scholarly journals Teaching plain language to medical students: improving communication with disadvantaged patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Doron Sagi ◽  
Sivan Spitzer-Shohat ◽  
Michal Schuster ◽  
Ligat Daudi ◽  
Mary Catharine Joy Rudolf
Keyword(s):  
Health Literacy ◽  
Communication Skills ◽  
Home Visit ◽  
Assessment Tool ◽  
Medical Condition ◽  
Written Communication ◽  
Plain Language ◽  
Post Discharge ◽  
Entire Cohort ◽  
Low Health Literacy

Abstract Background Low health literacy underpins health inequality and leads to poor adherence to medical care and higher risk of adverse events and rehospitalization. Communication in plain language, therefore, is an essential skill for health professionals to acquire. Most medical education communication skill programs focus on verbal communication, while written communication training is scarce. ETGAR is a student delivered service for vulnerable patients after hospital discharge in which, amongst other duties, students ‘translate’ the medical discharge letters into plain language and share them with patients at a home visit. This study ascertains how this plain language training impacted on students’ written communication skills using a tool designed for purpose. Methods Students, in pairs, wrote three plain language discharge letters over the course of a year for patients whom they encountered in hospital. The students handed over and shared the letters with the patients during a post-discharge home visit. Structured feedback from course instructors was given for each letter. An assessment tool was developed to evaluate students’ ability to tell the hospitalization narrative using plain and clear language. First and last letters were blindly evaluated for the entire cohort (74 letters; 87 students). Results Students scored higher in all assessment categories in the third letters, with significant improvement in overall score 3.5 ± 0.8 vs 4.1 ± 0.6 Z = -3.43, p = 0.001. The assessment tool’s reliability was high α = 0.797, it successfully differentiated between plain language categories, and its score was not affected by letter length or patient’s medical condition. Conclusions Plain language discharge letters written for real patients in the context of experience-based learning improved in quality, providing students with skills to work effectively in an environment where poor health literacy is prevalent. ETGAR may serve as a model for learning written communication skills during clinical years, using the assessment tool for formative or summative evaluation.

scholarly journals 3464 Readability, Understandability, and Actionability of Inpatient Discharge Instructions: A Health Literacy Perspective

2019 ◽  
Vol 3 (s1) ◽  
pp. 94-94
Author(s):  
Alexander Glick ◽  
Kyara Marquez ◽  
Michael Migotsky ◽  
Benard Dreyer ◽  
Suzy Tomopoulos ◽  
...  
Keyword(s):  
Health Literacy ◽  
Assessment Tool ◽  
Reading Level ◽  
Inpatient Setting ◽  
Medical Terminology ◽  
Plain Language ◽  
Discharge Instructions ◽  
Post Discharge ◽  
Discharge Outcomes ◽  
Pediatric Inpatient

OBJECTIVES/SPECIFIC AIMS: Parents often make errors in comprehending and executing their child’s inpatient discharge instructions, putting their child at risk for adverse post-discharge outcomes. Suboptimal provider-caregiver communication has been linked to errors in comprehension and execution of provider instructions, especially for parents with limited health literacy. Few studies have systematically examined features of pediatric inpatient written discharge instructions that may contribute to errors. Our objective was to assess the readability, understandability, and actionability of pediatric inpatient written discharge instructions. METHODS/STUDY POPULATION: This was a cross-sectional analysis of the written discharge instructions (standardized template, content not standardized) provided to parents at an urban public hospital, enrolled as part of a prospective cohort study (n=171) focused on parent ability to comprehend their child’s discharge instructions. Inclusion criteria were: English/Spanish-speaking parents of children ≤12 years old discharged on ≥1 daily medicine. Discharge instructions were assessed for: 1) Readability (Average of 5 formulas [Flesh Reading Ease, Flesch-Kincaid, Gunning Fog, Simple Measure of Gobbledygook, Forcast]), 2) Understandability and actionability (AHRQ Patient Education Materials Assessment Tool [2 independent reviewers; κ>0.8 for both]). RESULTS/ANTICIPATED RESULTS: Mean (SD) reading grade level was 11.4 (0.7); none of the instructions were written at a recommended reading level of 6th to 8th grade or below. Mean (SD) understandability was 37.7 (6.9)%; mean actionability was 41.7 (8.4)%. All 171 sets of instructions used medical terminology without adequate plain language explanations and included information that was not relevant to the child’s diagnosis and associated care (e.g., obesity counseling, smoking cessation given to a child with appendicitis). None of the sets of instructions presented information in a logical sequence (e.g., diet instructions in more than one location) or included any pictographic information or other visual aids to support the text (e.g., diagram of medication dose within a dosing tool). DISCUSSION/SIGNIFICANCE OF IMPACT: Written discharge instructions provided in the pediatric inpatient setting were suboptimal. Use of a systematic approach to improve discharge instructions, using a health literacy perspective, has the potential to improve post-discharge outcomes in children.

