Skip to main content

Educating good decisions


Can we educate decision-makers to make better decisions? In the present paper, I argue that we can in at least two broad ways: (1) teaching concrete knowledge about a specific decision or decision type; and (2) teaching more abstract decision-making competencies that are thought to lead to better decisions. Teaching knowledge can be done using decision aids and similar techniques that provide important information about a specific choice (e.g. a medical treatment option). In these cases, information presented using evidence-based techniques to improve comprehension and use of information will have greater effects on judgements and choices. Teaching more abstract decision competencies, on the other hand, involves formal schooling (with the bulk of formal education falling during childhood) or training in a specific competency that is important to decision processes and outcomes; I use numeracy interventions as an exemplar.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Educating good decisions
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Educating good decisions
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Educating good decisions
      Available formats
Corresponding author
*Correspondence to: Ellen Peters, The Ohio State University, OH, USA. Email:
Hide All
Abraham, C., Norman, P. and Conner, M. (2000), Understanding and changing health behaviour: From health beliefs to self-regulation, Hove, UK: Psychology Press.
Annan, K. (1997), United Nations Press Release SG/SM/6268 23 June 1997 [29 November 2016].
Banks, J. and Oldfield, Z. (2007), ‘Understanding pensions: Cognitive function, numerical ability and retirement saving’, Fiscal Studies, 143170.
Baron, J. and Brown, R. V. (1991), Teaching decision making to adolescents, Hillsdale, NJ: Erlbaum.
Betz, N. E. and Hackett, G. (1983), ‘The relationship of mathematics self-efficacy expectations to the selection of science-based college majors’, Journal of Vocational Behavior, 23(3): 329345.
Blanchette, I., Marzouki, Y., Claidière, N., Gullstrand, J. and Fagot, J. (2016), ‘Emotion-Cognition Interaction in Nonhuman Primates Cognitive Avoidance of Negative Stimuli in Baboons (Papio papio)’, Psychological Science, 0956797616671557.
Bosworth, H. B. (2012), ‘How can innovative uses of technology be harnessed to improve medication adherence?’, Expert Review of Pharmacoeconomics & Outcomes Research, 12(2): 133135.
Bosworth, H. B., Oddone, E. Z. and Weinberger, M. (eds), (2006), Patient treatment adherence: concepts, interventions, and measurement, Hove, UK: Psychology Press.
Braddock III, C. H., Edwards, K. A., Hasenberg, N. M., Laidley, T. L. and Levinson, W. (1999), ‘Informed decision making in outpatient practice: time to get back to basics’, Jama, 282(24): 23132320.
Braddock, C. H., Fihn, S. D., Levinson, W., Jonsen, A. R. and Pearlman, R. A. (1997), ‘How doctors and patients discuss routine clinical decisions - Informed decision making in the outpatient setting’, Journal of General Internal Medicine, 12(6): 339345.
Brewer, N. T., Hall, M. G., Noar, S. M., Parada, H., Stein-Seroussi, A., Bach, L. E., Hanley, S. and Ribisl, K. M. (2016), ‘Effect of Pictorial Cigarette Pack Warnings on Changes in Smoking Behavior: A Randomized Clinical Trial’, JAMA Internal Medicine. doi:10.1001/jamainternmed.2016.2621
Brownell, K. D. and Cohen, L. R. (1995), ‘Adherence to dietary regimens 1: An overview of research’, Behavioral Medicine, 20(4): 149154.
Canadian Cancer Society (2016), Cigarette Package Health Warnings: International Status Report, Fifth Edition. . [7 December 2016].
Cavanaugh, K., Huizinga, M. M., Wallston, K. A., Gebretsadik, T., Shintani, A., Davis, D., Gregory, R. P., Fuchs, L., Malone, R., Cherrington, A. and Pignone, M. (2008), ‘Association of numeracy and diabetes control’, Annals of Internal Medicine, 148(10): 737746.
Chang, J. T., Morton, S. C., Rubenstein, L. Z., Mojica, W. A., Maglione, M., Suttorp, M. J., Roth, E. A. and Shekelle, P. G. (2004), ‘Interventions for the prevention of falls in older adults: Systematic review and meta-analysis of randomized clinical trials’, British Medical Journal, 328: 680–7.
Chesney, D. and Peters, E. (in review), The causal impact of numeracy on judgments: Improving numeracy via symbolic and non-symbolic arithmetic practice improves risky judgments.
