Do medical trainees feel confident communicating with low health literacy patients?
BACKGROUND
Medical trainees infrequently use health literacy (HL) skills and overestimate their use of plain language and teach back skills. The aim of this study is to assess if level of training impacts the perception of medical trainees around HL knowledge and skills.


METHODS
A structured questionnaire consisting of 5 questions assessing the respondents' perception of their confidence in their HL knowledge, ability to identify and communicate with low HL patients, and use of relevant resources was completed by medical students and residents of 2 community-based internal medicine programs in Pennsylvania and Maryland between July 2012 and January 2013.


RESULTS
The response rate was 100% (40) for the PA program and 42% (17) for the MD residency program. All rotating medical students (17) completed the questionnaire. Out of 74 participants, less than 10% were confident of their HL knowledge and ability to identify and communicate with low HL patients. Only 1.4% (1) were confident of their ability to identify appropriate resources. There was no significant difference in communication skills (P=0.305) and ability to identify appropriate resources (P=0.143) across all participants irrespective of their training level. A significant improvement in HL knowledge was observed during the progression from first-year to third-year medical school (P=0.0126) and from internship to second year of residency (P=0.0496).


CONCLUSIONS
Medical trainees perceive that they do not receive adequate training on HL knowledge and skills required to feel confident in identifying and communicating with low HL patients and identifying appropriate resources. There is a need for addressing these deficiencies via medical school and residency curricula.
Department of Medicine, School of Medicine of Temple University, Philadelphia, PA ; Department of Internal Medicine, Crozer Chester Medical Center, Upland, PA.
Nadia K
NK
Ali
Department of Medicine, University of Maryland, Baltimore, MD ; Greater Baltimore Medical Center, Baltimore, Maryland, USA.
Robert P
RP
Ferguson
Department of Medicine, Crozer Chester Medical Center, Upland, PA.
Sharmin
S
Mitha
University of Pennsylvania School of Nursing, Philadelphia, PA.
Alexandra
A
Hanlon
health literacy; medical education; patient–provider communication