Health literacy, generally defined as an individual's skill in obtaining and understanding information related to their health, has been shown to have significant impact on patient outcomes. Low health literacy is associated with higher rates of hospitalization and health care resource utilization, higher prevalence and severity of chronic disease, and worsened global measures of health including mortality. Poor health literacy is prevalent in the United States; as many as 36 percent of the population demonstrates limited health literacy. Rates are higher in certain subgroups such as the elderly, minorities, and those of low education or socioeconomic status. Given the wide prevalence and far-ranging effects on long-term health outcomes, efforts to improve health literacy nationally clearly offer significant benefits across the population. This study surveyed ambulatory patients at four clinic sites within the UCSD health care system. Patients were offered participation in the survey based on availability while waiting for clinical appointments; no compensation or other reward for participation was offered. The survey included ten different platforms or categories of online source; for each source patients were asked to rate how often they used it, their level of trust in the source, and degree to which that source ultimately impacted their health care decisions. The order that sources were listed within survey questions was varied between copies of the survey. Responses were analyzed using repeated measures ANVOA to establish the significance of variation in responses for each measure.

The University of California San Diego (UCSD) School of Medicine (SOM) is transitioning its third-year primary care curriculum from a year-long longitudinal primary care course to a three-week clerkship in Family Medicine (FM). Additionally, there is a lack of FM physicians in the US, and limited information on what factors affect students’ decisions to enter FM. The aim of this pilot study is to analyze the effects of introducing sub-specialty tracks within an FM clerkship on student attitudes towards FM. A limiting factor for students within FM clerkships is that often they are not exposed to the full spectrum of FM. The aim of the tracks is to demonstrate that there are many FM clinicians practicing what may be considered more specialized aspects of primary care, including sports, sexual and reproductive health, and lifestyle and integrative medicine. There is a pre-existing family medicine clerkship for fourth-year medical students (FPM 426), which will serve as the pilot program. Three subspecialty tracks (sports medicine, sexual and reproductive health, and lifestyle and integrative medicine) will be introduced. Students will be assigned a track based on interest. A student will not be assigned a track if they did not express interest or if there was insufficient space to accommodate. Students not assigned a track will serve as the control group for this study. At the end of the clerkship, students will be emailed an anonymous survey to complete, and time will be provided during the course to complete the survey. The post-clerkship survey will collect data on students’ experience of the clerkship and perceptions of FM. We hypothesize that students placed in the subspecialty tracks will report a better experience during their clerkship and an expanded understanding of the scope of practice of family physicians. Comparisons will be made between students within tracks and those not in a track, who will serve as the control.