Hospital-Based Clinicians’ Knowledge and Practices Regarding Stigmatizing Language in Clinical Documentation: A Multicenter Survey - Scorecard - MDSpire
Clinical Scorecard: Multicenter Survey of Hospital Clinicians’ Awareness and Use of Stigmatizing Language in Clinical Notes
At a Glance
Category
Detail
Condition
Stigmatizing language in clinical documentation
Key Mechanisms
Prior literature cited in the introduction reports associations with clinicians’ attitudes and behaviors, recall during verbal handoffs, expressions of empathy, and patients’ trust.
Target Population
Internal medicine residents, faculty, and APPs; invitations went to residents and hospitalist faculty who routinely supervise residents at both sites, and to clinically documenting APPs who supervise APP students at one site.
Care Setting
Two large academic internal medicine departments; an electronic survey and knowledge test assessed participants’ knowledge, experiences, and values concerning stigmatizing language.
Key Highlights
The cross-sectional multicenter study surveyed internal medicine residents, faculty, and APPs between April and September 2025.
The survey and knowledge test were developed by the study team because validated instruments were unavailable for this emerging area.
Six cognitive interviews, three at each site, informed revisions intended to improve question clarity and relevance.
Five knowledge-test questions assessed recognition of 11 potentially stigmatizing terms in clinical documentation excerpts.
The supplied article text describes the study methods but does not provide survey results.
Guideline-Based Recommendations
Diagnosis
The study assessed knowledge by asking participants to identify potentially stigmatizing terminology in clinical documentation excerpts.
Management
The introduction states that clinicians must be trained to use patient-centered, non-stigmatizing language in documentation; this is background rationale, not a study guideline.
Monitoring & Follow-up
The study used survey items to examine clinicians’ knowledge, experiences, and values concerning stigmatizing language.
Risks
The introduction cites prior literature reporting adverse effects on clinicians’ attitudes and behaviors and possible diminished patient trust.
The introduction reports that stigmatizing language has been documented more often in records of Black patients, women, people with substance use disorders, and people with public insurance.
Patient & Prescribing Data
No patients were enrolled; participants were internal medicine residents, faculty, and APPs at two academic departments.
The study did not evaluate treatments or prescribing. The introduction cites prior research linking exposure to biased clinical vignettes with less willingness to prescribe adequate pain management.
Clinical Best Practices
The introduction defines patient-centered language as neutral, stigma-free, respectful, and demonstrating collaboration between clinicians and patients.
The introduction notes that documentation word choice has infrequently been addressed directly in medical education and is commonly acquired implicitly.
The introduction states that supervising faculty and APPs review and revise trainees’ documentation and offer feedback; it does not present this as a tested intervention or recommendation.
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