Clinical Utility of the Death Literacy Index in Canada: A Mixed-Methods Study
Bibliographic record
Abstract
Programs providing end-of-life education require a standardized tool to identify knowledge gaps and evaluate programming. The aims of this mixed methods study was to examine the perceived clinical utility of the Death Literacy Index (DLI) in the Canadian context. An online survey and focus groups captured quantitative and qualitative data from end-of-life care stakeholders. The survey included the DLI and a measure of clinical utility. Participants rated the DLI positively on a 5-point Likert scale: acceptability (4.3), relevance (3.9), and usefulness (4.1). Qualitative findings supported these ratings and highlighted areas for improvement, including simpler language and more inclusive cultural and spiritual content. Ratings for usefulness reflected the index's potential for initiating end-of-life discussions and program evaluation, though participants noted it may need more specificity to capture nuanced understandings of death literacy. Overall, the findings suggest the DLI requires further refinement and validation to enhance its applicability in the Canadian context.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.024 | 0.037 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.005 | 0.007 |
| Science and technology studies | 0.007 | 0.002 |
| Scholarly communication | 0.005 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".