Saint Louis University School of Medicine Incorporates AHRQ's Health Literacy Toolkit Into Curriculum

Saint Louis University's School of Medicine has incorporated AHRQ's "Health Literacy Universal Precautions Toolkit" into an enterprising and progressively evolving health literacy initiative to improve outcomes through increased patient engagement.

Work on the initiative began in 2006, with the development of the university's Interprofessional Team Seminars course. Students began using elements of the AHRQ toolkit, and by the 2010-2011 academic year, these tools were fully integrated into the course, which is directed by David Pole, MPH, Assistant Director, Interprofessional Education and Deputy Director, Area Health Education Center, and Fred Rottnek, MD, MAHCM, Associate Professor in Family and Community Medicine.

As of October 2011, over 1,200 students from seven professions had enrolled in the Interprofessional Team Seminars and used the toolkit's resources. "Before the toolkit was incorporated into the curriculum, health literacy was only an academic discussion. We talked about the problem and provided articles on the extent of the problem and its impact on patient outcomes. Then we gave students general guidelines on how providers could address limited health literacy," Pole explains.

When the Interprofessional Team Seminars course was piloted, health literacy education at the university evolved as part of a program to improve patient safety and health outcomes. Sample patient cases used in the course have been redesigned to include limited health literacy. Students practice negotiating group decisionmaking, learn about patient care from other professions, and demonstrate behaviors to address limited health literacy as part of obtaining better outcomes.

The course includes students from seven professions, including third-year medical students, fifth-year doctoral pharmacy students, and nursing, physician assistant, physical therapy, occupational therapy, and social work students, all engaged in the clinical training phase of their programs. At these monthly seminars, 44 faculty members from the seven professions facilitate small groups of interprofessional students. The students are presented with complex patient cases, many using standardized patients-individuals trained to act as real patients to simulate symptoms. Students are asked to practice interprofessional teamwork and communication skills, in addition to patient-centered health communications.

Students are challenged to apply two specific tools, "Tips for Communicating Clearly" and the "Teach-Back Method," from the AHRQ toolkit. Pole explains, "The health literacy problem is becoming real to students. They have to put tools into practice and demonstrate the behaviors of clear communication and teach-back."

With the inclusion of the AHRQ toolkit in the Interprofessional Team Seminars curriculum, other positive changes have also taken place. Faculty who teach in the Team Seminars report using the AHRQ toolkit in their own programs. Additionally, students are encouraged to use the toolkit during work with community agencies in outreach educational activities. The toolkit offers students consistent guidance in developing patient interaction skills, materials development, and applying these resources to their clinical problem solving and service projects.

The Interprofessional Team Seminars were originally a curriculum elective. Beginning in 2009, the deans of the School of Medicine and the Saint Louis College of Pharmacy made the seminars a requirement of each of their discipline's curricula. The other five professions have included the Interprofessional Team Seminars in their applied clinical practice courses.

The Saint Louis University School of Medicine is part of the national Area Health Education Center network, dedicated to improving the health of individuals and communities by developing and transforming the health care workforce.

Visit AHRQ's Health Literacy Universal Precautions Toolkit, 2nd Edition.