Utilizing the “teach-back” method to improve surgical informed consent and shared decision-making: a review

Seely, Kevin D.; Higgs, Jordan A.; Nigh, Andrew

doi:10.1186/s13037-022-00322-z

Cited by 18 publications

(18 citation statements)

References 56 publications

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“…Qualifying the clinician-patient relationship is critical to implementing SDM, so physicians should communicate effectively [ 87 , 88 ]. Verbal and non-verbal behavior and teach-back techniques were related to more patient-centered communication [ 37 , 49 , 53 ]. Interpersonal interactive communication is a significant and complex matter requiring continuous lifelong learning and improvement in daily practice for physicians.…”

Section: Discussionmentioning

confidence: 99%

“…A conversational model of risk communication facilitates high-quality decisions in cancer care because it addresses open spaces to discover links between clinical evidence and patient values while permitting a satisfactory level of participation from all parties [ 36 ]. The teach-back method is a practical communication instrument that can be used to improve SDM and patient safety [ 37 ]. Its utility in patient care has been seen in many clinical scenarios.…”

Section: Methodsmentioning

confidence: 99%

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Determining the Development Strategy and Suited Adoption Paths for the Core Competence of Shared Decision-Making Tasks through the SAA-NRM Approach

Wang²,

Chang³

et al. 2022

IJERPH

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Shared decision making (SDM) is an interactive process that involves patients and their healthcare professionals reaching joint decisions about medical care through negotiation. As the initiators of medical decision-making in daily routine, physicians should be aware of and concerned about the SDM process. Thus, professional competency development for SDM has become increasingly critical for physicians’ training. Therefore, this study investigates the professional competency and the important competency development aspects/criteria of SDM tasks through expert interviews and literature research. The study adopts the SAA (satisfaction-attention analysis) method to assess the status of competency development aspects/criteria and determine the NRM (network relation map) based on the DEMATEL (decision-making trial and evaluation laboratory) technique. The results demonstrate that the CE (concept and evaluation) aspect is the dominant aspect, and the CR (communication and relationship) aspect is the aspect being dominated. The CE aspect influences the aspects of SP (skill and practice), JM (joint information and decision making) and CR, and the SP aspect affects the aspects of JM and CR. Then, the JM aspect affects the CR aspect. The study also suggests suitable adoption paths of competency development for SDM tasks using the NRM approach. It provides recommendations and strategic directions for SDM competency development and sustainable training programs.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Determining the Development Strategy and Suited Adoption Paths for the Core Competence of Shared Decision-Making Tasks through the SAA-NRM Approach

Wang²,

Chang³

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…Physicians can appreciate patients’ culture, education, and language diversity and can accept the health values, beliefs, views, and feelings of patients and their families [ 8 , 42 ]. There are many ways to improve communication skills, such as using simple language, responding to teaching, verbal and nonverbal methods, gathering adequate information, checking the patient’s understanding, and expressing empathy [ 42 , 43 ]. Clinicians should consider the SDM process across disciplines to permit the exchange of information, deliberation, and the joint decision making regarding essential treatments [ 44 ].…”

Section: Methodsmentioning

confidence: 99%

Establishing the Competency Development and Talent Cultivation Strategies for Physician-Patient Shared Decision-Making Competency Based on the IAA-NRM Approach

Hsu

Wang

et al. 2022

Healthcare

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Shared decision making (SDM) is a collaborative process involving patients and their healthcare workers negotiating to reach a shared decision about medical care. However, various physician stakeholders (attending physicians, medical residents, and doctors in post-graduate years) may have different viewpoints on SDM processes. The purpose of this study is to explore the core competence of physicians in performing SDM tasks and to investigate the significant competency development aspects/criteria by applying the literature research and expert interviews. We adopt the IAA (importance awareness analysis) technique for different stakeholders to evaluate the status of competency development aspects/criteria and to determine the NRM (network relation map) based on the DEMATEL (decision-making trial and evaluation laboratory) technique. The study combines the IAA and NRM methods and suggests using the IAA-NRM approach to evaluate the adoption strategies and common suitable paths for different levels of physicians. Our findings reveal that SDM perception and practice is the primary influencer of SDM competence development for all stakeholders. The current model can help hospital administrators and directors of medical education understand the diverse stakeholders’ perspectives on the core competence of SDM tasks and determine common development plans. It provides strategic directions for SDM competency development and talent cultivation programs.

