Hi, I hope all is well. My name is Christopher Good, and I'm an OMS 4 student at the Arkansas College of Osteopathic Medicine. My research advisor for this project was Dr. Elizabeth McClain, and our project title is Assessing the Role of Osteopathic Medical Education on Community Health Literacy Interventions. And this was a pilot study where we released an anonymous virtual survey to clinical third and fourth year osteopathic medical students at four institutions to better understand the impact of health literacy curriculum in medical education, as well as challenges that clinical medical students encounter on clinical rotations from health literacy perspective and what mitigation strategies they use. So we went into this study with the knowledge that DO students play a large role in community health literacy. And we know from prior studies that health literacy is a risk factor in a number of conditions, particularly from a health disparities standpoint. And the osteopathic medicine is an expanding field in this country. So it warrants additional research on not just how our students are trained, but the impact of that training from public and community health standpoints. So our specific research questions were what health literacy interventions are utilized most by osteopathic medical students and clinical rotations, and how do they perceive literacy concerns in the current impact of undergraduate medical education. So our survey was released throughout the month of May of this year, and it featured 18 items in a variety of ranked response and multiple choice formats. Our questions were reviewed by faculty content experts to ensure we're asking questions in a beneficial way, without leading statements. And of course, we had IRB approval at our home institution. And we had 53 responses from four institutions, the vast majority coming from our com, our home institution, but quite a few coming from PCOM, as well as Rowan and KCU Joplin. So we had a little bit of a geographic spread in our responses. About two thirds were from OMS3 students, one third from OMS4 students. And in terms of our results, there does seem to be a disconnect when we ask students whether they strongly agreed, agreed, disagreed, or strongly disagreed to the following statements. The first being medical schools have an obligation to address health literacy in their curriculum. The vast majority of responses strongly agreed or agreed to this statement. But when we asked if health literacy is sufficiently addressed in medical school curriculum, over 40% disagreed with this statement, and a clear minority either strongly agreed or agreed. So we know that there's room for improvement. We also found that over 62% of respondents recalled that their institutions feature community outreach sessions with the public and half of respondents recalled either early experiential learning, standardized patients or simulation lab encounters relating to health literacy. We also know that a lot of the health literacy knowledge comes into play in third and fourth year, with over 96% of respondents agreeing or strongly agreeing their understanding of health literacy was strengthened on rotations. And when we asked which rotations featured a high average or low use of health literacy strategies and patient communication, the majority identified family and internal medicine as requiring a high use of health literacy strategies, while a majority identified osteopathic manipulative medicine in general surgery as requiring a low use of health literacy strategies. And in terms of the challenges that students reported on clinical rotations relating to health literacy and patient communication of the most common concerns that patients expressed to students that students reported related to treatment, disease cause and cost. These weren't too surprising, except for nearly 80% either identifying cost is most common or common concerns from patients. Cost isn't something that's routinely addressed in pre clinical education. So this was really interesting to us. We also saw that from health literacy standpoint, the most common challenge, the most common challenges that students reported related to patient education level, followed by social determinants of health. And this was tied with either English as a second language or non English speaking patients. And on that front, we found that over 90% in terms of the resources that students used on rotations over 90% had experience with language interpreters, while less than half, in fact, a clear minority reported experience with assistive technologies relating to visual, auditory, and physical impairments. So this may identify demographic groups for future experiential learning in health literacy curriculum. Some success measures that we identified were early experiential learning with diverse patients, in addition to interpreters, not just language interpreters, which a majority of students reported encountering on clinical rotations, but also ASL interpreters and assistive technologies for diverse patients, and continue to involve students in institution led community outreach programs on health literacy topics, and encouraging students to create and access health promotional materials. And this last success measure came from a question that we asked on our survey of what resources students found helpful in their own education. And of course, a majority identified question banks is very helpful. But there were quite a few responses that identified either drawing or writing or handouts as helpful in their own education. So it wouldn't be surprising for students to really lean on these resources in expanding their knowledge of health literacy in informing patients. Some important limitations that we recognize in this study are the number of respondents and participating programs since we had 53 responses from four institutions. A lot of this because the month of May is around graduation season. So we only had a third of our responses from fourth year students. So we really believe that having longitudinal and larger scale health literacy research and focusing on medical education, it's going to be beneficial, reinforcing a primary care emphasis in not only to have a uniform framework for health literacy curriculum, but also to reinforce osteopathic medicines, emphasis on underserved patient care. That's what we're all about. And that's all we have for now. But we appreciate any feedback or questions. Thank you.

osteopathic medical education

health literacy

curriculum enhancement

experiential learning

longitudinal research