Health literacy awareness among Canadian surgeons

Adequate health literacy is essential to navigate the healthcare system and has a major role in peri-operative care and outcomes. Minimal information exists regarding surgeons' understanding of health literacy, clinical implications, and awareness of universal measures of support. This study assessed Canadian surgeons' perceptions of patients' health literacy and their knowledge of available supportive resources. We conducted a cross-sectional study using an electronic survey distributed to surgeons at academic institutions. Data collected included sociodemographics, health literacy knowledge, and practice surrounding the use of supportive measures. Across four Canadian academic institutions (University of Toronto, McMaster University, University of Alberta, and University of Calgary), 35 surgeons from various surgical specialties, including general, plastic, and orthopedic surgery, completed the survey. Approximately 74% of surgeons reported familiarity with the concept "health literacy", but they used general impressions to estimate their patients' health literacy levels. Surgeons' perceptions were that patients who had proficient health literacy represented 50% or less of their practice. However, knowledge of supportive tools for measuring patient health literacy was variable. Surgeons familiar with health literacy spent significantly more time (>15 minutes) counselling patients (38%, p=0.02) and used language at a 10th grade level or less (92%, p=0.04). Common supportive measures included using simple, non-medical terms (97%, n=34), repetition (83%, n=29), and drawing pictures/diagrams (83%, n=29). This study highlights the importance of surgeon awareness of health literacy and how improved awareness may guide patient-surgeon interactions and improve the quality of care.