Health literacy in medical education

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These slides accompanied my May 8, 2011 talk at the Canadian Conference on Medical Education.

These slides accompanied my May 8, 2011 talk at the Canadian Conference on Medical Education.

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Transcript

  • 1. Health Literacy in Medical Education: Promoting Empowerment as a Patient-Centred Approach Canadian Conference on Medical Education Sunday, May 8, 2011
  • 2.
    • Philip Girvan, MA
    • Senior Associate, PGSO Project & Media Solutions
    • 3 Coady Avenue
    • Antigonish NS B2G 1T9
    • Tel: +1 (902) 863-6026
    • Email: pgso.solutions@gmail.com
  • 3. Disclosure Statement
    • I have no actual or potential conflict of interest in relation to this presentation.
  • 4. Background/Purpose:
    • A patient-centered approach positions the patient at the centre of health practices, policies, curricula, and pedagogies.
    • In order to practice in a patient-centred manner, health professionals must take into account the multiple social complexities of the patient, not the least of which is health literacy.
    • It is therefore important to consider how and where issues of health literacy are being addressed in undergraduate medical education.
  • 5. What is Health Literacy?
    • Health literacy encompasses knowledge, understanding, and access to and control of resources that promote and maintain satisfactory health and wellbeing. It is the outcome of such diverse abilities as reading, writing, numeracy, the ability to access information, and critical thinking. (Girvan, 2010)
  • 6. What is Patient Centredness?
    • The appropriate application of scientific knowledge and technical skills with acknowledgement of and respect for the emotional, social and cultural needs and preferences of individual patients and their families
      • Weismann, Branch et al. (2006)
  • 7. Five Dimensions of Patient-Centredness
    • Biopsychosocial perspective
    • Patient as a person
    • Sharing power and responsibility
    • Therapeutic alliance
    • Doctor as a person
      • Mead & Bower (2000)
  • 8. My Question
    • A search of the websites of the 17 Canadian Faculties and/or Schools of Medicines demonstrated that many medical education programs are described as “patient-centred.”
    • How does health literacy figure into a patient-centred approach?
  • 9. Methodology:
    • A systematic literature review, critical analysis and synthesis of the following bodies of literature:
      • patient-centered care
      • health literacy
      • medical education.
    • The review focused on articles published in English in peer-reviewed health professional education journals between 01 January 2000 and 31 December 2010.
  • 10. Methodology:
    • I conducted searches of the PubMed databases
    • The original search identified 37 papers, commentaries and reviews of the literature.
  • 11. Results:
    • A surprisingly small proportion of the literature in the area of patient-centred care focuses on health literacy as a determinant of health and well being. An even smaller proportion of the literature considered health literacy as an issue of concern to be addressed in the education of future physicians.
  • 12. Breakdown:
    • Searching PubMed using the MeSH terms “health-literacy”, “medical education” and “care, patient-centred” yielded 0 papers.
    • Searching PubMed using the MeSH terms “health-literacy”, “medical education” yielded 2 relevant papers ( 15 relevant).
  • 13. Breakdown (cont’d):
    • Searching PubMed using the MeSH terms “health literacy” and “patient-centred care” yielded 22 papers. None of the papers discussed UME issues; the focus was on clinical practice, e.g. drug adherence, cost savings
    • Searching PubMed using the MeSH terms “medical education” and “patient-centred care” yielded 249 papers.
  • 14. Issue with the search
    • Health literacy has not been indexed as a MeSH subject until 2010.
  • 15. Revised Search
    • Conducting a general PubMed search of health literacy, medical education and patient centred care identified 110 papers.
  • 16. Initial Findings
    • Initial analysis:
    • “health literacy” tends to appear in papers discussing clinical, rather than educational, contexts.
    • indicates zero studies undertaken within a Canadian context
  • 17. Conclusions/Discussion
    • The shortage of related literature indicates that there is much work to be done in considering how issues of health literacy might be addressed in patient-centred medical education.
    • An emphasis on health literacy in medical education will have implications on power relations in educational settings as well as in, and beyond, the clinical encounter.
  • 18. References
    • Girvan P. (2010). Health Literacy as Capital: Investigating the EAL Teaching Perspective . Unpublished MA dissertation.
    • Mead N & Bower P. (2000). Patient-centredness: a conceptual framework and review of the empirical literature. Social Science and Medicine 51: 1087-1110.
    • Weissman P, Branch W, et al. (2006). Role modeling humanistic behavior: leaning bedside manner from the experts. Academic Medicine 81: 661-667.
  • 19. Thank You
    • Questions?