MTWhen to Learn Speed Typing

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5/96, From Mary Morken
I think MT training, home or classroom, should include learning short-cut typing of some sort, rather than typing everything out "longhand." Learning to spell and learning to type are two different things, and MTs need to learn the most efficient text production from the start. What do you think? -Mary, veteran of creating six short-cut systems in seven years, and hating to see future generations of MTs doing the same!


From Robin G:
From my standpoint, I feel training should begin with basic skills. Students need to learn the correct spelling, definition and pronunciation of medical terminology. Once a student has achieved a level of competency they can always learn a short cut program. It sort of works on the same premise as using spell check and not reading the work for content.
From Gail McClendon:
What if students never really learned what went in the balance of the abbreviations? Learning is a process of building blocks, and I think a short cut would do a disservice to both the student and the profession. Once we actually learn something, it is sometimes easy to assume that we knew it all along. A student, however, just embarking on course work is already surprised by the depth and scope of curriculum, and adding this at the beginning would add to their confusion. Abbreviations can easily come after the basics. P.S. CCHS has ongoing discussions regarding teaching MT students those types of skills and will, at some point, offer additional courses.
From Michele Chavez:
My husband is learning MT now and I feel he should at least learn to recognize the new terminology he is learning in its true form. Later he can learn to abbreviate.
From Jennifer Martin:
Our program includes information about shorthand software, but I encourage students to learn the spelling of terms as well. They need to understand what the term means, and in order to look it up, the have to know how to spell it. Much more important that speed is the MT's ability to use terms accurately to ensure perfect patient care documentation. There's always time to speed things up when they start working.
From Jean Ichbiah, Textware Solutions.
Michele, You said the right word "recognize" but there is a big difference between recognizing and generating the same. Most people are using 2000 words and are able to recognize 10 to 50 times more. If two words are different in meaning, then it is vital that you should understand the difference, but this does not imply that you should necessarily know how to spell them.

Taking chemical examples, you might know the difference between N-Nitroso-N-ethylurea and N-Nitroso-N-methylurea without necessarily being comfortable writing them without help.

This "Robinson Crusoe" attitude of trying to do it as if you were on an island far from technology has limits. It forces you to learn things that are not the most useful. In actual practice, you will use technology and you better learn the best way to use it. This knowledge will be more useful.

"There's always time to speed things up when they start working." I disagree. When they start working, the pressures are such that they rarely take the time to rethink their methods. They rarely invest in learning new technology. And actually, only a minority ends up using abbreviation technology.

I concur that schools should teach not just the basics, but more importantly how to organize their work and use new tools. One certain thing for people who start in this profession is that they will see new technological advances every two years if not more frequently. To keep the productivity edge will require an attitude of permanent learning which schools do not seem to prepare for.


From Daniela:
As a student, I have to agree with you! I started reading this newsgroup about 2 weeks ago, and when everyone started talking about short cut keys for this and that, and speed typing doing this and that, I thought, "My God! I can't wait to learn that!!!" NOPE! It's not going to happen. I looked at the last 8 lessons I have left, and did not see anywhere, anything, about speed typing and shortcut keys. It's great that they are teaching us medical terminology, but it seems that may only be half of what we need to know, to be competitive in the MT market. I generally type about 65 wpm, but that doesn't include listening to a strange voice in my ear or typing words that don't look like they sound or words that are 20 or more characters long! I'm glad you brought this up because it's exactly what I've been thinking, but wasn't sure how to express!
From TJ Currey: In other words, teaching them to create their own macro system right off the bat? Frankly, I had a supervisor once tell me (she also meant having good editing skills, medical terminology, and "common sense") that a transcriptionist is as good as the macro system she has built up and can execute without having to think about it. I think it would be a great idea to teach them while they're still in the training process.
From Alisha: I agree that MT training courses should include short-cut typing. If I had known about this earlier, I would have been making more money sooner.
From Kim: I would like to add that perhaps it would be good to give an overview which would at least provide exposure to what they are and how they work in general -- along with maybe even some hands-on samples. Even one training session would go a long way in terms of promoting awareness.
From Linda: < Stach, The Brown Mackie College Salina, KS, walter@midusa.net> I have just been wondering whether to institute a medical spell checker in my classroom. However, your post gives me another idea that may be equally, if not more useful, for the students. I had decided against the medical spell check at least for the time being.

