Health Literacy: The Teach-Back Method

Did you know that patients forget 40-80% of information as soon as they leave the doctor’s office? And about half of the information they retain is incorrect?

My sense from speaking with doctors is that they are often surprised to find out that their patients are retaining so little information. I think they assume that if you don’t ask questions, and smile and nod when they’re speaking, then you are understanding and absorbing what they are telling you. Not so!

We know that providers should use plain language when speaking with patients, yet we also know from experience that that is often not the case. Providers may often rush through instructions as well. And not every provider’s office gives you an after-visit summary or provides a plain-language after-visit summary.
What is teach-back? According the Agency for Healthcare Research and Quality, “the teach-back method is a way of checking understanding by asking patients to state in their own words what they need to know or do about their health. It is a way to confirm that you have explained things in a manner your patients understand. The related show-me method allows staff to confirm that patients are able to follow specific instructions (e.g., how to use an inhaler).”

While teach-back is actually a method that providers should be trained in and use, we also know that they usually don’t. As patients, we can initiate a “teach back” moment ourselves! 

After your doctor tells you something, such as your diagnosis or treatment plan, repeat it back in your own words. That way, they can determine if you understood the instructions and it gives them an opportunity to make corrections.
For example, suppose you have diabetes and monitor your blood sugar level at home. The doctor explains to you what to do if your blood sugar is low or high. After they explain this to you, they should ask you to repeat it back to check for understanding. This understanding should include what range is low, what range is high, and what to do in each case. If the doctor doesn’t ask you to repeat it back, you could initiate the teach-back yourself: “Dr. Smith, I just want to be sure I understood correctly. If my blood sugar is low [give number], then I should eat or drink [give example]. If my blood sugar is high [give number], then I should [give example].” If you get this wrong, the doctor knows that they need to repeat the instructions, perhaps using different language or approach.

Teach-back is not a quiz for patients; it’s actually puts the onus on providers to explain information clearly. However, since I’ve rarely seen it used in practice, I recommend that we, as patients, take this into our own hands and use it for ourselves!

Bottom Line: We need to advocate for ourselves. One way to be sure that we understand information correctly is to use the teach-back method.