At the end of an appointment, most of us ask some version of 'Do you have any questions?' or 'Does that make sense?' Most people say yes, or that they have no questions, whether or not they have understood.
Health literacy, the ability to find, understand and use health information, is a significant issue in Australia. The Australian Commission on Safety and Quality in Health Care (2014) reported that around 60 per cent of Australian adults have low individual health literacy, and that the way services communicate can make information easier or harder to use.
What teach-back is
Teach-back is a way of checking understanding by asking the person to explain, in their own words, what they need to know or do. It is not a test of the person; it is a check on how clearly we explained.
A systematic review found that teach-back was linked to improvements in outcomes such as knowledge, self-care and adherence across a range of health settings, although the quality of studies varied (Talevski et al., 2020).
How to do it
- Explain one key point at a time, in plain language.
- Ask: 'I want to make sure I explained that clearly. Can you tell me in your own words what you will do when you get home?'
- If something is missed, explain it a different way and check again.
- Use it for what matters most: medicines, exercises, warning signs and next appointments.
- Pair it with written information the person can take away.
Why it is worth two minutes
Teach-back shifts responsibility for understanding from the person to the practitioner. It catches misunderstandings before they become missed exercises, wrong doses or unnecessary return visits. And it tells us something useful about our own explanations.
Related resources
- Teach-Back Checklist
- Checking Understanding Prompts
- Plain Language Report Summary Template
- Writing Accessible Health Information: A Team Checklist
References
- Australian Commission on Safety and Quality in Health Care. (2014). Health literacy: Taking action to improve safety and quality. ACSQHC. https://www.safetyandquality.gov.au/publications-and-resources/resource-library/health-literacy-taking-action-improve-safety-and-quality
- Talevski, J., Wong Shee, A., Rasmussen, B., Kemp, G., & Beauchamp, A. (2020). Teach-back: A systematic review of implementation and impacts. PLOS ONE, 15(4), e0231350. https://doi.org/10.1371/journal.pone.0231350
This article is general information for practitioners. It is not clinical advice: use your professional judgement and follow your organisation's procedures.