the first and second year, which provides background information and a list of available health literacy materials. Health literacy concepts are also integrated into other courses in the medical school curriculum; for example, patient case studies are presented in the second-year “Clinical Problems” course in which patients experience barriers related to communication misunderstandings and language issues. Also in the second year, the required community preceptorship includes a health literacy component. A fourth-year elective focusing on health literacy issues and including a service component is currently in development and will likely be offered in the spring of 2004. The University of Virginia (UVA) School of Medicine also provides a web interface to help other institutions develop health literacy curricula. It is made up of three main groups of information which can be individually tailored to the needs of an institution: (1) an outline on how UVA established its curriculum, with reference materials that include a faculty development handbook and examples of written cases used at various points of the curriculum; (2) an introductory health literacy lecture, examples of illustrations, and a bibliography and resources list; (3) standardized patient cases that illustrate work with patients with limited literacy, that also show how to work with interpreters for the deaf and for non-English-speaking patients; some of these case studies also integrate cultural competency issues.

Continuing Education Approaches

Most health literacy training for health professionals is done under continuing education umbrellas. Continuing medical education (CME) consists of those educational activities that serve to increase knowledge, skills, and performance of health professionals. They often are intended to update health professionals on new techniques as well as to expose them to new ideas and concepts relevant to their daily practice (ACCME, 2002). The Accreditation Council for Continuing Medical Education (ACCME) reports that over 45,000 directly sponsored CME courses were offered in 2002 to both physician and nonphysician participants (ACCME, 2003).

The Coalition for Allied Health Leadership (CAHL) formed a health literacy team during their 2003 meeting to assess health literacy practices of allied health professionals at the national level. The CAHL team developed a survey to assess further the current level of awareness of the allied health community and to develop materials to help the allied health community better meet their needs. The survey was electronically sent to members of the Health Professions Network and the National Network of Health Career Programs in Two Year Colleges. Approximately one-third of the respondents were unaware of the issues surrounding health literacy, or un-



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