Teach back Essay

Individual Assignment: Teach-Back Essay


This week try the teach-back method with one patient per day (or a friend/relative if you are not working as an RN) until you have taught at least 4 patients/learners or more until you may get the “ah…ha!” moment. Keep a log of your teach-back experiences. Write down your reflections to include:

  • What key information did you teach?
  • How did it go? How did the patient respond?
  • How did it feel for you as the nurse?
  • What would you do differently next time?
  • Did using the teach-back method feel like extra work?
  • Did the teach-back uncover any miscommunication?

Summarize your experience in implementing the teach-back method and what you learned in a formal essay. You may use the 1st person voice (I, me, we).


The essay should be 6 pages (excluding cover and reference pages). Use APA 6th edition format. First, submit the essay via the Turn-It-In at least 24 hours before the due date of the draft. Then, revise and submit the draft paper via the “Draft Teach-Back Essay” Assignment link.

After the submission of Teach-Back Essay paper, the instructor will comment and provide feedback to you in either written or oral form. Then, you will finalize the paper and submit it again via the “Finalized Teach-Back Essay” Assignment Link.

 Criteria for evaluation:

 Grading rubric for the DRAFT teach-back essay is shown below ((10 points):


 Points GivenPoints Earned
Turn-It-In: No more than 10% on originality report (excluded the cover & reference pages)2 
Comprehensive: Address all six reflective questions, minimum teaching of 4 learners4 
Engagement: Substantive, showing interest of learning2 
Critical thinking: Insightful, thoughtful, reflective2 

Grading rubric for the FINALIZED teach-back essay is shown below ((10 points):


 Points GivenPoints Earned
Comprehensive: Address all six reflective questions, minimum teaching of 4 learners4 
Engagement: Substantive, showing interest of learning2 
Critical thinking: Insightful, thoughtful, reflective2 
Overall writing ability: Clear, concise, flowing, grammar, spelling1 
Format: Support by appropriate resources/references, APA styles1 
Total 10 

A Patient Story


An ER nurse noticed that a newly diagnosed diabetic patient had sev­eral admis­sions to the ER over the last cou­ple weeks with uncon­trol­lable blood sug­ars. It appears that he was admit­ted and dis­charged with instruc­tions on diet, exer­cise, a glu­come­ter, and a slid­ing scale for insulin admin­is­tra­tion. Upon her assess­ment the nurse asked the patient about his diet and he stated that he had mod­i­fied it as directed and was not happy eat­ing the bland foods and was sad to give up his sweets. He also told her about his exer­cise regimen that his wife insisted he adhere to. The nurse inquired about his rou­tine for check­ing his blood sugar and asked him to demon­strate which he did very well. He was also able to show her how to effec­tively use the slid­ing scale. The nurse then asked him to demon­strate how he injected the insulin. The patient stated “I inject it just like I was instructed” then he pro­ceeded to take an orange from his bag. He wiped the orange with an alco­hol pad and injected the insulin into the orange then peeled it and was about to eat it. The nurse looked on in shock, she said “What are you doing?” the patient said “It’s what I been doing every day, four times a day since I last left here and I’m sick of eat­ing these oranges.”

Source: Gordon, (2009). Improving patient education utilizing the “teach back” method. ONS Connect.[Blog].


The Teach-Back Method


Teach-back is health literacy tool to confirm that patients understand health education or instructions. Also called “closing the loop” or “show-me,” it asking the patient to explain what they have been taught using their own words. When patients explain what they have learned to clinicians, it indicates how much and how well they understand after the teaching process. This feedback helps clinicians to assess if other strategies are needed to help patients understand better. The teach-back method can not only uncover misunderstandings but also the nature of the misunderstanding. Teach-back provides valuable information for both the patient and clinician to improve the outcomes of patient education

“Asking that patients recall and restate what they have been told is one of the 11 top patient safety practices based on the strength of scientific evidence” (AHRQ, 2001 Report, Making Health Care Safer). The method has been endorsed by the following organizations:

  • National Quality Forum
  • American Academy of Family Physicians
  • American College of Surgeons
  • American Hospital Association
  • American Nursing Association
  • The Joint Commission


This method has been used to close the gap of communication between clinicians and patients while enhancing patient’s knowledge in repeating cycles (see diagram below).


Schillinger, D., Piette, J., Grumbach, K. (2003). Closing the loop: Physician communication with diabetic patients who have low health literacy. Achieves of Internal Medicine. 163(1): 83-90.


Implementing Teach-Back:


Use manageable teaching points:

Narrow the educational topic down to key teaching points: the “must haves” or “vital few”


Ask individual (in a non-shaming way) to explain what was understood:

This is NOT a test of the patient’s learning, but of how well YOU explained the information to the patient.


Examples of lead-in phrases:

  • To make sure that I have explained everything clearly, can you tell me what medication(s) you are taking to control your blood sugar?
  • We have gone over a lot of information today. Can you tell me what are you going to do when your blood sugar is low?
  • I sometimes talk fast and may have gone over this information too quickly. Let’s talk about what you would do if . . .
  • I want to be sure that I did a good job of explaining this to you today because it can be confusing. Could you please tell me the problems you should call your doctor about?
  • We just discussed a lot of things for you to do every day. You may be doing some already. Which ones are you doing and which ones will be new for you?
  • Your family was not here today when we talked about ______. When they come in, how would you explain to them?

Do not ask:

  • Do you understand?
  • Do you have any questions?


  • Assess patient’s health literacy level, and come up with a proper strategy for teaching.
  • Use simple/plain language when explaining new materials to the patient.
  • Start slow, and break down information into simple, short pieces.
  • For more than one concepts, use “chunk and check” method: teach the major points of the first concept and check patient’s understanding using teach-back, then go to the next concept.
  • Ask the patient to use their own words.
  • Encourage the patient to ask questions.
  • Adjust your teaching style based on the results of teach-back from patient.
  • If family is available, involve the family into the process of learning and teaching back.
  • Document use of teach-back and patient’s response.


Adapted from North Carolina Program on Health Literacy http://www.nchealthliteracy.org



Last Updated on February 10, 2019