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Maybury C, Williams MA, Challenger K, Fassas E, Galvan S, Gelmann D, Jung KS, Lu AY, Wang J, Stines E, Baur C. How health literacy is taught and evaluated in dentistry, medicine, nursing, law, pharmacy, public health, and social work: a narrative review. J Commun Healthc 2024; 17:51-67. [PMID: 37707288 DOI: 10.1080/17538068.2023.2258315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND This narrative review examined the published peer-reviewed literature on how health literacy is taught and evaluated in seven health professional and adjacent disciplines: dentistry, medicine, nursing, law, pharmacy, public health, and social work. The study objectives were to assess how students are educated about health literacy and how their health literacy education and skills are evaluated. METHODS Study selection followed guidelines outlined in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We searched PubMed, CINAHL, SocINDEX (EBSCOhost), Lexis Advance and Public Health (ProQuest) for English-language publications of health literacy education studies across seven disciplines at U.S.-based institutions. Inclusion criteria included: 1) methods describing a primary health literacy educational intervention, 2) professional education in one or more of the seven disciplines, 3) educational institutions in the United States, and 4) articles published in peer-reviewed journals between 2000 and 2020. RESULTS The searches yielded 44 articles. Health literacy education is evident in six of the seven studied disciplines, and varies widely in the quality, quantity, timing and mode of education and evaluation. Despite the presence of health literacy accreditation requirements, none of the seven disciplines has developed and implemented a standard, rigorous health literacy education program for students. CONCLUSIONS Graduating institutions and professional accreditation organizations that set the standards for education must lead the way by implementing upstream changes in health literacy professional education. Teaching health literacy to students in health professions is one strategy to help close gaps in patient/client professional communication for graduates and those they serve.
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Affiliation(s)
- Catherine Maybury
- School of Public Health, Horowitz Center for Health Literacy, University of University of Maryland, College Park, USA
| | - Mary Ann Williams
- Health Sciences and Human Services Library, University of Maryland Baltimore, USA
| | | | | | - Sonia Galvan
- School of Nursing, University of Maryland Baltimore, USA
| | | | - Karen S Jung
- School of Dentistry, University of Maryland Baltimore, USA
| | | | - Jocelyn Wang
- Francis King Kerry School of Law, University of Maryland Baltimore, Baltimore, USA
| | - Elsie Stines
- University of Maryland Baltimore Medical Center and University of Maryland Baltimore, Baltimore, USA
| | - Cynthia Baur
- School of Public Health, Horowitz Center for Health Literacy, University of University of Maryland, College Park, USA
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Ng YK, Shah NM, Chen TF, Loganadan NK, Kong SH, Cheng YY, Sharifudin SSM, Chong WW. Impact of a training program on hospital pharmacists' patient-centered communication attitudes and behaviors. Explor Res Clin Soc Pharm 2023; 11:100325. [PMID: 37694168 PMCID: PMC10485631 DOI: 10.1016/j.rcsop.2023.100325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023] Open
Abstract
Background Effective communication that integrates the value of patient-centered care is important in healthcare encounters. Communication skills training (CST) has been indicated as effective in improving patient-centered communication behaviors. However, there is a paucity of studies on the impact of CST among Malaysian hospital pharmacists. Objective This study aimed to evaluate the effects of a patient-centered CST program on patient-centered communication scores, communication self-efficacy, and attitudes toward concordance among pharmacists in public hospitals. Methods A communication skills training (CST) program was conducted among hospital pharmacists. This training intervention was developed based on patient-centered communication frameworks and techniques, namely the Four Habits Model and motivational interviewing. A pre-test/post-test quasi-experimental design was implemented for the evaluation. Pharmacists underwent pre-test/post-test audiotaped simulated consultations and completed questionnaires, including the Revised United States-Leeds Attitudes Toward Concordance scale (RUS-LATCon) and Communication Self-Efficacy scale. The Four Habits Coding Scheme (FHCS) was used to evaluate patient-centered communication scores from the audiotapes, and the Wilcoxon signed-rank test was used to analyze for differences in the pre- and post-intervention scores. Results A total of 38 pharmacists from four tertiary hospitals participated in this study and completed the pre-test. However, due to the impact of COVID-19, only 23 pharmacists completed the post-test data collection. Improvements were noted in the FHCS scores post-training, including items related to exploring patients' concerns, acceptability, and barriers to treatment. Based on the questionnaire, there was an improvement in recognizing patients' needs and potential medication uncertainty and an increase in the overall communication self-efficacy scores after the training. Conclusions CST may help improve the adoption of patient-centered communication in pharmacists' consultations with patients.
