You Can Teach Every Patient: A Health Literacy and Clear Communication Curriculum for Pediatric Clerkship Students

Abstract

Introduction: Poor health literacy has a negative impact on various health care outcomes. Medical schools are not consistently providing health literacy training; when they do, they overly rely on didactics. Methods: Our curriculum for third-year pediatric clerkship students taught principles of health literacy and evidence-supported clear communication strategies. Communication skills were structured on a novel mnemonic: CTEP (clear language, teach-back, effectively encouraging questions, and pictures). The curriculum included a 30-minute didactic, followed 1-2 weeks later by a 90-minute interactive workshop. All 188 clerkship students attended the didactic lecture; approximately half (90) attended the follow-up workshop. All students completed a formative objective structured clinical encounter. Standardized patients then evaluated students' use of the four clear communication skills. Students completed a survey to assess confidence, knowledge, and use of the skills. Results: Compared to the didactic-only group, students in the didactic + workshop group more frequently used teach-back (53% vs. 27%, p < .01) and pictures (46% vs. 10%, p < .01). In addition, the didactic + workshop group had improved recall, self-reported use, and comfort with the skills. The didactic + workshop group solicited questions from the standardized patient less often, and there was no difference in use of clear language between the two groups. Discussion: An interactive curriculum in health literacy and clear communication for pediatric clerkship students was superior to a didactic alone. Optimizing instructional methods for health literacy skills can help future physicians properly communicate with their patients to improve health outcomes.