Adult Literacy Research Center, Georgia State University, Atlanta.
Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia.
Respir Care. 2020 Jan;65(1):68-74. doi: 10.4187/respcare.06896. Epub 2019 Aug 27.
Respiratory therapists (RTs) should communicate with patients in a way that leads to patients understanding their discharge plans and medical device instructions. The teach-back method is a patient-centered, health-literate technique that allows health care professionals to confirm patient understanding. The purpose of this mixed-methods pilot study was to measure the use of teach-back by first-year undergraduate RT students in a simulation-center experience after a 1-h teach-back skills training.
First-year RT students' health literacy knowledge and belief in communication skills were measured using a pre- and post- survey about their knowledge and beliefs. A 1-h health literacy and teach-back skills training lecture (ie, intervention) was delivered after the pre-testing. RT students were then assessed for teach-back use during a regularly scheduled simulation center experience. Their experiences were recorded in a semistructured interview immediately after the simulation-center experience.
14 of 20 RT students used teach-back in the simulation center. Knowledge scores increased from 8.278 to 8.944 postintervention, and the median scores for belief increased from 111 to 117 postintervention. There was a statistically significant postintervention increase in knowledge scores ( < .001) and in communication belief scores ( = .038). Thematic content analysis revealed 2 primary themes for teach-back use: to confirm patient understanding and to confirm proper use of medical devices. Teach-back was not used due to the discharge scenario used in the simulation center, due to the student forgetting and/or being nervous, due to how engaged the patient was, or due to individual communication style.
Results from our pilot study indicate that RT students may benefit from a 1-h health literacy and teach-back skills training. Furthermore, we identified reasons why the teach-back method was not used and determined what communication training students perceived would be helpful. Our findings can be used to help improve and implement communication skills training in the RT curriculum.
呼吸治疗师（RT）应该以能够让患者理解出院计划和医疗设备说明的方式与患者进行沟通。回述法是一种以患者为中心、注重健康素养的技术，可让医疗保健专业人员确认患者的理解程度。本混合方法试点研究的目的是测量在 1 小时回述技能培训后，一年级本科 RT 学生在模拟中心体验中使用回述法的情况。
使用预测试前后调查来衡量 RT 学生的健康素养知识和对沟通技巧的信念，了解他们的知识和信念。在预测试后进行了 1 小时的健康素养和回述技能培训讲座（即干预）。然后，在定期安排的模拟中心体验中评估 RT 学生使用回述法的情况。他们的体验在模拟中心体验后立即通过半结构化访谈进行记录。
在模拟中心，20 名 RT 学生中有 14 名使用了回述法。知识得分从干预前的 8.278 增加到干预后的 8.944，信念得分的中位数从干预前的 111 增加到干预后的 117。干预后知识得分（<0.001）和沟通信念得分（=0.038）均有统计学显著增加。主题内容分析揭示了使用回述法的两个主要主题：确认患者理解和确认医疗设备的正确使用。未使用回述法的原因包括模拟中心使用的出院场景、学生忘记和/或紧张、患者的参与程度或个人沟通风格。
我们的试点研究结果表明，RT 学生可能受益于 1 小时的健康素养和回述技能培训。此外，我们确定了未使用回述法的原因，并确定了学生认为哪些沟通培训将有所帮助。我们的发现可用于帮助改进和实施 RT 课程中的沟通技巧培训。