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Affiliation(s)
- Yew Keong Ng
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Noraida Mohamed Shah
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Timothy F. Chen
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia
| | - Navin Kumar Loganadan
- Department of Pharmacy, Hospital Putrajaya, Ministry of Health, Pusat Pentadbiran Kerajaan Persekutuan Presint 7, 62250 Putrajaya, Malaysia
| | - Shue Hong Kong
- Department of Pharmacy, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia
| | - Yi Yun Cheng
- Department of Pharmacy, Hospital Ampang, Ministry of Health, Jalan Mewah Utara, Taman Pandan Mewah, 68000 Ampang Jaya, Selangor, Malaysia
| | - Siti Shahida Md Sharifudin
- Department of Pharmacy, Hospital Kuala Lumpur, Ministry of Health, Jalan Pahang 50586, Kuala Lumpur, Malaysia
| | - Wei Wen Chong
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
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Barnett SG, Allen SM, Bastianelli KM, Chen JS, Clark Dula CA, Kachlic MD, Goliak KL, Knockel LE, Matthews DE, Volino LR, Lasarev MR, Reist JC. Determination of Interrater Reliability of a Universal Evaluator Rubric to Assess Student Pharmacist Communication Skills. Am J Pharm Educ 2022; 86:8544. [PMID: 34301546 PMCID: PMC8787169 DOI: 10.5688/ajpe8544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
Objective. To evaluate the interrater reliability of a universal evaluator rubric used to assess student pharmacist communication skills during patient education sessions.Methods. Six US schools and colleges of pharmacy each submitted 10 student videos of a simulated community pharmacy patient education session and recruited two raters in each of the five rater groups (faculty, standardized patients, postgraduate year one residents, student pharmacists, and pharmacy preceptors). Raters used a rubric containing 20 items and a global assessment to evaluate student communication of 12 videos. Agreement was computed for individual items and overall rubric score within each rater group, and for each item across all rater groups. Average overall rubric agreement scores were compared between rater groups. Agreement coefficient scores were categorized as no to minimal, weak, moderate, strong, or almost perfect agreement.Results. Fifty-five raters representing five rater groups and six pharmacy schools evaluated student communication. Item agreement analysis for all raters revealed five items with no to minimal or weak agreement, 10 items with moderate agreement, one item with strong agreement, and five items with almost perfect agreement. Overall average agreement across all rater groups was 0.73 (95% CI, 0.66-0.81). The preceptor rater group exhibited the lowest agreement score of 0.68 (95% CI, 0.58-0.78), which significantly deviated from the overall average.Conclusion. While strong or almost perfect agreement scores were not observed for all rubric items, overall average interrater reliability results support the use of this rubric in a variety of raters to assess student pharmacist communication skills during patient education sessions.
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Affiliation(s)
- Susanne G Barnett
- University of Wisconsin-Madison, School of Pharmacy, Madison, Wisconsin
| | - Sheila M Allen
- University of Illinois at Chicago, College of Pharmacy, Chicago, Illinois
| | | | - Jennifer S Chen
- University of Minnesota, College of Pharmacy, Minneapolis, Minnesota
| | | | | | - Kristen L Goliak
- University of Illinois at Chicago, College of Pharmacy, Chicago, Illinois
| | | | | | - Lucio R Volino
- Rutgers University, Ernest Mario School of Pharmacy, Piscataway, New Jersey
| | - Michael R Lasarev
- University of Wisconsin-Madison, School of Pharmacy, Madison, Wisconsin
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Kerr A, Kelleher C, Pawlikowska T, Strawbridge J. How can pharmacists develop patient-pharmacist communication skills? A realist synthesis. Patient Educ Couns 2021; 104:2467-2479. [PMID: 33726988 DOI: 10.1016/j.pec.2021.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/04/2021] [Accepted: 03/06/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To understand how pharmacists develop patient-pharmacist communication skills. METHODS A realist synthesis approach was used to understand how educational interventions work to improve patient-pharmacist communication. Initial programme theories were developed through a scoping search and stakeholder focus groups (faculty, students, patients and public). A systematic search was then conducted for evidence to test initial theories. Included papers were assessed for relevance and rigour. Extracted data was synthesised to refine the initial programme theories and develop modified programme theories. RESULTS Forty-seven papers were included in the final synthesis. Role-play with simulated patients and peers, video recording and lectures were the most widely reported interventions. Repeated practice, feedback, reflection and confidence were among the mechanisms by which interventions work. Modified programme theories relating to interactions of role-play, experiential learning, video recording, self-assessment and workshops were developed. CONCLUSIONS Outcomes of communication education interventions are influenced by the level of learner. Educational interventions that promote reflection are particularly useful. PRACTICAL IMPLICATIONS There are a wide range of theory-informed interventions, which should be used in a programmatic approach to communications education. A longitudinal programme of communication skills training, with intervention choice based on level of learning, is important.