Now you have given me some food for thought, because I use a keyboard expander at home. This, in my opinion, would be more beneficial in their training. My college is about to upgrade the MT program, and as Department Head, I am proposing changes I would like to see implemented. I would first like some form of digital dictation/transcription rather than the desktop transcribers and tapes that we currently use. These things are antiquated (though not obsolete by any means)- as far as the state of the art workplace is concerned now, and I have started to see job listings with "experience in digital systems a plus, etc." So why not a keyboard expander?? Certainly for the senior students it would be a plus. Several of the facilities they (the students) intern at utilize PRD or another form of expander. Therefore, from where I stand, it can only give them advanced training in MT and make the student more "employable."

I remember when I first started using FF, I got so mad because I would forget the shorthand and type it out - so for quite awhile, I took FF off, having decided "you can't teach an old dog new tricks" but then when my wrists began giving out, I decided it was time to reinstall it.


From Toni Mercadante
Knowing that Mary has devised an abbreviation system (16,000+/- abbreviated forms) she and one or two others would wish to have embraced as an industry standard and instituted as part of any MT training curriculum, I hesitate to respond to this . . . but I will and risk the possibility of going down in flames.

I believe it is unnecessary and perhaps even a disservice to require that an individual learn a shorthand or abbreviation system in order to complete an MT training course. Those who are interested in pursuing this career should, IMHO, learn to transcribe the terminology fully, if for no other reason than to gain familiarity with it. One does not learn to be proficient with Gregg shorthand without first having knowledge and understanding of the full word or combination of words each shorthand character represents. At the end of the formal training, again in my opinion, it should be sufficient for the various training resources, whether classroom-based or at-home, to present an overview of the various shortcut programs (PRD, IT, ST, FF, etc.) and abbreviation systems available, how they work, and what kind of productivity gains can be realized with their use. Not all job situations will have this type of program available; some, in fact, do not yet even provide for transcription to be done on other than a typewriter while others use computer systems with proprietary programs that will not accommodate any third-party abbreviation expansion software. Taking into consideration the "use it or lose it" factor, such specific training would likely be a waste of time and money in the long run.

Assuming we are speaking of training adults, it should be sufficient to inform wannabe MTs of the availability of these programs and let them take it from there should they so desire and should their final position warrant and provide for their use. What needs to be presented as part of the curriculum is the information that predetermined abbreviation lists, abbreviation and word-expansion software programs, and other time- and labor-saving devices do, in fact, exist and information on how one or the other may be obtained, not necessarily training in the use of one "shortcut" program over another or the requirement that they memorize one particular predetermined abbreviation list over something else, even an abbreviation system of their own making, that may work better and more efficiently for them personally in their final job situation.


From Stacy Abraham
I agree with Toni completely. I have been working as an MT for a year now in a hospital setting. When I started there, we had no word-expansion software, only a certain number of macros that had been put into our Wordperfect directory. I really did appreciate having to type out all those nasty long words and new terms that I came across because it helped me become more familiar with them. Our department recently began using Flash Forward, and at this point I feel very comfortable using it; I think that being accustomed to typing the entire words has made it easier for me to create abbreviations that feel natural to me. I feel that if we had trained with word-expansion programs and abbreviations in school and I had become accustomed to using them then, I would have been much more frustrated when I started my first MT job in a place where we had no such aids.
From Donna:
I agree that everyone should develop their own system, one that works best for their style and memory. However, we also need to consider those individuals who would accept just any abbreviation that popped up, whether it was right or wrong. Point in case: An individual who was being trained at the hospital I was working at would accept the first word that the spellchecker suggested without even looking up the meaning of the word. She was a terrible speller and didn't know that much terminology, so I guess she figured the WP5.1 spellchecker knew more than she did. There were a lot of reports caught by the person training her, and there were a lot more after she was off "proofreading" (I have no idea why she was taken off proofreading so soon). You can't be too careful when training a new person, and this person just wasn't MT material to begin with, but the hospital was desperate to hire someone to fill a space. I'm not saying all newbies are this way. We trained another lady who was wonderful from the first day. She just had a natural talent for MT.
From Jean Ichbiah, Textware Solutions, Instant Text
When I hear people asking whether it is better to know spelling and other basics or the practice of abbreviation systems, I am immediately reminded of the wisdom of this humorist, Pierre Dac, saying "Better be rich and healthy than poor and sick!" You can and you should have both.

