The Health Literacy Demonstrator: What we learned about Teach-Back Dr Phyllis Easton Health Intelligence Manager NHS Tayside Lead, Health Literacy Demonstrator Programme

Repetition alone does not necessarily improve understanding .... I have always spent ages re-iterating information to patients, sometimes I tell them too much and they don’t always take it in. I will now use Teach-Back more formally I feel that I am constantly repeating myself, however, I have always done this. The difference is in getting the patient to relay the information I have given them.

The Teach-Back conversation Sometimes it’s difficult to get into it ....... It was difficult to get into it because the patient said that was how they were shown to use the inhaler in the past On this occasion it was slightly difficult because the patient was unwilling to listen

Teach-Back is needed .... I actually thought I was good at explaining my instructions and advice to patients but when I asked at least 3 of them to remind me of what we had discussed they couldn’t! Before, I never asked them to do this. I will now make a point in asking all patients to remind me of what we discussed

.... and valued Self management is really important so it’s vital that the patients understand what to do I feel you are able to pick up any difficulties the patient may be experiencing and help them to correct these together Was slow to teach me technique initially but the more she did it the better she was. She said it made her think more about what she was doing and why

What if we don’t check understanding? I had to explain the signs to look for and what actions to take 3 or 4 times before the patient was able to teach back to me There is a lot of info to take in at one time. This lady struggled to repeat her instructions but eventually she got it It’s an insight into how communication is not straightforward

Teach-Back is not a one-off I had to go over instructions twice with one man and then he couldn’t tell me what I had said so we had to go over it a third time. He was able to repeat the instructions but I am unsure for how long he will retain this information. It’s easier with some patients than others. I had to go over each step of the plan and what he had to do at each step several times as he was mixing steps up. Teach-Back allowed me to focus fully on this aspect ..... We will go over it again at the next appointment

Does Teach-Back take longer? It took a bit more time to explain this and correct the technique but by the end of the consultation they knew exactly what to do and admitted it made it easier to take [the medication] It does take a few minutes extra time but it will save time in the long run. Does take a little more time in our already stretched time frames with our patients but it is vital to patient care and safety