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Affiliation(s)
- Aisling Kerr
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - Caroline Kelleher
- Department of Psychology, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - Teresa Pawlikowska
- Health Professions Education Centre (HPEC), RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - Judith Strawbridge
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
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Barnett SG, Porter AL, Allen SM, Bastianelli KMS, Chen JS, Kachlic MD, Gallimore CE, Goliak KL, Reist JC. Expert Consensus to Finalize a Universal Evaluator Rubric to Assess Pharmacy Students' Patient Communication Skills. Am J Pharm Educ 2020; 84:848016. [PMID: 34283782 PMCID: PMC7779880 DOI: 10.5688/ajpe848016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/19/2020] [Indexed: 05/22/2023]
Abstract
Objective. To use an expert consensus-building process to develop a rubric used by multiple evaluator types to assess Doctor of Pharmacy students' patient communication skills.Methods. Faculty and staff members from six schools and colleges of pharmacy collaborated on a multi-step expert consensus-building process to create the final version of a communication rubric. First, faculty and patient content experts evaluated each item in the rubric for its relevance, criticality, and global comprehensiveness using a five-point Likert scale (0=not at all, 4=to a high extent). Descriptive statistics were used to analyze the resulting data. Faculty members evaluated the results and came to a consensus on the second version of the rubric. A corresponding codebook was developed and refined through a two-phase process.Results. The initial communication rubric was evaluated by 13 expert reviewers. Mean global comprehensiveness on the rubric was 3.83 for faculty experts and 3.5 for patient experts. After evaluating results from the expert consensus-building process, 14 items on the rubric did not change, five items were revised, three items were removed, and two items were added. The second version of the instrument included 20 items in six topic areas. A codebook was finalized to increase scoring consistency for the 20 communication items.Conclusion. Overall, content experts concluded that the rubric had high global comprehensiveness. Collaboration involving faculty members from multiple schools of pharmacy resulted in a 20-item communication rubric and codebook that can be used to increase consistency in scoring student pharmacists' patient communication skills.
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Affiliation(s)
- Susanne G Barnett
- University of Wisconsin-Madison School of Pharmacy, Madison, Wisconsin
| | - Andrea L Porter
- University of Wisconsin-Madison School of Pharmacy, Madison, Wisconsin
- Editorial Board Member, American Journal of Pharmaceutical Education, Arlington, Virginia
| | - Sheila M Allen
- University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
| | | | - Jennifer S Chen
- University of Minnesota College of Pharmacy, Minneapolis, Minnesota
| | | | - Casey E Gallimore
- University of Wisconsin-Madison School of Pharmacy, Madison, Wisconsin
| | - Kristen L Goliak
- University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
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Hildenbrand GM, Perrault EK, Keller PE. Evaluating a Health Literacy Communication Training for Medical Students: Using Plain Language. J Health Commun 2020; 25:624-631. [PMID: 33131465 DOI: 10.1080/10810730.2020.1827098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Medical students tend to use technical terminology without explanation when communicating with patients, and do not feel confident interacting with patients who have low health literacy (LHL). The present study consisted of an evaluation of a brief health literacy training for first-year medical students seeking to enhance their knowledge of health literacy, self-efficacy in communicating with patients who have LHL, and clear communication skills. The training was guided by patient-centered communication, social cognitive theory, and the universal precautions approach to health literacy, and developed and delivered by communication scholars. Results indicated that medical students had increased health literacy knowledge, confidence in communicating with patients who have LHL, and found the training to be useful. Medical student interactions with standardized patients from the cohort who received the training were compared with the previous year's cohort who did not receive the training. Analysis of transcripts of interactions after the training indicated no significant differences in medical students' use of examples. Health literacy trainings should be incorporated into the medical student curriculum, taught in collaboration with communication scholars, and be given more frequently throughout the medical school career to reinforce utilization of clear communication strategies.
