Learning about Medicines

Submitted by Julie McKinney on Fri, 01/09/2015 - 12:30
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Hi Everyone,

I just wanted to share some stories and ideas for learning about medicine (and maybe math at the same time!)

One of my favorite activities is this one called Liquid Medicines: Taking the Right Dose. It was originally developed for health fairs, but can easily be used in classrooms or tutoring sessions. There is a poster with some facts about how often people take the wrong dose of medicine. There are two versions of the poster, one at a higher and one at a lower literacy level. Then you put a bunch of random teaspoons in front of it, along with some measuring spoons, a medicine dosing cup and a syringe. People try to guess which spoon or other implement gives one correct teaspoon of medicine. (One teaspoon is 5 milliliters, which can be very easily measured and dispensed with a plastic syringe. You can usually get one for free at the pharmacy!)

I have done this in classrooms using colored water and letting people test, measure, pour and compare. It is really nice way to have some hands-on exploration, and it usually is an eye-opener!

What kinds of math, language or literacy activities could you build around something like this?

 

Comments

Hi, all. Thanks, Julie, for this post and the link to the resource.  This reminds me of an ABE/workplace class I observed when I directed a workplace literacy program for cafeteria workers in the early nineties here in DC. I think it was at the Library of Congress,.The teacher was teaching math to the workers. She asked them first how many teaspoons they thought there were in a tablespoon, and they all predicted it and then tried it out. They also tried it out both with kitchen spoons and measuring spoons and discovered that whereas there are supposed to be three tsp in a tbsp, there were really only two if you used kitchen spoons The class included cooks and cooks helpers. It was fun and hands on.

The other thought I have about this is a story (true) another teacher, in an ESL program in Arlington, VA, told me. She said one day in her beginning-level class one of the students had brought her young daughter with her because the child wasn't feeling well. The teacher noticed that the little girl was REALLY sleepy - actually appeared to be doped --  and asked the mother if she had given her any medicine. The mom showed her the medicine, and yes, the mom had given two tablesppons rather than the correct dose of two teaspoons, The teacher called  911. Paramedics arrived and took the child to t he hospitial, where she was taken care of and had no lasting damage.  Wow. Talk about ESL/math in action.

By the way, Kate Singleon has a photo story about that very incident, I think. At least it could be!  As you see, it deals with more than just the tsp or tbsp issue; it also deals with two pills every four hours vs. four pills every two hours, vs differerences in adult/ and child dosages. Lots of language issues here. See http://www.cal.org/caela/esl_resources/Health/img/dose.gif  for the pictures and http://www.cal.org/caela/esl_resources/Health/ for suggestions on how to use this and other picture health stories.

By the way, I know we've mentioned Kate's resources on health before, but there are always new people to the CoPs and it doesn't hurt to bring up  these useful resources, I think, from time to time.

Miriam Burt

SME, adult ELL CoP

 

 

Hi, Miriam,

It's getting to be a long time ago now, but I do know that Kate Singleton developed the picture story from an incident that happened in a family literacy class I taught at an elementary school in Arlington, VA.  I taught both the mom and dad who had a young son--probably a second grader. We interacted with both parents and kids in the program and we noticed how groggy the (usually lively) boy was. Through conversation, we were able to ascertain that the parents had given the boy a tablespoon of medicine instead of the teaspoon that was prescribed.  Luckily, the dose wore off without serious incident, but I never forgot it and have double-checked dosages and medicines ever since then. In fact, near that same time, my own son had been very ill.  I needed and got a refill on the medicine he was taking.  I noticed that the pills looked different than the first prescription.  When I took the new pills back to the pharmacy, it turned out the pharmacist had filled the prescription with another that began with the same letter--C--but that would have been potentially life-threatening if I had given it to my son.  It pays to double-check!

I want to second Miriam's comments on Kate Singleton's Picture Stories for Adult ESL Health Literacy at http://www.cal.org/caela/esl_resources/Health/healthindex.html Not only are the scenarios pertinent to adult English language learners (and ourselves), but Kate's commentary about each topic is carefully researched and thoughtful.

