Table 1.

Outline of the health literacy-medical consultation skills (MCS) training-intervention.

Overview of Sessions	Learning Outcomes on Health Literacy Competencies
1.Introduction lecture (1 h). Outline of Health Literacy MCS training	Distinguish health literacy levels among people. -Define functional, communicative, and critical health literacy skills. -Describe the impact and frequency of problems related to health literacy. -Define methods to examine health literacy levels.
2.Diagnostic consultation (2 h) Announce diagnosis and provide understandable information connected to care request. Informing and anticipating of emotions and questions.	Demonstrate skills to enhance functional health literacy: -Asking open and easy questions to facilitate gathering of information. -Be able to examine the level of health literacy. -Prioritize and provide information to patients that matches with their acquired health literacy skills. -Use plain language, with avoidance of jargon.
	-Acknowledge emotions, concerns, and feelings of shame. -Encourage patients to ask questions. -Use teach-back to check patients’ comprehension and insight into the diagnosis and reteach information if needed.
3.Treatment consultation (2 h). Advise on treatment options and provide understandable information. Deliberate pros and cons of treatment options.	Demonstrate skills to address interactive health literacy: -Stimulate patients to take part in shared decision-making. -Teach patients to express their concerns and ask their questions. -Clarify treatment possibilities: check prior knowledge, give brief, understandable information on treatment, and discuss harms and benefits.
	-Facilitate patient to consider pros and cons in decisions. -Offer support to explore individual considerations.
4.Closing consultation (2 h). Clear instructions on treatment Closing, arrange of follow-up and end consultation.	Demonstrate skills to address critical health literacy: -Discuss strategies to prepare for self-management. -Incorporate patients’ perspectives to enable self-management; -Investigate if patients are willing to adapt their behaviour and obstacles to treatment adherence: formulate personal goals. -Give easy-to-understand instructions that match with previous knowledge. -Strengthen self-efficacy of people.
	-Use teach-back to check patients’ comprehension and insight into the medical treatment and reteach if needed. -Discuss the process for follow-up related to checking of self-care and repeating instructions on medical treatment. -Investigate need and possibilities for aid provided by from social networks or professionals.
5.Integration of consultation skills (2 h)	Demonstrate and evaluate own use of communication skills to address health literacy.
6.Summative oral assessment of consultation skills (2 h).	Demonstrate and evaluate own use of communication skills to address health literacy.