Novtny et al.

The Patient Decision Aid as a Pedagogical Tool: Exigencies between RHM and the Health Professions

Maria Novotny, William F. Hart-Davidson & Dawn S. Opel

Date posted: January 2022

This article focuses on the patient’s decision aid as a pedagogical tool that embraces the technological and multimodal changes in health and medicine. Novotny, Hart-Davidson & Opel make the case that patient decision aids can be understood as a multimodal tool which guides shared decision-making practices. Within a classroom setting, and in thinking of a decision aid as a genre, this tool prompts students to engage in a series of writing modalities as well as the application of user experience and design. This model also helps students learn about the importance of health literacy, how public health information is communicated as well as trusted, and the intersecting impact of public health policy on marginalized communities. To demonstrate this point, this article shares examples of student-created decision aids, particularly in the context of COVID-19. Novotny, Hart-Davidson & Opel’s article works to make transparent connections in writing and rhetoric classrooms, offering the decision aid as an assignment that links humanities-based students with broader healthcare industries.

Topic: patient decision aid, healthcare writing, multimodal composition, health literacy

Online supplemental material for article only.

Syllabus Example

Read below or download here.

ENG 430: Advanced Writing Workshop “Composing Information to Guide Health Decisions”

Dr. Maria Novotny
3 credit undergraduate course
Virtual, synchronous
Spring 2021

course description

This section of English 430 will focus on advanced writing practices related to the health professions, broadly, and more specifically the moments when patients encounter health writing. As students living in a global pandemic, who are consumers of health, this class will introduce you to the multiple genres that construct and shape how we consume, understand, and rely on written health information to make health-based decisions as patients. This past decade, the healthcare industry has undergone a transformation with where, how, and why writing happens. For example, what health and medical professions conceive of as
“documentation” or “charting” IS writing, even though practitioners call it by another name. And the technologies by which such writing is happening is also changing – drastically. Additionally, most writing in healthcare settings is now also multimodal, incorporating textual, digital, visual, and aural content (telehealth, m- and e-health, etc.). Multimodal composition is another area where writing studies and the English major, broadly, has much to offer the health and medical professions. A such, this course operates on the assumption that English students, with writing preparation, can serve as critical contributors to how and for whom health information is made available and is understood. Students in the class will read, discuss, and consider the rhetorical situation of when, who, and how writing is used in healthcare. The semester culminates with students working in groups creating a multimodal deliverable that encapsulates a particular writing practice — the health decision aid (DA). DAs are frequently used in the clinic to address issues of power and health literacy when a patient is confronted with a healthcare decision. This class considers the writer and rhetorician behind the DA – how the DA is created, what content is included, and why it is used. The DA will act then as a capstone project in this course, emphasizing how its genre prompts students to engage in a series of writing modalities – visuals, narrative, texts – as well the application of user experience and design.

course goals

course texts

Assignment 2: Health Information Presentation (10 pts)

Assignment 4: The Patient Narrative (20 pts)

Assignment 5: Health Decision Aid Document (40 pts)

grading criteria

As a course focused on advanced writing practices and supportive of drafting and learning how to effectively revise pieces of writing and design work, I’ve elected to grade all assignments as either accept, revise, fail. The only way to receive a failing grade on an assignment is to not submit a draft by its deadline (or within the two-day grace period, see below). I will accept partially completed assignments, which will be given a revise grade and offer the opportunity toturn in a final draft a week from the date I return the draft to you. If you neither turn in an assignment by its deadline (or two-day grace period) nor email me to discuss an alternative due date, you will receive a ‘0’ on that assignment.

accommodations & accessibility statement

I strive to make my classes as accessible as possible. Not only will I work with you if you need accommodations, but I dedicate myself to learning all I can about inclusive teaching with the goal that all of your individual needs will be accommodate without asking prior. With that, please know that I am not perfect and may not be meeting your needs to my best ability. As such, if you have a disability/in in which you feel that you need additional accommodations, beyond what I can offer, please contact the Accessibility Resource Center at UWM.

covid-19 statement

Because we are living in a pandemic, your health and safety should always be a priority. If you need additional time to work on a reading or assignment because you are sick, please communicate that ASAP. Additionally, I understand that the pandemic may also create challenges beyond one’s health and safety, such as economic uncertainty, anxiety and childcare-related struggles (to name a few), please know that I am more than willing to provide necessary accommodations to reduce any pandemic-related challenge you may face.

course schedule

Please be advised that as the instructor, I reserve the right to revise the syllabus (including this schedule) to meet student/s or university needs. I try to act as a responsive and engaged instructor. As such, there may be moments during this semester where some readings may no longer appear applicable or useful. Therefore, when the syllabus will change. If this happens, you will be notified with ample time so as not to impact the progress of your work.

Note: There are three guiding “units” in the course that build off of each other so that you can complete the “capstone” final project.

BuzzFeed Quiz Class Activity

Read below or download here.

BuzzFeed Quiz: Structuring the Decision Aid

D. Opel

Context: After some students used survey platforms like Google forms to create portions of their PtDAs, we came to realize that the survey hid from the patient the decision tree that groups had created behind the scenes. This classroom exercise was meant to assist students to “un-blackbox” the decision.

