Health Literate Communication: Teach-Back Training for First-Year Medical Students

Abstract

BACKGROUND: Effective physician communication skill requires implementation of basic standards of practice, such as empathy, listening, and close attention to non-verbal indicators. Medical students must learn and understand that enhanced communication skills ensure better patient understanding of diagnosis and prognosis, and compliance to treatment plans.  Health literate communication techniques like Teach-Back must be part of primary skills training for medical students in the early stage of medical education.  The purpose of this study was to measure medical students’ beliefs/knowledge about health literate communication and to evaluate use of Teach-Back skills during patient history taking and examination in the simulation center with standardized patients. METHODS: First-year medical students’ health literacy beliefs/knowledge of health literate communication were measured using pre- and post- Beliefs and Knowledge surveys.  A one-hour health literacy skills training intervention lecture was delivered after pre-testing.  Students were assessed for use of Teach-Back during the standardized patient encounter. RESULTS: 36 students participated in the study.  Median Belief scores increased from 9.25 pre-intervention to 10.00 post-intervention; mean Knowledge scores increased from 8.08 pre-intervention to 10.42 post-intervention with moderate to large effect sizes (beliefs r= .342, knowledge d=1.08).  There was a significant post-intervention increase in both belief and knowledge scores, p>.001 with high power (.954).  Eleven (11) students used Teach-Back successfully in the simulation center. CONCLUSIONS: Medical students’ beliefs, knowledge, and communication skills may benefit from a one-hour health literacy communication skills training.  Primary care skills courses should incorporate health literacy training as a key competence along with existing curricular foci in order to improve health literate patient communication.