US Graduating Pediatric Residents’ Health Literacy Training Experiences: 2005 and 2024

Gottschlich EA, Kist TW, Kudji J, Soffer S

Presented at the 2025 Pediatric Academic Societies Annual Meeting

Background: Health literacy is a critical part of pediatric training. While more residency programs have included this curriculum, little is known about national trends in resident confidence in health literacy and in the resources available for resident use in clinic.

Objective: Examine trends in health literacy training among graduating pediatric residents by comparing survey responses in 2005 and 2024.

Methods: Health literacy training questions were asked to national random samples of US categorical pediatric residents on the 2005 (n=500) and 2024 (n=1200) AAP Annual Survey of Graduating Residents; response rates were 56% and 44%, respectively. Chi-square tests compared residents’ reports in 2005 and 2024 on familiarity with the term “health literacy” (yes, no), exposure to child literacy-promotion programs (yes, no), received formal training in 6 areas of health literacy and patient communication (yes, no for each), self-rated ability in patient communication (very good or excellent vs good, fair, or poor), and availability of patient communication resources (always vs usually, sometimes, rarely, or never).

Results: Nearly all graduating residents in 2024 (97.8%) were familiar with the term “health literacy” compared to 53.4% in 2005 (p<.001). Most residents in 2024 (92.5%) had exposure to a child literacy-promotion program such as “Reach Out and Read” compared to 80.3% in 2005 (p<.001). More residents in 2024 reported formal health literacy training for all 6 areas queried, with 89.0%-95.0% reporting training in empathetic listening skills, working with interpretation services, communicating with parents of different cultural backgrounds, and communicating health information to parents (Figure). The largest increase from 2005 to 2024 was ensuring parent understanding of information (64.3% vs 91.3%, p<.001). Residents’ self-rated patient communication abilities improved significantly for identifying that a parent has a literacy problem (46.5% vs 27.8%, p<.001; Table). Perceived availability of patient communication resources was similar in 2024 and 2005, though more residents in 2024 reported interpretation services were always available (48.1% vs 32.7%, p<.001; Table).

Conclusion: Residents graduating in 2024 were more likely than those who graduated in 2005 to report formal training in health literacy and patient communication. Despite this, fewer than half of residents in 2024 felt they were able to identify parent literacy problems. Gaps also remain in residents’ perceived availability of patient communication resources, including interpretation services.

Figure 1. Percent of Graduating Pediatric Residents Who Reported Having Formal Training in Health Literacy and Patient Communication by Survey Year

Table 1. Graduating Pediatric Residents’ Self-rated Abilities in Patient Communication and Reported Availability of Patient Communication Resources by Survey Year