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Ebm@school – a curriculum of critical health literacy for secondary school students: results of a pilot study



Increasingly, patients and consumers are taking responsibility for their diagnostic and therapeutic decisions. This requires a certain amount of health literacy in order to critically assess the various procedures and products. The aim of this study was to develop and pilot test a curriculum of critical health literacy for secondary school students.


The curriculum is based on the concept of evidence-based medicine and consists of six modules. Development and pilot testing was performed with two classes of secondary school students (n = 45) in Grade 11. The Metaplan method was used to document feedback regarding teaching methods, worksheets, satisfaction and individually perceived benefits. Additionally, systematic observations by researchers were documented and students’ presentations assessed. A sample of untrained students (n = 218) served as a control group. The Critical Health Competency Test was employed for evaluating competencies in critical health literacy. Data were analyzed qualitatively and person parameters were calculated.


Overall, the pilot courses were well-accepted and have been proven to be feasible. Students’ feedback guided revision of the curriculum. Trained students achieved significantly higher person parameters (± SD) than the control group: 597 (± 79) versus 483 (± 94), p < 0.01, indicating enhancement of critical health competencies.


Teaching critical health literacy to secondary school students is feasible and is likely to enhance the competence of critical health literacy. Further studies are needed to show the effectiveness of the intervention.

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Correspondence to Anke Steckelberg PhD.

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Submitted: 31 March 2007; revised: 11 February 2008, 13 June 2008, 26 August 2008; accepted: 26 August 2008

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Steckelberg, A., Hülfenhaus, C., Kasper, J. et al. Ebm@school – a curriculum of critical health literacy for secondary school students: results of a pilot study. Int J Public Health 54, 158–165 (2009).

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