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Affiliation(s)
- Grace M Hildenbrand
- Brian Lamb School of Communication, Purdue University , West Lafayette, Indiana, USA
| | - Evan K Perrault
- Brian Lamb School of Communication, Purdue University , West Lafayette, Indiana, USA
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Ilardo ML, Speciale A. The Community Pharmacist: Perceived Barriers and Patient-Centered Care Communication. Int J Environ Res Public Health 2020; 17:ijerph17020536. [PMID: 31952127 PMCID: PMC7013626 DOI: 10.3390/ijerph17020536] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/09/2020] [Accepted: 01/11/2020] [Indexed: 12/17/2022]
Abstract
Nowadays, the classic perception of the pharmaceutical profession in community pharmacies is facing worldwide extinction due to many factors. Among the numerous factors, online pharmacies are increasingly gaining ground thanks to their ability to facilitate customer demand. Nevertheless, they are endangering “face-to-face” contact, affecting the building of customer loyalty based on direct “human” interaction, and consequently reducing pharmacists to mere commercial figures. Patient-centered care communication is emphasized as the essential element to build a solid and appropriate interpersonal relationship with the patient, to make the consultancy process effective, and to strengthen the pharmacist’s professionalism in community pharmacy. This paper presents a narrative review of existing literature with the first aim of pinpointing the factors affecting pharmacy professional practice, and secondly, of how to improve patient-centered communication skills. A more widespread introduction of in-depth study and practice of behavioral, communication, educational, and sociological methodologies and techniques would allow for the development of more effective skills used for providing an efficient consultancy service, improving the capacity of future professionals to approach public relations.
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Affiliation(s)
- Maria Laura Ilardo
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60020 Ancona, Italy;
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98168 Messina, Italy
| | - Antonio Speciale
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98168 Messina, Italy
- Correspondence:
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Kaper MS, Reijneveld SA, van Es FD, de Zeeuw J, Almansa J, Koot JA, de Winter AF. Effectiveness of a Comprehensive Health Literacy Consultation Skills Training for Undergraduate Medical Students: A Randomized Controlled Trial. Int J Environ Res Public Health 2019; 17:ijerph17010081. [PMID: 31861918 PMCID: PMC6982343 DOI: 10.3390/ijerph17010081] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/12/2019] [Accepted: 12/15/2019] [Indexed: 11/16/2022]
Abstract
Comprehensible communication by itself is not sufficient to overcome health literacy related problems. Future doctors need a larger scope of capacities in order to strengthen a patient’s autonomy, participation, and self-management abilities. To date, such comprehensive training-interventions are rarely embedded in curricula, nor systematically evaluated. We assessed whether comprehensive training increased these health literacy competencies, in a randomized controlled trial (RCT), with a waiting list condition. Participants were international undergraduate medical students of a Dutch medical faculty (intervention: 39; control: 40). The 11-h-training-intervention encompassed a health literacy lecture and five interactive small-group sessions to practise gathering information and providing comprehensible information, shared decision-making, and enabling of self-management using role-play and videotaped conversations. We assessed self-reported competencies (knowledge and awareness of health literacy, attitude, self-efficacy, and ability to use patient-centred communication techniques) at baseline, after a five and ten-week follow-up. We compared students’ competencies using multi-level analysis, adjusted for baseline. As validation, we evaluated demonstrated skills in videotaped consultations for a subsample. The group of students who received the training intervention reported significantly greater health literacy competencies, which persisted up to five weeks afterwards. Increase was greatest for providing comprehensible information (B: 1.50; 95% confidence interval, CI 1.15 to 1.84), shared decision-making (B: 1.08; 95% CI 0.60 to 1.55), and self-management (B: 1.21; 95% CI 0.61 to 1.80). Effects regarding demonstrated skills confirmed self-rated competency improvement. This training enhanced a larger scope of health literacy competences and was well received by medical students. Implementation and further evaluation of this training in education and clinical practice can support sustainable health literacy capacity building of future doctors and contribute to better patient empowerment and outcomes of consultations.
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Affiliation(s)
- Marise S. Kaper
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
- Correspondence:
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Frank D. van Es
- Faculty of Medical Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (F.D.v.E.); (J.d.Z.)
| | - Janine de Zeeuw
- Faculty of Medical Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (F.D.v.E.); (J.d.Z.)
| | - Josué Almansa
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Jaap A.R. Koot
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
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Palesy D, Jakimowicz S. Health literacy support for Australian home-based care recipients: A role for homecare workers? Home Health Care Serv Q 2019; 39:17-32. [PMID: 31710575 DOI: 10.1080/01621424.2019.1691698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Clear links have been established between low health literacy (HL) levels and poor health outcomes. One means of improvement may be found in the rapidly growing paid home care workforce, whose direct and frequent contact with aged/disabled care recipients positions them to provide HL support. This study examines Australian homecare worker (HCW) experiences in HL when providing assistance to their care recipients. A self-reported cross-sectional survey collected data from 75 HCWs. They reported concerns about their clients' HL, yet were cautious about providing support in this area. HL levels of the HCWs themselves were unconvincing, and the majority requested targeted education and training. Further research is needed into HL levels of both HCWs and care recipients, client demographics, the types of HL support being requested of HCWs, a more detailed scoping of the HCW role, and the curriculum and pedagogies which may comprise a HL education and training program for HCWs.