Cohen, G. L., Garcia, J., Apfel, N. and Master, A. (2006), ‘Reducing the racial achievement gap: A social-psychological intervention’, Science, 313(5791): 13071310.
Dieckmann, N. F., Peters, E., Leon, J., Benavides, M., Baker, D. P. and Norris, A. (2015), ‘The role of numeracy and fluid intelligence in sex-related protective behaviors’, Current HIV Research, 13(5): 337346.
Dillard, A. J., McCaul, K. D. and Klein, W. M. (2006), ‘Unrealistic optimism in smokers: Implications for smoking myth endorsement and self-protective motivation’, Journal of Health Communication, 11(S1): 93102.
Estrada, C. A., Martin-Hryniewicz, M., Collins, C., Byrd, J. C. and Peek, B. T. (2004), ‘Literacy and numeracy skills and anticoagulation control’, The American Journal of the Medical Sciences, 328(2): 8893.
Evans, A. T., Peters, E., Strasser, A. A., Emery, L. F., Sheerin, K. M. and Romer, D. (2015), ‘Graphic Warning Labels Elicit Affective and Thoughtful Responses from Smokers: Results of a Randomized Clinical Trial’, PloS One, 10(12): e0142879.
Fagerlin, A., Zikmund-Fisher, B. J., Ubel, P. A., Jankovic, A., Derry, H. A. and Smith, D. M. (2007), ‘Measuring numeracy without a math test: development of the Subjective Numeracy Scale’, Medical Decision Making, 27(5): 672680.
Fong, G. T., Krantz, D. H. and Nisbett, R. E. (1986), ‘The effects of statistical training on thinking about everyday problems’, Cognitive Psychology, 18(3): 253292.
Fraenkel, L., Matzko, C. K., Webb, D. E., Oppermann, B., Charpentier, P., Peters, E., Reyna, V. and Newman, E. D. (2015), ‘Use of decision support for improved knowledge, value clarification and informed choice in rheumatoid arthritis’, Arthritis Care & Research, 67(11): 14961502.
Fraenkel, L., Peters, E., Charpentier, P., Olson, B., Errante, L., Schoen, R. and Reyna, V. (2012), ‘A decision tool to improve the quality of care in rheumatoid arthritis’, Arthritis Care & Research, 64(7): 977985.
Ghazal, S., Cokely, E. T. and Garcia-Retamero, R. (2014), ‘Predicting biases in very highly educated samples: Numeracy and metacognition’, Judgment and Decision Making, 9(1): 15.
Greene, J. and Hibbard, J. H. (2012), ‘Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes’, Journal of General Internal Medicine, 27(5): 520526.
Greene, J., Hibbard, J. H., Sacks, R., Overton, V. and Parrotta, C. D. (2015), ‘When patient activation levels change, health outcomes and costs change, too’, Health Affairs, 34(3): 431437.
Hackett, G., and Betz, N. E. (1981), ‘A self-efficacy approach to the career development of women’, Journal of Vocational Behavior, 18(3): 326339.
Hall, C. C., Zhao, J. and Shafir, E. (2014), ‘Self-affirmation among the poor: Cognitive and behavioral implications’, Psychological Science, 25(2): 619625.
Heckman, J. J. (2007), ‘The economics, technology, and neuroscience of human capability formation’, Proceedings of the National Academy of Sciences, 104(33): 1325013255.
Huizinga, M. M., Beech, B. M., Cavanaugh, K. L., Elasy, T. A. and Rothman, R. L. (2008), ‘Low numeracy skills are associated with higher BMI’, Obesity, 16(8): 19661968.
Jha, P., Ramasundarahettige, C., Landsman, V., Rostron, B., Thun, M., Anderson, R. N., McAfee, T. and Peto, R. (2013), ‘21st-century hazards of smoking and benefits of cessation in the United States’, New England Journal of Medicine, 368(4): 341350.
Kees, J., Burton, S., Andrews, J. C. and Kozup, J. (2010), ‘Understanding how graphic pictorial warnings work on cigarette packaging’, Journal of Public Policy & Marketing, 29(2): 265276.
Kenkel, D. S. and Chen, L. (2000), ‘Consumer information and tobacco use’, in Jha, P. and Chaloupka, F. J. (eds), Tobacco control in developing countries, Oxford: Oxford University Press, 177214.
Kennedy, R. D., Spafford, M. M., Parkinson, C. M. and Fong, G. T. (2011), ‘Knowledge about the relationship between smoking and blindness in Canada, the United States, the United Kingdom, and Australia: results from the International Tobacco Control Four-Country Project’, Optometry-Journal of the American Optometric Association, 82(5): 310317.
