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Activity Details
  • Credit Amounts:
    • CME: 1.25
    • CPE: 1.25
    • CNE: 1.00
    • CHES: 1.00
  • Cost: Free
  • Release: May 27, 2015
  • Expires: May 26, 2018
  • Estimated Time to Complete:
    1 Hour(s)  15 Minutes
  • System Requirements:
  • Average User Rating:
    (4 Ratings)


Joy Goldsmith Joy Goldsmith, PhD
Associate Professor
Department of Communication Studies
Young Harris College
Young Harris, Georgia

Sandra Ragan Sandra Ragan, PhD
Professor Emerita
Department of Communication
University of Oklahoma
Norman, Oklahoma

Elaine Wittenberg-Lyles Elaine Wittenberg-Lyles, PhD
Associate Professor
Markey Cancer Center and Department of Communication
College of Communication and Information
University of Kentucky
Lexington, Kentucky

Needs Statement

Patient/family understanding and orientation to palliative care is limited by their own health literacy, clinician health literacy, palliative care availability, their own imaginations, and the actual prognostic information they were given. Communicating the entire story of the patient’s status and the options for care– ensuring this happens in an understandable manner—is the essence of Orientation to life-limiting illness and appreciating what opportunities for treatment and care exist. Without this orientation, far less desirable decisions, choices, and opportunities will be made for the patient/family in the face of acute dying.

Health literacy and its accompanying skills can be supported and extended to patients/families by the clinicians’ efforts to orient. These skills are vital to patient and family in talking about disease progression, consuming information about the disease and its progression, interpreting diagnostic outcomes, discerning involvement in research protocols, administering or operating medical equipment, and more (Ache & Wallace, 2009; Ratzan & Parker, 2006).

In light of the difficulty of communicating prognosis or other bad news in chronic and terminal cases, and the literacy obstructions for patient/family access to same, we can begin to understand the quagmire of complexities in extracting the most appropriate treatment for a seriously/chronically ill patient.

Patient/family/clinician/team conversations should enable families to prioritize care goals and translate them into practice. But students are not trained to talk to patients and families about their goals of care. Beginning with these goals in conversation and then actuating them into a pathway of care will require a paradigm shift in physician use of time and communication (Gillick, 2009). Talk will no longer be about a ten-minute explanation for a medical intervention, but rather a 30-minute conversation about how a patient wants to live.

Innovations for communicating prognosis and treatment options need to be implemented. An incorporation of health illiteracy is essential to these innovations. Related to this, the role of accommodation theory should be considered to help clinicians to understand the various reasons why individuals emphasize or minimize the social and cultural differences between themselves and others through verbal and non-verbal communication (Gallois, et al., 1991). Thus health literacy must include the links between language, context and culture.


Ache, K., & Wallace, L. S. (2009). Are end-of-life patient education materials readable? Palliative Medicine, 23, 545-548.

Gillick, M. R. (2009). Decision making near life's end: a prescription for change. J Palliat Med, 12(2), 121-125.

Gallois, Cynthia, and Callan, Victor, J. Interethnic Accommodation: The Role of Norms. Contexts of Accommodation. Ed. Giles, Howard, Coupland, Justine, and Coupland, N. New York, NY: Cambridge University Press, 1991.

Ratzan, S., & Parker, R. (2006). Health Literacy---Identification and Response. Journal of Health Communication, 11, 713-715.

Target Audience

All health professionals especially those who practice entirely or in part within teams who treat patients in palliative care.


Upon completion of this activity, participants will be to:

  1. Define the practice of accommodation in clinical encounters.
  2. Describe the role of health literacy in clinical communication.
  3. Discuss how cultural theory connects to patient and family health literacy.
  4. Identify two communication skills that assess for health literacy and cultural diversity.


The University of Kentucky College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Kentucky College of Medicine designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The University of Kentucky College of Medicine presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

ACGME Competencies

  • Interpersonal and communication skills
  • Professionalism

ACPEThe University of Kentucky College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

This knowledge-based activity has been assigned UAN 0022-9999-15-072-H04-P and will award 1.25 contact hours (0.125 CEUs) of continuing pharmacy education credit in states that recognize ACPE providers.

Statements of participation will indicate hours and CEUs based on participation and will be issued online at the conclusion of the activity. Successful completion includes completing the activity, its accompanying evaluation and/or posttest (score 70% or higher) and requesting credit online at the conclusion of the activity. Credit will be uploaded to CPE Monitor, and participants may print a statement of credit or transcript from their NABP e-profile. The College complies with the Accreditation Standards for Continuing Pharmacy Education.

The University of Kentucky, College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC).

This educational activity is offered for a maximum of 1.00 ANCC contact hour.

The Kentucky Board of Nursing (KBN) approves The University of Kentucky, College of Nursing (UKCON) as a provider as well. ANCC and KBN approval of a continuing nursing education provider does not constitute endorsement of program content nor commercial sponsors. The University of Kentucky does not approve commercial products. This educational activity is offered for a maximum of 1.2 KBN contact hours.

Provider #: 3-0008-01-13-388. In order to receive credit, participants complete this CNE activity and submit a credit application and evaluation form online. Certificates may be printed once the evaluation is completed.

The Department of Public Health, Western Kentucky University has been designated as a Multiple Event Provider (#KY0022) of Category I continuing education contact hours in health education by the National Commission for Health Education Credentialing, Inc. This program has been reviewed and approved for up to 1.00 Category I entry level contact hour in health education for event #61026.

Faculty Disclosure

No speakers, authors, planners, reviewers or staff members have any relevant financial relationships to disclose. No other speakers or authors will discuss off-label use of a product.

Content review confirmed that the content was developed in a fair, balanced manner free from commercial bias. Disclosure of a relationship is not intended to suggest or condone commercial bias in any presentation, but it is made to provide participants with information that might be of potential importance to their evaluation of a presentation.


In collaboration with UK College of Nursing Continuing Education Office and UK Center for Interprofessional Health Education.

CE Content Concerns


Concerns or complaints related to ACPE or ACCME standards may be submitted in writing to the Director of UK HealthCare CECentral by fax to 859-323-2920, or by mail to 2365 Harrodsburg Road, Ste B475, Lexington, KY 40504


  • The Director or his/her designee will review, investigate, forward and/or respond to complaints and will put forth a best effort to adjudicate the issue(s), along with CECentral staff members, within two (2) weeks of receipt of the grievance or complaint.
  • If needed, concerns, complaints, or grievances will be brought before the UK HealthCare CECentral Advisory Board.
  • Issues regarding activity content also will be reviewed and addressed by the Activity Director.
  • A written decision will be issued in a timely manner by the Director of UK HealthCare CECentral or his/herdesignee.
  • Grievances will be considered when planning future activities.

Appeal Procedure

  • Persons who wish to appeal a decision should address the appeal by email, fax or in writing to the Director of UK HealthCare CECentral within two (2) weeks of receipt of the response.
  • The Director will bring the appeal to the UK HealthCare CECentral Advisory Board.
  • The results of the appeal will be sent to the participant no later than two (2) weeks following the meeting of the board.