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Affiliation(s)
- Debra Palesy
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Samantha Jakimowicz
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Saunders C, Palesy D, Lewis J. Systematic Review and Conceptual Framework for Health Literacy Training in Health Professions Education. Health Professions Education 2019. [DOI: 10.1016/j.hpe.2018.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Bellottie GD, Kirwin J, Allen RA, Anksorus HN, Bartelme KM, Bottenberg MM, Dula CC, Kane TH, Lee PH, McMillan A, Riley BL, Waghel R. Suggested pharmacy practice laboratory activities to align with pre-APPE domains in the Doctor of Pharmacy curriculum. Curr Pharm Teach Learn 2018; 10:1303-1320. [PMID: 30497635 DOI: 10.1016/j.cptl.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 02/26/2018] [Accepted: 06/06/2018] [Indexed: 06/09/2023]
Abstract
OUR SITUATION The Accreditation Council for Pharmacy Education outlines ability statements that pharmacy students should be able to demonstrate prior to beginning their Advanced Pharmacy Practice Experiences (APPEs). Practice laboratory courses offer extensive opportunities for students to participate in activities and assessments that enable them to meet the objectives outlined in the Pre-APPE Core Domains in Standards 2016. This review identifies selected published literature, activities, and assessment methods that can be adapted and implemented in practice laboratory courses to help achieve the abilities outlined within the Pre-APPE Core Domains. METHODOLOGICAL LITERATURE REVIEW The Medline database and journals related to pharmacy education were searched to identify activities and assessments for each domain. Search terms for each core domain were extracted from the domain titles, ability statements, and performance competencies and coupled with "laboratory" or "lab." "Pharmacy" was also added as a search term when searching the Medline database. Preference was given to example activities published in the last 15 years. Abstracts and activities based on author experience were also included. OUR RECOMMENDATIONS AND THEIR APPLICATIONS Specific examples of how activities and assessments can be included in practice laboratories to develop or refresh skills identified in the pre-APPE core domains were described. POTENTIAL IMPACT The practice laboratory setting is an ideal place for students to learn and practice the skills necessary to demonstrate readiness for APPEs. This paper serves as a resource for instructors, curriculum committees, or pharmacy programs looking for ideas to expand specific training or develop particular skill areas.
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Affiliation(s)
- Gina DeSevo Bellottie
- Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, 901 Walnut Street, Suite 901, Philadelphia, PA 19107, United States.
| | - Jennifer Kirwin
- Department of Pharmacy and Health Systems Sciences, Northeastern University School of Pharmacy, Mail Stop - R218, 360 Huntington Avenue, Boston, MA 02115, United States.
| | - Rachel A Allen
- University of Washington School of Pharmacy, HSB H-375, Box 357630, Seattle, WA 98195-7630, United States.
| | - Heidi N Anksorus
- Division of Practice Advancement and Clinical Education, University of North Carolina Eshelman School of Pharmacy, CB #7574, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7574, United States.
| | - Kassandra M Bartelme
- Concordia University Wisconsin School of Pharmacy, 12800 N Lake Shore Drive, Mequon, WI, United States.
| | - Michelle M Bottenberg
- Drake University College of Pharmacy and Health Sciences, 2507 University Avenue, Des Moines, IA 50311, United States.
| | - Colleen Clark Dula
- The Ohio State University, 500 West 12th Avenue, Columbus, OH 43210, United States.
| | - Teresa H Kane
- Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany, NY 12208, United States.
| | - Phillip H Lee
- Belmont University College of Pharmacy, McWhorter Hall, 309, 1900 Belmont Boulevard, Nashville, TN 37212, United States.
| | - Ashlee McMillan
- West Virginia University, PO Box 9520, Morgantown, WV 26506, United States.
| | - Brittany L Riley
- Department of Pharmacy Practice, Administration and Research, Marshall University School of Pharmacy, 1 John Marshall Drive, Huntington, WV 25755, United States.
| | - Rashi Waghel
- Wingate University School of Pharmacy, 515 N. Main Street, Wingate, NC 28174, United States.
