STEP 3 | Clarify
Identify any misunderstandings and re-explain
Actively listen to what the person is ‘teaching-back’ to you. Have they misunderstood anything?
This is a vital step in teach-back. It is often at this point that you realise your assumptions about what someone knows or understands may be incorrect.
Everyone, regardless of education, language or age is at risk of NOT understanding.
Take time over this step, so you are really clear that someone fully understands.
If the person has not explained everything back to you correctly, you will need to provide feedback, focusing on the piece of information that is not understood. For example, you might say…
– “I don’t think I have been clear enough explaining about……”
– “What I meant when I talked about……..was that …”
– “I must not have done a good job explaining the bit about……
Let me try again.”
Tip!
Use this link for more information on how to write easy to understand resources.
How to identify your client’s learning style
Each person will have their own way they like to learn. It can be helpful to have a discussion with a client about their preferred learning style because it highlights the fact that education is occurring and that it is important to you that they understand.
How do you like to learn?
Click the image to download this pdf and tick which boxes apply to you.
There are a range of learning resources you might consider.
Here are some examples
Photos
Serving sizes
Videos
Apps
Props
Using analogies or stories can be effective
Adapt any measures into a format people can understand
Equipment demonstrations
You might draw a picture (but keep them simple – people can struggle with complex diagrams)
Write things down or ask if they would like to write things down themselves. This is a great way of making someone feel they have been given information specifically for them.
Success stories about how other people have managed to do something might also help
Be as innovative as you need to be!
Info!
The Ophelia Victoria study asked 58 older people with chronic and complex conditions about their preferred learning styles. The most popular way to learn was talking through the information with their healthcare worker, followed by handwritten information about what actions needed to be taken (written by either the client or the healthcare worker). 93% said they preferred to receive information face to face.
Tip!
Be specific. When re-explaining something, focus on what people ‘need to know/need to do’. Be concrete, not abstract. For example, say “let’s talk about what you can eat for lunch that will give you more protein”, rather than “let’s talk about high protein foods”. Ask your client to actually ‘show/tell you’ what they are going to do. Ask them to tell you the actual number of pills that make up a dose, or tell you the actual foods that they will eat.
How people learn
Watch these two videos below
Which video best demonstrates how a healthcare worker can identify someone’s learning style and use this as part of their education?
In Video A the dietitian relied on a closed ‘yes/no’ question to check Sue’s understanding of what a high protein is. She did not check understanding. She also did not identify how Sue liked to learn, but simply offered the written resource and said it was important to read. When Sue questioned the need to read all the information in the handout the dietitian did not identify this as a ‘red flag’ and that this approach may not be appropriate for her.
The correct answer is Video B. In this video the dietitian checks with Sue what resource she would like to use – the written or picture based one. She also checks understanding by asking Sue to give examples of high protein foods and how she could add them to each meal. We have included a useful handout that you can use with your patients to identify how they like to learn.
What to do if the client has explained everything back correctly in their own words
In this case, if you are comfortable that the client fully understands what they need to do, you do not need to re-explain anything. But do remember that even if someone ‘gets it’, this doesn’t necessarily mean they will remember it for next time. So rechecking next time you see them is a good idea.
One clinician in the Ophelia Victoria project said:
“the beauty of teach-back is, you don’t have to go back through the whole information. You can just say, ‘remember last time we talked about this…can you show me again?’ So you can jump straight back to where you were and get a really good picture of how much the person took on board and understands. So you can then either move forward or rewind a little bit and bring that into your consult and then move forward”.