title: Health Literacy in Transitions of Care: An Innovative Objective Structured Clinical Examination for Fourth-Year Medical Students in an Internship Preparation Course.
abstract: BACKGROUND
  Low health literacy is associated with adverse health outcomes, especially during transitions of care. Competency-based assessments may improve communication during this time.
  
  
  OBJECTIVE
  To develop an Objective Structured Clinical Examination (OSCE) for medical students to demonstrate communication skills to be used during the hospital discharge process with patients of low health literacy.
  
  
  METHODS
  The OSCE was integrated into the curriculum of an internship preparatory clerkship.
  
  
  METHODS
  One hundred and one fourth-year medical students participated.
  
  
  METHODS
  Students received a skills-based health literacy workshop. In the OSCE, learners counseled standardized patients regarding initiation of anticoagulation at discharge and wrote discharge instructions.
  
  
  RESULTS
  Fifty-seven students completed the workshop prior to the OSCE, and 44 participated in the workshop after the completing the OSCE. Participants who completed the workshop first outperformed their peers on the checklist (15.1 vs. 13.4, p < 0.0001) and on the reading level of their written instructions (9.9 vs. 10.6, p = 0.01); 82% felt confident communicating with patients of low health literacy after the workshop and OSCE.
  
  
  CONCLUSIONS
  This OSCE is a tool to train and evaluate future interns' ability to communicate with patients of limited health literacy levels at hospital discharge. Such innovations may make this period of time safer for patients, improving health outcomes.
authors.affiliation: Icahn School of Medicine at Mount Sinai, Box 1257, 1 Gustave Levy Place, New York, NY, 10029, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Bloom-Feshbach
authors.affiliation: Icahn School of Medicine at Mount Sinai, Box 1257, 1 Gustave Levy Place, New York, NY, 10029, USA.
authors.forename: Dana
authors.initials: D
authors.lastname: Casey
authors.affiliation: Icahn School of Medicine at Mount Sinai, Box 1257, 1 Gustave Levy Place, New York, NY, 10029, USA.
authors.forename: Lucy
authors.initials: L
authors.lastname: Schulson
authors.affiliation: Icahn School of Medicine at Mount Sinai, Box 1257, 1 Gustave Levy Place, New York, NY, 10029, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Gliatto
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Giftos
authors.affiliation: Icahn School of Medicine at Mount Sinai, Box 1257, 1 Gustave Levy Place, New York, NY, 10029, USA. reena.karani@mssm.edu.
authors.forename: Reena
authors.initials: R
authors.lastname: Karani
mesh_terms: D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D057220:Health Literacy; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009518:New York; D010360:Patient Transfer / Q000592:standards*; D010817:Physician-Patient Relations; D015397:Program Evaluation
keywords: OSCE; health literacy; medical student; transitions