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Abstract
This study aimed to identify and assess the factors that influence communication quality between clinical pharmacists and patients using a structural equation model based on the predisposing, reinforcing, and enabling constructs in educational/environmental diagnosis and evaluation–policy, regulatory, and organizational constructs in educational and ecological development model to identify the most effective path to increase their communication quality. A survey was conducted at 253 Class-A tertiary hospitals in China from March to December 2016. During on-site observations, verbal communications between clinical pharmacists ( n = 752) and patients were audio recorded, and communication quality was rated by an expert panel on an 8-item Quality of Communication Rating Scale. Clinical pharmacists completed questionnaires that examined the predisposing, enabling, and reinforcing factors that influenced communication quality. Finally, AMOS was employed to examine the relationships between the three factors and communication quality. The results indicated that all three factors positively affected communication quality, with correlation coefficients of .26, .13, and .17, respectively. The most influential predisposing factor was attitude (.77), the most influential enabling factors were self-efficacy (.71) and confidence (.72), and the most influential reinforcing factor was rewards (.74). The findings suggest that pharmacists’ attitudes toward, perceived knowledge of, and skill and confidence in communication, and the rewards offered by pharmacy management are the most influential factors that influence communication quality.
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Affiliation(s)
- Dongning Yao
- School of International Pharmaceutical Business, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- N22, State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
- Both the authors have equally contributed to this article
| | - Liang Jiang
- School of International Pharmaceutical Business, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- Both the authors have equally contributed to this article
| | - Yuankai Huang
- School of International Pharmaceutical Business, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
| | - Lei Chen
- School of International Pharmaceutical Business, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
| | - Yitao Wang
- N22, State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China
| | - Xiaoyu Xi
- School of International Pharmaceutical Business, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
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Kaper MS, Sixsmith J, Koot JAR, Meijering LB, van Twillert S, Giammarchi C, Bevilacqua R, Barry MM, Doyle P, Reijneveld SA, de Winter AF. Developing and pilot testing a comprehensive health literacy communication training for health professionals in three European countries. Patient Educ Couns 2018; 101:152-158. [PMID: 28823383 DOI: 10.1016/j.pec.2017.07.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 07/12/2017] [Accepted: 07/14/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Skills to address different health literacy problems are lacking among health professionals. We sought to develop and pilot test a comprehensive health literacy communication training for various health professionals in Ireland, Italy and the Netherlands. METHODS Thirty health professionals participated in the study. A literature review focused on evidence-informed training-components. Focus group discussions (FGDs) explored perspectives from seventeen professionals on a prototype-program, and feedback from thirteen professionals following pilot-training. Pre-post questionnaires assessed self-rated health literacy communication skills. RESULTS The literature review yielded five training-components to address functional, interactive and critical health literacy: health literacy education, gathering and providing information, shared decision-making, enabling self-management, and supporting behaviour change. In FGDs, professionals endorsed the prototype-program and reported that the pilot-training increased knowledge and patient-centred communication skills in addressing health literacy, as shown by self-rated pre-post questionnaires. CONCLUSION A comprehensive training for health professionals in three European countries enhances perceived skills to address functional, interactive and critical health literacy. PRACTICE IMPLICATIONS This training has potential for wider application in education and practice in Europe.
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Affiliation(s)
- Marise S Kaper
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, PO Box 30.001, FA10, 9700 RB Groningen, Netherlands.
| | - Jane Sixsmith
- Health Promotion Centre, National University of Ireland Galway, University Road, H91 TK33, Galway, Ireland.
| | - Jaap A R Koot
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, PO Box 30.001, FA10, 9700 RB Groningen, Netherlands.
| | - Louise B Meijering
- University of Groningen, Urban and Regional Studies Institute, Population Research Center, PO Box 800, 9700 AV, Groningen, Netherlands.
| | - Sacha van Twillert
- University of Groningen, University Medical Center Groningen, Center for Rehabilitation, PO Box 30002, 9750 RA Haren, Netherlands.
| | - Cinzia Giammarchi
- The Regional Agency for Health (ARS of the Marche Region), Palazzo Rossini, Via Gentile da Fabriano 3, 60125, Ancona, Italy.
| | - Roberta Bevilacqua
- National Institute of Health and Science on Aging (INRCA),Via S. Margherita 5, 60124 Ancona, Italy.
| | - Margaret M Barry
- Health Promotion Centre, National University of Ireland Galway, University Road, H91 TK33, Galway, Ireland.
| | - Priscilla Doyle
- Health Promotion Centre, National University of Ireland Galway, University Road, H91 TK33, Galway, Ireland.
| | - Sijmen A Reijneveld
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, PO Box 30.001, FA10, 9700 RB Groningen, Netherlands.
| | - Andrea F de Winter
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, PO Box 30.001, FA10, 9700 RB Groningen, Netherlands.
