How health literacy is taught and evaluated in dentistry, medicine, nursing, law, pharmacy, public health, and social work: a narrative review

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.

KEYWORDS:

• Academic training
• clinical skills
• communication
• health literacy
• interprofessional education
• provider communication skills training
• health communication training
• health literacy narrative review

Disclosure statement

No potential conflict of interest was reported by the author(s).

Acknowledgements

We would like to acknowledge and thank the University of Maryland Strategic Partnership MPowering the State (MPower) for funding and supporting an interprofessional education class on health literacy for health professions students in the summer of 2020, as well as funding and support from the 2020–2021 University of Maryland Baltimore President’s Symposium and White Paper Project Health Literacy as a Social Determinant of Health. We would like to express our gratitude to the faculty team for their tremendous assistance, support, and availability: Melissa Bellin, PhD, MSW, LCSW; Lisa Bress, RDH, MS; Heather Congdon, PharmD, BCPS, CDE; Lori Edwards, DrPH, BSN, RN CNS-PCH, BC; Alice M. Horowitz, PhD, RDH; Kathleen Hoke, JD; Jill Morgan, PharmD, BCPS, BCPPS; Yolanda Ogbolu, PhD, CRNP, FNAP, FAAN; Sandra Quezada, MD, MS; Debra Rodriguez, DDS; Everett Smith Jr., LMSW; Nedelina Tchangalova; Lauren Wheeler, MLIS; We are grateful for the support from the following University of Maryland leaders: Chancellor Jay Perman, MD; UMB President Bruce E. Jarrell, MD, FACS; UMDCP President Wallace Loh, PhD, JD, MA; UMDCP President Darryll J. Pines, PhD, MSME, BSME; UMB Provost Dr. Roger J Ward, EdD, JD, MSL, MPA.

Data availability statement

The research strategy is available in Appendix.

Authors’ contributions

CB conceptualized and designed the study, directed the research, and made significant revisions to the paper. ES collaborated on the study design and contributed to the refinement of the paper. MAW helped students define the search terms, guided the database selection, consulted on search results, and helped refine the paper. CM drafted, edited, and made significant contributions to the paper. KC, EF, SG, DG, KSJ, AYL and JW investigated the status of health literacy in curriculum of their respective schools and searched the literature in their respective disciplines and wrote the first draft of the paper.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The University of Maryland Strategic Partnership MPowering the State (MPower) funded and supported an interprofessional education class on health literacy for health professions students in the summer of 2020, as well as funding and support from the 2020–2021 University of Maryland Baltimore President’s Symposium and White Paper Project Health Literacy as a Social Determinant of Health.

Notes on contributors

Catherine Maybury

Catherine Maybury is a Faculty Specialist in the Horowitz Center in the School of Public Health at the University of Maryland College Park.

Mary Ann Williams

Mary Ann Williams is a Research & Education Librarian at the Health Sciences & Human Services Library, University of Maryland Baltimore.

Kelsie Challenger

Kelsie Challenger is a student at the University of Maryland College Park, School of Public Health.

Elisabeth Fassas

Elisabeth Fassas is a student at the University of Maryland Baltimore, School of Medicine.

Sonia Galvan

Sonia Galvan is a student at the University of Maryland Baltimore, School of Nursing.

Dominique Gelmann

Dominique Gelmann is a student at the University of Maryland Baltimore, School of Medicine.

Karen S. Jung

Karen S. Jung is a student at the University of Maryland Baltimore, School of Dentistry.

Alice Yanhong Lu

Alice Yanhong Lu is a student at the University of Maryland Baltimore, School of Pharmacy.

Jocelyn Wang

Jocelyn Wang is a student at the University of Maryland Baltimore, Francis King Kerry School of Law.

Elsie Stines

Elsie Stines is a pediatric nurse practitioner and as assistant vice president of special projects and initiatives to UMB President Bruce E. Jarrell.

Cynthia Baur

Cynthia Baur is the Director of the Horowitz Center in the School of Public Health at the University of Maryland College Park.