Differences in Self-Reported Health Literacy Practices Amongst First, Second, and Third Year Physical Therapy Students
Low health literacy is associated with negative patient outcomes and over $100 billion in healthcare costs in the United States (US) annually. Thus, effectively addressing the health literacy epidemic is critical to physical therapyÕs vision of transforming society, with a call for clinicians to adopt effective communication strategies to optimize patient outcomes. Unfortunately, there is a lack of consensus regarding best practices for incorporating health literacy education within medicine and allied health training, although inclusion of teaching strategies in both didactic and clinical contexts is stressed. Similarly, while the responsibility for addressing low health literacy has been identified as an important part of physical therapist education, literature informing physical therapist skill development in this crucial area is sparse. This study examined differences between first, second, and third year physical therapy (PT) studentsÕ self-reported usage of health literacy practices, aiming to provide valuable baseline data as well as inform future curricular intervention strategies. We hypothesized that differences will exist among 1st, 2nd, and 3rd year PT students in self-reported usage of health literacy practices.
A total of 152 PT students [1st year PT students (Y1)= 49, 2nd year PT students (Y2)= 47, third-year PT students (Y3)= 56] in the midwestern United States completed an 8-item paper survey at the end of their respective academic year on self-reported usage of health literacy practices (5-item Likert Scale: 0 = Ònever or 0%Ó to 4 = Òalways or 100%Ó). Guided by the literature, the survey focused on core concepts/items of health literacy practice including use of teach-back, avoidance of medical jargon, universal precautions, utilization of an interpreter, establishing a mutual agenda, and addressing patient-specific concerns. At the time of survey completion, Y1 students did not have any full-time clinical experiences, Y2 students had completed 2 full-time clinical experiences, and Y3 students had completed 4 full-time clinical experiences. Results reported as mean ± SD. Group differences were determined by a one-way ANOVA with significance accepted at p< 0.05
Significant differences were found between Y3 and Y1/Y2 cohorts for teach-back (Y3 mean=2.68+ .86, Y2 mean=2.21+ .88, Y1 mean= 2.20+ .96, p< .05) and use of an interpreter (Y3 mean=2.20+ 1.35, Y2 mean=1.40+ 1.56, Y1 mean=1.12+ 1.56, p< .005). No other significant differences (p>0.05) in concepts/items were seen among Y1, Y2 or Y3.
Conclusions/Relevance to the conference theme:
The increase in self-reported use of teach-back and use of the interpreter in the Y3 cohort suggests current teaching and curricular design efforts can promote a change in self-report behaviors. However, there were limited differences between Y1 and Y2. Such findings suggest the need for early and explicit health literacy curriculum interventions to enhance the development of skilled providers prepared to mitigate the negative consequences of low health literacy