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The aim of this study was to investigate whether an introductory educational course on rational decision making is able to improve decisions about health and health care including decisions based on the quality-adjusted life year model. Specifically, this study analyzed the impact of the course on i) health preference reversals (PRs); ii) violations of the condition of mutual utility independence (MUI) between preferences for longevity and health status; and iii) violations of the independence axiom (IA) of expected utility theory. A total of 162 undergraduate students were randomly assigned to a pre- or post-educational group based on a pre-specified allocation sequence. In both groups students took a survey with choice and valuation exercises on health and longevity and made health decisions for themselves and for those for whom they are responsible. More than 70% of students without training demonstrated PRs. Yet, education did not significantly alter the number of PRs. The IA was violated in almost half of participants without training but significantly less so in the group receiving the educational intervention. Violations of MUI were found in 51% of participants without training with a non-significant change in the educational group. In this sample violations of conditions for rational choice in health care were common and only to a small degree amenable to education.
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