Reflection: a tool for change and improved health literacy

Sundy, a fourth-year student at Barts and the London School of Medicine and Dentistry, reflects on the role that health literacy plays when faced with a public health crisis.

COVID-19 has made us all stop, reflect, and change.

A recurring theme in medical school is the emphasis on reflection and how it has the power to help identify areas of improvement and active learning. This is also supported by the GMC document titled ‘Benefits of becoming a reflective practitioner’, which highlights the advantage this mentality can bring to improving ‘practice and services’ (1).

A few months before the end of my second year in medical school, placements were cancelled, lectures became virtual, and there was a compelling need to try and take an active role in helping in the effort to fight this ‘invisible enemy’. Many students volunteered as healthcare assistants, vaccinators, and with charities. I worked extra shifts in my part-time work as a counter assistant in a community pharmacy. This role provided me with a unique opportunity to have an open window and observe in real-time the evolution of the pandemic, as well as common ideas, concerns, and expectations that the public may have.

Reflecting now, two years on, my first memory is of long queues of people outside the pharmacy desperately asking for paracetamol (2,3). In early 2020, availability of this widely used drug became sparse due to the increased demand, coupled with the belief that alternatives, such as ibuprofen, were thought to be ineffective or detrimental in the context of COVID-19. Stocks of hydroxychloroquine, dubbed the promising treatment for the virus, were also being stacked and stored, with individuals trying to obtain a private script from doctors. Beyond this, people were asking for vitamins they had seen online that could boost their immune response (3).

As we learnt more about the virus, key preventative measures were enforced by the government: face coverings, hand sanitiser, social distancing, lockdowns, vaccinations, lateral flow tests, PCR tests, fit to travel tests (2). These concepts and items quickly became protagonists in our lives. Understandably, there were many questions regarding fair and equal access to these resources, as well as understanding their relevance and how to utilise them effectively. This made me reflect on how difficult it was for all of us to readily become acquainted with new information in order to slow the burden of the virus. It also made me contemplate the role of health literacy and its variability in different communities, as there are diverse barriers which exist in terms of facilitating compliance with healthcare related information, such as socioeconomic status, literacy level, language barriers, disability and access to care (4,5).

"...there are diverse barriers which exist in terms of facilitating compliance with healthcare related information"

Championing the power of reflection to understand gaps in the knowledge of healthcare professionals and the public is essential. The adversity of the pandemic has humbled us all, and reminded us of the strength, resilience, and solidarity it takes to navigate through uncertainty. I believe it has taught me to become a reflective medical student and empowered me to become a future doctor who advocates and champions for improved access, understanding and utility of health information. By taking the time to stop and reflect, we can encourage change for the future, empower patients, and facilitate positive change in health behaviour to optimise health and quality of life for patients.

About the Author

Kyriaki-Barbara (Sundy) Papalois

Fourth year medical student at Barts and the London School of Medicine and Dentistry

References

GMC. The reflective practitioner - guidance for doctors and medical students. GMC; 2022 p. 1-14. [accessed 28 Dec 2021] Available from: https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/reflective-practice/the-reflective-practitioner---guidance-for-doctors-and-medical-students
Ciotti M, Ciccozzi M, Terrinoni A, Jiang WC, Wang CB, Bernardini S. The COVID-19 pandemic. Critical reviews in clinical laboratory sciences. 2020 Aug 17;57(6):365-88.
Romano S, Galante H, Figueira D, Mendes Z, Rodrigues AT. Time-trend analysis of medicine sales and shortages during COVID-19 outbreak: Data from community pharmacies. Research in Social and Administrative Pharmacy. 2021 Jan 1;17(1):1876-81.
Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health promotion international. 2000 Sep 1;15(3):259-67.
Paakkari L, Okan O. COVID-19: health literacy is an underestimated problem. The Lancet. Public Health. 2020 May;5(5):e249.