![]() ![]() Teach-back involves asking patients to explain in their own words what a health provider has just told them. Interventions to improve communication at the patient-clinician interface are warranted with one approach being the use of education and recall communication strategies such as ‘teach-back’. Studies have shown that less than half the information provided about medication and diet is accurately recalled by patients, and can be even more challenging for people with low levels of education. Recall is considered an important mediator for treatment adherence and improved health outcomes. Another major challenge in healthcare communication is patients’ ability to recall the information provided to them. A frequently observed barrier to patient understanding is the continued use of medical terminology by doctors, with one systematic review reporting that patients want clearer explanations about their condition as they frequently misunderstand terms used in medical consultations. ![]() These communication gaps can lead to adverse outcomes including compromised safety and increased economic burden. Another qualitative study reported that 77% of doctors believed their patients were aware of their diagnosis, although only 57% of patients could correctly recall this. ![]() One survey-based study reported that 75% of surgeons believed they communicated well with their patients, but only 21% of their patients reported satisfactory communication. There is a well-recognized communication gap in health care, with several studies identifying that healthcare providers may overestimate their own ability to communicate. The ability to understand and use health information is a core component of health literacy, a concept which is consistently associated with health outcomes and identified by the World Health Organization as key to achieving the Sustainable Development Goals. Self-management of health is becoming increasingly complicated, leading to the need for strategies that support patients to not only understand complex health information, but also to apply this information in everyday life. The healthcare system places a significant burden on patients to participate in their own care such as shared decision-making, providing informed consent or adhering to therapeutic regimens. Use of implementation strategies such as training and education of stakeholders and supporting clinicians during implementation may improve the uptake and sustainability of teach-back and achieve positive outcomes. While its mode of delivery is well-defined, strategies to support its translation into practice are not often described. Teach-back was found to be effective across a wide range of settings, populations and outcome measures. hospital re-admissions, quality of life). knowledge recall and retention) to objective health-related outcomes (e.g. ![]() Use of teach-back proved effective in 19 of the 20 studies, ranging from learning-related outcomes (e.g. The most used implementation strategies were training and education of stakeholders (n = 8), support for clinicians (n = 6) and use of audits and provider feedback (n = 4). Implementation strategies were infrequently reported (n = 10 studies). In most studies (n = 15), teach-back was delivered as part of a simple and structured educational approach. Studies were heterogeneous in terms of setting, population and outcomes. Overall, 20 studies of moderate quality were included in this review (four rated high, nine rated moderate, seven rated weak). Implementation strategies were extracted into distinct categories established in the Implementation Expert Recommendations for Implementing Change (ERIC) project. Two reviewers independently extracted study data and assessed methodologic quality. We searched Ovid Medline, CINAHL, Embase and The Cochrane Central Register of Controlled Trials for studies reporting the use of teach-back as an educational intervention, published up to July 2019. This review aims to synthesize evidence about the translation of teach-back into practice including mode of delivery, use of implementation strategies and effectiveness. Use of ‘teach-back’ has been shown to improve patients’ knowledge and self-care abilities, however there is little guidance for healthcare services seeking to embed teach-back in their setting. Patients often have difficulty comprehending or recalling information given to them by their healthcare providers. ![]()
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