Based on powerpoint
Tool 5 The Teach-Back Method
The Teach-Back Method
Overview
Studies have shown that 40-80 percent of the medical information patients receive
is forgotten immediately1 and nearly half of the information retained is incorrect.2
One of the easiest ways to close the gap of communication between clinician and
patient is to employ the “teach-back” method, also known as the “show-me”
method or “closing the loop.”3 Teach-back is a way to confirm that you have
explained to the patient what they need to know in a manner that the patient
understands. Patient understanding is confirmed when they explain it back to
you. It can also help the clinic staff members identify explanations and
communication strategies that are most commonly understood by patients.
Purpose
To provide your practice with examples and helpful advice on performing the
teach-back method.
Action
1. Learn the teach-back method.
Teach-Back Video : View a 5-minute video that gives two examples
of using teach-back with medication changes.
Testimonial
“I decided to do teach-back on five patients. With one mother and her
child, I concluded the visit by saying ‘So tell me what you are going to do
when you get home.’ The mother just looked at me without a reply. She
could not tell me what instructions I had just given her. I explained the
instructions again and then she was able to teach them back to me. The
most amazing thing about this “ah ha” moment was that I had no idea she
did not understand until I asked her to teach it back to me. I was so
wrapped up in delivering the message that I did not realize that it wasn’t
being received.”
-resident physician, pediatric office
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Tool 5 The Teach-Back Method
Teach-Back: A Health Literacy Tool to Ensure Patient
Understanding: This PowerPoint presentation can be used in a
group setting or as a stand-alone self-study. It contains 20 slides
developed by clinicians at the Iowa Health System.
AMA video: View a video entitled “Health Literacy and Patient
Safety: Help Patients Understand.” The last 5 minutes of the 23-minute
video includes an example of a clinician using teach-back.
Keep in mind:
This is not a test of the patient’s knowledge: This is a test of
how well you explained the concept.
Use with everyone: Use teach-back when you think the person
understands and when you think someone is struggling with
your directions.
Teach to all staff: All members of the practice staff can use it
to make sure their communication is clear.
Tips
Suggested Approaches When Using Teach-back.
“I want to be sure that I explained your medication correctly. Can you
tell me how you are going to take this medicine?”
“We covered a lot today about your diabetes, and I want to make sure
that I explained things clearly. So let’s review what we discussed. What
are three strategies that will help you control your diabetes?”
“What are you going to do when you get home?”
2. Try the teach-back method.
Start Slowly. Initially, you may want to try it with the last patient of
the day.
Plan your approach. Think about how you will ask your patient to
teach-back information based on the topic you are reviewing. Keep in
mind that some situations will not be appropriate for using the teach-
back method.
Use handouts. Reviewing written materials to reinforce the teaching
points can be very helpful for patient understanding. Refer to Tool
12: Use Health Education Materials Effectively.
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Tool 5 The Teach-Back Method
Clarify. If patients cannot remember or accurately repeat what you
asked them, clarify your information or directions and allow them to
teach it back again. Do this until the patient is able to correctly
describe in their own words what they are going to do, without
parroting back what you said.
Practice. It may take some getting used to, but studies show that once
established as part of a routine, it does not take longer to perform.
Track Your Progress
Assess results of the teach-back method with staff and patients.
The Teach-Back Self-Evaluation and Tracking Log provides a
method for staff to document their experience using the teach-back
method. Encourage staff to use the logs, and hold a discussion about
their experience. This will allow people to share teach-back strategies
that worked best. In addition, it is helpful to ask patients if they find
the teach-back interaction positive and helpful during the patient
encounter.
Assess how often the teach-back is used.
A few weeks after first trying the teach-back, track how many
clinicians or staff members are using it. Have each individual keep a
log of when and how it was used over the course of a few days.
References
1. Kessels RP. Patients’ memory for medical information. J R Soc Med. May 2003;96(5):219-22.
2. Anderson JL, Dodman S, Kopelman M, Fleming A. Patient information recall in a
rheumatology clinic. Rheumatology. 1979;18(1):18-22.
3. Schillinger D, Piette J, Grumbach K, et al. Closing the loop: physician communication with
diabetic patients who have low health literacy. Arch Intern Med. 2003;163(1):83-90.
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