General population’s knowledge about the anatomical locations of organs and medical terms today and 50 years ago: a replication study

Background: Physicians are frequently not aware that patients may not be familiar with the meaning of medical terms or have limited knowledge about the location of organs. These aspects of functional health competence require particular attention when designing communication curricula for undergraduate medical students. The aim of our study was to evaluate the knowledge of laypersons about the anatomical locations of organs and the definitions of commonly used medical terms as relevant aspects of health literacy. Furthermore, we wished to compare it with the knowledge of a historical patient cohort who performed this study 50 years ago. Methods: In this replication study, multiple-choice questionnaires with simple anatomy and common medical terms which were published in 1970 were distributed among a convenience sample of lay volunteers (n=537) from the streets of Hamburg, Germany. Sociodemographic data including sex, age, highest educational school achievement, occupation in a field associated with medicine, and German as first language were also collected. The percentage of laypersons’ correct answers was compared to the percentage of correct answers of a historical patient cohort (n=234) published in 1970 to identify the development of health literacy as basis for curricular planning. Results: Laypersons showed significantly more correct answers in four of eight simple anatomical locations of organs (p<0.001). For seven commonly used medical terms laypersons only gave significantly more correct answers for the definitions of “jaundice” (p<0.001) and “diarrhoea” (p=0.001) compared to the historical cohort from 1970. Participants with a senior high school degree performed significantly better with respect to total scores of correct organ locations (p<0.001, d=0.35) and correct definitions of medical terms (p=0.001, d=0.30) than participants who completed junior high school. Conclusion: The definitions of common medical terms and the correct anatomical locations of organs by laypersons have increased during the past 50 years but could still need improvement by school education and media information of better quality. Medical educators should know about the low health literacy of laypersons with respect to these aspects to raise medical students’ awareness for this problem and to provide communication training for medical students to use comprehensible language during history taking and shared decision making.