Health literacy competencies among future healthcare providers: a cross-sectional study of preclinical medical students using TSOY-32

Abstract Background Health literacy is essential for effective physician–patient communication and high-quality healthcare delivery. However, the extent to which future physicians possess these competencies during the early stages of medical training remains insufficiently understood. This study aimed to assess health literacy levels among preclinical medical students using the Turkish Health Literacy Scale-32 (TSOY-32) and to examine differences according to academic year. Methods This cross-sectional study was conducted among preclinical medical students (Year 1–3) at Gaziantep University Faculty of Medicine during the 2025–2026 academic year. Health literacy was assessed using the TSOY-32, which provides an overall health literacy index as well as domain- and competence-specific indices. Group comparisons were performed using one-way analysis of variance and chi-square tests. Pearson correlation analyses and multivariable linear regression analyses were performed to evaluate whether academic year was independently associated with overall health literacy after adjustment for sex and body mass index. Sensitivity analyses including age were conducted to assess the robustness of the findings. Results A total of 305 students were included. According to the TSOY-32 Overall Health Literacy Index, 74.4% of participants were classified as having inadequate or problematic/limited health literacy. Mean overall health literacy scores differed between academic-year groups (Year 1: 28.51 ± 6.13; Year 2: 28.81 ± 5.82; Year 3: 30.74 ± 6.72; p = 0.036), with a small effect size (η² = 0.022). Between-group differences were most apparent for appraisal- and application-related indices. In multivariable analysis adjusted for sex and body mass index, third-year students scored 2.24 points higher than first-year students on the TSOY-32 index (95% CI: 0.47–4.01; p = 0.013); however, the model explained only a small proportion of score variability (adjusted R² = 0.022). Conclusions A high proportion of students demonstrated suboptimal health literacy (inadequate or problematic/limited). Although third-year students had statistically higher health literacy scores than first-year students, the small effect size and low explained variance indicate that academic year had limited explanatory value. These findings should therefore be interpreted as modest between-group differences rather than evidence of longitudinal progression. As the present study did not directly assess curricular content or educational interventions, these findings are descriptive in nature; whether structured or competency-based educational approaches would improve health literacy in this population remains a hypothesis to be tested in future interventional research.