Hospital Clinician Survey Finds Gaps in Recognizing Stigmatizing Documentation Language

Researchers conducted a cross-sectional online survey and knowledge test at two large academic internal medicine departments to assess clinicians’ knowledge, attitudes, and perceived skills regarding stigmatizing language in documentation. Respondents included 72 faculty members, 10 advanced practice providers (APPs), and 63 residents. Response rates were 52% for faculty/APPs and 21% for residents. The test assessed recognition of stigmatizing terms in documentation excerpts, while Likert-style questions assessed attitudes and perceived skills.

Most respondents said they considered how word choices affected patients: 91% of faculty/APPs and 92% of residents. Similarly, 90% and 84%, respectively, considered effects on other clinicians. However, only 10% of faculty/APPs and 24% of residents were confident their own documentation avoided stigmatizing language. Just three faculty/APPs (4%) and two residents (3%) correctly identified all 11 stigmatizing terms assessed.

The findings suggest a gap between valuing patient-centered language and recognizing potentially stigmatizing wording, supporting consideration of targeted education and systems-level interventions. The two-department sample and low resident response rate limit generalizability and raise the possibility of nonresponse bias. This cross-sectional assessment does not establish effects on actual documentation practices or patient outcomes, or whether educational interventions would improve either.