Health Literacy Learning Activity

Submitter Information

Author: Tammy Spencer, MS, RN
Title: Senior Instructor
Institution: University of Colorado Denver College of Nursing
Coauthors: Kathy Foss, MS, RN

Competency Category(s)
Patient-Centered Care

Learner Level(s)
Pre-Licensure ADN/Diploma, Pre-Licensure BSN

Learner Setting(s)
Classroom, Clinical Setting

Strategy Type
Case Studies

Learning Objectives

  • Provide patient-centered care with sensitivity and respect for the diversity of human experience.
  • Value seeing health care situations “through patients’eyes.”
  • Examine common barriers to active involvement of patients in their own health care processes.
  • Describe strategies to empower patients or families in all aspects of the health care process.
  • Recognize the boundaries of therapeutic relationships.

Strategy Overview

This learning activity works well with any level pre-licensure student, and is an excellent activity for a post clinical conference.  The students will need to complete the following reading before this learning activity:

Center on an Aging Society (1999)  Low health literacy skills increase annual health care expenditures by $73 billion.  Washington D.C.: Georgetown University.  Accessed on the web 10/6/08 at:

Center for Medicare Education.(2000).Considering health literacy. Issue Brief Vol. 1 No.6.

Institute for Healthcare Advancement.  (2008). Easy to use California advance health care directive. (pdf attached)  Downloaded from the web on 10/6/08 at:

Instructions for the Instructor:

This activity is to be done as a single post clinical conference experience ideally by the mid-term point in the rotation.  The students will divide into pairs and perform the role of nurse or patient in a learning activity designed to illustrate the experience of having limited language skills similar to those experienced in situations of low health literacy.  The role descriptions for the nurse and patient are attached as separate files.  Following the Learning Activity: In Another’s Shoes, discuss the questions listed below.

As part of this activity, share your own examples of forms, literature, etc. used in your organization that are written in an easy to read and easy to understand format.

An evaluation follows this exercise.  Students need to complete the evaluation and return it to you.  At the end of the rotation, please return the learning activities evaluations to the course coordinator.

Instructions for the Learning Activity:

  1. Divide students into pairs.
  2. Each student chooses one role (For example: Student A is the Nurse, Student B is the Patient)
  3. The student does not look at his/her partner’s instructions.
  4. Instruct the student to read the entire role sheet prior to starting the activity.
  5. Non-verbal communication can be used in this exercise.
  6. Students should role play for 2 – 3 minutes.

Submitted Materials

Additional Materials

Evaluation Description

Following completion of the Learning Activity, use the following questions* as a guide for clinical instructor/student discussion:

  1. Tell about your experience in your role as nurse or patient.
  2. How does this exercise correlate to the frustrations experienced by nurses trying to provide health care information to clients who have low health literacy skills or limited ESL skills?
  3. How does this exercise correlate to the frustrations experienced by patients trying to assimilate healthcare information without relying on printed materials?
  4. What other factors might play a role in a patient’s understanding of health information? (For example:  Medications that cause memory loss, sleep deprivation)
  5. What is health literacy?  How can nurses assess illiteracy and adapt approaches to patient teaching?
  6. How does low health literacy skills impact patient outcomes?
  7. What resources are available on your unit or in your organization to assist patients with low health literacy skills?
  8. Why is it important to assess patient literacy?  How does health literacy play a role in patient safety?

 * Reference:  Young, J. & Ironside, P.  Patient Teaching and Safety: Exploring Health Literacy.

An evaluation tool was used to collect student attitudes and feedback (attached document).