The teach-back method, also called the "show-me" method, is a communication confirmation method used by healthcare providers to confirm whether a patient (or care takers) understands what is being explained to them. If a patient understands, they are able to "teach-back" the information accurately. This is a communication method intended to improve
health literacy
Health literacy is the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment. There are multiple definitions of health literacy, in part, because heal ...
.
There can be a significant gap in the perception of how much a patient needs information, or how effective a provider's communication is.
[Teach Back: A tool for improving provider-patient communication. The Ethics Center. 2006. Retrieved from http://www.ethics.va.gov/docs/infocus/InFocus_20060401_Teach_Back.pdf] This can be due to various reasons such as a patient not understanding medical terminology, not feeling comfortable asking questions or even cognitive impairment.
Not only does the teach-back method help providers understand the patient's needs in understanding their care, it also allows providers to evaluate their communication skills.
Case studies led by the
National Quality Forum on the informed consent processes of various hospitals found that those that effectively used the teach-back method benefited in areas of quality, patient safety, risk management and cost/efficiency.
[Implementing a National Voluntary Consensus Standard for Informed Consent: A User's Guide for Healthcare Professionals. National Quality Forum. 2005. Retrieved from http://www.qualityforum.org/Publications/2005/09/Implementing_a_National_Voluntary_Consensus_Standard_for_Informed_Consent__A_User’s_Guide_for_Healthcare_Professionals.aspx]
The method
The
National Quality Forum describes the practice as follows:
Who should use the method→ Any healthcare providers. E.g. physicians, nurses, healthcare professionals
What should patients teach-back→Information about their diagnosis, treatment plan, medications, risks and benefit of treatment, etc.
When to ask for teach-back→ Early in the care process
Why is it important→Many patients have difficulty understanding medical information.
How→When asked to teach-back, patients should be able to clearly describe or explain the information provided to them.
Depending on the patient's successful or unsuccessful teach-back, the provider will clarify or modify the information and reassess the teach-back to confirm the patient's comprehension and understanding.
[The Teach Back Method. SurroundHealth. 2012. Retrieved from www.surroundhealth.net]
Knowledge retention
The cycle of reassessing and teaching back to confirm comprehension has been found to improve knowledge retention and lower readmission rates in heart failure patients.
[Is "teach back" associated with knowledge retention and ]hospital readmission A hospital readmission is an episode when a patient who had been discharged from a hospital is admitted again within a specified time interval. Readmission rates have increasingly been used as an outcome measure in health services research and as a ...
in hospitalized heart failure patients? The Journal of Cardiovascular Nursing. 2013 Mar-Apr;28(2):137-46. doi: 10.1097/JCN.0b013e31824987bd
Beyond healthcare literacy, the teach-back method can be utilized in academic and professional settings as well. Teachers often create
feedback loops
Feedback occurs when outputs of a system are routed back as inputs as part of a chain of cause-and-effect that forms a circuit or loop. The system can then be said to ''feed back'' into itself. The notion of cause-and-effect has to be handled ...
in which the instructor asks the student to share what they heard, and promote peer to peer coaching where students explain what they just learned to other students. Retention is also most positively impacted in
participatory learning environments, when students participate in group discussions, practice by doing, and teaching others.
[Teaching Methods and Retention. 2002. Retrieved from http://www.simulations.co.uk/pyramid.htm]
References
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Health education
Practice of medicine