Dental students’ self-efficacy and intention to use clear communication techniques that support individuals with low health literacy

Objectives Clear and effective communication is critical to delivering quality dental care to all patients, especially those who have low health literacy. There is limited information about U.S. dental students’ exposure to communication techniques shown to improve patient understanding. Our primary objective was to assess rising fourth-year dental students’ knowledge, understanding, skills, self-efficacy, and behavioral intention to use communication techniques such as speaking slowly, using simple language and practicing the teach-back method. We also inquired about whether their dental curricula provided education about and evaluated them on the communication techniques. Methods This 2018 national cross-sectional study used a 34-item online survey to assess fourth-year dental students’ behavioral capability, self-efficacy and behavioral intention related to 17 communication techniques. The survey link was sent to 6,061 students; 242 finished it. Statistical analyses included descriptive statistics; ANOVA to examine associations between demographic variables and behavioral intention; and logistic regression to analyze associations between the predictor variables behavioral capability and self-efficacy and the dependent variable behavioral intention. The level of significance was set at p<0.05 for all analyses. Results Over 90 percent of students reported having the knowledge and skills to speak slowly, use simple language and teach-back, but they had lower self-efficacy and intention to use these techniques. They also were less knowledgeable, less confident and had lower intention to use other techniques. Students who reported higher self-efficacy were 9.2 times as likely to report higher behavioral intention to use the techniques than those who reported lower self-efficacy, 95% CI (4.10, 16.96), p<.01. Conclusions Our results indicate some dental students need additional education and training to increase their knowledge, skills, self-efficacy and behavioral intention related to plain language communication skills. It is possible that communication concepts are introduced in dental school but are not mastered at a level sufficient to be used in practice.