A Refined Teach-back Observation Tool: Validity Evidence in a Pediatric Setting.
Health Literacy Research and Practice
|October 9, 2023
Summary
This study refined the Teach-back Observation Tool (T-BOT) to assess pediatric residents' communication skills. Initial validity evidence suggests the T-BOT can improve essential Teach-back training and enhance patient understanding.
Area of Science:
- Medical Education
- Health Literacy
- Communication Skills Training
Background:
- Teach-back (TB) is crucial for patient understanding, safety, quality, and equity.
- Existing TB training lacks validated assessment tools.
- A competency-based curriculum was used to develop the Teach-back Observation Tool (T-BOT).
Purpose of the Study:
- Develop initial validity evidence for a refined T-BOT.
- Provide recommendations for enhancing TB skills training for pediatric residents.
- Improve essential TB skills and organizational health literacy.
Main Methods:
- Residents underwent health literacy training and participated in standardized patient encounters.
- Raters developed T-BOT scoring criteria and assessed recorded encounters.
- Inter-rater agreement was measured using Kappa statistics and intraclass correlation (ICC).
Main Results:
- With six raters, moderate to substantial agreement was found for the gold standard (Kappa=0.554) and SP encounters (Kappa=0.637).
- With five faculty raters, substantial agreement was observed for the gold standard (Kappa=0.779) and SP encounters (Kappa=0.751).
- Individual item agreement varied, with some reaching perfect scores.
Conclusions:
- Initial validity evidence supports the modified T-BOT.
- Refinements and shared understanding of criteria can enhance the T-BOT's utility.
- The T-BOT has the potential to improve TB skills, health literacy, and patient outcomes.
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