No faculty required: Use of a health literacy low inference self-assessment measure to promote behavior change

Abstract Objective: To determine if use of a health literacy low-inference, self-assessment measure (LISAM), promoted behavior change as measured by increased use of health literacy communication skills (HLCS). Methods: The LISAM is a tool used by educators to self-assess their performances after giving a lecture. The tool is low inference because it self-assesses behaviors that are specific, with little room for subjectivity. Forty-four third-year medical students self-assessed HLCS using a LISAM modified to include health literacy communication skills (LISAM-HLCS).  Self-assessment followed participation in an audiotaped, standardized patient encounter and again after listening to the recording.  Students also created three written goals for improvement.  This session was repeated one week later. Results: At Session two, 71.4% of students met at least two of their three self-created objectives. The three most commonly created objectives were using teach-back, asking more open ended questions, and obtaining patient input into the management plan. Use of the LISAM increased HLCS use at Session two vs. Session one as assessed by both students and study investigators (p Conclusions: Without faculty present, students met and adjusted objectives, catalyzing changes in HLCS. The LISAM-HLCS has the potential to empower students to improve communication skills and to reduce dependence on faculty observations.