Logel, C., and Cohen, G. L. (2012), ‘The role of the self in physical health: Testing the effect of a values-affirmation intervention on weight loss’, Psychological Science, 23(1): 5355.
Lusardi, A. and Mitchell, O. S. (2014), ‘The economic importance of financial literacy: Theory and evidence’, Journal of Economic Literature, 52(1): 544.
Miyake, A., Kost-Smith, L. E., Finkelstein, N. D., Pollock, S. J., Cohen, G. L. and Ito, T. A. (2010), ‘Reducing the gender achievement gap in college science: A classroom study of values affirmation’, Science, 330(6008): 12341237.
Niederdeppe, J., Fiore, M. C., Baker, T. B. and Smith, S. S. (2008), ‘Smoking-cessation media campaigns and their effectiveness among socioeconomically advantaged and disadvantaged populations’, American Journal of Public Health, 98(5): 916924.
O'Connor, A. M., Stacey, D., Entwistle, V., Llewellyn-Thomas, H., Rovner, D., Holmes-Rovner, M., Tait, V., Tetroe, J., Fiset, V., Barry, M. and Jones, J. (2003), ‘Decision aids for people facing health treatment or screening decisions (Cochrane Review)’, The Cochrane Library, 2.
O'Connor, A. M., Drake, E. R., Fiset, V., Graham, I. D., Laupacis, A. and Tugwell, P. (1998), ‘The Ottawa patient decision aids’, Effective Clinical Practice: ECP, 2(4): 163170.
O'Connor, A. M., Tugwell, P., Wells, G. A., Elmslie, T., Jolly, E., Hollingworth, G., McPherson, R., Bunn, H., Graham, I. and Drake, E. (1999), ‘A decision aid for women considering hormone therapy after menopause: decision support framework and evaluation’, Patient Education and Counseling, 33(3): 267279.
Osterberg, L. and Blaschke, T. (2005), ‘Adherence to medication’, New England Journal of Medicine, 353(5): 487497.
Peters, E. (2006), ‘The functions of affect in the construction of preferences’, in Lichtenstein, S. and Slovic, P. (eds), The Construction of Preferenc, New York: Cambridge University Press, 454463.
Peters, E. (2012), ‘Beyond comprehension: The role of numeracy in judgments and decisions’, Current Directions in Psychological Science, 21(1): 3135.
Peters, E., Baker, D. P., Dieckmann, N. F., Leon, J. and Collins, J. (2010), ‘Explaining the effect of education on health a field study in Ghana’, Psychological science, 21(10): 13691376.
Peters, E., Evans, A. T., Hemmerich, N. and Berman, M. (2016), ‘Emotion in the law and the lab: The case of graphic cigarette warnings’, Tobacco Regulatory Science, 2(4): 404413.
Peters, E., Meilleur, L. and Tompkins, M. K. (2014), ‘Numeracy and the Affordable Care Act: Opportunities and challenges. Appendix A. IOM (Institute of Medicine)’, in Health Literacy and Numeracy: Workshop Summary. Washington, DC: The National Academies Press.
Peters, E., Romer, D., Slovic, P., Jamieson, K. H., Wharfield, L., Mertz, C. K. and Carpenter, S. M. (2007), ‘The impact and acceptability of Canadian-style cigarette warning labels among US smokers and nonsmokers’, Nicotine & Tobacco Research, 9(4): 473481.
Peters, E., Shoots-Reinhard, B., Tompkins, M. K., Schley, D., Meilleur, L., Sinayev, A., Tusler, M., Wagner, L. and Crocker, J. (in review), Improving numeracy enhances STEM and decision outcomes.
Peters, E., Västfjäll, D., Slovic, P., Mertz, C. K., Mazzocco, K. and Dickert, S. (2006), ‘Numeracy and decision making’, Psychological Science, 17(5): 407413.
Petrova, D. G., van der Pligt, J. and Garcia-Retamero, R. (2014), ‘Feeling the numbers: on the interplay between risk, affect, and numeracy’, Journal of Behavioral Decision Making, 27(3): 191199.
Redick, T. S., Shipstead, Z., Harrison, T. L., Hicks, K. L., Fried, D. E., Hambrick, D. Z., Kane, M. J. and Engle, R. W. (2013), ‘No evidence of intelligence improvement after working memory training: a randomized, placebo-controlled study’, Journal of Experimental Psychology: General, 142(2): 359.
