JMIR Publications

ABSTRACT

Background:

As telemedicine plays an increasing role in the healthcare 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 healthcare information provided by healthcare 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 virtual care settings.

Objective:

This project aimed to design and evaluate the feasibility of a patient-centered telehealth-focused teach-back training for family medicine residents to promote the use of teach-back during virtual visits.

Methods:

A Platform to Enhance Teach-back methods in virtual care visits (POTENTIAL) curriculum for medical residents was co-developed to promote teach-back during virtual visits. A patient participated in the development of the workshop’s videos and in a patient-provider panel about teach-back. A pilot two-arm cluster, non-randomized controlled trial was conducted. Family medicine residency at the intervention site (n=12) received didactic and simulation-based training in addition to weekly cues-to-action. Assessment included: pre- and post-surveys, observations of residents, and interviews with patients and providers. To assess differences between pre- and post-intervention scores among the intervention group, chi-square and t-tests were used. Four difference-in-difference models were constructed to evaluate pre-post 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 (75%) residents 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. Post-intervention there was an increase in residents’ confidence in ability to use teach-back (mean 7.33 vs. 7.83, p=0.039) but no statistically significant difference in familiarity with nor perception of importance nor ease of use of teach-back. None of difference-in-difference models were statistically significant. The main barrier to practicing teach-back was time constraints.

Conclusions:

This study highlights ways to effectively integrate best-practice training of telehealth teach-back skills into a medical residency program. At the same time, this pilot study points to important opportunities for improvement for similar interventions in future larger-scale implementation efforts as well as pointing to ways to also mitigate providers concerns or barriers for more incorporating teach-back in their practice. Teach-back can impact virtual practice by increasing providers’ ability to actively engage and empower patients by using the features (whiteboards, chat rooms, and mini view) of their virtual platform. Clinical Trial: N/A