Poor Numeracy Research Articles

Nurse academics and the teaching of undergraduate nursing numeracy: A cross-sectional study of self-reported confidence and anxiety

BackgroundNumeracy and mathematics are terms that can cause anxiety, not only in students, but this emotion can also be experienced in teachers. Anxiety can inhibit teacher performance and is correlated with low self-confidence. The anxiety felt by school teachers when teaching mathematics is widely reported, however, the self-reported confidence and anxiety levels of nurse academics when teaching numeracy concepts to undergraduate nursing students has never been studied. AimTo explore and analyse Australian nurse academics' self-reported confidence and anxiety levels when teaching nursing numeracy to undergraduate nursing students. DesignCross-sectional survey. SettingAustralian universities that provide an undergraduate nursing degree leading to nursing registration. ParticipantsAustralian nurse academics employed either permanent full time or part time; casual /sessional; or on a fixed term contract, who teach nursing numeracy and medication calculations to undergraduate nursing students. MethodsA combination of convenience and purposive sampling was used to recruit Australian nurse academics (n = 170). Data were collected between Nov 2023 and Feb 2024 using an online survey platform. ResultsAlmost 50 % of participants self-reported feeling either not confident or somewhat confident and very or somewhat anxious when teaching nursing numeracy. There were no significant differences in overall confidence and anxiety based on demographic variables, indicating this is a widespread issue. A non-significant trend towards level A academics experiencing higher anxiety and less confidence was noted. ConclusionsA significant proportion of students are being taught nursing numeracy by nurse academics who lack confidence and experience anxiety, which can be transferred to students, affecting learning and performance. The downstream consequences are potentially poor numeracy skills in students and compromised patient safety. Strategies that have been effective in reducing school teachers' anxiety could be used to support nurse academics.

Training & Community Involvement for Remote Housing Projects in Australia Northern Territory

Abstract—Construction of houses in remote communities faces a range of challenges, many of which would be reduced by the involvement of local community members during the construction. Remote housing demand is high and under-resourcing in existing houses impacts on the health of the occupants. This research investigates and evaluates ways to improve community engagement in remote housing projects. Builders with experience delivering remote housing projects were asked to provide insight relating to the potential training and involvement of community members during construction. It was found that builders have major challenges with work ethics, poor numeracy and literacy and language barrier in remote areas which hinder community engagement in remote projects. Some building techniques such as slab on ground and steel wall framing were found more effective for community engagement. Results also show that training of community members could be improved by setting benchmark goals to be achieved throughout a project. This means there is an opportunity for housing projects in remote communities to improve on essential training and employment through better involvement of local community members during construction, in turn this will lead to better maintenance and understanding of houses.

Assessing the Numeracy Gaps among Junior High School Students through Project PEMDAS

This study sought to understand and address the numeracy challenges faced by Junior High School students at Kapayapaan Integrated School. The goal was to develop and implement effective interventions to improve basic arithmetic skills. A comprehensive assessment of all 2,303 Junior High School students enrolled in the 2022-2023 school year revealed a concerning reality. An overwhelming majority of students, approximately 86%, exhibited poor numeracy skills. This finding underscores a significant gap in foundational mathematical knowledge. While a small group excelled, the urgent need for targeted support to strengthen the arithmetic abilities of the majority of students was evident. To bridge this numeracy gap, teachers employed a diverse range of instructional strategies focused on strengthening the four fundamental arithmetic operations: addition, subtraction, multiplication, and division. The positive impact of these interventions is reflected in the posttest results, which showed a dramatic improvement in numeracy levels. The percentage of students demonstrating high numeracy skills increased significantly to 63%, while the number of students with below-numerate levels dropped to just 1%. These findings highlight the effectiveness of the Project PEMDAS in enhancing students’ mathematical proficiency. The study’s outcomes provide valuable insights for developing an action plan to sustain and expand these improvements, ensuring that all students at Kapayapaan Integrated School have a solid foundation in numeracy.