scholarly journals How doctors make themselves understood in primary care consultations: A mixed methods analysis of video data applying health literacy universal precautions

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257312
Author(s):  
Jennifer V. Byrne ◽  
Katriina L. Whitaker ◽  
Georgia B. Black
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Health Literacy ◽  
Communication Skills ◽  
Video Data ◽  
Universal Precaution ◽  
Universal Precautions ◽  
Qualitative Thematic Analysis ◽  
Low Health Literacy ◽  
Tone Of Voice

Purpose To mitigate the health risks that result from low health literacy and difficulty identifying patients with insufficient health literacy, health organizations recommend physicians apply health literacy universal precaution communication skills when communicating with all patients. Our aim was to assess how health literacy universal precautions are delivered in routine GP consultations, and explore whether there were differences in how GPs used universal precaution approaches according to areas of deprivation in England. Methods This was a mixed methods study using video and interview data. Ten physicians conducted 217 consultations in primary care settings with adults over 50 years old between July 2017 and March 2018 in England. Eighty consultations (N = 80) met the inclusion criteria of new or persisting problems. Descriptive quantitative analysis of video-recorded consultations using an observation tool and qualitative thematic analysis of transcribed scripts. Meta-themes explored differences in physicians’ communication by areas of deprivation. Results Descriptive statistics showed physicians used a caring tone of voice and attitude (n = 73, 91.3%) and displayed comfortable body language (n = 69, 86.3%) but infrequently demonstrated profession-specific health literacy universal precaution communication skills, such as the teach-back technique (n = 3, 3.8%). Inferences about physicians’ communication from qualitative analysis converged with the quantitative findings. Differences in physicians’ communication varied according to areas of deprivation. Conclusions Physicians need health literacy universal precautions communication skills to improve population health.

scholarly journals 2030

2017 ◽  
Vol 1 (S1) ◽  
pp. 52-53
Author(s):  
Tina Moore ◽  
Laura P. James ◽  
Jennifer Holland ◽  
Edith Paal ◽  
Kristie Hadden
Keyword(s):  
Informed Consent ◽  
Health Literacy ◽  
Focus Group ◽  
Retrospective Analysis ◽  
Plain Language ◽  
Research Subjects ◽  
Regulatory Requirements ◽  
Post Intervention ◽  
10Th Grade ◽  
Low Health Literacy

