Abstract
BACKGROUND: Low literacy is associated with poor self-management of disease and increased hospitalization, yet few studies have explored the extent to which physicians consider literacy in their patient care.
OBJECTIVE: To examine trainee recognition of low literacy as a potential factor in patient adherence and hospital readmission.
DESIGN AND PARTICIPANTS: Randomized study of 98 Internal Medicine residents and medical students. Trainees reviewed a case history and completed a questionnaire pertaining to a fictional patient’s hospital readmission. Case version A contained clues to suggest limited patient literacy skills, while version B did not. Responses were reviewed for mention of low literacy and educational strategies recommended for low-literate patients.
RESULTS: Few trainees raised the possibility of low patient literacy, even when provided clues (25% in Group A vs 4% in Group B, P=.003). Furthermore, while most trainees listed patient education as an important means of preventing another readmission, only 16% suggested using a strategy recommended for low-literate adults.
CONCLUSION: Few trainees recognized low literacy as a potential factor in patient nonadherence and hospital readmission, and few recommended low-literate educational strategies. Medical residents and students may benefit from additional training in the recognition and counseling of low-literate patients.
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The content of this paper was presented in abstract form at the Society of Hospital Medicine national meeting in April 2003 and at the Society of General Internal Medicine national meeting in May 2003.
Dr. Kripalani receives support from a K23 Mentored Patient-Oriented Research Career Development Award (1 K23 HL077597), a Pfizer Health Literacy Scholar Award, and an Heart Association Scientist Development Grant. While conducting the present research, he was supported by the Emory Mentored Clinical Research Scholars Program (NIH/NCRR K12 RR017643).
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Powell, C.K., Kripalani, S. Brief report: Resident recognition of low literacy as a risk factor in hospital readmission. J GEN INTERN MED 20, 1042–1044 (2005). https://doi.org/10.1007/s11606-005-0246-6
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DOI: https://doi.org/10.1007/s11606-005-0246-6