Lynda Terrill

Hi, Lynda. Thanks for clarifying the story. It's kind of scary to know that the mistakes can also happen at pharmacy. And, as Julie pointed out, you don't have to be an English learner or someone with limited literacy to make these dosage errors.

I think an activity to do would be a sort of reader's theatre where the teacher could present a short paragraph - two-three sentences about picking up medicine at the the pharmacy, Then the class could write up the dialogue between the phamacist and the customer where the customer verifies the dosage. Actually, the students could use Kate's pictures to write a dialog - this time fixing the problem by clarifying the dosage prior to taking the medicine home and dispensing it.

Miriam

 

Hi, Miriam,

Working with learners to develop dialogues about important life issues, such as health matters, has worked well for me in literacy- and beginning-level classes.  The activity also works well in working with multilevel groups: Some pairs might work on copying the class-generated dialogue from the board and then practicing while other pairs might develop their own dialogues on the same or similar topic.  In one class, after we had worked on dialogues for 911 emergencies, one young woman was able to report being able to successfully navigate a real-life health emergency involving her young son the following weekend! I think working whole-group and then in pairs and then asking volunteers to present their dialogues can give the learners a good opportunity to hear and absorb important language repeated several times so that they may feel more comfortable and able to use it when needed  in their lives outside of school.

Lynda Terrill

This is a story that a friend of mine tells when he does health literacy trainings for doctors, pharmacists, and graduate students. This is a man who has advanced degrees, works in a hospital and is health literacy expert....

My daughter was sick and the doctor prescribed her Amoxicillin. I work at the hospital and it was called into the hospital pharmacy so I could pick it up after work. After work I went down and when they asked if I had any questions, I said no.  Having administered it before, I figured I could do so again, no problem. Also, I was ready to get home. It had been a long day.

When I got home, it wasn’t until just before bedtime when we remembered that we had to give her the medicine. I opened the bag and saw that they had given me 2 dosing cups. I then read the instructions on the bottle. "Give 2 teaspoons by mouth once daily."  As I looked at the cups, I realized that there was no 2 teaspoon marking on them. Looking back now, I could have googled how many milliliters in a tsp and done some math but I was tired and wasn’t thinking about Google nor wanting to do math. I was just trying to figure out how to give 2 teaspoons with what I had on hand.

Since they gave me 2 cups I thought they must have intended for me to fill both up to 1 tsp and administer it that way, but they don’t know my daughter, for whom taking medicine is an incredible ordeal. I didn’t want to have to go through that twice.

As I am struggling with the cup, my wife comes in and asks me what the holdup is. I explain my dilemma and she takes the cup and looks at it, noting that the marking that says “DSSP” looks like it is about 2 teaspoons. She suggested that maybe “DSSP” stood for double spoon. We were tired and ready to get the kids to bed so we could watch some TV.  So, I filled it to the "DSSP" level and we fought for 5 minutes to finally get my daughter to take it.

The next day, I, being a HL expert, decided I should explain my situation with the pharmacist. But before I did, I took a quick poll with folks around the office asking them how they would use this cup given those instructions. Two of my male colleagues who I found out don’t cook, said they would fill it up to the 2 TBS. They didn’t know the abbreviations for teaspoon and tablespoon; and, of course, the abbreviation wasn’t provided on the prescription directions.

When I relayed all of this information to the pharmacist, she very nicely informed me that DSSP actually stood for dessert spoon, which is almost 2 ½ teaspoons. So I had given my daughter an incorrect dose.

One way to use this story in class is to remind people that they are not alone in being confused by things like this. It can help for people to know that it's not their deficiency, but rather a problem in how things like medicine cups and instructions are designed! You could also address abbreviations, asking questions (for example, to the pharmacist), or how to problem-solve in a case like this, maybe with role plays. 

The end of the story is that my friend suggested to the pharmacist to take a sharpie marker and draw a line at the 10 ml level on the cup, which is 2 teaspoons. A simple, low-tech solution!

