Understand how teach-back aligns with equity, safety, quality and patient- and client-centered care and services; organizational health literacy; and advancing as a health literate organization
Guidance and Resources
- Teach-back helps health organizations and every member of the health team to advance health equity, safety, quality, and patient- and client-centered care and services, and improve outcomes. Click here to download.
- Healthy People 2030's framework includes health literacy among its Overarching Goals and Foundational Principles.
- Conveying respect and being aware of and addressing cultural and language differences are vital when using teach-back. Click here to download.
- Examples of how teach-back can be used in high-risk clinical and non-clinical situations when extra assurance that people fully understand is needed. Click here to download.
- Clinicians who prescribe, counsel, or provide support should use teach-back to help people understand and use their medicines. Click here to download.
- Use teach-back with transitions between providers or settings of care or services when people are at increased risk for harm. Click here to download.
Stories and Insights (Testimonials and Videos)
It helps people learning to use teach-back to realize that anybody can have difficulty understanding. Often, they don’t share those difficulties with their physician, dentist, nurse, pharmacist, therapist, or other member of the health team. People may be embarrassed about asking questions or not know what questions to ask. Here are stories, testimonials, and videos that describe such struggles and that provide ideas for applying health literacy-related solutions.
- See the stories and insights below.
- Consider how to use similar stories in your setting to inspire and motivate.
- Collect your own stories and insights and share them widely to increase awareness and recognition, and improve use of health literacy practices—especially plain language and teach-back—to prevent harm, and support safe, high-quality, equitable care.
Stories about Struggles to Understand
- A science teacher told a nurse he knew that she wouldn’t believe what the oral surgeon’s office nurse told him to do after his oral surgery. His instructions included rinsing his mouth with a dilution of hydrogen peroxide and water. When his nurse friend asked, “Well did you do it?” he said “No!” “I’m a science teacher and I know better than to put hydrogen peroxide in my mouth.” His friend called the surgery center to ask about the post-procedure instructions and confirmed it was the appropriate treatment. As long as people dilute it according to the directions, don’t swallow it, and don’t use it too much, it is safe and helpful to promote healing.
- A student nurse was working with an older person in a community health center, on remembering to take her medicines. When the woman was unable to teach back after three tries, the student nurse was worried and began asking about help at home with the woman’s medicines. The woman asked her whether she had anything in writing that might help her remember now and at home. She said, “I learn best by reading.”
The student nurse responded “Absolutely!” After reviewing the medicine sheet—customized with times of day, symbols for morning, midday, evening, and symbols for taking with food--the woman was able to teach back and demonstrated confidence and satisfaction that she understood.
- “The night after my neighbor returned home from the hospital, she experienced some bad side effects. But did not call the doctor right away. When asked why, she said she was scared because she felt like she never knew what was going on when she talked with her doctors. She ultimately decided to go to the emergency room, but her poor experience with health communication could have had a massive impact on her well-being at that time and in the future.”
- “With a little teach-back, we could have saved this mom–and the healthcare system–a lot of time and energy. That’s basically what my “why?” question was–a chance for the patient’s mother to explain in her own words what the plan was. When we find ways to let the patient explain the next steps in their own words, we improve the quality and safety of our care. That’s why teach-back is so important.”
- A physical therapist tells of a time she and an interpreter were doing a home visit with a non-English-speaking family. The mother handed her a letter and asked what it was for. This was the 2nd time the mother had gotten the letter. She threw away the first one because she didn’t know what it was. It turned out to be a recall letter for her daughter’s medical stroller. “With the help of an interpreter, I did my best to explain what a recall was…The scary thing is that if she had not given me that letter, her child could have been at serious risk because the recall said that the actual seat the child sits in had a risk of detaching from the base, thereby putting her at serious risk for injury. While this situation was indeed complicated by a language barrier, I had a similar situation with an English-speaking family who also disregarded the letter and recall because they didn’t understand its importance.”
- Listen to a physical therapist describing how stress and worry interfere with understanding and remembering important information.
- A physical therapist describes how technical medical terms lead to confusion.
Insights on Applying Health Literacy Practices
A mother describes a potentially serious adverse effect related to a change in her child’s medicine dose that was conveyed over the telephone (1:35)
A patient describes why it was important to him that the nurse used teach-back with him before he left the hospital (:22)
A primary care physician shares her surprise at what a highly educated and knowledgeable patient didn’t understand, and the value of teach-back as a universal precaution (1:19)
A complex medication schedule (2:25)
It doesn't matter what your background or education are when your loved one is the patient (1:06)
Successfully learning to manage insulin (1:21)
Why Use Teach-backHealthy People 2030Culture and RespectTeach-back in High-risk Health SituationsUsing Teach-back with MedicinesUsing Teach-back with Transitions in Care or Services Science Teacher Who Did Not Follow Oral Surgery Post-procedure Instructions. Student Nurse Discovers How a Patient Learns Best Afraid to Go to the Emergency Department A Primary Care Physician Explains How Asking ‘Why’ Can Reveal a Lot A Stroller Safety Recall When It Is Your Child… Technical Terms