Integrating Health Literacy and Cultural Competency Concepts Across the Doctor of Pharmacy Curriculum.

Objective. To determine the longitudinal impact of integrating health literacy and cultural competency content throughout the professional pharmacy curriculum and the impact of additional changes made to the curriculum based on the results of a longitudinal analysis. Methods. Health literacy and cultural competency concepts were integrated throughout a four-year professional pharmacy curriculum. A cohort of students were assessed using health literacy and cultural competency survey instruments at baseline, the end of the fall semester of the first professional (P1) year, and the end of each subsequent academic year. From the four-year assessment, a need for additional reinforcement in the spring P1 semester was identified, so a health literacy activity was incorporated into an introductory pharmacy practice experience (IPPE) for two cohorts of students. The outcomes were compared to those of a single cohort of students who had completed their P1 year prior to integration of the additional content. A health literacy survey instrument was given at the beginning and after completion of the semester to assess change. Preceptors also completed a brief survey. Results. Curricular integration improved health literacy and cultural competency attitudes and self-perceived ability in P1 students, as assessed by the instruments. However, declines in students' health literacy and cultural competency were identified when the students were retested in the spring semester. After implementing the health literacy IPPE activity, the health literacy scores of P1 students in the two subsequent years improved. Preceptors also gave positive feedback on the utility of this activity. Conclusion. Integrating health literacy and cultural competency content throughout the curriculum resulted in improvement in students' scores in these areas from the first to the fourth professional year, but when there were no integrated activities, scores dropped. Implementing additional activities improved student-perceived HL skills. Thus, it may be important to ensure there is inclusion of content in each semester of the curriculum to maximize effects.