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Incorporating Health Literacy Into Medical Education

For Claudette Dalton, MD, of the University of Virginia (UVA) School of Medicine, teaching health literacy is a priority that must begin in medical school. Dalton, an associate dean for medical education at UVA, began an effort to introduce health literacy training into Virginia’s classrooms in 2000 after learning at an AMA leadership conference that no organized curriculum for teaching health literacy existed.

“A light bulb went on for me,” she says. “It was something I had been interested in 20 years ago, and the AMA meeting helped get it started in my thinking again. Then everything just fell into place.”

She returned to UVA, and with the support of her dean, established the first health literacy courses for medical students there. Rather than introducing a new course, Dalton says she had more success simply introducing a health literacy module into existing courses. “Once faculty members heard the statistics, they were all for it,” she recalls. Since then, she says the program has grown to include training in all four years of medical school, with “an escalating assumption that students will apply it more and more as they begin to practice.”

Dalton says AMA Foundation programs have also been helpful in moving health literacy efforts forward in the state of Virginia. An AMA Foundation grant helped the UVA develop testing models to gauge how much of an impact the training curriculum is having in real practice, and she says participation by Virginia health care professionals in the AMA’s Train the Trainer (TOT) program is also helping affect health literacy locally.

After going through the TOT program, she helped set up two regional sessions that trained 160 more people, and the training has continued. “I spoke to someone recently who had conducted 30 to 40 trainings herself,” she says.

Dalton is a firm believer in the train-the-trainer concept: “As I go around the country doing health literacy training I almost always run into people who say that want to be trained like I was so they can teach, too,” she says.

Dalton believes a priority for development should be health literacy modules that deal directly with issues related to interpreter services in medical settings and the informed consent process. UVA has such a module and she is now helping others develop their own programs.

The school has established a health literacy Web site that offers helpful tips for anyone in education who is trying to establish a curriculum or other programming.