Ali Nadia K, Ferguson Robert P, Mitha Sharmin, Hanlon Alexandra
Department of Medicine, School of Medicine of Temple University, Philadelphia, PA ; Department of Internal Medicine, Crozer Chester Medical Center, Upland, PA.
Department of Medicine, University of Maryland, Baltimore, MD ; Greater Baltimore Medical Center, Baltimore, Maryland, USA.
J Community Hosp Intern Med Perspect. 2014 Apr 14;4(2). doi: 10.3402/jchimp.v4.22893. eCollection 2014.
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.
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.
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).
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.
医学实习生很少运用健康素养（HL）技能，且高估了他们对通俗易懂语言和反馈教学技能的运用。本研究的目的是评估培训水平是否会影响医学实习生对HL知识和技能的认知。
2012年7月至2013年1月期间，宾夕法尼亚州和马里兰州两个社区内科项目的医学生和住院医师完成了一份结构化问卷，该问卷由5个问题组成，评估受访者对自身HL知识的信心、识别低HL患者并与之沟通的能力以及相关资源的使用情况。
宾夕法尼亚州项目的回复率为100%（40人），马里兰州住院医师项目的回复率为42%（17人）。所有轮转医学生（17人）都完成了问卷。在74名参与者中，不到10%的人对自己的HL知识以及识别低HL患者并与之沟通的能力有信心。只有1.4%（1人）对自己识别合适资源的能力有信心。无论培训水平如何，所有参与者在沟通技能（P=0.305）和识别合适资源的能力（P=0.143）方面均无显著差异。从医学院一年级到三年级以及从实习到住院医师第二年，HL知识有显著提高（P=0.0126和P=0.0496）。
医学实习生认为他们没有接受足够的HL知识和技能培训，从而无法自信地识别低HL患者并与之沟通以及识别合适的资源。需要通过医学院和住院医师课程来解决这些不足。
