Making health literacy real: adult literacy and medical students teach each other

Abstract

This paper reports a pilot project at Harvard Medical School (HMS) that taught medical students the importance of plain language communication by collaborating with adult literacy students. Classes provided students with patient-doctor communication experience and health information. After a lecture on health literacy and cross-cultural care, a librarian taught students where to find high-quality, easy-to-read, and non-English health information. Adult learners identified health topics of interest. Medical students then created presentations on these topics and received critical feedback from the adult students. HMS students improved their use of plain language communication and their understanding of health disparities. Everyone expressed a desire to learn more. The project demonstrated that health literacy competencies can be integrated into medical school instruction using a combination of didactic and experiential methods. Medical schools and their librarians are in a unique position to work with future providers to ameliorate the problem of low health literacy. The profound consequences of poor health literacy have been well documented and indicate that vast amounts of health information are incomprehensible to millions of people [1–4]. People with low functional health literacy have more difficulty navigating the health care system and obtaining services. They are less likely to comprehend the written and oral information given to them by providers. They are also more likely to suffer higher health care costs and disproportionately have poorer health outcomes than those with high levels of health literacy. Older people, nonwhites, immigrants, and low-income people constitute a large segment of people with low health literacy [3]. Issues of culture, language, and learning are interrelated, and to be effective, health information must be provided in both culturally and linguistically appropriate formats to address the increasingly diverse multicultural and multilingual population [4]. The Liaison Committee on Medical Education of the American Association of Medical Colleges (AAMC), the American Medical Association (AMA), and the Institute of Medicine (IOM) all emphasize the need to address these issues in medical education [5–8]. While other medical education efforts focused on health literacy are described in the literature, their methodology relies on role-playing between medical students and faculty [8,9]. To the authors' knowledge, this class was different because it offered an opportunity to work with adult literacy students. The creation and implementation of this educational opportunity by the coauthors, a community service program manager and a librarian, illustrates a novel pathway for medical librarians to share their knowledge of health literacy with both adult learners and medical students. Medical librarians are active in the health literacy movement, participating as both consumer health information specialists and educators for health care professionals. The Medical Library Association's Health Information Literacy (HIL) web page—with links to projects, presentations, and information sources created by librarians—provides evidence of this involvement [10]. The Countway Library at HMS has hosted displays to raise awareness of health literacy issues both at the library and in the medical education building.