Geriatric Health Literacy Workshop

Abstract

Abstract Introduction Anticipated demographic changes, including aging and minority status, in the next decade demand that health care professionals-in-training develop the skills necessary to provide culturally competent care for some of America's most vulnerable patients, minority older adults. Communication skills are especially important in the care of older adults, who are at particularly high risk of having low health literacy. Low health literacy may lead to increased morbidity and mortality and increased health care costs. Medical education strategies to combat low health literacy include raising awareness of this issue, enhancing provider communication skills, and identifying characteristics of culturally-appropriate patient handout materials. These objectives are the backbone of this 2.5-hour workshop for interdisciplinary trainees, including social work, nursing, and medical students. Methods The workshop is made up of the following components: optional preworkshop assignment, preworkshop survey, didactic lecture and slide presentation (45–50 minutes), role-playing cases (30 minutes), critiquing and revising patient handout materials (40 minutes), presentation of revised patient handout materials (15 minutes), posttest, and optional postworkshop assignment. In the pre/post surveys, using a 5-point scale (1 = poor, 5 = excellent), learners rated their skill in the following five domains: explaining change in medication dose, explaining a new diagnosis, explaining the rationale for ordering a diagnostic test, explaining referral to a specialist, and selecting appropriate patient education materials. Results Data were gathered on 29 physicians and physicians-in-training who participated the health literacy workshop. Twenty-one were University of Chicago medicine interns and residents, and eight were a combination of family medicine fellows, attending physicians, and family medicine residents at Cook County Hospital in Chicago, IL. Three results emerged from the workshop: University of Chicago residents completed 100% of direct observation using the teach-back method in three patient encounters per learner; revision of patient handout material by University of Chicago residents resulted in lowering the reading level from grade 11.5 to grade 6.3 (N = 21), and statistically significant improvement in self-assessment of communication skills occurred in each of the five domains among all learners (N = 29). Discussion This course is appropriate for interprofessional health care providers at various levels of training and professional experience. The workshop has been presented to senior medical students; family medicine and internal medicine residents; fellows in family medicine, geriatrics, and hospice and palliative medicine; family medicine practitioners; advance practice nurses; and social work interns. Class sizes have ranged from three to 20.

Keywords

• Teach-Back Method