Checking for comprehension: mastering teach-back techniques.

UNLABELLED: Patients frequently misunderstand or cannot apply health information they receive from health professionals. Certain populations-particularly individuals with limited English skills or limited education-pose an additional challenge. The average American only reads and speaks at an eighth- or ninth-grade level, yet we assume patients understand basic health care vocabulary. Those with limited health literacy skills may have a poor understanding of their chronic diseases, manage their health poorly, have lower health status, and have a greater probability of hospitalization. Checking for comprehension is critical. The "teach-back" technique is akin to having someone repeat back road directions so you can confirm they will reach their destination using your directions. Teach-back is a three-part process: 1) assess comprehension, 2) offer feedback, and 3) re-evaluate comprehension. Several videos and Web sites are available to walk professionals through this process. PROBLEM: When I talk to patients and their families, I often feel like the information I give them goes in one ear and out the other. Recently, our administrators talk about "teach-back." What is this, and how is it best used?