Training residents in pediatric literacy: impact on knowledge, attitudes and practice

Abstract

Objective To determine whether training in emergent literacy-building techniques increases self-reported literacy-related knowledge, attitudes, and intervention with patients.

Design Quasi-experimental; prepost with intervention and comparison groups.

Subjects/setting Pediatric resident continuity clinics in three urban locations, serving primarily low-income patients. A total of 66 residents participated.

Intervention Residents in the intervention group (n = 48) were scheduled to receive a half-hour training session as part of their clinic didactic series. In addition, some intervention residents were exposed to other literacy-related training such as Grand Rounds, readings, and individual modelling by a supervising physician related to specific clinic families. Residents in the comparison group (n = 18) received no literacy training.

Measurement A demographic questionnaire was administered at pretesting. The Knowledge About Literacy Development and Attitudes Regarding Early Childhood Literacy Scales were administered prior to training and 6 months later. The Practice Activities questionnaire was administered at post-testing only.

Results Relative to 18 comparison subjects, 48 residents in the intervention group exhibited trends toward more frequent assessment of literacy milestones and more frequent literacy-related anticipatory guidance. Specifically, the observation of modelling by a supervising physician was significantly related to an increased frequency of literacy-related assessment and anticipatory guidance and to a trend toward more positive attitudes. Intervention and comparison residents did not significantly differ overall in knowledge or attitude gains. However, literacy-facilitative attitudes were significantly correlated with frequency of literacy-related anticipatory guidance.

Conclusions/implications for practice Residents had fairly high initial levels of general literacy-related knowledge

and positive attitudes about providing guidance in this area to parents.

Exposure to specific training in this area does appear to lead to an increased likelihood of addressing these issues in practice. Modeling by a supervising physician may be a particularly important component of training that can help residents learn how to integrate literacy assessment with overall developmental assessment and family guidance.