Learning Teach-Back in clinical practice: a qualitative study of healthcare professionals

Teach-Back is a widely recommended communication method to support patient understanding, yet little is known about how healthcare professionals learn Teach-Back in everyday clinical practice. The study aimed to explore how healthcare professionals learn Teach Back within an acute hospital setting, and how this learning is experienced and enacted in everyday clinical practice.

This qualitative study invited staff in two healthcare settings that had partaken in a Teach-Back method training program. Participants included 18 healthcare professionals and four first-line managers. Data were generated through interviews conducted in the beginning and after the training program, and through observations of clinical encounters when applying the Teach-Back method. Data were analyzed using reflexive thematic analysis.

Learning Teach-Back was identified as a multilevel workplace learning process that developed through interactions between individual experiences, interpersonal learning processes, organizational engagement, and workplace conditions. This was reflected in four interrelated themes: (1) Individual level: Learning by doing and experiencing Teach-Back: authentic Teach-Back encounters with patients were critical for skill development but could trigger insecurity when Teach-Back was experienced as unnatural. Emotional responses, discouragement and "aha" moments, shaped whether healthcare professionals used Teach-Back or not; (2) Interpersonal level: Learning through feedback and shared meaning: recurring peer reflection and supportive feedback were crucial for learning Teach-Back, yet often lacking; (3) Organizational level: Engaging the organization to promote learning: early adopters, ambassadors, leadership support, and interprofessional communication were decisive for learning Teach-Back; and (4) Workplace conditions: Making space for learning in a pressured work environment: staff shortages, turnover, and high workload constrained opportunities for doing and engaging in reflection and feedback about Teach-Back.

Learning Teach-Back can be understood as a multilevel workplace learning process that develops through opportunities for practice, reflection, and collegial feedback in everyday clinical work. Supporting Teach-Back learning requires workplace learning approaches that foster shared meaning across professional teams, organizational engagement, and protected space for learning.

ClinicalTrials.gov ID: NCT02925871. Registration date: first submitted 8 April 2016; first posted 6 October 2016.