• Author
    Laura Solano
  • Discovery PI

    Kenechukwu Ojukwu MD MS MPP

  • Project Co-Author

    Somtochukwu Uzoka BS, Michele Mitchell BS MS PMP

  • Abstract Title

    Improving Patient Understanding of Pathology Reports: A PDSA QI Approach to Enhancing an Educational Tool for Health Literacy and Diagnostic Communication

  • Discovery AOC Petal or Dual Degree Program

    Healthcare Improvement & Health Equity Research

  • Abstract

    Background:

    Clear communication of pathology cancer diagnoses directly impacts health literacy and patient outcomes. With input from primary care, dermatopathology, and patient advocates, we developed a patient-centered brochure to enhance skin cancer diagnostic communication in primary care. Pilot testing with medical students enabled iterative refinement using a Plan-Do-Study-Act (PDSA) framework, centering early stakeholder-informed design.

    Objective:

    To use rapid-cycle pilot testing with medical students to refine a survey evaluating a health literacy tool and assess baseline preparedness for pathology communication.

    Methods:

    We conducted a multi-phase quality improvement pilot study. In Phase 1, a REDCap survey was administered to 57 medical students (MS1–MS4) over 5 days following review of the brochure. Outcomes included confidence in communicating pathology results, perceived training adequacy, and tool usability. Likert responses were summarized using medians/IQR and descriptive statistics; subgroup comparisons were performed using independent t-tests. Open-ended responses underwent thematic analysis to identify barriers and inform iterative refinement prior to expansion to primary care providers.

    Results:

    Baseline preparedness for pathology communication was low, including confidence in discussing results (2 [IQR 1–2]) and training adequacy (2 [2–3]). Confidence increased with training (MS1 1.47 vs MS2+ 2.08, p=0.009) but remained limited. Prior dermatology/pathology exposure trended toward higher confidence (2.33 vs 1.75, p≈0.055).

    The brochure demonstrated high acceptability (mean ~4.1/5), including navigation (4.18) and support for patient-centered communication (4.22). Qualitative findings highlighted readability, patient empowerment, and the “Questions to Ask” section, with suggestions for improved visuals and digital integration.

    Conclusions:

    This PDSA pilot demonstrates low trainee preparedness for pathology communication, highlighting a gap in diagnostic communication training. A simple, patient-centered educational tool was highly accepted and perceived as clinically useful, suggesting that scalable, health literacy–informed interventions may improve diagnostic communication. Ongoing work will evaluate implementation in primary care and integration into clinical workflows to enhance patient understanding.

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