Cancer Risk Communication with Low Health Literacy Patients

A Continuing Medical Education Program

This article describes a continuing medical education program designed to improve physicians’ ability to effectively communicate about cancer risks with patients with low-health literacy. Low-health literacy poses a risk factor for cancer patients as patients with low-health literacy are less likely to use preventive health measures, understand risk reduction, or clarify points of confusion about their care. The continuing education program is a four-year program to teach primary care physicians to communicate better with low-health literacy patients about cancer risk.

The program randomized 18 primary practice physicians into an intervention and a control group. Both groups had unannounced standardized patient visits at regular intervals, but only the physicians in the intervention group received training to improve their communication techniques. The standardized patients rated physician communication, physicians self-evaluated their communication, and 73 study patients also rated their communication with their physician. Baseline reports from standardized patients, physicians and study patients are reported in this article.

Key Findings:

  • Physicians described their ability to discuss cancer risks to patients with low-health literacy as very good.
  • Standardized patients rated physician communication skills as satisfactory to good. They cited the ability of physicians to avoid medical jargon as very good.
  • Study patients gave low ratings to their ability to participate in medical decision-making, but reported physician communication as good or better.

This study indicates that, prior to a continuing education program, standardized patients and low-health literacy patients rate physician communication about cancer risks lower than physicians do. Subsequent research from this program should indicate whether continuing education can improve physician communication with patients.