Arabic medical terms because they receive their medical education in foreign languages.Only 52.8% of them are confident in taking medical history in Arabic.Majority of patients don’t know medical terms in English-Arabic AUT score.Yet, majority of patients report that doctors explain in simplified Arabic words. They prefer doctors to use more Arabic.This points out the importance to educate both physicians and patients on medical communication skills to find middle ground between physicians who find it easier to use medical terms in foreign language and patients who understand more Arabic which is their mother tongue language.Attitude toward learning communication skills.More than half of physicians have positive attitude, especially older and more experienced doctors as they are more mature and experienced in the practical field knowing the importance of the communication skillsSpecialty affecting attitude toward learning communication skillsIM physicians have more positive attitude and tend to attend more communication courses. Surgeons focus more on technical skills and less on communication.Introduction of communication course in Arabic in medical schoolMajority find it beneficial for a better care and satisfaction among patient-physician communication. Language proficiency,* cultural competency*,* and patient-centered communication are examples of topics to be covered;* also include instruction on taking a medical history,* explaining diagnoses and treatment plans*,* and handling sensitive or difficult conversations*.
This study is the first in Lebanon to assess both patients’ understanding of medical terminology used by healthcare professionals and the Arabic language proficiency of medical students, residents, and physicians. The study provides valuable insights into how language barriers impact the quality of care given to the patient. A key strength is the large participant pool, including patients, specialized physicians, and medical students at various stages of training, which enhances the study’s validity and generalizability.
However, there are limitations to consider. The study’s cross-sectional design establishes associations but not causation. The use of self-administered questionnaires for healthcare professionals increases the risk of information and recall bias. Although patient interviews were conducted face-to-face, responses may have been influenced by social desirability bias, potentially leading to inflated satisfaction ratings. Additionally, while the study included previously hospitalized patients, recall bias was mitigated by limiting the call to recent hospitalizations to ensure more accurate responses.
As the recognition of the significance of communication skills in contemporary medical practice continues to grow, we believe that including communication courses in Arabic in medical school in Arabic-speaking countries is a crucial step in enhancing medical communication between doctors and patients. It would be beneficial to practice history taking in Arabic language, and to include workshops on Arabic medical terminology prior to starting clinical training. Also, it would be great to practice communicating with patients through simulation in Arabic, to help students feel more confident and accurate, when having medical conversations in Arabic.
Effective communication between physicians and their patients is an essential stakeholder for high-quality standard of care. Although in Lebanon, as well as in most of neighbor countries in the middle East region, the primary language is Arabic, yet medical formation in these countries is almost completely taught in foreign languages whether English or French. As a first study of its kind, we aimed to evaluate the extent of this language barrier among doctors, students and their patients, and its impact on the medical field.
This study offers a new assessment tool that we designed, the Arabic Usage Tool (AUT) allowing better assessment of both patients and physicians knowledge, understanding and proper usage of Arabic medical words. Our results show lack of knowledge among both parties, with a vast majority of physicians and students feeling unconfident when having to take history or explain to their patients in their native language. Nevertheless, patients preferred their doctor to communicate with them more in their primary language instead of using many medical jargon instructions and explications in a foreign language. As a result, we emphasize the importance of introducing communication courses in Arabic in medical schools of Arabic-speaking countries as a crucial step in enhancing communication and quality of care between patients and doctors, allowing better understanding, compliance, and reducing errors and misunderstanding of the patients, and thus improving outcomes.
In this study, we also demonstrated that attitudes toward learning communication skills in treating doctors and medical students were extremely positive, particularly older more experienced doctors, and medicine specialties compared to surgical ones tending to have more positive attitude.
In conclusion, our study points out on the importance of incorporating communication courses including Arabic medical terminology, simplified jargon, history taking, explaining diagnosis, treatment plans and sensitive conversations in Lebanon and all Arabic speaking countries.
Additionally, attention to language barriers and similar evaluations and incorporation of communication courses in medical schools’ curricula should be attained in every multilingual speaking country tailoring best communication between patients and physicians in the most understandable language.
Yet, further research should be done involving also outpatients, children and critical care units, but also developing international-based communication and language-based courses to be incorporated in all medical field curricula.
Supplementary Material 1.
Supplementary Material 2.
Supplementary Material 3.
Supplementary Material 4.