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Lundeby T, Jacobsen HB, Lundeby PA, Loge JH. Emotions in communication skills training - experiences from general practice to Porsche maintenance. Patient Educ Couns 2017. [PMID: 28641994 DOI: 10.1016/j.pec.2017.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The emphasis on skills in communication training of physicians has gained momentum over the last 30 years. Furthermore, a specific focus on skills to address emotions has been suggested and more recently supported by empirical studies. In this paper we use the Expanded Four Habits Model to illustrate how a structured consultation model supplemented with specific skills to address emotions is considered useful in medical and non-medical settings. The primacy of emotions in different types of professional encounters is discussed in relation to education and practice.
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Affiliation(s)
- Tonje Lundeby
- Regional Advisory Unit on Palliative Care, Department of Oncology, Oslo University Hospital, Norway.
| | | | | | - Jon Håvard Loge
- Regional Advisory Unit on Palliative Care, Department of Oncology, Oslo University Hospital, Norway; Department of Behavioral Sciences, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
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Grice GR, Gattas NM, Prosser T, Voorhees M, Kebodeaux C, Tiemeier A, Berry TM, Wilson AG, Mann J, Juang P. Design and Validation of Patient-Centered Communication Tools (PaCT) to Measure Students' Communication Skills. Am J Pharm Educ 2017; 81:5927. [PMID: 29200447 PMCID: PMC5701322 DOI: 10.5688/ajpe5927] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 01/17/2017] [Indexed: 05/30/2023]
Abstract
Objective. To develop a comprehensive instrument specific to student pharmacist-patient communication skills, and to determine face, content, construct, concurrent, and predictive validity and reliability of the instrument. Methods. A multi-step approach was used to create and validate an instrument, including the use of external experts for face and content validity, students for construct validity, comparisons to other rubrics for concurrent validity, comparisons to other coursework for predictive validity, and extensive reliability and inter-rater reliability testing with trained faculty assessors. Results. Patient-centered Communication Tools (PaCT) achieved face and content validity and performed well with multiple correlation tests with significant findings for reliability testing and when compared to an alternate rubric. Conclusion. PaCT is a useful instrument for assessing student pharmacist communication skills with patients.
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Affiliation(s)
| | | | | | | | - Clark Kebodeaux
- University of Kentucky College of Pharmacy, Lexington, Kentucky
| | - Amy Tiemeier
- St. Louis College of Pharmacy, St. Louis, Missouri
| | | | | | - Janelle Mann
- Washington University Infusion Center Pharmacy, St. Louis, Missouri
| | - Paul Juang
- St. Louis College of Pharmacy, St. Louis, Missouri
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16
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Soellner R, Lenartz N, Rudinger G. Concept mapping as an approach for expert-guided model building: The example of health literacy. Eval Program Plann 2017; 60:245-253. [PMID: 27771012 DOI: 10.1016/j.evalprogplan.2016.10.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 10/07/2016] [Indexed: 06/06/2023]
Abstract
Concept mapping served as the starting point for the aim of capturing the comprehensive structure of the construct of 'health literacy.' Ideas about health literacy were generated by 99 experts and resulted in 105 statements that were subsequently organized by 27 experts in an unstructured card sorting. Multidimensional scaling was applied to the sorting data and a two and three-dimensional solution was computed. The three dimensional solution was used in subsequent cluster analysis and resulted in a concept map of nine "clusters": (1) self-regulation, (2) self-perception, (3) proactive approach to health, (4) basic literacy and numeracy skills, (5) information appraisal, (6) information search, (7) health care system knowledge and acting, (8) communication and cooperation, and (9) beneficial personality traits. Subsequently, this concept map served as a starting point for developing a "qualitative" structural model of health literacy and a questionnaire for the measurement of health literacy. On the basis of questionnaire data, a "quantitative" structural model was created by first applying exploratory factor analyses (EFA) and then cross-validating the model with confirmatory factor analyses (CFA). Concept mapping proved to be a highly valuable tool for the process of model building up to translational research in the "real world".