Meningkatkan Hasil Belajar PAKat dan Gotong Royong Melalui Model PBL Fase A SD Negeri 04 Ngarak

Researchers found that SDN 04 Ngarak students had poor literacy and numeracy skills. Students with conditions like this tend not to be motivated to learn, therefore researchers apply one of the learning models, namely Problem-based learning. This research was conducted to (1) improve mutual cooperation through the PBL model in grade II A SDN 04 Ngarak students, (2) improve learning outcomes through the PBL model in grade II A SDN 04 Ngarak students, (3) improve learning completeness through the PBL model in grade II A SDN 04 Ngarak students. This study is a classroom action research consisting of four steps that must be carried out in each cycle. The four steps are (1) planning; (2) implementation; (3) observations; (4) reflection. The subjects of this study were 21 students. Data collection techniques in this study used tests, observation and documentation. Data analysis techniques use descriptive analysis and are explained with graphs and tables. The result of this study is that in cycle I, cognitive test results showed 29% proficient, 14% proficient, 43% viable, and 14% newly developed. The target teachers are 50% proficient, 45% proficient, 5% feasible, and 0% newly developed. In cycle II, there was a significant increase with 71% of participants in the advanced category and 29% proficient. This result exceeds the target of cycle II, which is 70% proficient and 30% proficient. Feasible and newly developed to reach 0%, in accordance with the target. With PBL, there is an improvement in learner learning outcomes, validating the effectiveness of the model in achieving learning objectives.

PROFILE OF STUDENTS' NUMERACY LITERACY ABILITY AND SELF EFFICACY IN MATHEMATICS LEARNING

This study aims to describe the ability of numeracy literacy and mathematical self-efficacy of students in learning mathematics. This research is a descriptive study with a quantitative approach conducted at SMPN 34. The research instruments used are numeracy literacy test questions and self-efficacy questionnaires that have met the criteria for good instrument feasibility. The data analysis technique used is Descriptive Analysis. The results showed that overall the numeracy literacy skills of the students included in the criteria were not good. There are 73.30% or 20 people of the total number of students who have not been able to solve the numeracy literacy test questions correctly. Furthermore, the overall mathematical self-efficacy of students is included in the moderate criteria with a percentage of 70% or 21 students. Next for numeracy literacy skills in terms of mathematical self-efficacy (high, medium, and low), each has different numeracy literacy skills. Students whose self-efficacy is high, have good numeracy literacy skills, while students whose self-efficacy is moderate and low, have poor numeracy literacy skills. From the results of this study, it is necessary to research to improve the numeracy literacy skills and mathematical self-efficacy of students at SMPN 34 Pekanbaru.

Numeracy skills learning of children in Africa:-Are disabled children lagging behind?

Significant progress has been achieved in universal basic education in African countries since the late 1990s. This study provides empirical evidence on the within- and across-country variation in numeracy skills performance among children based on nationally representative data from eight African countries (DR Congo, The Gambia, Ghana, Lesotho, Sierra Leone, Togo, Tunisia, and Zimbabwe). We assess whether and to what extent children with disabilities lag in numeracy skills and how much it depends on their type of disabilities. More specifically, we explore whether disabled children benefit equally from better school system quality. The assessment is analysed as a natural experiment using the performance of non-disabled children as a benchmark and considering the different types of disabilities as random treatments. We first evaluate the variation in average numeracy skills in the eight African countries. They can roughly be divided into low- and high-numeracy countries. We apply Instrumental Variable (IV) methods to control the endogeneity of completed school years when assessing subjects' school performance and heterogeneous disability effects. Children with vision and hearing disabilities are not especially challenged in numeracy skills performance. The low numeracy skills among physically and intellectually disabled children are mainly attributable to their limited school attendance. Children with multiple disabilities are constrained both by low school attendance and by poor numeracy skills return to schooling. The average differences in school performance across the high- versus low-numeracy skill country groups are larger than the within-group average differences for disabled versus non-disabled kids. This indicates that school enrolment and quality are crucial for children's learning of numeracy skills, and that disabled children benefit equally from better school quality across these African countries.

Fear of COVID-19 is associated with trust, subjective numeracy, and differentially with loneliness in older versus younger adults.

