Teach-Back Training
Introduction
SAY:
Greeting: Good (Morning, Afternoon, or Evening).
Thank you for joining us today!
Introduction: My Name is __________________, I will
be facilitating today’s session on a technique called
TEACH-BACK. (provide brief overview of your role and
professional background if you are new to the group)
SLIDE 1
Housekeeping Items:
 This session is scheduled to run from 0:00 to 0:00
 Everyone should have the following
materials/handouts_______________________
 Restrooms are
located_______________________
 Refreshments are
available___________________
 Active participation is highly encouraged. Feel
free to ask questions or offer comments at any
time!
ACTIVITY: Before we get started, I’d like for
all of us to get to know each other a little better. Let’s
take a few minutes, go around the room and each person
introduce themselves by sharing their name, role,
organization/hospital and one characteristic of a good
teacher.
10 minutes
Supplies/Equipment:







Laptop and projector
Flipchart or whiteboard
Markers
Copies of ppt presentation in 3
slide per page format with lined
notes section
Attendance sheet
Pens or pencils
Name tags (if appropriate)
On a flip chart or white board, list characteristics of a
good teacher shared by participants. You will reference
back to this list later in the presentation.
(You may get responses such as Patient, Kind, Caring,
Funny, Encouraging, Knowledgeable, Organized, Gives
Positive Feedback, Good Listener, Easy to Talk to, etc.)
1|Page
Teach-Back Training
Objectives
SAY:
Upon completion of the teach-back training today, you will
be prepared to:
1. Define the teach-back method and the key
components for effectively using it with patients (in
other words, what is it, with who, when, where, why
and how do I do it?)
2. Understand and explain the value of teach-back to
improve patient care and safety
3. Apply the knowledge and skills you learn today so
you feel comfortable conducting teach-back with
patients
SLIDE 2
3 minutes
ASK:
Based on the objectives listed, are there any questions about
what we will be discussing today?
Is there anything specific about teach-back that you want to
be sure we cover today?
Supplies/Equipment:


Flipchart or whiteboard
Markers
On a flip chart or white board, list specific teach-back
content that participants want to learn about in this
session. Be sure to reference this when you address the
content throughout the presentation. Incorporate where
appropriate or communicate with participant that this
won’t be covered today but you will follow-up with a
resource for more information on their specific topic of
interest. Request a business card and write the topic of
interest on the back.
2|Page
Teach-Back Training
What is Teach-Back?
SAY:
In the PFP-HEN metric set for reducing readmissions,
you may recall one of the process measures is
“number of observations of nurses where teachback is used to assess understanding”
So what exactly do we mean when we say teach-back?
Teach-back is defined as a simple mechanism by which
a patients understanding of a concept or topic may be
assessed. Or in other words, you want the patient to
restate or “teach back” to you what he or she is
supposed to know. It can be used when you teach both
concepts and techniques.
SLIDE 3
Source: Society of Hospital Medicine. Teach-Back Process.
Dr. Dean Schillinger
2 minutes
Effective communication promotes greater satisfaction
and helps ensure better adherence to treatment plans
with better health outcomes for patients.
ASK:
I want to make sure I explained the definition of teachback clearly. Can someone explain what “teach-back”
is in their own words?
3|Page
Teach-Back Training
Who Should I use Teach-back with?
SAY:
Teach-back should be used with every patient. Assume that
all patients, regardless of factors such as education level,
language, or age, are vulnerable to NOT understanding.
Teach-back can also be used with family caregivers, so be
sure to identify all learners on admission. Keep in mind the
primary or emergency contact may not always be the primary
person who will provide care at home.
All staff who interact with patients should know how to do
teach back. They should use it whenever critical information
is being communicated to the patient and/or family member.
This includes all health care professionals (physicians, nurses,
nursing assistants, physical therapist, respiratory therapist,
pharmacists, etc.)
SLIDE 4
2 minutes
By using this technique frequently with patients, they will
become accustomed to the practice and will increase their
understanding of their care. Especially, if information is
communicated consistently.
Keep in mind this is NOT a test of the patient. They should
not feel as if they are being quizzed on content or feel shamed
if they don’t provide the right answer back. This technique is
used to test how well YOU explained a concept and whether
the patient understands what you tried to teach them.
Source: AHRQ Project RED training program: Teach-Back
4|Page
Teach-Back Training
Why Should I use Teach-Back?
SAY:
When you consider that often the primary method of
patient education is print material and statistics show
we only remember 10% of what we read, is it any
wonder that patients may not comprehend and retain
important information about their health and treatment
plan?
Also, consider the many other factors that may impact
the patient’s ability to take in information, such as lack
of sleep, sedating medications, pain, worry about
diagnosis, finances, work and family while they’re in
the hospital.
SLIDE 5
4 minutes (video clip 33 seconds)
A quote from Confucius describes it well “What I
hear, I forget; what I see, I remember; but what I
do I understand”
Use this mantra with patient education: Read it,
See it, Hear it, Say it, Do it – engage as many
senses to educate and reinforce the message
Ask the patient how they learn best and provide
the education in that format – whether it’s print
material, audiovisuals, simulation, or analogies.
Reinforce teachings to promote understanding and
retention by using consistent information and
teach-back several times during the patient’s stay.