Coming back to what schools should teach, you can safely omit something if it can be acquired later. This is a point where we are going to differ. I believe that many of the skills required in making effective use of abbreviation systems have to do with hand-eye coordination and as such they take time to acquire. Modern system can make you very effective if you develop the reading skills that allow you to use the phenomenal ability of the human eye (better said, the brain that is behind) to find out in a glimpse what you are looking for among many other things : Using your eye skills instead of your finger muscles.

You make a plea for learning the terminology, but a distinction should apply between the ACTIVE vocabulary - those that you will use on your own - and the PASSIVE vocabulary - those that you can safely distinguish and recognize. For most people, the passive vocabulary is about 10 to 50 times larger than the active vocabulary and I conjecture that for your profession, it may well go as high as 100.

Abbreviation systems allow you to use SAFELY the passive vocabulary. And this will be more and more important as you deal with evolving medical specialties. For fear that this distinction be too abstract, let me use an example: Your eye can distinguish the shape of a cat from that of a dog in a 1/100 of a second - this is passive. Active would be the ability to draw the picture of a cat or a dog. Your argument taken to the extreme (and of course, we should not) would mean that you could only recognize the cat once you have learnt how to draw it.

My belief is that the proper skills needed to make efficent use of abbreviations should be taught in schools because they take reflection and therefore time. Students should learn about making proper glossaries and use them (as you see here, I disagree with Mary about teaching a specific set of abbreviations). This requires thinking about methods and it is doubtful that this thinking will take place - for most people - once taken in the pressures of daily production.

Part of the conservative attitude of schools comes from the fact that most have very little awareness of abbreviation systems and would therefore have difficulty imparting this knowledge.


From Rita: I have just entered into this profession from 25 years of a nonmedical background. While an application like Smartype is a God send, I had to learn, and I have to continue to learn the language. I believe that these short cut applications are tools for us to help us transcribe faster and better based on knowledge of the language. Abbreviations will not help me determine if it is mucus or mucous.

Also, I prefer to create my own short cut keys and hot keys. My brain may process differently than others, and I like having the ability to do so. However, it would be nice if companies did provide exposure to applications like Smartype, PDR, etc., and certainly offer abbreviatons if one does not prefer to create their own.

Nothing replaces education and an excellent tutor. I was fortunate -- I had a great tutor and believe that her training/feedback made this career dream a reality for me. I had Smartype, so words would appear and look correct, but if I was not familar with the word, I had to look it up. She stressed, "DO NOT GUESS." That is what makes Stedmans's Medical Dictionary so great to use with ST. If I am not familar with the word, I hit and most of the time I get the defintion of the word. Both are great tools to make this very challenging career possible for those like me who enter without a medical background and must learn a new language.


From Debbie Hahn: I agree with Daniela. I don't believe MT students should be taught any specific abbreviations or any specific software shorthand program, but I think they should simply be made aware of what's available and a simple overview of how one works, and then leave it up to them to decide which one to purchase (if any) and what abbreviations to use for themselves. I seriously doubt that most MT students who hadn't finished their course yet would be ready to dish out several hundred dollars to buy one of the programs to start using at home, anyway, and it wouldn't do any good to try to teach them specific abbreviations for a specific software program if they weren't actively using it at home - how could they remember all those abbreviations! Not to mention that if they did decide to purchase one later, it might be a totally different software package.

I think any good MT program should give an overview of ALL software options available to transcriptions - including shorthand programs, electronic dictionaries, third party spellcheckers, etc. It is only fair to make them aware of everything that is available to them, then let them decide what they want to use for themselves. It benefits no one to keep them in the dark just because they are beginners.


Jean: The concentration on teaching spelling is completely misleading because it sounds correct and is of no value whatsoever, as it is reading skills that are used for speed typing with advisories. For example, you may be able to distinguish a Renoir from a Monet in 1/10 of a second and it does not mean you could produce a copy of either. The same goes for medical terminology: You may be 100% able to safely recognize a term such as ciprofloxacin or diethylstilbestrol (when it appears in an Instant Text or Smartype advisory list) without being comfortable spelling it without assistance.
From Robert T. Hill, rhill@spacelab.net
I agree with the argument that MTs should understand what they're typing and therefore should do the hard work involved in learning. I think it's important to know what the M.D. should be saying and how to notate it properly. How the MT translates that knowledge down the arms, through the fingers, into the keyboard and onto the screen is a matter of personal choice. I think it's a perfectly valid choice to powertype every single character (two keystrokes for capitals), and it's also a valid choice to take advantage of whatever abbv. expansion technology you're comfortable with.

I vote that we accept that people can use some sort of abbreviation system if they want to. I vote that schools acknowledge this choice and help their students work through the decisions involved.


From Bev Hearn:
I trained for one year as a Court Reporter before suffering burnout from commuting five hours a day from home to school. That was in 1987. At that time, CAT transcription was really coming into its own (CAT = computer aided transcription). But, of course, with this method you had to "build your dictionary", and if your used brief forms that could mean two things, for example, pn = opinion and pn = pain. Depended upon the context. But how the software would work was that after you finished taking a job, you ran it through your translater and it would kick out "conflicts" and you could choose the word you wanted to use.

Well, the course I was taking was touted to be "conflict-free", and guess what! They wanted us to spell everything out in machine shorthand. So opinion would be 0-pin-yun. and pain would be pain. What a drag. Of course *I* wanted to use brief forms because I think in them....but a lot of other people were more content spelling everything out because they didn't want to "stop and try to remember the brief form". (Interestingly enough, some of the youngsters who were taking this course learned their phonetics really well and could write faster than anyone in the class ---- but when it came to reading back, they could read it back all right, but they didn't have a clue as to what the sounds (i.e. words) they were reading back meant. That was a real eye-opener.

I have a slight bit of dyslexia, and if you have ever seen a court reporting machine, you'd freak out because, as Alisha said, it's all code. The word, or sound "J", for example, is written as "SKWR". So, when you have to spell everything out, and you start reversing your letters, it can be pretty tricky to be accurate. I LOVED brief forms...but couldn't use them. I worked about 2-3 years doing medical transcription before I found PRD+, and so, had to spell everything out. But it was good, because I learned my craft. Now, I use mainly my own brief forms, and have found my accuracy has increased because they're not long enough for my dyslexia to take over! I can type a page or two without even a mistake. That's a far cry from what happens when I do it without my productivity software.

To each their own! The important thing is that you know the meaning of what you type - no matter how you get it down on paper, or screen, or whatever!


From Kathy Karjala
I went through court reporting school and worked in the profession for about a year, a long time before becoming an MT. We certainly had courses (only one semester each, I think, but I could be wrong) in both legal and medical terminology. However, steno typing is quite different from regular typing. You have only twenty keys, and one or all may be pressed simultaneously. Each depression of a key(s) produces one line of text on a short continuous- feed roll of paper. Steno typing is entirely phonetic, and you usually make one hand motion for every syllable you hear. There are some systems which teach a few abbreviations for very common terms, but I suspect that for most medical typing most court reporters simply type what they hear, one syllable at a time. (By the way, most people speak between 180-220 wpm, sometimes increasing to almost 300 wpm if very excited). In verbatim and immediate stenotranscription, if you wait too long to hear the end of a long medical word, you may not have time to catch up, even if you have an abbreviation for it.

So I would say most court reporters probably type by sound alone, and then later may have to decipher what the term is. The learning of the term and the learning of the transcription skill really have nothing to do with each other, or very little.

To add to the thread, I can't see that using abbreviations from the beginning would hurt anyone, as long as you are clear what word is needed and how it is spelled. By the same token, any new MT would be looking up a lot of things even if s/he had an abbreviation for them. I imagine different people would learn differently. However, I agree with whoever said that no specific abbreviation system should be forced down students' throats: I'm for broad exposure to a lot of potential time-savers, with each person deciding what will work best for them.


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