OBJECTIVES/SPECIFIC AIMS: Develop a plain language informed consent template that met IRB and regulatory requirements. Evaluate the effectiveness of the template at improving the readability of informed consents. Field test the informed consent with low health literacy. METHODS/STUDY POPULATION: We conducted a retrospective analysis of over 200 UAMS IRB approved, investigator initiated informed consents from 2013 to 2015 to determine the readability before intervention. The mean grade level readabilities were derived from the results of 3 readability formulas (Flesch-Kincaid, SMOG, and Fry) using open-source readability tools. A plain language informed consent template that meets IRB and regulatory requirements was developed, adhering to health literacy best practices for written communication. The template was made available to investigators as an optional resource, and IRB committees were trained on use of the template. In addition, a focus group will be conducted to qualitatively assess understandability of the template with study participants identified as having inadequate health literacy. Data analysis will include readability assessment of IRB approved informed consents post intervention with and without use of the plain language template, as well as qualitative feedback from focus group participants. RESULTS/ANTICIPATED RESULTS: The retrospective analysis revealed a mean readability of 10th grade for IRB approved informed consents from 2013 to 2015 (n=217). The readability of the developed plain language template was 5th grade. Preliminary post-intervention results show adoption of the template by investigators (n=16) resulted in informed consents with a mean readability of 7th grade (range 6–9th grade), compared to a mean of 10th grade (range 7–11th grade) for the comparator (“no adoption” group, n=24). Data collection will continue through May 2017. The focus group is forthcoming and results will be included in the poster. DISCUSSION/SIGNIFICANCE OF IMPACT: Low health literacy is common in individuals with healthcare disparities and can limit their participation in clinical research. Few studies have examined interventions to address this barrier to research. Preliminary results of this study support the utilization of a plain language informed consent template in investigator-initiated research. Moreover, this study demonstrates the importance of stakeholder engagement among CTSA leadership, health literacy experts, the institutional review board, investigators, and research subjects in the development and testing of this intervention to make informed consents “understandable to the subject” while containing all required elements.

Addressing the Content Vocabulary With Core: Theory and Practice for Nonliterate or Emerging Literate Students

2012 ◽  
Vol 21 (3) ◽  
pp. 74-81 ◽  
Author(s):  
Debbie Witkowski ◽  
Bruce Baker
Keyword(s):  
Communication Skills ◽  
High Performance ◽  
Theory And Practice ◽  
Written Communication ◽  
Academic Tasks ◽  
Meaningful Participation ◽  
Core Theory ◽  
Communication Needs ◽  
Core Vocabulary ◽  
Personal Success

Abstract In the early elementary grades, the primary emphasis is on developing skills crucial to future academic and personal success—specifically oral and written communication skills. These skills are vital to student success as well as to meaningful participation in the classroom and interaction with peers. Children with complex communication needs (CCN) may require the use of high-performance speech generating devices (SGDs). The challenges for these students are further complicated by the task of learning language at a time when they are expected to apply their linguistic skills to academic tasks. However, by focusing on core vocabulary as a primary vehicle for instruction, educators can equip students who use SGDs to develop language skills and be competitive in the classroom. In this article, we will define core vocabulary and provide theoretical and practical insights into integrating it into the classroom routine for developing oral and written communication skills.

Utilizing Standardized Patients to Enhance Health Literacy Communication Skills

MedEdPORTAL ◽  
2008 ◽  
Vol 4 (1) ◽  
Author(s):  
Lisa Howley ◽  
Christine Peterson ◽  
Eugene Barrett ◽  
John Gazewood ◽  
William Wilson ◽  
...  
Keyword(s):  
Health Literacy ◽  
Communication Skills ◽  
Standardized Patients

scholarly journals Mental health, compliance with measures and health prospects during the COVID-19 epidemic: the role of health literacy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lize Hermans ◽  
Stephan Van den Broucke ◽  
Lydia Gisle ◽  
Stefaan Demarest ◽  
Rana Charafeddine
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Health Literacy ◽  
Prevalence Ratio ◽  
Physical Distance ◽  
Poor Mental Health ◽  
Infection Prevalence ◽  
Cross Sectional ◽  
Normal Life ◽  
Low Health Literacy