The emotional impacts of the COVID-19 pandemic and resulting public health emergency are only beginning to be understood. We assessed the contributions of emotional and cognitive factors and age-related comorbidities to greater COVID-19 fear in a community dwelling sample of 142 younger (Mage = 19.63, SDage = 2.59) and 157 older (Mage = 72.01, SDage = 7.06) adults, between July 2020 and July 2021. We hypothesized that individuals with increased loneliness, depression, and/or decreased subjective numeracy (SN) and interpersonal trust would experience more COVID-19 fear. We also predicted that females and older adults would experience more COVID-19 fear given that age-related comorbidities are associated with increased illness severity. Results showed that the extent of loneliness in older adults was more strongly related to fear of COVID-19 than it was in younger adults (β = 0.197, p = 0.016), and poorer SN was associated with increased COVID-19 fear in both age groups (β = -0.138, p = 0.016). Further, higher interpersonal mistrust was associated with increased COVID-19 fear (β = 0.136, p = 0.039), as was identifying as female (β = 0.137, p = 0.013). Given that self-described poor numeracy was a marker for greater COVID-19 fear, investigators and policy makers might consider mitigation opportunities addressing data literacy requirements imposed by the media. Further, outreach to mitigate loneliness, particularly of the elderly, might effectively lessen the negative psychological impact of this ongoing public health crisis.

Linking Canadian Administrative Data: Income Trajectories, Residential and School Mobility, and Grade 3 Academic Achievement.

ObjectiveThe objective is to examine the association between trajectories of childhood residential and school mobility and academic achievement (literacy, numeracy) in Grade 3 using linked whole-population administrative data in Manitoba, Canada. Secondarily, we assessed childhood residential/school mobility based on neighbourhood income levels (moving in/out of low- or mid-/high-income neighbourhoods). ApproachThis retrospective cohort study used linkable, de-identified administrative data (health, education, national census, provincial survey) from the provincial Population Research Data Repository housed at the Manitoba Centre for Health Policy (MCHP). Among kindergarteners from 2005 to 2014 (n = 83,894), those not having continuous residency in Manitoba, valid education assessments, and relevant family-level covariates were excluded. We followed this eligible cohort from kindergarten to Grade 3 based on various neighbourhood income trajectories of residential and school mobility. To assess Grade 3 literacy and numeracy scores based on trajectories, log-binomial regression models were conducted using SAS® version 9.4. ResultsThe total cohort included 36,754 children; at the end of kindergarten, 14.2% resided in low-income neighbourhoods, and 84.8% lived in mid-/high-income neighbourhoods. Moving between two low-income neighborhoods between kindergarten to Grade 3 was associated with an increased risk of poor Grade 3 numeracy and literacy scores (numeracy aRR=1.39 [1.16,1.67]; literacy aRR=1.31 [1.08,1.59]). When moving between neighborhood income levels, the association was stronger for children moving into low-income neighbourhoods (e.g., mid-/high-income to low-income: numeracy aRR=1.41 [1.19,1.67]) than children moving into mid/high-income neighbourhoods (e.g., low-income to mid-/high-income: numeracy aRR=1.31 [1.08,1.59]). Changing schools between kindergarten and Grade 3 was also associated with poorer numeracy and literacy scores in Grade 3 (numeracy aRR=1.31 [1.22,1.40]; literacy aRR=1.34 [1.24,1.44]); however, the strength varied based on residential mobility patterns. ConclusionMoving homes/schools can differentially impact children’s educational attainment depending upon the income level of residing neighborhood(s). Stakeholders should recognize different levels of risks related to mobility and provide support accordingly to reduce the adverse impact. Support systems should be tailored to not only children but also families and neighbourhoods.

