Date of Award
Spring 2026
Degree Name
Bachelor of Arts
Department
Psychology; College of Arts & Sciences
First Advisor
Dr. Steven Robbins
Second Advisor
Dr. Juan Duque
Abstract
Healthcare decisions often require patients to interpret numerical risk information under stress, yet many struggle with low numeracy, which can distort comprehension and undermine informed consent. Well-designed visual aids can improve diagnostic inference, calibrate confidence, and support better choices, especially for patients with limited numeracy, but their impact depends on whether users can actually interpret the format accurately. Drawing may further enhance these tools by adding a tactile, generative layer that engages visual, semantic, and motoric processing while helping patients organize information into concrete models.
Passive visual aids appear useful but limited because they often position patients as observers rather than active constructors of meaning. Drawing may help patients externalize misunderstandings, deepen memory, and support interpretation of probabilistic information in ways that standard aids do not fully capture. It is crucial to consider practical barriers, including graph literacy differences, implementation challenges, and the need for participatory design to make tools scalable, equitable, and clinically useful.
The current study aimed to test whether higher tactile engagement resulted in greater comprehension, regardless of numeracy. Participants were randomly assigned to one of three conditions: no tactile engagement (passive control), low tactile engagement (coloring), and high tactile engagement (tracing and coloring), to examine a potentially graded effect. The experiment did not produce significant results in the main analysis, though it highlighted important design questions regarding measure sensitivity, task clarity, and how to optimize active engagement for learning to effectively transfer into comprehension.
Drawing and other forms of tactile engagement offer a promising extension to existing visual decision aids, with potential to improve patient engagement, risk understanding, and value-consistent decision-making in healthcare environments.
Recommended Citation
Markley, Zephyr J., "Visual Aids and Numeracy in Healthcare: Leveraging the Drawing Effect" (2026). Capstone Showcase. 1.
https://scholarworks.arcadia.edu/showcase/2026/psychology/1
Additional Files
ZephyrJMarkley2026_ThesisPoster.pdf (675 kB)Poster
ZephyrJMarkley2026_ThesisPosterReferences.pdf (112 kB)
Poster References
ZephyrJMarkley2026_ThesisDefensePresentation_DrawingOuttheNumbers.pdf (1404 kB)
Defense Presentation
ZephyrJMarkley2026_ThesisDefenseReferences.pdf (97 kB)
Defense References
ZephyrJMarkley2026_ThesisExperimentSummary.pdf (204 kB)
Experiment Summary
ZephyrJMarkley2026_ThesisExperimentFullDataCoded.xlsx (12 kB)
Experiment Data
ZephyrJMarkley2026_ThesisExperimentCompletedWorksheets.pdf (35796 kB)
Experiment Worksheets
ZephyrJMarkley2026_ThesisExperimentIRBApplication(seeappendixformaterials).docx.pdf (1646 kB)
IRB Application with Appendix
Included in
Clinical Psychology Commons, Cognition and Perception Commons, Cognitive Psychology Commons, Educational Psychology Commons, Educational Technology Commons, Graphic Design Commons, Health and Physical Education Commons, Health Information Technology Commons, Health Psychology Commons, Human Factors Psychology Commons, Information Literacy Commons, Instructional Media Design Commons, Medical Humanities Commons, Medicine and Health Commons, Other Medicine and Health Sciences Commons, Science and Technology Studies Commons, Visual Studies Commons
Visual Aids and Numeracy in Healthcare: Leveraging the Drawing Effect
Healthcare decisions often require patients to interpret numerical risk information under stress, yet many struggle with low numeracy, which can distort comprehension and undermine informed consent. Well-designed visual aids can improve diagnostic inference, calibrate confidence, and support better choices, especially for patients with limited numeracy, but their impact depends on whether users can actually interpret the format accurately. Drawing may further enhance these tools by adding a tactile, generative layer that engages visual, semantic, and motoric processing while helping patients organize information into concrete models.
Passive visual aids appear useful but limited because they often position patients as observers rather than active constructors of meaning. Drawing may help patients externalize misunderstandings, deepen memory, and support interpretation of probabilistic information in ways that standard aids do not fully capture. It is crucial to consider practical barriers, including graph literacy differences, implementation challenges, and the need for participatory design to make tools scalable, equitable, and clinically useful.
The current study aimed to test whether higher tactile engagement resulted in greater comprehension, regardless of numeracy. Participants were randomly assigned to one of three conditions: no tactile engagement (passive control), low tactile engagement (coloring), and high tactile engagement (tracing and coloring), to examine a potentially graded effect. The experiment did not produce significant results in the main analysis, though it highlighted important design questions regarding measure sensitivity, task clarity, and how to optimize active engagement for learning to effectively transfer into comprehension.
Drawing and other forms of tactile engagement offer a promising extension to existing visual decision aids, with potential to improve patient engagement, risk understanding, and value-consistent decision-making in healthcare environments.