The 5Ts for Teach Back: An Operational Definition for Teach-Back Training

Abstract

Background: Teach Back is a health communication strategy used to confirm patient understanding in a nonshaming way. Although Teach Back is widely recommended as a best practice strategy for improving patient outcomes and organizational health literacy, there is lack of consensus in the literature on the definition of Teach Back and the best methods for training health care workers (HCWs). Our experience suggests that if you teach specific, observable skills, these can be identified in practice and potentially measured in research. Brief description of activity: We created a training program, the 5Ts for Teach Back, based on a standardized operational definition of Teach Back and five specific, observable components. Participants use a Teach-Back Observation Tool to identify the 5Ts in practice and during peer evaluation. The program incorporates lecture, observation, practice, and videos with good and bad examples of Teach Back. Implementation: The training was offered to HCWs in a large academic health care system. Flexible training options ranged from a single 4-hour training to a more comprehensive program that included clinic-specific scenarios, peer coaching, and refresher activities over a 6-month period. Results: The 5Ts for Teach Back operationalizes the definition of Teach Back and provides a model for training HCWs in the use of Teach Back. The 5Ts for Teach Back can be used to train any HCW. A single training session does not guarantee proficiency in practice. Through coaching and refresher activities, competence in Teach Back increases. Lessons learned: Teaching entire clinical units may increase effectiveness, because Teach Back becomes embedded in the unit culture. The Observation Tool can be used for training, coaching, and evaluation. The standardized method and Observation Tool are potentially useful when evaluating Teach Back during outcomes and patient satisfaction research. [HLRP: Health Literacy Research and Practice. 2020;4(2):94-103.] Plain Language Summary: Health care workers may be clearer when giving information to patients if they use Teach Back. Studies do not show what methods are best for training health care workers how to do Teach Back. The 5Ts method breaks Teach Back into five skills that help health care workers do it well. The 5Ts can also confirm use and may be helpful for research. No evidence exists favoring one method of teaching communication strategies, including Teach Back, over another (Coleman, 2011). Methods found in the literature for

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“…A number of health communication strategies have been demonstrated to help individuals understand health information [ 59 , 60 ]. For example, the teach-back method prompts patients to “show” the provider the information being communicated (repeat her or his understanding of the information back to the HCPs) and to receive clarifying feedback, which is a non-stigmatising way of enhancing and confirming the patient’s understanding [ 61 , 62 ]. The “clear communication” strategy suggests using plain language, focusing on 1–3 key messages, repeating or summarising key messages and suggestions, and using multiple teaching channels (e.g., visual aids and written summaries) [ 60 , 63 ].…”

A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: The ADVICE pilot study

“…The diagnoses were based on the Clinical Care Classification system (CCC) [ 24 ] and served as a reference point for tailoring the teach-back intervention. To ensure quality and homogeneity of the education sessions, the FNP were required (for every session) to fill in a checklist, adapted from the Teach-back Observation Tool [ 25 ].…”

As Competências dos profissionais de saúde ao serviço do envelhecimento saudável

“…Será abordada especificamente a técnica Teach-back como técnica promotora de literacia em saúde, que prova ser eficaz em todas as fases do ciclo de vida. Anderson et al, (2020) referem que este método é "uma definição operacional padronizada, que transforma a técnica num conjunto de habilidades que são fáceis de aprender, verificáveis em prática e, potencialmente, mensurável em pesquisa" (p. e94).…”