Early Literacy Research Library (ELRL) - Article

Parent-Provider Paediatric Literacy Communication: A Curriculum for Future Primary Care Providers

Kindratt, T., Bernard, B., Webb, J., Pagels, P. (2019) Parent-Provider Paediatric Literacy Communication: A Curriculum for Future Primary Care Providers. Perspectives on Medical Education, 8(2), 110-117.,

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Publication year


study description

Training curriculum development, implementation, and evaluation.


Our purpose was to develop and evaluate a curriculum to improve learners’ knowledge, attitudes, and skills towards paediatric literacy concepts. We present our findings and curriculum materials for use by other training programs.


Reach Out and Read (ROR) training curriculum.

outcomes evaluated

Knowledge, attitudes, and skills related to pediatric literacy training.


Healthcare "learners" (family medicine residents, physician assistant students, medical students) from University of Texas Southwestern Medical Center.


Family medicine residents (n = 30), physician assistant students (n = 36), and medical students (n = 28) participated in a curriculum consisting of service learning, online didactic training, objective structured clinical exams (OSCEs) and a debriefing session. Standardized patients (SPs; 6 months to 5 years) and standardized patient caregivers were recruited and trained. Learners were evaluated on their abilities to offer books to patients, provide anticipatory guidance, and demonstrate parent-provider communication skills. Knowledge, attitudes, and satisfaction were collected pre- and post-curriculum.

sample size

n=30 (FM residents); n=36 (PA students); n=28 (med students); n=94 (total)


Measure of Training Outcomes: Kirkpatrick’s levels of evaluation including:

    1. reaction
    2. learning
    3. behavior

Measure of Attitudes and Knowledge: survey with 5-point Likert (attitudes) and dichotomous variables (knowledge)


Measure of Behavior: caregiver scores about learners using OSCE scoresheets based on ROR’s Milestones of Early Literacy Development Chart


Significant increases in total knowledge were observed after completing curriculum activities (p < 0.001). All attitudes improved after training (p < 0.05). All learners (100%) recommended that caregivers talk back and forth with their 6‑ to 12-month-old babies and make eye contact. Few (18.2%) learners recommended playing games like ‘peek-a-boo’ while reading. When caregivers evaluated learners’ basic parent-provider communication skills, all reported that the learners treated them with respect and used plain language.


Our curriculum extends beyond previous studies by measuring recommended books, anticipatory guidance, and communication skills using paediatric SPs and standardized patient caregivers. Curriculum activities can be tailored to best promote parent-provider literacy communication training in other programs.


A limitation was that not all learners completed all curriculum activities. Only 56.7% completed pre and post-tests. However, this response rate is higher than previous studies evaluating online survey responses [20]. Due to the complexities of residency and medical school schedules, only two residents and no medical students were able to complete the OSCE and debriefing session. OSCE stations were held on one day. Future OSCEs should be designed to better suit residency and medical student schedules. Our OSCE stations were not specifically designed for homeless patients. The focus of our stations was on patients with minimal risk for language and developmental delays. This focus was due to learners’ limited exposure to paediatric patients. Future OSCEs could be modified to address barriers experienced by underserved populations. While our curriculum was only evaluated at one institution, the supplementary materials provided can be tailored for other programs interested in paediatric literacy training, regardless of formal participation in Reach Out and Read.