Today, I want to try to answer a question I got asked a week ago: “How do we talk about numbers with our patients?” It’s a big question, and I’m so happy to dig into it with you today. What I’m going to share I hope can inform how you’re already talking about numbers, maybe give you some new options, and maybe even reduce some stress in the process.
Hi everybody, this is 10 Minutes to Better Patient Communication from Health Communication Partners. Since 2017, we’ve been giving you inspiration and strategies to improve engagement, experience, and satisfaction. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator specializing in communication and education. This podcast digs into what we often take for granted about communication in our professional lives, especially in healthcare and public health, and increasingly across sectors because communication touches everything. We’re here to learn, get inspired, and most importantly, make the difference we got into our work to make.
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This is a question about numbers. And numbers in healthcare are everywhere. They are in medications, they’re in treatment plans, they’re in a lot of health decision-making. This is where people are having to interpret evidence and some probability in order to make some important decision about their lives. This kind of health information that you’re trying to share also involves complex numbers and calculation and reasoning on patients’ parts. So if this is your realm, I’m talking to you today.
I understand the situations that you’re in are often high stakes and complex. The decisions that people have to make are highly consequential to their lives, and sometimes other people’s lives too. Sometimes these are permanent decisions, irreversible. And what I hear is how carefully you are thinking about these, and how much you are considering, in wanting to support patient’s decision making. You definitely are consulting the research. You know there’s journal upon journal dedicated to these topics, communication around clinical trials, decision making, risk assessment, patient decision aids.
So to this, I want to add something that I’m hoping will help, and it has to do with my areas of expertise. Which are: how people learn, and then a part of the literacy field that I haven’t gotten to talk directly about in all eight years of doing this series, and that’s numeracy. So I want to tell you something about learning, and then something about numeracy as my way of answering this question.
Now, first of all, about learning. People learn well when the new is built on the known. Another way of saying that is that if we start with the familiar, we can then show connections to what’s unfamiliar. And that’s what I want to help you with. Because you want to be effective in communicating and educating patients, because you want patients to be able to make informed decisions and have the best outcomes possible.
The question I was asked was about, how do we talk about numbers? And that itself is a pretty broad question. It falls into the realm of numeracy, where I come from, and numeracy, quick overview. It’s maybe less about “Can you add, subtract, multiply, and divide,” and more, “How do you work with quantities? Like, how do you make sense of what’s quantifiable in life?”
All of us have and do numeracy every day, but of different kinds. The model of numeracy I’m working with, it sees numeracy as sets of practices that are context-specific. And it might help to think about the fact that we all draw on formal numeracy practices, and informal numeracy practices.
Without getting into the weeds, here’s the difference between the two of them. The formal one you could call school-based numeracy. That’s anything you had to learn in school, like the addition and subtraction all the way through to graduate level courses in STEM fields. If you’re a scientist, you were trained to interpret data statistically and clinically, as part of your work.
Then there’s the informal everyday numeracies that we all do. These are context-specific practices. But they also involve comparisons, proportions, and uncertainty, and other forms of mathematic reasoning involving history and other people. There’s likely to be endless variations of these kinds of processes. They are mathematically sophisticated. And we do them routinely, without really realizing how sophisticated they are, because they’re a part of our everyday lives. So we’ve all got these informal and formal numeracies. And I’m guessing that what you probably are wanting to talk to patients about might fall in the formal numeracies category.
Going back to what I said about connecting the new to the known, when you want to teach about numbers, you would want to start with what’s already known to the patient, the familiar. What does your patient know, and have, and understand, and do with numeracy? Then you would want to show some relationships to what you have, the new or unfamiliar information or concepts that you’re sharing.
Unfortunately, we don’t get to hear too much about what patients are already doing with numeracy in the literature. We’re more likely to see statistics like “only 1 in 8 are proficient in numeracy,” something like that. We don’t get to hear too much about what people are already doing with numbers. But I want to help you be as effective as you can with your patients, and be able to use this very powerful teaching and learning approach, connecting the new to the known. So I’m drawing on some numeracy research and from learning sciences to share with you a quick sampling of some ways of working with numbers and numeracy that might be familiar to your patients.
I’m going to share five everyday domains just to start with. This is definitely not an exhaustive list. First of all, food and cooking. We’re headed into the holidays. So put your thinking cap on in terms of how much math and science is involved in shopping, meal planning, and budgeting, ingredient substitution, and actual cooking. So much math and science there.
Commerce and personal finance. Again, so many possible examples here. It’s a world of math. You’ve got personal or household finance, budgeting, saving, loans, investing, insurance, debt, maybe even running a small business, evaluating what sales to take advantage of and not, right?
Another domain: the weather! Deciding whether to bring an umbrella or reschedule an outdoor activity based on the forecast and your past experience with forecasts.
Another one, sports. Oh my gosh, so much math and science involved with playing sports, and also with watching sports. I think as fans, we intuitively use probability and a risk assessment because we also understand the power of momentum.
And the one I want to end with is one that kind of surprised me when I got into it. Wow, this is really complex! There’s an awful lot here in the world of travel and transportation. So travel meaning, getting around, and transportation, however you get around, whether it’s bike, car, walking, public transportation. There’s so many different calculations. This may be one of the most complex things we do on an everyday basis, just because of the number of variables. Everybody else out there is one of the biggest variables. The time of day is a big variable, and just the sheer number of paths we could take. There’s enormously complex calculations going on here.
So I want to invite you to kind of start thinking in these directions about everyday numeracy practices that are really pretty complex mathematically, not just skills-based, but also reasoning, estimating, and being able to measure proportions and make calculations. On an everyday basis, we don’t recognize this all the time.
I have a chart in the show notes that breaks down different numeracy practices, and some of the health scenarios that they might map well onto. The show notes to this episode and every episode are available on healthcommunicationpartners.com.
| Numeracy practices | Possible Health Context |
| Reading numbers, units, and time | Medication schedules, dosage labels |
| Proportions, percentages, conversions | Lab values, risk statements (“1 in 200”) |
| Probabilities, trade-offs, expected values | Weighing treatment risks and benefits |
| Interpreting uncertainty, trend data, cumulative risk | Clinical trials, lifestyle risk management |
How can you fold this into how you are already educating about numbers?
First of all, if you aren’t already, let your patient know, yeah you recognize there’s complex calculations involved, but there’s parallels to some complex calculations that people do every day.
- I’ve just shared with you some common domains and a bit of food for thought. But hey, jump on AI, describe the kinds of numbers or numeracy situations you talk about, and ask it to generate some common everyday tasks that use similar mathematical reasoning.
- Offer a few of these examples to your patient. Ask if they’re familiar with any of them, or if it gets ideas going with them.
- And then explain the everyday example and offer what you see as the parallel to your topic.
I’m inviting you to ask about, and make use of, patient’s own existing, informal numeracy practices. Because starting where they’re at is going to be more likely to facilitate their learning of your new numeracies. If you’d like more help with us, get in touch. Visit healthcommunicationpartners.com and click on contact. And while you’re there, sign up for our newsletter! This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel, additional music from Alexis Rounds. Thanks for listening to 10 minutes to better patient communication from Health Communication Partners LLC. Find us at health communication partners .com.