Pre-service teachers’ teaching challenges and the transformative learning opportunities during teaching practice in Indonesian remote areas

ABSTRACT Teaching practice in remote areas is beneficial for pre-service teachers’ professional development. The geographical structure and society in remote areas provide unique experiences. This study focuses on how teaching practice in remote areas opens up opportunities for transformative learning. Forty-one pre-service primary teachers from three universities participated in semi-structured interviews. The interviews were conducted in retrospect after participants had finished their teaching practice. Results show that PSTs encountered nine types of challenges during teaching practice; parents’ low awareness of the importance of their children’s education, local teachers’ low motivation, limited teaching resources at school, pupils’ absenteeism, pupils’ poor numeracy and literacy skills, the principal’s low responsibility, natural hazard factors, pupils’ low ability to understand Indonesian, and local conflicts between different communities. Encountering these nine types of challenges fosters PSTs’ disorientation, which might lead to transformative learning. In conclusion, remote areas have potential for transformative learning.

ANALISIS LITERASI NUMERASI PADA MATERI PERSAMAAN DAN PERTIDAKSAMAAN NILAI MUTLAK LINEAR SATU VARIABEL DIKAJI DARI KECERDASAN EMOSIONAL

This study aims to determine numeracy literacy in the material equations and inequalities of the absolute value assessed from the emotional intelligence of students at SMA Panca Setya Sintang. The method used in this research is descriptive with a case study research. The subjects in this study were students of grade X IPA 3 with a total of 17 students. The object to be researched is numeracy literacy in the material equations and inequality of the absolute linear value of one variable assessed from the emotional intelligence of students. The techniques used in data collection are questionnaires, numeracy literacy tests and interviews. The results obtained from this study that there were four students who had high levels of emotional intelligence and tended to have high numeracy literacy, eleven students had moderate emotional intelligence and also varied numeracy literacy with one student with good numeracy literacy, six students with good numeracy and four students with poor numeracy, and two students who had low levels of emotional intelligence and had low numeracy literacy. Keywords: Numeracy Literacy, Emotional Intelligence, Equations And Inequalities Of The Absolute Value

Children with Secondary Care Episodes for Otitis Media Have Poor Literacy and Numeracy Outcomes: A Data Linkage Study.

We examined the association between otitis media (OM) and educational attainment in a retrospective population cohort of Western Australian children who participated in the grade 3 National Assessment Program—Literacy and Numeracy in 2012 (N = 19,262). Literacy and numeracy scores were linked to administrative hospital and emergency department data to identify secondary care episodes for OM. Results of multivariate multilevel models showed that children with OM episodes had increased odds of poor performance on literacy and numeracy tests, compared to children without OM episodes (46–79% increase in odds for Aboriginal children; 20–31% increase in odds for non-Aboriginal children). There were no significant effects found for age at the first episode, nor for OM episode frequency (all ps > 0.05). Regardless of the timing or frequency of episodes, children with OM episodes are at risk of poor literacy and numeracy attainment. Aboriginal children with OM appeared to be particularly at risk of poor literacy and numeracy achievement. Intervention to reduce the prevalence of otitis media in young children, and early treatment of OM, are important for limiting the negative effects on academic outcomes.

A Meta-Analysis Investigating the Association Between Metacognition and Math Performance in Adolescence

Poor math and numeracy skills are associated with a range of adverse outcomes, including reduced employability and poorer physical and mental health. Research has increasingly focused on understanding factors associated with the improvement of math skills in school. This systematic literature review and meta-analysis investigated the association between metacognition and math performance in adolescence (11–16-year-olds). A systematic search of electronic databases and grey literature (to 04.01.2020) highlighted 31 studies. The quantitative synthesis of 74 effect sizes from 29 of these studies (30 independent populations) indicated a significantly positive correlation between metacognition and math performance in adolescence (r = .37, 95% CI = [.29, .44], p < .001). There was significant heterogeneity between studies. Consideration of online (versus offline) measures of metacognition and more complex (versus simple) measures of math performance, and their combination, was associated with larger effect sizes; however, heterogeneity remained high for all analyses.

