By Amber Hollingsworth
The Institute for Healthcare Advancement — the leading health literacy advocacy organization in the country — recently honored Associate Professor of Family Medicine Cliff Coleman, M.D., M.P.H., with the Health Literacy Award for Innovative Programs. Dr. Coleman’s pioneering work focuses on teaching health professionals about health literacy and clear communication best practices, such as using plain language, limiting information overload, eliciting patients' questions, and using teach-back (where patients teach information back to their provider).
In the U.S., 43% of adults have basic or below-basic literacy skills. Low literacy levels make it difficult for patients to understand their diagnoses and treatment plans, or simply how to improve their health. “Every health outcome we care about is linked to literacy skills,” Dr. Coleman explains.
When the health care industry began talking about health literacy around two decades ago, the focus was on improving patients’ literacy skills. Not much was being done to address the way the industry interacted with patients. That’s been Dr. Coleman’s life’s work: teaching health care professionals how to communicate better with patients.
“Good communication actually takes less effort and less time,” Dr. Coleman says. In addition to improving patient understanding, “these techniques are designed to make the clinician's life better. We never add to the burden of care.”
What he’s discovered is that learners are very capable of demonstrating clear communication practices, and have strong intentions to use these skills. But occasional lectures and workshops (the way most medical schools currently address health literacy) don’t result in sustained habitual use of clear communication practices in real-world environments. Learners tend to revert back to less patient-centered forms of communication.
In order to overcome this, Dr. Coleman has created a longitudinal curriculum to develop durable patient-centered communication habits among medical students, which, the hope is, can withstand pressures to revert back to the status quo once students get into clerkship training and beyond. This is believed to be the most thoroughly integrated health literacy curriculum of its kind in any U.S. medical school.
Since 2014, approximately 775 medical students have completed OHSU's Modified 4 Habits for Patient-Centered Care curriculum, with overwhelmingly positive feedback from students and the faculty who work with them. A recent evaluation of fourth-year medical students showed that only 20% used unnecessary medical jargon during observed clinical interactions (a major improvement over the past).
Dr. Coleman’s curriculum is now producing a new generation of physicians for whom clear communication is the norm, rather than the exception.