Teach-back Education Method for Wound Care Compliance

Overseen By Christina Wong, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Case Comprehensive Cancer Center

Disqualifiers: Non-English, Disabilities, Dementia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 2 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new method for teaching patients wound care, aiming to improve satisfaction and adherence to care instructions. Researchers will compare the traditional method with the "ask-tell-ask" approach, also known as the Teach-back Method. In this approach, patients discuss their wound care knowledge, receive educational information, and then repeat what they've learned to ensure understanding. The trial seeks English-speaking patients visiting a specific dermatology clinic for the first time with leg wounds healing naturally after surgery. Participants will receive guidance and follow-up calls to track their progress and experience. As an unphased trial, this study offers participants the opportunity to contribute to improving patient education methods and enhancing future care experiences.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that the ask-tell-ask education method is safe for wound care compliance?

Research has shown that the teach-back method, using the ask-tell-ask approach, is generally well-received. This method involves asking patients what they know, providing information, and then asking them to repeat it back. The educator addresses any misunderstandings.

Studies have found that this method helps patients better understand and manage their care, proving it safe and effective for patient education. No reports indicate negative effects from this method, as it is a communication tool, not a medical treatment.

In summary, current evidence supports the safety of the ask-tell-ask method for teaching patients about wound care. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the ask-tell-ask education method for wound care compliance because it takes a more interactive approach to patient education compared to the standard of care. Traditional methods often involve simply providing patients with information, but ask-tell-ask encourages a two-way conversation. This method involves checking what patients already know, informing them about wound care, and then asking them to repeat the information back. This interactive process ensures that patients truly understand how to care for their wounds, which could lead to better adherence and faster healing.

What evidence suggests that the ask-tell-ask education method is effective for wound care compliance?

Research has shown that the teach-back method, referred to in this trial as the "ask-tell-ask" method, effectively helps patients understand their care. It reduces the likelihood of hospital readmissions and aids patients in better managing their health. This method involves explaining information to patients and then asking them to repeat it back to ensure comprehension. Studies have found that this technique helps patients remember what they learn and follow care instructions more closely. This approach is particularly beneficial in ensuring proper wound care. ^{1 2 3 4 5}

Who Is on the Research Team?

Christina Wong, MD

Principal Investigator

University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center

Are You a Good Fit for This Trial?

This trial is for English-speaking individuals getting their first Mohs Micrographic Surgery on the lower extremities at a specific outpatient clinic. It's not for those who've had this surgery before, or have mental, learning, visual disabilities, or dementia.

Inclusion Criteria

Have excision(s) from Mohs Micrographic Surgery on the lower extremities that are left to heal by secondary intention

English-speaking

Presenting to outpatient Mohs clinic at University Department of Dermatology, Two Chagrin Highlands for the first time

Exclusion Criteria

You have been diagnosed with mental, learning, or visual disabilities.

You have been diagnosed with dementia.

You have previously had Mohs Micrographic Surgery, no matter where it was done on your body.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive either the teach-back method or standard of care education for wound care post-Mohs surgery

2 weeks

1 visit (in-person), 1 phone call

Follow-up

Participants are monitored for wound care adherence, patient experience, and complication incidence

2 weeks

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Ask-tell-ask education

Trial Overview The study tests the 'teach-back' method where patients are educated about wound care post-surgery using an ask-tell-ask approach to improve satisfaction and adherence to care instructions.

How Is the Trial Designed?

Group I: Ask-tell-ask method Experimental Treatment 3 Interventions

Study team will provide participant education using the ask-tell-ask method. Participants will receive a post-operative instruction sheet containing detailed information regarding wound care for reference and will receive a phone call at 1 week to inquire about wound care adherence. Participants will come to clinic at 2 weeks to have wounds assessed in addition to answering surveys regarding wound care adherence and participant experience.

Group II: Standard of Care (SOC) Active Control 3 Interventions

Participants will receive SOC education from the researcher. Participants will receive a post-operative instruction sheet containing detailed information regarding wound care for reference and will receive a phone call at 1 week to inquire about wound care adherence. Participants will come to clinic at 2 weeks to have wounds assessed in addition to answering surveys regarding wound care adherence and participant experience.

Who Is Running the Clinical Trial?

Case Comprehensive Cancer Center

Lead Sponsor

Trials

472

Recruited

33,400+

Published Research Related to This Trial

A brief educational intervention for over 300 clinical staff at a pediatric healthcare organization significantly improved their knowledge and use of the teach-back method, which enhances patient understanding of discharge instructions.

The use of teach-back led to higher rates of clarifying information and correcting misunderstandings, particularly regarding medications and skill-based treatments, thereby improving patient safety and healthcare quality.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Teach Back Project: A System-wide Evidence Based Practice Implementation. Klingbeil, C., Gibson, C.[2022]

Effective communication methods, including theoretical frameworks and motivational interviewing, can significantly enhance patient adherence to wound healing recommendations.

