One of the easiest ways to improve communication between health professionals and consumers is to use the Teach Back method. Teach Back involves a health professional giving information, then asking the consumer to recall and “teach back” the information as they understand it.

Teach Back enables a health professional to ensure that their patient:

• has heard and understands the information they have been given,
• knows what it means for them, and
• what the required action is.

If a consumer shows they don’t understand, you can try presenting the information in a different way. You then ask the consumer to ‘teach back’ the information again using their own words, repeating the process until you are comfortable they really understand all the necessary information. If they simply repeat your words back to you, they may not have understood. Once you are sure they understand, you can then move on and repeat the process for any additional information.

If the consumer still does not understand, you should consider other strategies to help them understand the information. This could mean presenting it in a different way or reducing the amount of information to a few key points.

It is helpful to use written/visual material (including pamphlets, diagrams, models) to reinforce the verbal information to improve consumer understanding and support different learning styles.

Key points to remember are:

• Use plain language and ask the consumer to explain back, using their own words, what was discussed and what the consumer needs to do.
• Use non-shaming open-ended questions.
• The responsibility to explain and ensure understanding is on you, the provider.
• Repeat the process until you are confident the key messages are understood. If a key point seems to be unclear, rephrase the information, rather than just repeating the information as previously presented.

Tips, Tricks and Techniques

• This is not a test of the consumer’s knowledge. It is a test of how well you explained the information.
• Plan ahead. Think about how you will ask your patients to teach back the information. Find some open ended questions that you can use regularly so that they become a natural part of how you communicate.
• Chunk and Check. Don’t wait until the end of the visit to use Teach Back. Break the information into smaller bites and repeat the Teach Back process several times during a visit.
• Clarify and check again. If there is a misunderstanding, explain things again in a different way. Repeat the process until they can correctly describe the information in their own words.
• Start slowly. Start with one patient a day and increase as your confidence increases.
• Practice. It will take a little time, but once it is part of your routine, Teach Back becomes second nature and does not lengthen a visit. Once you are comfortable with the technique, use it with everyone, every time.
• Use handouts. Write down key information to help patients remember the most important information after they leave. Highlight important information and make notes or draw on written material to reinforce understanding.

Resources:

Information and resources:

The Teach-Back website is an Australian resource developed by South Eastern Sydney Local Health District and Deakin University.  It has a range of information and resources to support health professionals or community workers integrate the method into their practice.

The Centre for Culture, Ethnicity and Health (CEH) has developed a guide on Using Teach-back via an Interpreter.

Toolkits:

The Always Use Teach-Back! Toolkit  describes principles of plain language, teach-back, coaching, and system changes necessary to promote consistent use of teach-back. It’s 45-minute Interactive Teach-Back Learning Module  includes key content and videos of clinicians using teach-back. The module can be used by clinicians, staff members, in a group setting, or as a self-directed tutorial.

Videos:

University of North Carolina: https://hsl.lib.unc.edu/health-literacy/videos-tutorials/

North Western Melbourne Primary Health Network  – Teach back – a technique for clear communication.    Run time: 4.31 minutes  https://www.youtube.com/watch?v=d702HIZfVWs

Articles:

Yen, Peggy H, and A Renee Leasure. “Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes.” Federal practitioner : for the health care professionals of the VA, DoD, and PHS vol. 36,6 (2019): 284-289.