Climate of Health Literacy Practices Amongst Physical Therapy Clinical Instructors
Purpose/Hypothesis: In order to effectively address the health needs of society, therapists must create partnerships that focus to empower patients with knowledge, skills and adequate self-efficacy to manage their health. Unfortunately, the health literacy epidemic can be a significant barrier in these efforts. Successful management of health literacy requires healthcare providers utilizing appropriate communication/teaching skills. Evidence from other health professions suggests didactic instruction alone will not produce the appropriate behaviors and skills. Additionally repetition is needed to reinforce the behaviors that reflect sensitivity to health literacy issues. Clinical education offers a significant opportunity to practice these skills. However, the role-modeling of these behaviors has been called into question in some professions. The purpose of our study was to evaluate the physical therapy clinical climate related to health literacy practices, clinician knowledge surrounding health literacy and self-reported behaviors that have been identified as priorities in health literacy. Understanding current practice will inform the educational priorities to address health literacy barriers.
Number of Subjects: n= 108
Materials and Methods: Clinical Instructors (CIs) affiliated with a midwestern physical therapy program received a two-part survey which (1) asked to report their utilization of specific behaviors and communications skills linked to health literacy priorities on a 5-point Likert scale (0%, 25%, 50%, 75%, 100%) and (2) answer 14 health literacy knowledge questions.
Results: CIs responding to the survey represented most practice settings with the greatest representation in the outpatient domain. Sixty percent of CIs self-reported using “teach back method” over 75% of patient care time. Forty-one percent of CIs used “universal precautions” 75% of the time or greater, with 30% of respondents using it very infrequent or never. When analyzing the second-tier questions for knowledge of health literacy, the greatest discrepancy in answers centered around discerning what the average patient reading level is and what reading level education material be should produced for patients’ comprehension.
Conclusions: Current practicing CIs do utilize strategies such as “teach back method”. However, there are areas to improve such as understanding of “universal precautions” for health literacy, asking open ended questions as well as providing educational material at an appropriate reading level to promote greater understanding.
Clinical Relevance: Effectively addressing the health literacy epidemic is essential to the vision of ‘transforming society’. Doctors of Physical Therapy must possess the communication skills and adopt specific behaviors to confront health literacy and empower their patients. Academic programs need to equip graduates with these tools. Clinical instructors play a vital role in modeling and reinforcing these behaviors during clinical experiences. Elevating the standard of care in these areas for practicing physical therapists along with enhanced academic preparation of future graduates could contribute to improved health outcomes.