A Curriculum, Instruction, and Assessment (CIA) Framework for Health Literacy Education (HLE) in Medical and Health Professions Schools

Abstract

There is increasing need to implement Health Literacy Education (HLE) as essential curriculum content in medical and health professions schools, supported by skill-based instructional strategies and authentic assessments. This paper reviews two decades of historical progress in health literacy and advances a new conceptual model to organize Curriculum, Instruction, and Assessment (CIA) themes for Health Literacy Education (HLE). Three themes are integrated into the Health Literacy Education (HLE) curriculum: 1) interprofessional communication in HLE, 2) cultural and linguistic competencies in HLE, and 3) a language typology that informs HLE. Two pedagogical themes are integrated into HLE instruction: 1) skill-based instructional strategies to improve oral communication (n = 7), and skill-based instructional strategies to improve written communication (n = 3). Skill-based instructional strategies to improve oral communication of medical and health professions students includes use of plain language, use of Teach Back or Show Me, encourage patients to ask questions, use medical interpreters and translators, be an active listener, respond with empathy when breaking bad news to patients, and use Chunks and Checks method. Skill-based instructional strategies to improve written communication of medical and health professions students includes write in plain language, evaluate written materials, and use pictures or visual aids to aid patient understanding. Two themes are integrated into HLE assessments: 1) formative assessment, and 2) summative assessment. The paper promotes the Curriculum, Instruction, and Assessment Framework for Health Literacy Education (CIA-HLE) for use by faculty in medical and health professions schools to ensure their students are well prepared to use oral and written communication with their patients as guided by selected research studies and initiatives. To further advance interprofessional collaboration and dialogue across the medical and health professions, a language typology and a knowledge typology are provided as building blocks to health literacy education.