Medical students' recognition of health literacy in a single embedded curricular activity

Objectives: To explore medical students' recognition of health literacy as a barrier to care and social determinant of health within a single embedded curricular activity. Methods: Data was collected from 262 second-year medical students' responses to the following questions: what are some potential barriers to patient adherence and preventative health screening? What aspects of a social history would you include in your patient interview to ensure emphasis on the social determinants of health? All narrative responses were analyzed using both frequency analysis and qualitative content analysis methods. Results: Students' responses revealed three themes: the impact of low health literacy on health, the correlation between health literacy and literacy, and health care provider strategies for addressing health literacy. The majority of students 61.5% (n= 161) recognized health literacy as a barrier to optimal health outcomes; however, an equal number of students 66.8% (n= 175) failed to identify the manner in which health literacy serves as a social determinate of health. Conclusion: While students may recognize health literacy as a barrier to care, they may need more formalized instruction and evaluation on understanding the ways in which it is a social determinant of health. It is therefore essential for medical educators to incorporate this topic more intentionally into medical school curricula to ensure the understanding of health literacy within the clinical context to facilitate meaningful adaptations that can potentially decrease health disparities.