documentation of what the patient has learned rather than just what was taught. Welcome booklets provided on admission can introduce the concept to patients and families so they understand their team of providers wants to enhance their knowledge and skills for successful management of their condition once they are discharged.

Summary Healthcare professionals don’t often recognize how uninformed or misinformed the public can be on health issues. Once nurses begin to add teach-back to their practice, they may discover more patients misunderstand instructions than previously thought. The best way to know how well patients understand is through teach-back. Teach-back is easy to learn, but it takes practice to do well.


1. Patient education is important be- cause:

a. Every patient should get a teaching handout on discharge.

b. It is required by accrediting agencies.

c. Most patients don’t know how to take care of themselves.

d. Most healthcare is self-care.

2. An effective way to evaluate a pa- tient’s understanding is to ask:

a. “Was there anything I said that wasn’t clear?”

b. “Do you have any questions?”

c. “I’d like to make sure I was clear. Can you explain that to me in your own words?”

d. “Do you understand?”

3. What should you ask the patient to teach-back?

a. Everything you teach b. Only the doctor’s discharge instructions

c. The anatomy and physiology related to his condition

d. Essential self-care skills and how to recognize and respond to problems

4. Which is TRUE about teach-back?

a. Teach-back is the most efficient way to test the patient’s knowledge.

b. The primary purpose of teach-back is to reinforce teaching and to enhance recall.

c. Teach-back saves teaching time be- cause it makes teaching more efficient and effective.

d. Teach-back should only be used with patients with poor health literacy skills.

5. What is the most efficient way to pro- vide patient education?

a. Give the patient a handout b. Have the patient watch a video c. Give a five-minute bedside lecture d. Have a conversation.

6. Conversation is an efficient teaching method because:

a. It gives you an opportunity to listen to the patient and modify your teaching appropriately.

b. It doesn’t require you to take the time to find an appropriate handout.

c. It doesn’t involve looking for the right video.

d. Conversation is efficient when you tell the patient to hold questions until you are finished teaching.

7. How do the steps in using teach- back parallel the process of treat- ing pain?

a. Give treatment (teach or give pain medicine) and document it

b. Assessment, individualized treatment, evaluate patient’s response

c. A doctor’s order is needed for both. d. The patient initiates both.

8. When teach-back shows the patient doesn’t understand, which is the best response?

a. “I’ll explain it again. Listen carefully this time.”

b. “No, that’s not quite right. Read this and I’ll ask you again.”

c. “I must not have done a good job explaining that. Let me try again.”

d. “I’m just trying to help you, but you’re not interested in helping yourself.”

9. What makes teach-back a top safety practice?

a. Teach-back allows nurses to correct misunderstandings before they be- come medical errors.

b. Once the patient demonstrates knowl- edge, errors are his responsibility.

c. Teach-back supports patient engagement.

d. When the patient teaches back accurately, you know he will follow instructions.

10. If you ask the patient to teach-back, and the patient just repeats your words, you should:

a. Document the patient was able to teach-back accurately

b. Tell the patient, “Good job!” and move on to the next topic

c. Ask the patient to say the same thing using his or her own words

d. Ask, “What other questions do you have?”

11. How often should you repeat teaching and teach-back on a specific topic?

a. Teach, evaluate understanding, and reteach another way until you are con- vinced the patient understands.

b. Repeat teaching and teach-back once, if necessary. If the patient still doesn’t understand, teach caregivers.

c. Repeat teaching and teach-back once, if necessary. If the patient still doesn’t understand, ask another professional on the healthcare team to teach the patient.

d. Repeat teaching three times. If the patient still doesn’t understand, ask the social worker to arrange for community support.

12. Why should a hospital support the use of teach-back?

a. Teach-back saves money by eliminat- ing the need for a closed-circuit TV system to show teaching videos.

b. Teach-back is evidence-based and improves health outcomes.

c. Teach-back saves money because you don’t have to give patients many teaching handouts.

d. Teach-back does not require any equipment.

2016 • Visit us at 29

Teach-back may be the most effective intervention that is

underused in healthcare today. It is supported by research and widely endorsed by professional organizations. If nurses are to impact health outcomes, they need to ensure patients under- stand and can follow their instructions. Best of all, teach-back supports patient-family centered care, because it facilitates conversations between healthcare professionals and patients. It provides a structure by which nurses can listen to patients, modify teaching so they can better understand, and build ther- apeutic relationships. •

Fran London, MS, RN, is the author of several books and dozens of articles. Her book, No Time to Teach: The Essence of Patient and Family Education for Health Care Professionals, was a 2010 American Journal of Nursing Book of the Year.

EDITOR’S NOTE: References available at

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