Abstract Background The importance of health literacy in dealing with the COVID-19 epidemic has been emphasized but scarcely addressed empirically. In this study, the association of health literacy with mental health, compliance with COVID-19 preventive measures and health prospects was assessed in a Belgian context. Methods Data were extracted from the third of a series of cross-sectional online COVID-related surveys (n = 32,794). Data collection took place for 1 week starting the 28th of May 2020. People residing in Belgium and aged 18 years or older could participate. Data were collected on sociodemographic background, health literacy, multimorbidity, mental health (depression, anxiety, sleeping disorder, vitality), knowledge about COVID-19, compliance with COVID-19 measures (hygiene, physical distance, covering mouth and nose on public transport and in places where physical distance cannot be respected), and health prospects (risk for health when returning to normal life and possibility of infection). Prevalence Ratio (PR) of poor mental health, non-compliance with the measures and health prospects in relation to health literacy were calculated using Poisson regressions. Results People showing sufficient health literacy were less likely to suffer from anxiety disorders (PR = 0.47, 95% CI = [0.42–0.53]), depression (PR = 0.46, 95% CI = [0.40–0.52]) and sleeping disorders (PR = 0.85, 95% CI = [0.82–0.87]), and more likely to have optimal vitality (PR = 2.41, 95% CI = [2.05–2.84]) than people with low health literacy. They were less at risk of not complying with the COVID-19 measures (PR between 0.60 and 0.83) except one (covering mouth and nose in places where physical distance cannot be respected). Finally, they were less likely to perceive returning to normal life as threatening (PR = 0.70, 95% CI = [0.65–0.77]) and to consider themselves at risk of an infection with COVID-19 (PR = 0.75, 95% CI = [0.67–0.84]). The associations remained significant after controlling for COVID-19 knowledge and multimorbidity. Conclusions These results suggest that health literacy is a crucial factor in managing the COVID-19 epidemic and offer a perspective for future studies that target health literacy in the context of virus outbreaks.

scholarly journals Low health literacy is associated with higher risk of type 2 diabetes: a cross-sectional study in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Tajdar ◽  
Dagmar Lühmann ◽  
Regina Fertmann ◽  
Tim Steinberg ◽  
Hendrik van den Bussche ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Literacy ◽  
Statistical Models ◽  
Cross Sectional Study ◽  
Diabetes Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Low Health Literacy ◽  
The Individual

Abstract Background Low health literacy is believed to be associated with behaviours that increase the risk of type 2 diabetes. But there is limited knowledge on the relation between health literacy (HL) and diabetes risk, and whether improving HL could be a potential prevention strategy. Therefore, the main purpose of this study was to examine the link between HL and diabetes risk among non-diabetic adults. Methods We used data from the Hamburg Diabetes Prevention Survey, a population-based cross-sectional study in Germany. One thousand, two hundred and fifty-five non-diabetic subjects aged 18–60 years were eligible. The German Diabetes Risk Score (GDRS, ranging 0 to 123 points) was used to determine the individual risk of type 2 diabetes. The short version of the European Health Literacy Questionnaire (HLS-EU-Q16, ranging 0 to 16 points) was applied to assess the individual self-reported HL. Subjects were asked to self-estimate their diabetes risk, which was then compared with the calculated GDRS. Descriptive statistics were calculated to investigate group differences in the GDRS and self-estimated diabetes risk. Linear as well as logistic regression models were performed to analyse potential influencing variables of the GDRS as well as incorrect self-estimated diabetes risk. In three nested statistical models for each outcome, these analyses were adjusted for age, gender, educational level and the presence of chronic conditions. Results According to the criteria of the GDRS, 996 (79.4%) subjects showed “low risk”, 176 (14.0%) “still low risk”, 53 (4.2%) “elevated risk”, and 30 (2.4%) “high to very high risk” to develop type 2 diabetes within the next 5 years. In the statistical models including all control variables, subjects with “inadequate HL” scored 2.38 points higher on the GDRS (95% CI 0.378 to 4.336; P = 0.020) and had a 2.04 greater chance to estimate their diabetes risk incorrectly (OR 2.04; 95% CI 1.33 to 3.14; P = 0.001) compared to those with “sufficient HL”. Conclusion The risk of type 2 diabetes is increased in people with inadequate self-reported HL. People with high diabetes risk and inadequate HL might be provided with educational programs to improve diabetes knowledge and reduce behavioural risk factors.

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