Sonia Bhandari: Promoting Health Literacy BACK

Published by AFAR

As a former undergraduate at UNC, I knew that returning to Chapel Hill for the MSTAR program would be comforting, but I had never thought that the team I would be working with this summer would be so welcoming and supportive. Today marks the end of my third week here and learning about health literacy, the focus of my project, has been breathtaking. I knew little about the subject before starting the project, and my literature review of health literacy quickly taught me that the nearly 48% of our nation is affected by low health literacy, which severely impacts the way health care is delivered to them. Health literacy is defined as the sets of skills that empowers patients and allows them to effectively function in the health care environment while understanding basic health information, services, and their individual medical needs. My PI, Dr. Leigh Callahan, and her team at the Thurston Arthritis Research Center have developed toolkits that contain methods that physicians, nurses, pharmacists, and the administrative staff can use to improve patient satisfaction in the clinical setting. The tools focus on improving spoken communication, written communication, self-management & empowerment, and supportive systems. The tools are accompanied by educational resources, links to videos, and methods to implement the tools.

Our project entails testing quick start guides that aim to promote health literacy, which are adapted from the larger toolkits, in three of the geriatric practices in the community. We want to see whether the short, six-page manuals were useful for the clinicians and staff members in altering and improving the ways that patients with low health literacy levels are cared for. Next week the team and I will be attending the weekly Division of Geriatric Medicine meeting to present our project and pass out the quick start guides to the clinicians and staff members there. They will be given a month to independently review the guides, and then we’ll return after that time to see how effective the guides were in improving interactions, promoting communication, and increasing understanding with patients of all health literacy levels.

During my time here I have also gotten the opportunity to shadow a geriatrician in the Cedars retirement home community clinic. The experience had a large impact because he was implementing many of the tools to promote health literacy with the patients that he saw, such as the teach-back method and the brown bag medication review. Seeing the same cases in the clinic that we study about in the classroom is always a humbling experience for me. Thus, it was very interesting to meet one of his patients with secondary parkinsonism, which had been caused by a recent stroke that obstructed blood flow to the substantia nigra in his brain. But the human element of the situation came to the forefront when the patient began discussing his sudden symptoms, the sadness he experienced about recently losing his son, and the pain he felt every time he was given Botox injections in his knuckles, fingers, and arms. The physician tried to comfort the patient’s anxiety by saying that there were observable improvements in his health, but the patient saw no such improvements and kept asking the physician over and over again what he could visibly notice that the patient himself could not feel. The physician was very compassionate and he empathetically explained to the patient information concerning his symptoms and options that he had to control his pain. I think it’s vital for us as medical students to see such emotions between physicians and patients early on so that we understand ways to connect with our patients throughout our careers. I feel privileged to be given a chance to shadow such a caring, dedicated physician. Overall I’ve truly enjoyed my time at UNC thus far and look forward to the rest of the summer.

Sonia Bhandari
University of South Carolina School of Medicine

"Diary of an MSTAR Student" follows scholars in the 2012 Medical Student Training in Aging Research (MSTAR) Program, highlighting their summer experiences. As they continue their path of research, training and clinical practice, read their daily thoughts at www.afar.org/mstarblog. New diary entries are posted every day, so check back soon.