 

Hi, AELL & Health Lit. Groups -

I like how this activity starts out accessing learners' prior knowledge.  I agree that there should be a next step in the activity though, to address any confusion, and instruct learners on what 5 milliliters looks like in a syringe, and different sized measuring spoons.  The Queens Library Adult Learner Program has two great lesson plans on dosages, frequency, warnings and additional instructions.  They would make great lessons following your highlighted activity.

The first lesson and materials are available here: http://www.queenslibrary.org/sites/default/files/health_literacy/PDF_teachers/Session_11-We.pdf

The larger health literacy site can be found here:  http://www.queenslibrary.org/services/health-info/english-for-your-health/teacher-beginner-level

Best,

Mike

 

 

Thanks so much for sharing these materials, Michael. I agree that using Kate's pictures as a warmup and a way to both build background and engage students - so important to all  learners -  could be followed by acitivies discussed above. Then, the lessons from Queen's Library would be extremely useful. I think the drawings are so clear, and truly could be used even at the literacy level.

Miriam Burt

SME, Adult ELL CoP

Yes, thanks, Mike! These are really nicely developed materials! I like the way they use a few different types of labels, and that they have an audio component. I have a few general suggestions for doing these types of lessons:

  • Bring in some real prescription bottles as well so they can practice on those as well. (And bring in a magnifying glass or glasses if you have older students. The writing can be really small!)
  • Don't forget over-the-counter medicines.
  • Cycle back to these activities every once in a while so they can practice.
  • You could add a pill card activity to do after they fill out the information from the prescription labels (on the Queens Curriculum activity).  Here's a site that walks you through creating pill cards: http://archive.ahrq.gov/patients-consumers/diagnosis-treatment/treatments/pillcard/pillcard.html 

Michael, Thanks for sharing this lesson and for letting everyone know about the Queens Library's health curriculum, which is one of the most beautiful and well-designed set of curricular materials I've seen. There are separate lesson plans for lower level students and higher level. These resources are incredibly valuable for our field.

Cheers, Susan Finn Miller

Moderator, Assessment CoP

 

Here's another good source for learning about medicine:

Medicines in My Home is an interactive educational site created by the FDA (Food and Drug Administration.) This is full of high and low tech resources for teaching 6th-8th graders through adults about OTC (over-the-counter) medicines. Here's a small sample of what they offer:

  • a virtual house in which to explore and interact, with a written guide to help you navigate through it
  • teacher's guides with lesson plans, slide shows, worksheets and pre- and post-tests
  • video presentations
  • fact sheets and other take-home materials

These materials can be easily adapted to use in literacy classes. 

I love the idea of an interactive, online teaching tool to teach adult students about how to make their home safer when it comes to meds and will recommend this to all of our ESL instructors in Adult Ed.

A fun activity I have used for all levels of adult ESL was to take a boxful of old medicine bottles and packages and give one to each student.  Then, pair students up and have them sit back-to-back.  Distribute a short list of questions to be filled out, such as, "What is this medicine used for?"  "How much do I take?"  "Can I give it to my child?"  I usually have three forms on a page, so each pair practices at least three times, each time with a different set of medicine packages.

The objective is for students to ask each other about their medicine, but they cannot see the package or their partner's face.  They have to communicate orally and employ good listening skills to determine the answers to the questions and record them on the form.  

The difficulty of the questions is determined by the level of the class. Very low beginners, for example, could simply have a check list or a circle-the-answer form.

Kat Bradley-Bennett
Longmont, CO

Julie,

What a great way to contextualize so many math objectives and truly increase a learner's depth of understanding!  The idea of ratios/proportions, fractions, measurement, and yes, dare I say ALGEBRAIC thinking!  I could see several possibilities for activities based on this one!!!  Thank you for sharing.

Brooke

Ooh, algebraic thinking! Cool. I tend to think of the lower level math concepts, like how many teaspoons in two tablespoons. Brooke, can you give us an example of how this kind of activity can address algebraic thinking?