Identifying Strengths and Weaknesses in Health Literacy among Medical Students: A Systematic Review

识别医学生健康素养的优势和劣势:一项系统性综述

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Abstract

BACKGROUND: Limited health literacy is a global public health concern linked with increased healthcare expenses and poor health outcomes. Health literacy (HL) is crucial for medical students as patients and future medical practitioners. This systematic review aims to provide a global understanding of the state of HL among medical students, identify strengths and weaknesses across HL domains, and determine different variables associated with HL. METHODS: A systematic literature search was conducted using the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42024608968. The CINAHL, PubMed, Scopus, Medline, and Web of Science were searched for cross-sectional studies that reported the HL of medical students from 2013 to February 2025. The AXIS tool was used to assess the quality of the included studies. The results are presented using narrative analysis. RESULTS: Thirteen studies met the inclusion criteria. These studies collectively included 3,647 medical students, approximately 44% female and 29% male. Different HL assessment tools were used, resulting in variations in the findings. Medical students demonstrated proficiency in locating and comprehending health information but faced challenges in managing their own health, feeling understood and supported by healthcare providers, and appraising health information. Symptoms of depression, social support, and the amount of time spent using the internet were associated with HL. All studies included revealed a very low risk of bias. CONCLUSION: The health literacy of medical students ranged from moderate to high. The strengths identified both in the general context and in the digital context were finding and understanding health information. However, areas needing improvement were identified in its practical application, particularly in self-management and critical appraisal of health information. These findings indicate the potential benefit of incorporating targeted health literacy training into medical education to enhance critical thinking, practical application, and communication skills in support of patient-centered care.

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