Wound care practitioners can improve patient outcomes by selecting appropriate self-care strategies tailored for individuals with nonhealing wounds.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient-Centered Education in Wound Management: Improving Outcomes and Adherence. Callender, LF., Johnson, AL., Pignataro, RM.[2023]

An educational program for nurses significantly improved their confidence and understanding of using the teach-back method during informed consent discussions for cancer clinical trials.

Nurses already had a good knowledge of research, but the program enhanced their recognition of key teach-back elements, indicating a positive impact on their communication skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical Trials Informed Consent: An Educational Intervention to Improve Nurses' Knowledge and Communications Skills. Regan, EM.[2019]

The Teach-Back intervention, Teaching Important Medication Effects (TIME), significantly improved patients' knowledge of new medication side effects compared to usual care, with 94.3% of TIME group patients knowing their side effects at discharge versus 72.5% in the usual care group.

Patients who received the TIME intervention reported much higher satisfaction with their medication education (97% very satisfied) compared to those who received usual care (46.9% very satisfied), highlighting the effectiveness of the Teach-Back method in enhancing patient education experiences.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using a teach-back intervention significantly improves knowledge, perceptions, and satisfaction of patients with Nurses' discharge medication education. Marks, L., O'Sullivan, L., Pytel, K., et al.[2022]

Using the teach-back method for discharge education significantly reduced 30-day readmission rates by 45%, with an odds ratio of 0.55 based on a meta-analysis of five studies involving various patient groups.

Despite the promising results, the analysis was limited by a small number of studies and a high risk of selection bias, highlighting the need for more rigorous randomized controlled trials to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of Discharge Education With the Teach-Back Method on 30-Day Readmission: A Systematic Review. Oh, EG., Lee, HJ., Yang, YL., et al.[2023]

The teach-back method significantly improved patient comprehension of the risks and benefits of laparoscopic cholecystectomy, with participants scoring higher on knowledge assessments compared to a control group.

Using the teach-back method also increased surgeon trust among patients, enhancing the overall informed consent process, while only adding an average of 2.45 minutes to the consultation time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The "teach-back" method improves surgical informed consent and shared decision-making: a proof of concept study. Seely, KD., Higgs, JA., Butts, L., et al.[2022]

The 'teach-back' process is an effective strategy that empowers nurses to ensure patients and families understand discharge instructions, which can help prevent medication errors.

An educational intervention implemented at Children's Hospital of Wisconsin showed positive effects on nurses' ability to verify understanding and correct misinformation, highlighting the importance of this approach in patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using "teach-back" to promote a safe transition from hospital to home: an evidence-based approach to improving the discharge process. Kornburger, C., Gibson, C., Sadowski, S., et al.[2022]

The Teach-back method significantly reduced preoperative anxiety and improved surgical cooperation among 116 elderly patients undergoing outpatient ophthalmology surgery, compared to standard education methods.

Patients who received Teach-back education experienced lower intraoperative blood pressure and heart rate fluctuations, indicating a more stable physiological response during surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of Teach-back method on preoperative anxiety and surgical cooperation in elderly patients undergoing outpatient ophthalmology surgery: A randomized clinical trial. Shen, D., Huang, W., Wei, S., et al.[2023]

Teach-back is an effective health literacy tool that helps orthopaedic nurses assess and improve patients' understanding of medical information, which can lead to better self-management and reduced hospital readmissions.

The article outlines a four-stage process for nurses to implement teach-back in their patient education, aiming to enhance patient safety, satisfaction, and overall health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Utilizing Teach-Back to Reinforce Patient Education: A Step-by-Step Approach. Caplin, M., Saunders, T.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6590951/

Use and Effectiveness of the Teach-Back Method in Patient ... A review of the literature on the teach-back method of education suggests that the technique may be beneficial in reinforcing patient education.

2. withpower.com withpower.com/trial/phase-10-2020-7a464

Teach-back Education Method for Wound Care Compliance It has been shown to reduce hospital readmissions, improve self-management, safety, patient satisfaction, and patient outcomes. It is used in various contexts, ...

3. centerwatch.com centerwatch.com/clinical-trials/listings/NCT04377971/teach-back-method-on-patient-satisfaction-and-adherence-to-wound-care-regimen

Teach-back Method on Patient Satisfaction and Adherence ... The teach-back method is delivered using the ask-tell-ask method. Investigators will ask the patient about their knowledge of wound care healing ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7156054/

Teach-back: A systematic review of implementation and impacts Most studies in this review delivered teach-back as part of a simple educational program and compared outcomes against participants receiving ' ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S0965206X24000421

Facilitators and barriers for nurses when educating people ... Recent systematic reviews and meta-analysis demonstrate efficient patient education results in ulcer size reduction [15], especially when wearing compression [ ...