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Health Literacy for Interprofessional Education (IPE) eToolkit


"Numeracy, the “ability to understand and use numbers in daily life” is an important but understudied component of literacy. Numeracy-related tasks are common in healthcare and include understanding nutrition information, interpreting blood sugar readings and other clinical data, adjusting medications, and understanding probability in risk communication. While literacy and numeracy are strongly correlated, we have identified many patients with adequate reading ability but poor numeracy skills." From: Rothman RL, Montori, VM,  Cherrington, A and Pignone, MP. Perspective: The Role of Numeracy in Health Care. J Health Commun. 2008 September; 13(6): 583–595.

Compared to other developed countries, the U.S. Dept of Education's National Center for Education Statistic's (NCES)  first published analysis of the 2012 Programme for the International Assessment of Adult Competencies (PIAAC) U.S. data on numeracy and problem solving in technology-rich environments shows abysmal results. You'll find the report here:  Goodman, M., Finnegan, R., Mohadjer, L., Krenzke, T., and Hogan, J. (2013). Literacy, Numeracy, and Problem Solving in Technology-Rich Environments Among U.S. Adults: Results from the Program for the InternationalAssessment of Adult Competencies 2012: First Look (NCES 2014-008). U.S. Department of Education. Washington, DC: National Center for Education Statistics. Retrieved [March 13, 2017] from

The information posted in this section of the eToolkit will help you understand and respond to patients with low health numeracy skills.


Numeracy and Patient Communication

Communicating Risk to Patients

Make Your Own Icon Array to Communicate Risk

Icon arrays (sometimes referred to as “pictographs”) are an evidence-based standard in medical risk communication. They are more effective than bar or pie charts at communicating risk and reducing cognitive biases in risk perceptions.

Icon arrays:
•  use a matrix of icons (usually 100 or 1000 icons) to represent an at-risk population, and display both the number of expected events and the number of expected non-events. 
•  can be read simply by counting icons. 
•  are inherently a frequency-based representation of risk. 
•  use height as a visual cue for risk.

Click here to make your own icon array with this free tool from the Risk Science Center and Center for Bioethics and Social Sciences in Medicine, University of Michigan. 

Citation: Images created by Risk Science Center and Center for Bioethics and Social Sciences in Medicine, University of Michigan. Accessed Year-Month-Date.

Short Video: Communicating Risk to Patients - Daniella Zipkin, M.D.