Overall, 150 patients were recruited for the study and 133 patients agreed to participate. There was an even spread of patients in each age group category (age 15–30, 31–40, 41–50, 51–60 and over 60 years). Of those surveyed, 74% (98/133) identified themselves as having English as a first language and 88% (117/133) considered themselves to be fluent in English.
‘Broken bone’ was defined correctly in the free text section by 71% (94/133) of respondents, with 4% (5/133) of respondents being almost correct, 5% (6/133) being wrong, 16% (21/133) leaving no answer and 5% (7/133) who did not know. However, ‘fractured bone’ was defined correctly by only 33% (44/133), with 32% (43/133) of respondents defining it as a less severe injury than a broken bone and the remaining 35% (46/133) giving an answer that was either wrong or indicated that they did not know. ‘Sprain’ was correctly defined by 17% (23/133) of respondents', with 29% (38/133) being almost correct, 25% (33/133) being wrong and 29% (39/133) saying they did not know. The results for ‘strain’ were 39% (52/133), 12% (16/133), 24% (32/133) and 25% (33/133) respectively. There was a lot of confusion and crossover between the meanings of sprain and strain among patients ().
Responses to free text questions
In the MCQs, 51% (68/133) of respondents knew that a fracture meant that the bone was broken while 20% (26/133) believed it meant the bone was bruised and 6% (8/133) understood that a fracture meant the muscles had become detached from the bone. The meaning of arthroscopy was correctly identified by 55% (73/133), while 14% (18/133) believed an arthroscopy to be an x-ray of the knee. A torn meniscus was correctly identified correctly by 46% (61/133) as damage to the cartilage in the knee while 12% (16/133) believed it meant a torn muscle in the knee and 27% (36/13) were unsure of the meaning.
Uncertainty between the terms ‘tendon’ and ‘ligament’ was common. Of those surveyed, 35% (46/133) knew that a tendon joined muscle to bone but 16% (21/133) believed it joined bone to bone. Similarly, 23% (31/133) chose the correct definition for ligament while 40% (53/133) confused it with the definition for a tendon. ‘Sprained’ caused the most confusion with only 11% (14/133) answering correctly and 55% (73/133) choosing the answer ‘twisted’ ().
Responses to multiple choice questions
Speaking English as a second language was a statistically significant predictive factor for patients who had difficulty with definitions. In the free text questions, 81% (79/98) of native speakers gave a correct definition of the term ‘broken bone’ compared with 43% (15/35) of those for whom English was not a first language (p=0.023). Similarly, 47% (46/98) of those with English as a first language correctly defined ‘strain’ compared with 17% (6/35) (p=0.0154). In the MCQs, 41% (40/98) and 28% (27/98) of native speakers chose the correct definition of ‘tendon’ and ‘ligament’ respectively compared with 17% (6/35) and 11% (4/35) of people who did not speak English as a first language (p=0.041; p=0.089) (). Of the patients who did not speak English as a first language, none had requested a hospital translator to be present. Some had brought an English-speaking relative with them to help with translation.
Comparison of number of correct answers between patients for whom English is their first language and those for whom it is not
Using the chi-square test, there was no significant difference in the knowledge of orthopaedic terms between different age groups.