Supplies/Equipment
Internet Access to YouTube; set up
access to YouTube link prior to session
for quick play
http://www.youtube.com/watch?v=dMAS2S5
1bM8
Let’s take a look at an example that demonstrates
why teach-back is so important………
YouTube video clip “Do I look like an
idiot” House MD Episode
5|Page
Teach-Back Training
Is it Research Supported?
SAY:
Teach-back not only makes logical sense, but it is also a
patient safety practice that is endorsed by organizations such
as:
 National Quality Forum
 American Academy of Family Physicians
 American College of Surgeons
 American Hospital Association
 American Nurses Association
 Federation of American Hospitals
 Joint Commission
As well as supported by research. Here are a few alarming
statistics that reinforce how important it is to ensure that
patients understand information shared with them about their
condition and health care plan.
●
SLIDE 6
2 minutes
Studies have demonstrated that patients recall and
comprehend as little as 50% of what they are told by
their physicians.
●
Often times health care providers tend to underestimate
patients’ needs for information, and overestimate their
own effectiveness in conveying the information. In fact, a
recent study found that 37% of patients reported
understanding what they were told during a medical visit
– but their physicians thought that 80% of patients
understood the information conveyed.
Source: National Center for Ethics in Health Care
●
In some disease conditions, more than 40% of patients
sustain significant risks by misunderstanding, forgetting
or ignoring healthcare advice.
Asking patients to recount instructions for taking medication
or to describe a proposed procedure can alert practitioners to
individuals’ particular needs and challenges and help tailor
communications more effectively.
6|Page
Teach-Back Training
When Should I use Teach-back?
SAY:
You may be wondering when the teach-back method
should be used.
Teach-back can work in any setting and in all situations
where you want clarification for what was taught or said.
Use Teach-back with every patient, every time you’re
sharing important information, when teaching new
concepts or re-teaching after using a different method.
An important tip to remember is “Don’t wait right
before discharge to begin patient education” Patients
are typically more focused on going home than on
learning new information. Do patient education and
teach-back throughout the patient’s hospital stay.
SLIDE 7
2 minutes
ASK:
Let’s take a minute to think of all the opportunities during
your workday when you could use teach-back.
Supplies/Equipment:


