Academic journal article American Journal of Pharmaceutical Education

Teaching and Learning Health Literacy in a Doctor of Pharmacy Program

Academic journal article American Journal of Pharmaceutical Education

Teaching and Learning Health Literacy in a Doctor of Pharmacy Program

Article excerpt


Health literacy (HL) is the degree to which individuals can obtain, process, understand, and communicate health-related information needed to make health decisions. (1-3) Patients with low HL can have difficulty following medical instructions, understanding health information, and performing self-management tasks. Over 90 million Americans have inadequate HL skills, which can lead to poor health outcomes including increased hospitalizations, poor disease control, and poor medication adherence and self-management behaviors. (1,4-7)

Health care professionals must be able to identify patients with limited HL and modify communication strategies to meet their health care needs. Organizations such as the Institute of Medicine, the American Medical Association, and the American Pharmacists Association recommend that health care professional programs incorporate HL into their professional curricula. (8-10) The American Pharmacists Association encourages all pharmacists and student pharmacists to increase their awareness of HL and modify communication strategies for patients with limited HL. (10)

Since limited HL can lead to poor outcomes, especially with regard to medication use, pharmacists can play a key role in improving health care among these patients. (1) However, many pharmacists are unaware of issues related to HL or fail to make attempts to identify or assist patients with limited HL. (11,12) These deficiencies could be adequately addressed through changes in pharmacy education. Both the Accreditation Council for Pharmacy Education (ACPE) and the Center for the Advancement of Pharmaceutical Education (CAPE) require pharmacy schools to address HL. (13,14) Specifically, the ACPE and CAPE outcome statements mandate that pharmacy students be able to provide patient-centered care through the ability to address HL and to modify communication strategies to meet patients' needs. (13,14)

A handful of studies have examined strategies to incorporate HL in pharmacy education. Sicat and Hill evaluated the impact of a 50-minute lecture and small-group active-learning activities in a communication course on P1 students' knowledge about HL and comfort with low HL patient populations. (15) Most students agreed that they had previously underestimated the prevalence of low HL in patient populations and that the activities were useful. Chen and colleagues reported that in one doctor of pharmacy (PharmD) program, as part of a required administration course, P3 students gained a greater understanding and awareness of HL issues after completing a 3-hour module and accompanying HL assignment. (16) Another program examined an active-learning, multi-session HL module in a cultural competency course, which included activities such as patient counseling exercises, HL assessment, and improving the readability of education materials, improved P3 students' knowledge and confidence. (17,18) Ha and Lopez evaluated the effects of case-based learning on P3 students' HL knowledge and skills. (19) After completing one patient case that involved a patient with poor HL, the majority of students agreed that the activity was effective at meeting the HL-related learning objectives. To address a curricular mandate, these studies showed initial strategies to incorporate HL into pharmacy education. However, no study has examined P1 students' knowledge, confidence, and attitudes regarding HL using multiple, integrated, active-learning strategies.

The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences introduced a new curriculum in the fall of 2012. A patient-centered communication course was developed, and an HL component was included in order improve students' knowledge and abilities in this area. The objective of this study was to evaluate the impact of the course on students' knowledge, abilities, confidence, and attitudes regarding HL.


Patient-Centered Communication 1, a required, 3-credit course, is offered during the fall semester of the P1 year of the PharmD program. …

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