Typical Errors Made by Children and Adolescents with Developmental Dyscalculia&#x0D;

Abstract. Background: Poor numeracy and numerical learning problems are very common in our society and present serious obstacles in daily live, school or professional success. Accordingly, the goal of this study was to identify typical error patterns and problem solving strategies in children and adolescents with developmental dyscalculia (DD). Methods: We have examined 86 participants; half had a diagnosed DD (mean 15.5 years) and were compared to typically developing peers (mean 13.9 years). Numerical skills were tested by the standardized test battery BASIS-MATH 4–8. In addition, intelligence, alertness, spatial working memory, and math anxiety were assessed. Results: Results showed that subtractions, completion, and division are particularly challenging for DD. This applied notably to basic operations with large numbers, crossing tens/hundreds, but also simpler calculation problems. Item analyses revealed 10 calculation problems that differentiated best between groups. Moreover, DD used efficient calculation strategies to a lower extent. Discussion: In summary, basic numerical skills in DD, including those of lower difficulty levels, are clearly limited and even adolescents fail in such tasks. Moreover, we were able to identify 10 numerical tasks that would be particularly meaningful to implement in a DD-screener. Finally, our findings highlight the importance of considering individual problem-solving strategies when evaluating people with DD in a clinical, therapeutic or school setting.

Journeys towards sociomathematical norms in the Foundation Phase

Background: The co-establishment of social and sociomathematical norms in the microculture of South African classrooms and its possible effects on early number learning has largely been unexplored. Social norms are considered to be general classroom norms that are relevant in any teaching and learning space, whilst sociomathematical norms are specific to the mathematical aspects of students’ working.Aim: In the midst of poor numeracy outcomes in South African schools, our interest lies in the connections between the establishment of particular norms and the affordances or constraints for learning that they provided. Part of our interest, in a context where sense-making, co-operative working and mathematical progression beyond one-by-one counting have been described as infrequent in Foundation Phase mathematics learning, was to explore whether it was possible to institute norms related to these aspects.Setting: We report on the social and sociomathematical norms established within group intervention sessions with two groups of four Grade 2 learners across 9 weeks of intervention in a suburban school which serves a historically disadvantaged learner population.Methods: The frequency of specific norm codes was used to determine the normative behaviour within groups across intervention lessons.Results: Two significant inferences are drawn from study results: a culture of co-operative working based on social norms was needed in the grouped learning space before sociomathematical norms could be foregrounded within the same space; and one particular sociomathematical norm – ‘use the structure of 10’ – was particularly important as the ‘hand hold’ that allowed for progression in participants’ early number skills.

Dunning-Kruger Effect: Intuitive Errors Predict Overconfidence on the Cognitive Reflection Test.

The Cognitive Reflection Test (CRT) is a measure of analytical reasoning that cues an intuitive but incorrect response that must be rejected for successful performance to be attained. The CRT yields two types of errors: Intuitive errors, which are attributed to Type 1 processes; and non-intuitive errors, which result from poor numeracy skills or deficient reasoning. Past research shows that participants who commit the highest numbers of errors on the CRT overestimate their performance the most, whereas those with the lowest error-rates tend to slightly underestimate. This is an example of the Dunning-Kruger Effect (DKE). The present study examined how intuitive vs. non-intuitive errors contribute to overestimation in the CRT at different levels of performance. Female undergraduate students completed a seven-item CRT test and subsequently estimated their raw score. They also filled out the Faith in Intuition (FI) questionnaire, which is a dispositional measure of intuitive thinking. Data was separated into quartiles based on level of performance on the CRT. The results demonstrated the DKE. Additionally, intuitive and non-intuitive errors predicted miscalibration among low, but not high performers. However, intuitive errors were a stronger predictor of miscalibration. Finally, FI was positively correlated with CRT self-estimates and miscalibration, indicating that participants who perceived themselves to be more intuitive were worse at estimating their score. These results taken together suggest that participants who perform poorly in the CRT and also those who score higher in intuitive thinking disposition are more susceptible to the influences of heuristic-based cues, such as answer fluency, when judging their performance.

Words or numbers? Communicating probability in intelligence analysis.

