Date of Award

Spring 2021

Project Type

Clinical Doctorate

College or School




Program or Major

Doctor of Nursing Practice

Degree Name


First Advisor

Shirley Jackson

Second Advisor

Liana Plotke


BACKGROUND: The Institute of Medicine has defined health literacy as “the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions”. Health literacy is a significant social determinant of overall health and can be particularly challenging in the critical care environment. According to the U.S. Department of Health and Human Services, only 12% of adults have proficient health literacy, 53% have intermediate health literacy, 21% have basic health literacy ability, and 14% have below basic health literacy (, 2008).

METHODS: A pre- and post-intervention survey of satisfaction with clinician communication and assessment of patient or surrogate health literacy was conducted on 67 unique patients or surrogates to evaluate the effectiveness of a single 2-week online educational program on health literacy and comprehensive communication strategies. A total of 87 clinicians at all levels completed the educational intervention including a pre- and post-intervention assessment tool and survey to assess effectiveness.

INTERVENTIONS: A questionnaire modeled after the REALM-SF and AHRQ Health Literacy Survey was used to evaluate 67 patients on their experience and satisfaction with clinician communication. Eighty-seven clinicians completed the educational intervention, which included assessment of baseline understanding of health literacy.

RESULTS: Among all patients and surrogates surveyed pre- and post-intervention there was no significant difference in level of health literacy (p>0.95). However, there was statistical evidence the intervention positively impacted patient satisfaction with clinician communication (p-0.041).

CONCLUSION: A strong relationship between patient satisfaction and health literacy was demonstrated. Educating clinicians on communication techniques can positively impact patient satisfaction. The literacy screening tool may prove useful in identifying a subset of the patient population who would benefit from enhanced communication techniques and focused health literacy interventions to bridge the gap of those most at risk for poor outcomes and increase patient satisfaction.

Included in

Nursing Commons