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Misunderstood or confusing dictation - Sandy

Posted: Jan 31, 2011

I am currently in my last quarter of schooling and have a project I am currently working on. My instructor wants me to research the different ways of how to handle dictation that cannot be understood or is confusing and also how this procedure differs depending on work environment, such as on site, at home, large service, etc.

I have talked to a few transcriptionists and some suggestions they have given are; speeding up or slowing down the recording, looking to see if the word makes sense according to the subject matter, contacting the physician or service provider, using OneLook.com, and highlighting the questionable word so it stands out for QA.

Can anyone else give me any more suggestions on how to handle this problem? Also, is there a difference depending on your work environment?

should be no difference re: work environment - ICManiac

[ In Reply To ..]
What I learned early on was not to spend a huge amount of time on the first run through of listening to a difficult dictation. I can be working along, come to a difficult spot, leave a blank or bracket and keep going. Repeat for every spot in the dictation.

Once the report is as best completed on the first pass, rewind and re-listen at a slower speed beginning from the beginning. The blanks are much more likely to get filled in. When you see the report as a whole rather than in its individual words, it makes more sense. It sounds like it would take more time, but it can actually save time.

Ask for samples of that physician's dictations as well. Much dictation is repeated from one report to another and you can glean clues from previous reports.

Also, I put a limit on how much time I invest in a single blank. For blanks for new equipment, I usually limit myself to 15 mins researching (Grays anatomy, Stedman's Dictionary, etc.). I may give myself longer when I am newer than after having some experience under my belt. If I have 10 blanks and allow 15 mins per blank, I won't earn enough to eat that day!

Make use of a jump marker in your document so that you can jump both in the text and within the recording to swiftly move from one blank to another.

Don't be afraid to leave blanks after an honest investment of researching a blank. Don't take feedback from QA or the physician personally; use it as a learning experience. Finally, remember the feedback and use it for future reports.

I rarely leave a blank and expect a response from the physician. If I work on site, I might present it to him/her personally, but to be honest, that privilege can be abused quickly and you will find him/her less willing to help you. I have found it really is better to leave a blank than to approach him/her personally. That way, you have written documentation and you avoid appearing less than knowledgeable or making him/her feel intruded upon.

Sure there's a difference in work environments - longtime MT

[ In Reply To ..]
If you're working where there are other MTs, one of your greatest resource is available-- ANOTHER EAR.

I miss those days sometimes of having my bestie MT buddy coming to listen and then both of us diving for the books if neither was sure!!

And now even faster with the internet for looking up... - lka

[ In Reply To ..]
I agree with these 2 posters except I would never spend 15 minutes on any new word. Where I work they say average is 2 minutes and you would be surprized how many searches you can do on the internet, especially google.

Also, make use of signs, symptoms, diseases, names of rongeurs, names of sutures and the like. If you have the surgical book and they say a certain rongeur but you are just not sure, look up rongeur and see if anything sounds like what the MD is saying. Same for names of diseases, signs, symptoms and the like. It all comes with practice to find these shortcuts. Even, if you are typing the name of a piece of surgical equipment and not sure how to spell it (say the first word), type what it phonetically into Google with the rest of the phrase. Sometimes it will give you suggestions like did you mean this....

If in doubt I would always blank it, keep track of the job # or way you can access it later on to see if they filled it in. After a while you will become familiar with these words.

The other day for example I had a doc name a piece of surgical equipment he was using and he said the word select and spelled Celect (and I thought, he's wrong), but no, sure enouogh it was Celect whatever the rest of the phrase was. I still use my reference books but sometimes you can find things so quickly on the internet just in 2 minutes. Can be tedious in the beginning but does get better after time. Now after 25 plus years I can say I am glad I took the time to "learn" these things that sometimes did not sink in until about the 2 year mark.

ya know, I did not even consider my fellow MTs - ICManiac

[ In Reply To ..]
as a resource as mine actually gave me wrong information on purpose! To this day, I tend to rely more on myself than to trust in others. I am absolutely certain that if that had not been my initial experience, rather having had a positive one, that resource would have come to mind!

One of the best resources I ever had - long time MT

[ In Reply To ..]
was my fellow MTs. I was an MTSO/MT for a long time- this was my only experience working side-by-side with MTs as I did it remotely for all the other time of my career.

I worked with some of the brightest, most intelligent, resourceful women I've ever met. One of them I've stayed in contact with often for the last 20 years and we still giggle over the time we spent hunting down the right words :)

HOWEVER, that was a long time ago and the TAT pressures were not like they are now. I would spend no longer than 5 minutes looking for a word.

And to this day, as much as I love Google (and I sooooo love Google) my Dorlands sits 3 feet from my grasp just in case!

Thanks :) - Sandy

[ In Reply To ..]
Thank you all for sharing your experiences with me. This gives me a few more topics to bring up in my research paper, as well as knowledge for when I finally am in the field working.

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