Intelligence analysis is fundamentally an exercise in expert judgment made under conditions of uncertainty. These judgments are used to inform consequential decisions. Following the major intelligence failure that led to the 2003 war in Iraq, intelligence organizations implemented policies for communicating probability in their assessments. Virtually all chose to convey probability using standardized linguistic lexicons in which an ordered set of select probability terms (e.g., highly likely) is associated with numeric ranges (e.g., 80-90%). We review the benefits and drawbacks of this approach, drawing on psychological research on probability communication and studies that have examined the effectiveness of standardized lexicons. We further discuss how numeric probabilities can overcome many of the shortcomings of linguistic probabilities. Numeric probabilities are not without drawbacks (e.g., they are more difficult to elicit and may be misunderstood by receivers with poor numeracy). However, these drawbacks can be ameliorated with training and practice, whereas the pitfalls of linguistic probabilities are endemic to the approach. We propose that, on balance, the benefits of using numeric probabilities outweigh their drawbacks. Given the enormous costs associated with intelligence failure, the intelligence community should reconsider its reliance on using linguistic probabilities to convey probability in intelligence assessments. Our discussion also has implications for probability communication in other domains such as climate science. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Electronic media use and academic performance in late childhood: A longitudinal study.

IntroductionThe effects of electronic media use on health has received much attention but less is known about links with academic performance. This study prospectively examines the effect of media use on academic performance in late childhood.Materials and methods1239 8- to 9-year-olds and their parents were recruited to take part in a prospective, longitudinal study. Academic performance was measured on a national achievement test at baseline and 10–11 years of age. Parents reported on their child’s duration of electronic media use.ResultsAfter control for baseline reading, watching more than two hours of television per day at 8–9 years of age predicted a 12-point lower performance in reading at 10–11 years, equivalent to the loss of a third of a year in learning. Using a computer for more than one hour a day predicted a similar 12-point lower numeracy performance. Regarding cross-sectional associations (presumed to capture short-term effects) of media use on numeracy, after controlling for prior media exposure, watching more than two hours of television per day at 10–11 years was concurrently associated with a 12-point lower numeracy score and using a computer for more than one hour per day with a 13-point lower numeracy performance. There was little evidence for concurrent effects on reading. There was no evidence of short- or long-term associations between videogame use and academic performance.DiscussionCumulative television use is associated with poor reading and cumulative computer use with poorer numeracy. Beyond any links between heavy media use and health risks such as obesity, physical activity and mental health, these findings raise a possibility of additional risks of both television and computer use for learning in mid-childhood. These findings carry implications for parents, teachers and clinicians to consider the type and timing of media exposure in developing media plans for children.

Health Numeracy and Relative Risk Comprehension in Perioperative Patients and Physicians

Helping patients to understand relative risks is challenging. In discussions with patients, physicians often use numbers to describe hazards, make comparisons, and establish relevance. Patients with a poor understanding of numbers-poor "health numeracy"-also have difficulty making decisions and coping with chronic conditions. Although the importance of "health literacy" in perioperative populations is recognized, health numeracy has not been well studied. Our aim was to compare understanding of numbers, risk, and risk modification between a patient population awaiting surgery under general anesthesia and attending physicians at the same center. We performed a single-center cross-sectional survey study to compare patients' and physicians' health numeracy. The study instrument was based on the Schwartz-Lipkus survey and included 3 simple health numeracy questions and 2 risk reduction questions in the anesthesiology domain. The survey was mailed to patients over the age of 18 scheduled for elective surgery under general anesthesia between June and September 2019, as well as attending physicians at the study center. Two hundred thirteen of 502 (42%) patient surveys sent and 268 of 506 (53%) physician surveys sent were returned. Median patient score was 4 of 5, but 32% had a score of ≤3. Patients significantly overestimated their total scores by an average of 0.5 points (estimated [mean ± standard deviation (SD)] = 4.3 ± 1.2 vs actual 3.8 ± 1.3; P < .001). Health numeracy was significantly associated with higher educational level (gamma = 0.351; P < .001) and higher-income level (gamma = 0.397; P < .001). Physicians' health numeracy was significantly higher than the patients' (median [interquartile range {IQR}] = 5 [4-5] vs 4 [3-5]; P < .001). There was no significant difference between physicians' self-estimated and actual total numeracy score (mean ± SD = 4.8 ± 0.6 vs 4.7 ± 0.6; P = .372). Simple health numeracy (questions 1-3) was predictive of correct risk reduction responses (questions 4, 5) for both patients (gamma = 0.586; P < .001) and physicians (gamma = 0.558; P = .006). Patients had poor health numeracy compared to physicians and tended to overrate their abilities. A small proportion of physicians also had poor numeracy. Poor health numeracy was associated with incomprehension of risk modification, suggesting that some patients may not understand treatment efficacy. These disparities suggest a need for further inquiry into how to improve patient comprehension of risk modification.

