title: Brief report: Resident recognition of low literacy as a risk factor in hospital readmission.
abstract: BACKGROUND
  Low literacy is associated with poor self-management of disease and increased hospitalization, yet few studies have explored the extent to which physicians consider literacy in their patient care.
  
  
  OBJECTIVE
  To examine trainee recognition of low literacy as a potential factor in patient adherence and hospital readmission.
  
  
  METHODS
  Randomized study of 98 Internal Medicine residents and medical students. Trainees reviewed a case history and completed a questionnaire pertaining to a fictional patient's hospital readmission. Case version A contained clues to suggest limited patient literacy skills, while version B did not. Responses were reviewed for mention of low literacy and educational strategies recommended for low-literate patients.
  
  
  RESULTS
  Few trainees raised the possibility of low patient literacy, even when provided clues (25% in Group A vs 4% in Group B, P=.003). Furthermore, while most trainees listed patient education as an important means of preventing another readmission, only 16% suggested using a strategy recommended for low-literate adults.
  
  
  CONCLUSIONS
  Few trainees recognized low literacy as a potential factor in patient nonadherence and hospital readmission, and few recommended low-literate educational strategies. Medical residents and students may benefit from additional training in the recognition and counseling of low-literate patients.
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA. powellck@musc.edu
authors.forename: Caroline K
authors.initials: CK
authors.lastname: Powell
authors.forename: Sunil
authors.initials: S
authors.lastname: Kripalani
mesh_terms: D000046:Academic Medical Centers; D004522:Educational Status; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007803:Language Arts; D008297:Male; D010353:Patient Education as Topic; D010359:Patient Readmission; D010817:Physician-Patient Relations; D012648:Self Care; D011795:Surveys and Questionnaires; D016312:Treatment Refusal