“What I hear, I forget. What I see, I remember. But what I do, I understand.” 

 This quote by Confucius is an important reminder that to truly understand new information, most people have to hear or see it and apply it. This principle is the foundation of the teach back method. Teach back is a framework for patient-provider communication that promotes sharing information with patients in ways that improve both understanding and retention.

Effective communication is critical to the patient-provider relationship. Increased patient satisfaction, more accurate diagnoses, and better adherence to prescribed treatment are all potential benefits of improved communication in a healthcare setting.1 The teach back method builds off the concept of “teach the teacher,” encouraging active participation on the part of the patient in the learning process.

There are four steps to the teach back method – Explain, Assess, Clarify, Understanding.

  1. Explain – Effective communication draws on use of the Universal Precautions approach and plain language as a foundation for patient-provider interactions. In addition to these techniques, concentrate on what the patient needs to know or do. Settle on 2-3 key points and chunk information accordingly, checking understanding after each point. Enhance the verbal explanation with visual aids, videos, or technology as needed.
  2. Assess – Remember that teach back is not a test of the patient. It’s a test of how well the information is explained. Ask patients to repeat what they hear in their own words or how they might explain what they hear to a loved one. Listen for signs of confusion or misunderstanding. It is not sufficient to ask “Do you understand?”
  3. Clarify – When confusion is obvious, repeat the explanation. Modify the explanation using different words, a non-medical concept, or the addition of visuals. Recheck with the patient to see how the modified explanation changed their understanding.
  4. Understanding – The goal of teach back is to create dialogue that leads to understanding and retention of important medical information. Continue going through the steps until you are confident this goal is achieved.

The teach back process is simple, but implementing it consistently takes time and practice. For additional training on the teach back method, check out the online modules in the Communicating to Connect series. For quick reference, this pocket guide is a great reminder of the core teach back techniques.

For more information about our health literacy initiatives, contact Kelsey Salazar, ksalazar@hcifonline.org.

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