Knowledge of Potential Harms and Benefits of Tamoxifen among Women Considering Breast Cancer Preventive Therapy.

Tamoxifen reduces breast cancer incidence in women at increased risk, but may cause side effects. We examined women's knowledge of tamoxifen's potential harms and benefits, and the extent to which knowledge reflects subjective judgments of awareness and decision quality. After a hospital appointment, 408 (55.7%) women at increased risk of breast cancer completed a survey assessing objective knowledge about the potential benefit (risk reduction) and harms (endometrial cancer, thromboembolic events, and menopausal side effects) of tamoxifen, and subjective tamoxifen knowledge and decisional quality. Two hundred fifty-eight (63.2%) completed a 3-month follow-up survey. Sixteen percent (15.7%) of participants recognized the potential benefit and three major harms of using tamoxifen. These women were more likely to have degree-level education [vs. below degree level; OR, 2.24; 95% confidence interval (CI), 1.11-4.55] and good numeracy (vs. poor numeracy; OR, 5.91; 95% CI, 1.33-26.19). Tamoxifen uptake was higher in women who recognized all harms and benefits (vs. not recognizing; OR, 2.47; 95% CI, 0.94-6.54). Sixty-six percent (65.8%) of tamoxifen users were unaware of its potential benefit and harms. Most (87.1%) women reported feeling informed about tamoxifen, and subjective decisional quality was high [Mean (SD), 17.03 (1.87), out of 18]. Knowledge regarding the potential harms and benefit of tamoxifen is low in women considering prevention therapy, and they may need additional support to make informed decisions about tamoxifen preventive therapy.

Abstract ES9-1: Discussing risk &amp; uncertainty with patients in the context of GEP testing

Abstract Many discussions between physicians and their patients about the logic and rationale for different treatment recommendations are increasingly complex. The information required to aid educated decision-making requires careful balancing of the likely absolute benefits in terms of cure or preventing recurrence versus any treatment-related side effects. Few realise that medicine is an uncertain science where most facts are probabilities defined and refined by repeated hypothesis testing. In the context of life-threatening disease this can make communication with patients about risk and uncertainty challenging. Health literacy and numeracy skills in the general population are often poor, creating other communication difficulties; furthermore confusion increases when such conversations are set against a backdrop of fear and anxiety. Clinico-pathologic features traditionally help determine which women with early stage breast cancer are most likely to benefit from adjuvant chemotherapy, but many patients still believe that in life-threatening situations, more treatment must be better. Scores from gene expression profiling tests such as OncotypeDX®, EndoPredict® and Prosigna® may reduce some of the uncertainty and anxiety about omitting chemotherapy and increase the confidence of doctors helping patients with their decision-making.(1) However explaining high, intermediate and low risk test scores is not always straightforward especially when patients have widely varying personality and socio-educational characteristics. Both clinicians and their patients may also have a measurable intolerance to uncertainty that may contribute (irrespective of the recurrence score) to seemingly irrational decisions about treatment. This interactive session will incorporate materials from Talking About Risk in the context of Genomic Testing (TARGET), an evidence-based program (2) funded by the BCRF- This includes didactic presentations (PPT) exercises and video clips of doctors explaining risk scores from genomic tests. After attending the session participants should:- a) recognise how poor literacy and numeracy in general populations affects understanding about risk and decision-making b) understand how their own intolerance to uncertainty may ‘leak’ through into communication with patients and c) increase their repertoire of skills when explaining GEP scores to patients