Dataset Information

A State-of-the-Art Review of Teach-Back for Patients and Families With Heart Failure: How Far Have We Come?

ABSTRACT:

Background

Heart failure (HF) prevalence has risen for more than a decade. Effective patient and family education strategies for HF are needed on a global scale. One widely used method of education is the teach-back method, where learners are provided information, then their understanding assessed by "teaching it back" to the educator.

Purpose

This state-of-the-art review article seeks to examine the evidence focusing on the teach-back method of patient education and patient outcomes. Specifically, this article describes (1) the teach-back process, (2) teach-back's effect on patient outcomes, (3) teach-back in the context of family care partners, and (4) recommendations for future research and practice.

Conclusions

Study investigators report the use of teach-back, but few describe how teach-back was utilized. Study designs vary widely, with few having a comparison group, making conclusions across studies challenging. The effect of teach-back on patient outcomes is mixed. Some studies showed fewer HF readmissions after education using teach-back, but different times of measurement obscure understanding of longitudinal effects. Heart failure knowledge improved across most studies after teach-back interventions; however, results related to HF self-care were mixed. Despite family care partner involvement in several studies, how they were included in teach-back or the associated effects are unclear.

Clinical implications

Future clinical trials that evaluate the effect of teach-back education on patient outcomes, such as short- and long-term readmission rates, biomarkers, and psychological measures, are needed, as patient education is the foundation for self-care and health-related behaviors.

SUBMITTER: Howie-Esquivel J

PROVIDER: S-EPMC10480340 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

A State-of-the-Art Review of Teach-Back for Patients and Families With Heart Failure: How Far Have We Come?

Howie-Esquivel Jill J Bidwell Julie T JT

The Journal of cardiovascular nursing 20230306

<h4>Background</h4>Heart failure (HF) prevalence has risen for more than a decade. Effective patient and family education strategies for HF are needed on a global scale. One widely used method of education is the teach-back method, where learners are provided information, then their understanding assessed by "teaching it back" to the educator.<h4>Purpose</h4>This state-of-the-art review article seeks to examine the evidence focusing on the teach-back method of patient education and patient outco ...[more]

PMID: 36881405

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Project description:Patients often have difficulty comprehending or recalling information given to them by their healthcare providers. Use of 'teach-back' has been shown to improve patients' knowledge and self-care abilities, however there is little guidance for healthcare services seeking to embed teach-back in their setting. This review aims to synthesize evidence about the translation of teach-back into practice including mode of delivery, use of implementation strategies and effectiveness. We searched Ovid Medline, CINAHL, Embase and The Cochrane Central Register of Controlled Trials for studies reporting the use of teach-back as an educational intervention, published up to July 2019. Two reviewers independently extracted study data and assessed methodologic quality. Implementation strategies were extracted into distinct categories established in the Implementation Expert Recommendations for Implementing Change (ERIC) project. Overall, 20 studies of moderate quality were included in this review (four rated high, nine rated moderate, seven rated weak). Studies were heterogeneous in terms of setting, population and outcomes. In most studies (n = 15), teach-back was delivered as part of a simple and structured educational approach. Implementation strategies were infrequently reported (n = 10 studies). The most used implementation strategies were training and education of stakeholders (n = 8), support for clinicians (n = 6) and use of audits and provider feedback (n = 4). Use of teach-back proved effective in 19 of the 20 studies, ranging from learning-related outcomes (e.g. knowledge recall and retention) to objective health-related outcomes (e.g. hospital re-admissions, quality of life). Teach-back was found to be effective across a wide range of settings, populations and outcome measures. While its mode of delivery is well-defined, strategies to support its translation into practice are not often described. Use of implementation strategies such as training and education of stakeholders and supporting clinicians during implementation may improve the uptake and sustainability of teach-back and achieve positive outcomes.

Project description:BACKGROUND:Teach Back is a health communication strategy used to confirm patient understanding in a non-shaming 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.

Dataset Information

A State-of-the-Art Review of Teach-Back for Patients and Families With Heart Failure: How Far Have We Come?

Background

Purpose

Conclusions

Clinical implications

Publications

A State-of-the-Art Review of Teach-Back for Patients and Families With Heart Failure: How Far Have We Come?

Similar Datasets

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