The purpose of this study is to determine what knowledge and experience first semester FNP students have regarding health literacy using the Health Literacy Knowledge and Experience Survey (HL-KES) (Cormier & Kotrlik, 2009). This pilot study is expected to determine current health literacy knowledge and experience of FNP’s in the UNCW program. This will allow the development and implementation of a specific module for HL learning and the use of assessment and intervention strategies in the clinical experience. A follow up study will implement a health literacy learning module and subsequent implementation in clinical practice.
- What are the characteristics of Nurse Practitioner students
- To what extent do Family Nurse Practitioner students have health literacy Knowledge
- To what extent do family nurse practitioner students have health literacy experience?
- What is the relationship between health literacy knowledge and health literacy experience?
Methods:
This descriptive correlational study was used to assess the health literacy knowledge and experiences of first semester family nurse practitioner students. The target population for the study was family nurse practitioner students beginning their first semester in a FNP program. A convenience sample of FNP students (n = 68) who attended the program orientation was used. All attendees were invited by the researcher to participate in the study. Invitation began with a notification flyer posted in an email that was sent to all students attending the orientation. The students were also invited at the beginning of the orientation. The survey instrument, the Health Literacy Knowledge and Experience Survey (HL-KES) was made available in a separate room during the orientation day at the School of Nursing for the newly admitted FNP Students.
Results:
Research question 1 attempted to answer the question, what are the characteristics of the incoming FNP students. A total of 35 students participated in the study. Most study participants were females 83% while 17% were males. The age of participants ranged from 23 to 59. The ethnicity of the group identified as 77% Caucasian and 22% African America. All participants are employed as Registered nurses in the state.
The second research question examined the extent to which FNP students had health literacy knowledge. The results of the HL-KES found the mean to be 79.1% with a variance of 55.18 and standard deviation of 7.43. Responses showed that 56 % believed that socioeconomic status was the best predictor of healthcare status. Only 20 % knew what the functional health literacy instrument is and 45 % believed that 5-6 items was best for information and a majority did not how to activity engage learning.
The study found that although participants demonstrated that they had experience in some areas of health literacy. Sixty percent reported that health literacy was never or sometimes addressed in their nursing curriculum. Only 3- 5% responded they always participated in health literacy activities. It is also important to note that the only item on the health literacy experience scale whereby the majority of participants indicated frequent use or interaction was using written materials to provide healthcare information to individuals or community groups
The fourth research question assessed the relationship between health literacy knowledge and health literacy experience. A Pearson Correlation was performed using SPSS. The correlation reached significance at the .01 level. Results from this study demonstrated an inverse relationship between health literacy knowledge and health literacy experience. This may be due to new nurses entering the workforce with health literacy knowledge gained from their nursing curriculum but lacking health literacy experience; while nurses with many years experience health literacy experience was gained from working with low literacy patients not from their nursing curriculum.
Conclusion:
The study demonstrated FNP students have some health literacy knowledge and some health literacy experience but findings revealed significant gaps in both health literacy knowledge and experience. Most participants had health literacy knowledge in the areas of consequences associated with low health literacy and evaluation of health literacy interventions. However, a majority of participants did not have knowledge of health literacy screening or guidelines for written healthcare materials. The study also found inconsistency in levels of health literacy experience. Participants’ strongest health literacy experience was in using healthcare materials and videotapes to provide healthcare information to patients and community groups. But, there were three areas where participants exhibited less health literacy experience. They included using health literacy screening tools; evaluating the reading level of healthcare materials before using them for patient teaching, using audiotapes to provide healthcare information, and using computer software to provide health information.
Nurse Practitioners need be proficient in both identifying limited health literacy and applying appropriate interventions. Developing competencies in the NP curriculum will allow NP to increase knowledge and competencies in health literacy. Nursing educators must take a hard look at established nursing curricula to determine if they are providing nursing students with the knowledge and experiences required to provide healthcare to individuals with low health literacy skills. As FNP programs continue to grow with an estimated 224,000 FNP in practice by 2024(American Association of Nurse Practitioners, 2017) these new practitioners will be equipped with the tools to improve quality patient outcomes and meet the needs of health care organizations where they are employed.