Instruction for the Class Activity

1. Take the BuzzFeed quiz here.
2. After receiving your result, make a list of the values and preferences you hold that you believe led to that result.
3. Go back to the quiz again. Go through each question and think about how a response is connected to a value and/or preference in your list. (If the value/preference isn’t there already, add it to your list.)
4. Get in your group for the decision aid project. Compare results. Make a master list for each of the sorting hat results and the values/preferences that you each listed to accompany them. (If you are missing a particular Hogwarts House, make up some values and/or preferences that you believe connect to that House.)
5. Take your chart and use it to create a comparative chart for a person wanting to make an informed decision about a Hogwarts House. Make four columns (one for each house), and underneath, make checkboxes next to each value/preference that underlies house members.
6. Return to class–discussion:

• • What work does this comparative values/preferences chart do that the BuzzFeed quiz does not?
  • How does knowing all four options and the values that underlie them affect your decision making?
  • What can we do to add to patients’ knowledge and confidence in their decision making in our own PtDA project?

Assignment 3: Field Research Assignment Description (20 pts)

Read below or download here. 

ENG 430 | Spring 2021
M. Novotny

Individual assignment.

Description:

This assignment asks students to gather information about the writing practices of health and medicine. Specifically, this assignment asks students to conduct research and develop a report that focuses on a specific health issue (i.e. asthma or acne) or medical profession (i.e. epidemiologist or radiation therapist). After selecting a specific focus, the student will report on: the genre of health/medicine that is produced, the training that person receives to write about that topic, who their audience or stakeholders are (who consumes that information), and the challenges they face in writing that information. A works cited page will be submitted with the report along with a 1-page reflection about what was interesting, surprising, or challenging in doing this assignment.

Purpose:

To research how either a health issue (i.e. acne) is written about OR how a specific health profession (i.e. pediatric nurse) uses writing.

Steps:

1. Identify if you want to research either a health issue or a health profession and a question or two you want to guide your investigation of this issue/profession.
2. Consider where you may get information to inform your research. (AKA will you use some of the information offered on the OWL sites OR do you need to consult articles/medical society websites/etc.)
3. Develop your research plan for this assignment. For your plan, come with a one-page doc that explains: (1) what you are investigating; (2) your approach to investigate; (3) the resources you plan on consulting; (4) your rationale as to why those resources are appropriate and supportive of your investigation goals. **You’ll come to class with this on Tues. Feb 9th.
4. Gather your data. (AKA: do your plan). **This will happen on Thurs. Feb 11th when we don’t have class.
5. Bring your data to class to troubleshoot discuss what is working well, what is not, additional information you need to find. **This will happen on Tues. Feb 16th.
6. Develop a working draft of your report. ** This will happen on Thurs. Feb 18th.

Deliverables: 

(1) This report should be written as a memo and should be 3 double-spaced pages. The memo should include sub-sections that address:

a. The health issue or profession you are investigating and a guiding question or two that you are asking as you do this research.

b. The data you found (incorporating in-text discussion of some the sources you used to find that data)

c. A 500-word response to your question/s posed above. (AKA use the data you collected in part “b” of this assignment to answer the question/s you posed in part “a”.)

(2) A reference page will be submitted with the report in APA citation style.

(3) A 1-page reflection about what was interesting, surprising, or challenging in doing this assignment. You may also want to discuss and reflect if you are satisfied with the information you found and how capable you are of answering your initial guiding question/s.

Assignment 5: Health Decision Aid (40 pts)

Read below or download here.

ENG 430 | Spring 2021
M. Novotny Assignment 5: Health Decision Aid Document (40 pts) Group assignment. Description: This assignment serves as the capstone project to the course and incorporates elements of the field research assignment and patient narrative assignment in order to create a health decision aid. Health decision aids are rhetorical documents that are commonly used by physicians, physician assistants, and nurses to help communicate, inform, and guide the patient decision making process. These are highly designed and rhetorically effective documents that walk patients through a series of narratives, tools (such as quizzes and ranking systems), and information to assist patients in making the most informed decision regarding their health. Purpose: The goal of this assignment is for students: (1) to practice communicating health/medical information using clear and accessible language; (2) to explore how documents are rhetorical and that when designed well can guide patient decision making; and (3) to consider how patient narratives can be used to inform health decision-making. Creating a health decision aid requires health research around a specific decision, the gathering of a patient narrative, visual document design, and user testing. As a complex document to effectively create, this assignment is a group project and will require teamwork and communication (just as real-world health decision aids are created). Below, a Healthwise decision aid shows how a patient might review the facts to decide whether to see their doctor about acne:

Assessment of this project will include consideration of the following criteria:

Meeting the purpose of the health decision aid:

• Decision aid presents well-documented, evidence-based guidance using clear language
• Authoring team makes choices that strengthen appeals to a specific patient population (audience)
• Authoring team created effective materials that embrace concepts of shared decision-making

Producing a high-quality health decision aid:

• Narrative elements are used to construct an effective patient narrative relevant to the decision presented
• Features of explanatory medical writing/jargon are used effectively
• Decision making moves (conceptual info, options & probabilities, process & intended outcomes) are used effectively
• Visual rhetoric strategies are used effectively