Flipchart or whiteboard
Markers
Examples may include the following:
 New or change in medications
 Procedure preparations
 Care planning/goal setting
 New self-care technique
 Safety measures
 Informed consent
 Orientation to room and equipment
 Discharge instructions
 Follow-up phone calls
You may even find teach-back to be a useful strategy
outside of work, for example with your children! A great
way to practice the technique.
7|Page
Teach-Back Training
How do I use Teach-back?
SAY:
You realize the importance of teach-back so now you’re
asking “how do I do it”?
The teach-back technique should replace the more
common practice of simply asking a patient “Do you
understand?” Experience shows that patients often
answer “yes” to such questions, even when they don’t
really understand.
SLIDE 8
ASK:
Here are two ways to approach patient education. I’m
going to read two statements and you tell me which one
you think will provide you with the best information to
assess the patient’s understanding of their condition?
5 minutes (2.31 minutes video)
1. “Mr. Smith, you are in the hospital because you
have COPD. Do you understand?”
2. “Mr. Smith, will you explain to me the reason
you are in the hospital?”
Say:
Additional strategies in using teach-back include:
 Avoid asking yes/no questions
 Ask open ended questions
 Re-phrase or use a different method of teaching
if the patient is not able to repeat the
information accurately

Supplies/Equipment
Internet Access to YouTube; set up
access to YouTube link prior to
session for quick play
http://www.youtube.com/watch?v=2N0gCzd
VFnM
Let’s take a look at a short video clip of a nurse
conducting teach-back with a patient. As you’ll see, it
goes better than the previous video with Dr. House.
YouTube video clip patient education teachback example from Minnesota Health Literacy
Partnership
8|Page
Teach-Back Training
Additional Tips with Teach-back
SAY:
Remember at the beginning of the session I asked you
for characteristics of a good teacher? Let’s take a look
at that list again.
(You may get responses such as Patient, Kind,
Caring, Funny, Encouraging, Knowledgeable,
Organized, Gives Positive Feedback, Good Listener,
Easy to Talk to, etc.)
When you’re providing important information to
patient’s, using these same techniques can be very
effective in creating a trusting and supporting
environment where they can participate in the
learning experience and understand the information
shared.
Listed on the slide are a few additional tips to keep in
mind: (Additional Tips for Teachback slide)
SLIDE 9
15 minutes (10 minutes practice exercise)
ACTIVITY:
Let’s take about 10 minutes to apply what we’ve
learned about teach-back and practice with the person
sitting to your right. Okay, just testing to seeing if you
were paying attention.
Break into groups of 3 for this practice exercise. I’ve
provided a list of scenarios you can use for your
teach-back practice. One person plays the role of the
patient, one the health professional and the third
person observe the language and dynamics between
the patient and health professional.



Supplies/Equipment
Refer back to list of good teacher
characteristics
Distribute Word document with practice
scenarios for participants
Distribute teach-back pocket guides
I’ve also passed out teach-back pocket guides that
you may use in this practice exercise. You may want
to keep this in your pocket and pull out for a quick
review before you conduct teach-back with your
patients. This will help you find the right words to ask
a patient so you can assess their understanding of the
information you shared with them.
9|Page
Teach-Back Training
Conclusion: Closing the Loop
SAY:
Today we’ve talked a lot about the what, when, why,
and how of the teach-back method. The diagram on this
last slide is just a simple visual to show the steps used to
ensure we close the communication loop when providing
patient education.
Many of you may be familiar with PDCA or also known
as PDSA as a process improvement method. This can
also be applied to teach-back with the critical step being
“CHECK”. Asking patients to explain or “teach-back” in
their own words what they need to know or do. This is a
chance to CHECK understanding and re-teach
information if needed.
SLIDE 10
Applying PDCA:
-
Plan education based on needs of the patient
Do the education in a supportive way
CHECK to make sure they understand what you
shared with them by using teach-back
Act by re-teaching if necessary or reinforce with
demonstration, written materials, or visual aids.
Using teach-back to communicate more effectively does
take time. However, research by NQF’s Safe Practice
10, found that teach back typically took less than a
minute to complete. Patients have the right to understand
information that is needed for them to make informed
health care decisions and to safely care for themselves.
A few minutes to do teach-back can make a big
difference!
5 minutes
SLIDE 11
I’d like to leave you with this quote by Vice Admiral
Richard Carmona “If they don’t do what we want, we
haven’t given them the right information”
Thank you for your time and attention today!
Any questions?
10 | P a g e