Improving Patient Health Literacy During Telehealth Visits Through Remote Teach-Back Methods Training for Family Medicine Residents: Pilot 2-Arm Cluster, Nonrandomized Controlled Trial

• Published in: JMIR formative research 2023-01, Vol.7, p.e51541-e51541
• Main Authors: Barksdale, Shanikque, Stark Taylor, Shannon, Criss, Shaniece, Kemper, Karen, Friedman, Daniela B., Thompson, Wanda, Donelle, Lorie, MacGilvray, Phyllis, Natafgi, Nabil
• Format: Article
• Language: English
• Subjects: Active listening; Adult learning; Chronic illnesses; Clinics; Communication; Curricula; Health education; Health literacy; Medical education; Medical personnel; Medical residencies; Medicine; Patient-centered care; Patients; Primary care; Teaching; Telemedicine; Visual aids; Workshops
• ISSN: 2561-326X; 2561-326X
• DOI: 10.2196/51541

Background:As telemedicine plays an increasing role in health care delivery, providers are expected to receive adequate training to effectively communicate with patients during telemedicine encounters. Teach-back is an approach that verifies patients’ understanding of the health care information provided by health care professionals. Including patients in the design and development of teach-back training content for providers can result in more relevant training content. However, only a limited number of studies embrace patient engagement in this capacity, and none for remote care settings.Objective:We aimed to design and evaluate the feasibility of patient-centered, telehealth-focused teach-back training for family medicine residents to promote the use of teach-back during remote visits.Methods:We codeveloped the POTENTIAL (Platform to Enhance Teach-Back Methods in Virtual Care Visits) curriculum for medical residents to promote teach-back during remote visits. A patient participated in the development of the workshop’s videos and in a patient-provider panel about teach-back. We conducted a pilot, 2-arm cluster, nonrandomized controlled trial. Family medicine residents at the intervention site (n=12) received didactic and simulation-based training in addition to weekly cues-to-action. Assessment included pre- and postsurveys, observations of residents, and interviews with patients and providers. To assess differences between pre- and postintervention scores among the intervention group, chi-square and 1-tailed t tests were used. A total of 4 difference-in-difference models were constructed to evaluate prepost differences between intervention and control groups for each of the following outcomes: familiarity with teach-back, importance of teach-back, confidence in teach-back ability, and ease of use of teach-back.Results:Medical residents highly rated their experience of the teach-back training sessions (mean 8.6/10). Most residents (9/12, 75%) used plain language during training simulations, and over half asked the role-playing patient to use their own words to explain what they were told during the encounter. Postintervention, there was an increase in residents’ confidence in their ability to use teach-back (mean 7.33 vs 7.83; P=.04), but there was no statistically significant difference in familiarity with, perception of importance, or ease of use of teach-back. None of the difference-in-difference models were statistically significant. The main barrier