What can we do to help improve communication and understanding?
Use
We can use teach-back to help identify gaps in understanding. Teach-back involves someone expressing that information in their own words.
Teach-back puts the responsibility onto healthcare workers to make sure the information they provide is easy to understand.
Teach-back can be used at any time or in any context. Not only in clinical interactions, but also in non-clinical interactions such as making appointments, or giving directions. For example,
Explaining how to find your way around a hospital.
Showing someone how they can manage their diabetes.
Helping people know what to do when they go home from the Emergency Department.
Showing people how to modify their home to reduce the likelihood of a fall.
Why is teach-back so important?
Let’s look at an example.
“What is happening here?”
What may seem clear to one person can be misunderstood by another.
We cannot assume anything about a person’s ability to understand, particularly when they are in stressful situation or hearing things for the first time. Just because someone has a higher education or income, this doesn’t mean they will understand what you are saying.
Teach-back and health literacy
Teach-back is a good alternative to formal screening because it can quickly provide healthcare workers with information about a person’s health literacy strengths and needs.
For more information on health literacy visit the following links:
What is the evidence for the effectiveness of teach-back in improving client outcomes and safety?
Ha Dinh, T., Bonner, A., Clark, R., et al. 2016. The effectiveness of the teach‐back method on adherence and self‐management in health education for people with chronic disease: a systematic review. JBI Database of Systematic Reviews and Implementation Reports. 14(1), 210-47.
Negarandeh, R., Mahmoodi, H., Noktehdan, H., et al. 2013. Teach back and pictorial image educational strategies on knowledge about diabetes and medication/dietary adherence among low health literate persons with type 2 diabetes. Primary Care Diabetes. 7(2), 111-8.
Negarandeh, R., Mahmoodi, H., Noktehdan, H., et al. 2013. Teach back and pictorial image educational strategies on knowledge about diabetes and medication/dietary adherence among low health literate persons with type 2 diabetes. Primary Care Diabetes. 7(2), 111-8.
Paasche-Orlow, M., Bilderback, A., Chanmugam, A., et al. 2005. Tailored education may reduce health literacy disparities in asthma self-management. Am J Respir Crit Care Med. 172(8), 980-986.
Schillinger, D., Piette, J., Grumbach, K., et al. 2003. Closing the loop: physician communication with diabetic persons who have low health literacy. Arch Intern Med. 163, 83–90.
Dantic, D. 2013. A critical review of the effectiveness of ‘teach-back’ technique in teaching COPD persons self-management using respiratory inhalers. Health Educ J. 73(1), 41-50.
DeWalt, D., Malone, R., Bryant, M., et al. 2006. A heart failure self-management program for persons of all literacy levels: A randomized, controlled trial. BMC Health Services Research. 6, 30.
Krumholz, H., Amatruda, J., Smith, G., et al. 2002. Randomized trial of an education and support intervention to preventreadmission of persons with heart failure. JAMA. 39(1), 83-9.
Peter, D., Robinson, P., Jordan, M., et al. 2015. Reducing readmissions using teach-back. Journal of Nursing Administration. 45(1), 35-52.
Kornburger, C., Gibson, C., Sadowski, S., et al. 2013. Using “teach-back” to promote a safe transition from hospital to home: an evidence-based approach to improving the discharge process. Journal of Pediatric Nursing. 28, 282–291.