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I agree with Gerd Gigerenzer's stated aim of increasing the health literacy of people so that they can make informed decisions about participation in screening programmes (BMJ2015;350:h2175).
At Keele School of Medicine, we have a five day course on clinical reasoning which includes training fourth year students in communicating with patients about risk. Two days of this course specifically address this issue, using simulated patients so that the students can practice in a safe environment. The intention is that they develop the skills needed to achieve shared decision making.
One session involves a scenario where an asymptomatic 63 year old man asks for a prostate specific antigen test and the students must interpret and 'translate' information about the test (its sensitivity, specificity and predictive values) and data about outcomes in order to complete the consultation with the patient. We hope that the students will carry the skills learned from this course forwards into their clinical practice, but I suspect that the pressures that they will face will make it difficult to implement them. A national paradigm shift sounds just the thing.
No competing interests
10 May 2015
Keele University School of Medicine
David Weatherall Building , Keele University, Staffordshire, ST5 5BG