Reyna, V. F., Nelson, W. L., Han, P. K. and Dieckmann, N. F. (2009), ‘How numeracy influences risk comprehension and medical decision making’, Psychological Bulletin, 135(6): 943.
Reyna, V. F., Weldon, R. B. and McCormick, M. (2015), ‘Educating Intuition Reducing Risky Decisions Using Fuzzy-Trace Theory’, Current Directions in Psychological Science, 24(5): 392398.
Sahyoun, N. R., Pratt, C. A. and Anderson, A. M. Y. (2004), ‘Evaluation of nutrition education interventions for older adults: a proposed framework’, Journal of the American Dietetic Association, 104(1): 5869.
Schmeichel, B. J. and Vohs, K. D. (2009), ‘Self-Affirmation and Self-Control’, Journal of Personality and Social Psychology, 96(4): 770782.
Schroy, P. C., Emmons, K., Peters, E., Glick, J. T., Robinson, P. A., Lydotes, M. A., Mylvanaman, S., Evans, S., Chaisson, C., Pignone, M., Prout, M., Davidson, P. and Heeren, T. C. (2011), ‘The impact of a novel computer-based decision aid on shared decision-making for colorectal cancer screening: A randomized trial’, Medical Decision Making, 31(1): 93107.
Shapiro, J. A., Seeff, L. C., Thompson, T. D., Nadel, M. R., Klabunde, C. N. and Vernon, S. W. (2008), ‘Colorectal cancer test use from the 2005 National Health Interview Survey’, Cancer Epidemiology Biomarkers & Prevention, 17(7): 16231630.
Sherman, D. K. and Cohen, G. L. (2006), ‘The psychology of self-defense: Self-affirmation theory’, Advances in Experimental Social Psychology, 38: 183242.
Shipstead, Z., Redick, T. S. and Engle, R. W. (2012), ‘Is working memory training effective?’, Psychological Bulletin, 138(4): 628.
Sinayev, A. and Peters, E. (2015), ‘Cognitive reflection vs. calculation in decision making’, Frontiers in Psychology, 6: 532.
Slovic, P. (2001), Smoking: Risk, Perception, & Policy. London: Sage.
Smith, P., Bansal-Travers, M., O'Connor, R., Brown, A., Banthin, C., Guardino-Colket, S. and Cummings, K. M. (2011), ‘Correcting over 50 years of tobacco industry misinformation’, American Journal of Preventive Medicine, 40(6): 690698.
Strasser, A. A., Tang, K. Z., Romer, D., Jepson, C. and Cappella, J. N. (2012), ‘Graphic warning labels in cigarette advertisements: recall and viewing patterns’, American Journal of Preventive Medicine, 43(1): 4147.
US Centers for Disease Control (2016), Smoking & Tobacco Use. [29 November 2016]
US Department of Health and Human Services (1994), Preventing Tobacco Use Among Young People. A Report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
Viscusi, W. K. (2000), ‘Comment: the perils of qualitative smoking risk measures’, Journal of Behavioral Decision Making, 13(2): 267272.
Ward, M. M., Sundaramurthy, S., Lotstein, D., Bush, T. M., Neuwelt, C. M. and Street, R. L. Jr. (2003), ‘Participatory patient–physician communication and morbidity in patients with systemic lupus erythematosus’, Arthritis and Rheumatism, 49(6): 810818.
Weinstein, N. D. (1998), ‘Accuracy of smokers' risk perceptions’, Annals of Behavioral Medicine, 20(2): 135140.
Weinstein, N. D., Marcus, S. E. and Moser, R. P. (2005), ‘Smokers’ unrealistic optimism about their risk’, Tobacco control, 14(1): 5559.
Weinstein, N. D., Slovic, P., Waters, E. and Gibson, G. (2004), ‘Public understanding of the illnesses caused by cigarette smoking’, Nicotine & Tobacco Research, 6(2): 349355.
Wilfley, D. and Brownell, K. D. (1994), ‘Physical activity and diet in weight loss’, in Dishman, R. K. (ed.), Advances in exercise adherence, Champaign, IL: Human Kinetics, 361393.
Zullig, L. H., Shaw, R. J. and Bosworth, H. B. (2014), ‘Applying technology to medication management and adherence’, in Marsch, L. A., Lord, S. E. and Dallery, J. (eds), Behavioral health care and technology: using science-based innovations to transform practice, New York: Oxford University Press, 8194.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Behavioural Public Policy
  • ISSN: 2398-063X
  • EISSN: 2398-0648
  • URL: /core/journals/behavioural-public-policy
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed