Tabriz University of Medical Sciences Research and Development in Medical Education 2322-2719 15 1 2026 01 01 Conceptualization of Complexity, Accuracy, and Fluency in Assessing Medical Writings: Comparing language and Content Specialist 33395 33395 10.34172/rdme.33395 EN Sayyed Mohammad Alavi https://orcid.org/0009-0001-8924-1454 Neda Rahmatvand https://orcid.org/0000-0002-5764-7425 Journal Article 10.34172/rdme.33395 2025 10 04 2025 12 01 Introduction: This study investigates how language specialists and content experts conceptualize and prioritize the dimensions of Complexity, Accuracy, and Fluency (CAF) in the assessment of medical writing. Methods: Six hypertension-related medical texts were independently evaluated by medical specialists and language specialists using a standardized CAF rubric. Results: The quantitative analysis showed near-perfect inter-rater agreement for Accuracy, substantial agreement for Complexity, and moderate agreement for Fluency. A qualitative thematic analysis of raters’ justifications and panel discussions revealed a shared emphasis on the critical importance of accuracy, nuanced differences in the interpretation of complexity, and divergent views on fluency shaped by stylistic and disciplinary preferences. The findings highlight the central tension between maintaining clinical precision and ensuring language accessibility, underscoring the importance of interdisciplinary evaluation for comprehensive assessment of medical texts. Conclusion: This integrated approach offers a replicable model for evaluating medical texts that balances clinical accuracy with linguistic clarity, ultimately supporting clear and effective scientific communication. This study contributes valuable insights to language assessment and medical writing pedagogy, supporting tailored interventions to improve the linguistic quality and practical effectiveness of scientific texts authored by non-native English speakers.