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“…1 Teach-back is a dynamic, interactive, and patient-centered process that may require multiple repeated sequential explanations, checks for comprehension, and clarifications. Figure used with permission from Seely et al [ 13 ] …”

Section: Introductionmentioning

confidence: 99%

“…The teach-back method has been shown to improve communication and enhance the relationship between patients and their healthcare providers to meet many of the aims of effective communication. However, current literature on the teach-back method’s application to the pre-surgical informed consent process is limited [ 10 – 13 ]. Therefore, the objective of this proof-of-concept study was to provide foundational evidence to determine the beneficial effect of the teach-back method for pre-surgical informed consent based on a clear actionable definition and formula.…”

Section: Introductionmentioning

confidence: 99%

The “teach-back” method improves surgical informed consent and shared decision-making: a proof of concept study

et al. 2022

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Introduction The teach-back method is a communication tool that can improve patient safety and shared decision-making. Its utility in patient care has been studied extensively in many areas of clinical medicine. However, the literature on teach-back in surgical patient education and informed consent is limited, and few studies have been conducted to test its impact on perioperative patient interactions. The objective of this study was to evaluate if the teach-back method can improve informed consent and surgeon trust. An assessment of the time required to be implemented was also evaluated. Methods A standardized interaction role-playing a pre-operative informed consent discussion was designed. Laparoscopic cholecystectomy was selected as the proposed procedure. Standardized patients were split into two groups: teach-back and a control group. The control group was delivered a script that discloses the risks and benefits of laparoscopic cholecystectomy followed by a concluding prompt for any questions. The teach-back group was presented the same script followed by the teach-back method. Interactions were timed and patients completed a quiz assessing their knowledge of the risks and benefits and a survey assessing subjective perceptions about the interaction. Statistical analysis through Generalized Linear Models (GLMs) was used to compare visit length, performance on the comprehension quiz, and subjective surgeon trust perceptions. Results 34 participants completed the scenario, the comprehension quiz, and the survey (n = 34). Analysis of the subjective evaluation of the physician and encounter was significant for increased physician trust (p = 0.0457). The intervention group performed higher on the knowledge check by an average of one point when compared to the control group (p = 0.0479). The visits with intervention took an average of 2.45 min longer than the control group visits (p = 0.0014). People who had the actual procedure in the past (evaluated as a confounder) were not significantly more likely to display the same effect as the teach-back method, suggesting that the knowledge and trust gained were not based on previous experiences with the procedure. Conclusion When employed correctly by surgeons in the perioperative setting, the teach-back method enhances shared decision-making, comprehension, and surgeon trust. Incorporating the teach-back method into risk and benefit disclosures effectively informs and more fully engages patients in the informed consent process. Notably, the added benefits from using teach-back can be obtained without a burdensome increase in the length of visit.

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Utilizing the “teach-back” method to improve surgical informed consent and shared decision-making: a review

Cited by 18 publications

References 56 publications

Determining the Development Strategy and Suited Adoption Paths for the Core Competence of Shared Decision-Making Tasks through the SAA-NRM Approach

Determining the Development Strategy and Suited Adoption Paths for the Core Competence of Shared Decision-Making Tasks through the SAA-NRM Approach

Establishing the Competency Development and Talent Cultivation Strategies for Physician-Patient Shared Decision-Making Competency Based on the IAA-NRM Approach

The “teach-back” method improves surgical informed consent and shared decision-making: a proof of concept study

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