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Affiliation(s)
- Renate Soellner
- Institut für Psychologie, Universität Hildesheim, Universitätsplatz 1, D-31141 Hildesheim, Germany.
| | | | - Georg Rudinger
- Institut für Psychologie, Universität Bonn, Kaiser-Karl-Ring 9, D-53111 Bonn, Germany.
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Abstract
While national concern is growing, the scholarly body of knowledge in health literacy is still relatively small in health communication literature. The field began to distinguish itself as an outgrowth of adult literacy that focused on patient understanding of health information. It grew out of medicine and public health science mostly, and still today the majority of research can be found in health professional journals. However, the links with health communication, particularly with provider-patient communication and with printed health information, have been established and documented over the last decade. This article is a conceptual review that highlights state-of-the-science literature that has made connections between health literacy and health communication. Evidence reveals the contribution that health literacy can have on the health communication body of knowledge. The article illuminates the gaps in research and possibilities for theory development and future studies.
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Affiliation(s)
- Linda Aldoory
- a Department of Communication , University of Maryland
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Abstract
BACKGROUND Research within the framework of Self-Determination Theory (SDT) indicates that patients' autonomy is to be considered a critical health care outcome in its own right since it promotes improved mental and physical health. This paper presents an analysis of studies addressing communication and interaction interventions in health literacy curricula for medical and health care practitioners, focusing on patient-oriented skills in "making sense" and "to adapt and self-manage". For evaluating interventions, underlying communication models were traced. The criteria for good practice are "making sense" and "supporting autonomy in making choices". For the search of interventions, keywords from both the framework of the EU-project, Intervention Research on Health Literacy among Ageing population (IROHLA (The IROHLA project received financial support from the European Union through FP7 Grant 305831)), as well as the SDT (Self Determination Theory) were applied. The research question of this paper is to what degree is autonomy supporting communication skills part of the curricula of health literacy (HL) for medical and health care practitioners and providers? A Pubmed search revealed: a) that "making sense" is clearly represented in HL interventions in curricula; however, b) very few interventions teach medical and health care practitioners how to give autonomy support in the interaction with their (future) patients. Four promising, beneficial practices were identified. Several recommendations were presented encouraging curriculum developers to adapt skills of supporting autonomy into their programs. METHODS A qualitative content analysis of interventions in the curricula of communication and interaction skills for medical students and practitioners. RESULTS A review of literature indicates: a) most interventions in curricula for medical students and practitioners are focusing on skills in adequately providing information to patients by using an underlying (advanced) Sender-Message-Receiver Model; and b) only a few interventions in curricula are available for providing the acquisition of interaction skills in supporting autonomy. CONCLUSIONS The proposal of Huber and others to change the emphasis in the definition of the WHO definition on health towards "to adapt and self manage" has impact on the training of medical students and practioners in dealing with patients with low levels of health literacy. From the present study it can be concluded that a dynamic approach to communication can be linked to theoretical constructs on self-management. In such an approach interaction techniques like scaffolding can increase the level of HL of the patient.
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Affiliation(s)
- Herman Veenker
- Hanze University of Applied Sciences, P.O. Box 70030, 9704 AA Groningen, Netherlands
- Zernikeplein 9, 9747 AS Groningen, Netherlands
| | - Wolter Paans
- Hanze University of Applied Sciences, Eyssoniusplein 18, 9714 CE Groningen, Netherlands
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Affiliation(s)
- Carly T. McKenzie
- Department of Clinical and Community Sciences; School of Dentistry; University of Alabama at Birmingham
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Abstract
We have previously proposed that by identifying a set of Educationally Sensitive Patient Outcomes (ESPOs), medical education outcomes research becomes more feasible and likely to provide meaningful guidance for medical education policy and practice. ESPOs are proximal outcomes that are sensitive to provider education, measurable, and linked to more distal health outcomes. Our previous model included Patient Activation and Clinical Microsystem Activation as ESPOs. In this paper, we discuss how Health Literacy, defined as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions," is another important ESPO. Between one-third and one-half of all US adults have limited health literacy skills. Providers can be trained to adopt a "universal precautions approach" to addressing patient health literacy, through the acquisition of specific skills (e.g., teachback, "chunking" information, use of plain language written materials) and by learning how to take action to improve the "health literacy environment." While there are several ways to measure health literacy, identifying which measurement tools are most sensitive to provider education is important, but challenging and complex. Further research is needed to test this model and identify additional ESPOs.
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Affiliation(s)
- H Shonna Yin
- Department of Pediatrics, Division of General Pediatrics, New York University School of Medicine, New York, NY, USA
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