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Acad Med. 2002 Oct;77(10):1039-41.

Residents' ability to identify patients with poor literacy skills.

Author information

  • 1Departments of Internal Medicine and Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky 40292, USA. rickybass@lauisville.edu

Abstract

PURPOSE:

To determine whether residents could identify patients with poor literacy skills based on clinical interactions during a continuity clinic visit. The authors hypothesized residents would overestimate patients' literacy abilities and fail to recognize many patients at risk for poor literacy.

METHOD:

The Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R) was administered to screen patients for potential literacy problems. Residents were asked "Do you feel this patient has a literacy problem?" and answered yes or no. Continuity adjusted chi-square was used to test for overestimation of literacy abilities by residents.

RESULTS:

REALM-R scores and residents' evaluations of literacy were available for 182 patients. The residents believed 10% of patients (18) had literacy problems based on their clinical interactions. Only three patients passing the literacy screen were incorrectly identified as at risk for literacy. Of the 90% of patients (164) the residents perceived to have no literacy problem, 36% (59) failed the literacy screen.

CONCLUSION:

Resident physicians overestimated the literacy abilities of their patients. A significant portion of these residents' patients may not have the skills to effectively interact with the health care system and are at increased risk for adverse outcomes.

PMID:
12377684
[PubMed - indexed for MEDLINE]
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