I recently attended a seminar presented by UMHS Patient Education Division on the idea of teaching back. In there, I learned that 36% of adult patients in the USA have low health literacy, and that low health literacy is associated with stigma and shame. And my mind immediately wondered about patients that regularly use our interpretation services.
If among native English speaking patients, as it was stated, 40-80% of medical information is forgotten and that as more information is provided, more information is forgotten, which of those percentages might apply to patients in need of an Interpreter?
One way to make sure that information is explained clearly to, and fully reaches, its corresponding audience is the use of the teach-back strategy. A strategy consisting, after a given explanation, in asking the patient and/or accompanying person to explain back, in their own words, what they had just been taught.
Although the use of the teach-back strategy is upon the clinician, it might fall on us, the Medical Interpreters, to remind them of its existence. We, as Medical Interpreters, are also in charge, even if in a minimal part, to ensure the patient’s understanding of the encounter with the care provider. Therefore, knowing the whereabouts of this strategy can be helpful.
Amid the main elements that teach-back should include are:
- Open, non-shaming questions
- The use of small chunks of information at a time
- If the patient is not able to explain, check, re-explain, and re-check
- Plain language
- Reader-friendly print materials to support learning
- Document use and patient response to teach-back strategy.
The strategy should avoid:
- Closed questions: yes/no questions
- Questions such as:
- Do you understand?
- Do you have any questions?
Keep these tips in mind and surreptitiously suggest them to care providers whom, in a given situation, may especially benefit from the application of the teach-back strategy.
In addition, as Medical Interpreters, we can also slow down the pace of doctor’s explanations by speaking slowly, even if the doctor speaks fast, to help patients relax and understand; thus, facilitating accurate and complete communication, and at the same time preclude patients from the feeling that they are not being treated properly because of time constraints or, even worse, of any sort of underlying discrimination issues.
• Badour, Brenda (2016) Brown Bag Presentation: “Teach-Back”: What It Does Your Patient Really Understand”, Danto Auditorium, CVC, UMHS.