Health Literacy, Michelle Obama,  and  Dictionary Based Electronic Learning

by Robert Oliphant - May 22, 2009
Columnist EducationNews.org

Call it change or reform, will our new health care system actually have an impact upon how Americans think about their bodies?  By way of a yes we can cite Michelle Obama’s current involvement with the Health Literacy Foundation, along with the Obama administration’s praise of the Kaiser Permanente HMO, whose web site offers its 10 million members a health literacy glossary comprising 2,000 largely Graeco-Latinate medical terms and over 6,000 separate word-definition combinations..

But does the Health Literacy Foundation actually expect American health care consumers to learn medical jawbreakers like “cardiovascular” from wildly variable glossaries like those of Kaiser, University of Maryland, and others?  By way of a practical alternative, let’s look at how this goal can be reached via the online Random House Unabridged Dictionary at dictionary.com.

The Scripps testing format. . . . As far as testing formats go, our Scripps national spelling definition-based format is ideal, e.g. “Please spell the 14-letter medical term defined as ‘/kahr'dee oh vas"kyeuh leuhr/, adj. Anat. of, pertaining to, or affecting the heart and blood vessels.  As a practical step, this question format can also be translated into a multiple-choice “A-E-I-O-none of these” format asking for the target’s second vowel letter. 

This testing format fits beautifully with full service dictionaries like RHU, which can produce study lists for different medical fields of different sizes with different levels of difficulty.  Using the WordGenius download of RHU, anyone, repeat anyone, searching for single-definition 14-letter terms in the subject field of “anatomy” (anat.) will quickly produce a 12-term study list as a first stage introduction to how our medical vocabulary works as a system. 

And it IS a system according to Steadman’s Medical Dictionary (107,000 entries), which notes that 80% of those entries draw from a construction pool of only 1,200 Graeco-Latinate word elements.

Memory friendliness. . . . But the most valuable feature of authoritative full-service dictionaries is the memory-friendliness of their entries for daunting entries like CARDIOVASCULAR. Pronunciation (transcription and audio), part of speech, subject field, definition, date of entry into the language, and click access to cross references — this range of memory clues offers each learner far more potential “stickiness” than skimpy learn-by-rote glossary definitions which are bound to vary from one HMO to another.

Granted the desirability of health literacy, using a full service electronic dictionary like Random House Unabridged will free individual HMOs from reinventing their own lexicographical wheels.  All they need is to decide which RHU terms to list and what kind of personal best learning-testing program to offer their members (websites are cheapest).

Personal best self confidence. . . . For both HMOs and their individual members, the central advantage of dictionary based electronic learning and testing can be summed up in one phrase: Self Confidence.  Although HMO physicians have for years wisely advised many of their patients to lose weight and to exercise, and although patients themselves usually promise to follow this advice, HMO records clearly indicate that overall very few pounds come off and very few bikes get ridden, largely because patients themselves lack confidence in their ability to choose a diet-exercise regimen, stick with it, and produce measurably satisfactory results.

If, as I’ve argued here, the lack of personal best self confidence plays a major role in the current persistence of low levels of patient compliance, then I believe American HMOs and medical leaders have good reason to take health literacy and Michelle Obama’s Health Literacy Foundation very seriously as a step toward transforming our present medical-services consumption industry into an interactive health improvement partnership between patients and practitioners. 

The potential success of this partnership requires us to distinguish between “in your face” information and “in your mind” information.  Right now the health literacy movement, like many worthy causes, is in its in-your-face “good idea” stage.  Let’s hope it moves into a confidence builder in-your-mind slot for many of us, especially the thousands of fiftyish Americans yearning for some personal confidence magic that will help them lose twenty pounds — without drugs.