Teach-Back Training for First-Year Respiratory Therapy Students: A Mixed Method Pilot Study

Abstract

Background: A patient’s ability to follow recommendations and manage their medical condition is related to the respiratory therapists’ (RTs) communication skills. Teach-Back is a health-literate communication technique that allows RTs to confirm patient understanding, and enhances patient-centered care by improving RT communication skills. Methods: After obtaining IRB approval, first-year undergraduate RT students’ completed a Health Literacy Knowledge and Belief Survey Pre (n = 20) and Post (n = 18) intervention. Students attended a one-hour Health Literacy and Teach-Back skills training intervention. Simulated patients assessed RT students for teach-back use during a regularly scheduled simulation center experience. RT students’ perceptions were documented in a semi-structured interview immediately after the simulation center experience. Results: Facilitators to Use of Teach-Back 1. Confirm patient understanding “… [I] wanted to make sure they understood the reason behind it [the medication] since I’m not going to be supervising them all the time when they are doing it.” 2. Confirm proper use of medical devices “[I] wanted to make sure the patient knew how to properly use the device before I gave it to him. To make sure there weren’t any mishaps pretty much.” Barriers to Use of Teach-Back 1. Discharge scenario used in the simulation I had a mental health patient scenario and I didn’t get that far. It was hard to bring up and incorporate many things because of the scenario.” 2. Forgot/Nervous The patient was paraplegic so I was thinking about other things I was overwhelmed by the setting and forgot about it.” 3. Engagement level of the patient “She [the patient] didn’t really ask anything. While I was observing her it seemed like she was doing it right.” 4. Individual communication style “I’m not the type of person [to use Teach-Back]. I want to use it, but because I don’t have much communication with other people- so I didn’t use it.” Conclusions: Results indicate that RT students benefited from a one-hour Health Literacy and Teach-Back skills training. There was a moderate effect size for both Knowledge (d = 0.539) and Beliefs (r = 0.489) which indicates they are both clinically and statistically significant. Findings show that adding health literacy skills training into the RT curriculum improved RT students understanding and use of patient-centered communication skills when working with simulated patients.