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Assessing the Role of Osteopathic Medical Education on Community Health Literacy Interventions Pilot Study

Journal: Journal of Osteopathic Medicine Date: 2024/12, 124(12):Pages: A110-A112. doi: Subito , type of study: cross sectional study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2024-2000/html)

Keywords:

communication [89]
cross sectional study [872]
curriculum [297]
health literacy [5]
medical students [671]
osteopathic medicine [2072]
pilot study [201]
USA [1725]

Abstract:

Context: Physician obligations to inform and communicate effectively with patients about their care is an essential component of the patient-provider dynamic. As future physicians, medical students will be key to tackling the challenges of health literacy, which prior studies have identified as a disparity risk factor in chronic disease prevention and management including cancer 1,2, diabetes 3,4, obesity 5,6, smoking cessation 7, and cardiovascular disease 8,9. Considering Osteopathic Medicine is a growing field in the United States 10 , additional research is warranted into the roles of osteopathic medical training from preventive and community health standpoints. Objective: The goal of this study was to better understand what health literacy interventions are utilized most by osteopathic medical students on clinical rotations in addition to their perceptions of health literacy concerns and the current impact of undergraduate medical education to propose curriculum recommendations. Methods: This non-experimental study utilized an anonymous 18-item electronic survey distributed to third and fourth-year clinical medical students at osteopathic medical schools nationwide. The survey items were vetted with literature and reviewed by faculty content experts to ensure validity. Items included multiple choice and ranked response format. Survey questions addressed non-identifiable student demographics, experiences with health literacy challenges, strategies on clinical rotations, perceptions of health literacy, and the role of health literacy in medical education. No identifiable data was collected to maintain participant anonymity. Descriptive statistics were used to explore survey data. Results: 53 clinical medical students (63.46% OMS-III and 36.54% OMS-IV) responded from four medical schools: Arkansas College of Osteopathic Medicine (ARCOM), Kansas City University - Joplin (KCU), Philadelphia College of Osteopathic Medicine (PCOM), and Rowan-Virtua School of Osteopathic Medicine (Rowan-Virtua SOM). Survey data demonstrates students are aware their institutions provide information sessions on health literacy topics to the public with 62.50% reporting institution-led local community outreach sessions and 37.50% recalling outreach sessions provided on campus. From a curriculum standpoint, 43.75% of respondents were unsure what academic year health literacy-specific curriculum was provided but 62.50% recalled at least one didactic lecture that addressed knowledge and health literacy skill development and 50% recalled relevant standardized patient/simulation encounters or early clinical experiences. Respondents identified the most common concerns expressed by patients on rotations are treatments (64.29%) followed by cost (53.37%) and disease cause (21.43%), while the most common health literacy challenges students reported relate to patient education level (85.71%) followed by non-English speaking or English as a Second Language (ESL) patients and social determinants of health (both reported at 78.57%, respectively). Regarding health literacy tools utilized on rotations, 96.43% of respondents reported utilizing interpreters for languages other than English, yet far fewer reported utilizing assistive technology for patients with physical limitations (46.43%), hearing impairments (25%), and visual impairments (10.71%). Additionally, 39.29% of students reported the most used intervention for hearing impaired patients were virtual American Sign Language (ASL) interpreters and the most common visual aids were handouts (46.43%). In their own education, students reported the teaching tools they found most helpful were guided questions (71.43%), visual aids (67.86%), and drawing/writing (60.71%). Core rotations that required a high use of health literacy strategies in patient communication were identified as Family Medicine (82.14%​), Internal Medicine (57.69%​), and Pediatrics (46.43%​), while ​General Surgery and Osteopathic Manipulative Medicine (OMM) were identified most by respondents as requiring a low use of health literacy strategies in patient communication (64.29%​ and 55.56%​, respectively). Most notably, 96.43% of respondents agreed/strongly agreed that medical schools have an obligation to address health literacy in their curriculum. However, 46.43% of respondents disagreed that health literacy is sufficiently addressed in medical school curriculum. Finally, 96.43% of respondents agreed/strongly agreed their understanding of health literacy was strengthened on clinical rotations with students largely agreeing/strongly agreeing to confidence in their abilities to recognize health literacy challenges (96.43%), use a variety of strategies in patient communication (92.86%), and avoid using medical jargon when communicating with patients (82.14%). Conclusion: While this study uniquely analyzes the impact of health literacy in osteopathic medical education, significant limitations include the number of respondents and the limited number of programs that participated in the survey. Additionally, most responses were from ARCOM reflected by 75% of the respondents indicating their program requires an underserved care rotation in a rural setting, compared to the 25% of respondents who indicated their program requires an urban underserved care rotation. Finally, survey data analysis suggests health literacy curriculum needs to be more clearly defined with a primary care emphasis. Other success measures could include early experiential learning with diverse patients in addition to ASL and ESL interpreters, continuing to involve medical students in institution-led community outreach programs focused on health literacy, as well as encouraging students to create health promotional materials since most respondents identified these measures as helpful in their education. In conclusion, more large-scale and longitudinal research is warranted on health literacy and clinical medicine, the results of which may provide a more uniform framework for health-literacy-specific curriculum in undergraduate medical education and reinforce Osteopathic Medicine’s emphasis on underserved patient care.


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