STEP 2 | Check understanding
Ask the person to demonstrate understanding in their own words about what they need to know or do.
Teach-back is not a test of the person but of how well you explained the topic. How you ask questions is also important. What you say, along with your tone of voice and body language, conveys whether you are working with the person or they feel like they are being tested. Don’t ask yes/no questions such as “do you understand?” because most times people just say ‘yes’ or ‘no’ – even if they haven’t understood. You as the healthcare worker need to take responsibility for their understanding. A key is to be genuine, which means you will need to find your own way and words to genuinely engage with each individual.
Here are some examples of specific questions you could adapt:
Pick three ways to ask someone to repeat back in their own words:
J is also incorrect as it might make the person feel like they are being tested. The onus is on you to explain clearly. So you might say, "I need to check I have explained this clearly, can you explain back to me what you need to do when you go home?"
Using open-ended, non-shaming questions
Creating a shame-free environment where questions are encouraged is essential.
In which video does the nurse use a non-shaming, open-ended question to check understanding?
In Video A the nurse assumes the burden of communicating clearly by asking the question “To make sure I have given you the right information can you tell me what I have told you in simple words.”
In Video B the nurse does not check if understanding has taken place but looks for a simple un-tested affirmation.