Teach Back for Orthopedic Trauma

Overseen By Kallie J Chen, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University Hospitals Cleveland Medical Center

Disqualifiers: Non-English speaking, Incarcerated, Cognitive impairment, others

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

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 1

Duration: Immediate postoperative period

216 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to evaluate whether receiving education after trauma surgeries affects three things: 1) knowledge about injury and treatment ("recall"), 2) how well patients follow treatment recommendations, and 3) how satisfied patients are with their care. To do so, some participants in this study will receive education, and some will not.

Will I have to stop taking my current medications?

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

What data supports the effectiveness of the treatment Educational Teach Back, Teach-Back Method, Educational Teach Back, Show Me Method, Closing the Loop Method for orthopedic trauma?

Research shows that the teach-back method helps patients understand their care better, which can lead to fewer hospital readmissions and better overall health outcomes. This method involves asking patients to repeat back what they've learned to ensure they understand their treatment plan. ^{1 2 3 4 5}

Is the Teach-Back method safe for use in humans?

The Teach-Back method is a communication tool used to improve patient understanding and safety. It has been shown to reduce hospital readmissions, prevent medication errors, and improve patient outcomes, indicating it is generally safe for use in humans. ^{4 6 7 8 9}

How does the Teach Back treatment for orthopedic trauma differ from other treatments?

The Teach Back treatment is unique because it focuses on improving patient understanding and engagement through a method where patients repeat back what they've learned to ensure clarity. This approach enhances self-management, reduces hospital readmissions, and improves overall patient outcomes, setting it apart from traditional treatments that may not emphasize patient education and understanding as much. ^{4 10 11 12 13}

Research Team

John Sontich, MD

Principal Investigator

University Hospitals Cleveland Medical Center

Eligibility Criteria

This trial is for English-speaking individuals who've had surgery for a fracture in the pelvis or lower extremity. It's not open to those with cognitive impairments, prisoners, people already in conflicting studies, or patients getting orthopedic care elsewhere.

Inclusion Criteria

I had surgery for a broken pelvis or leg bone.

Exclusion Criteria

History of traumatic brain injury, dementia, or other cognitive impairment

Patient receiving orthopedic care or follow-up at another institution

Currently enrolled in a study that does not permit co-enrollment

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive education after trauma surgeries to evaluate recall, adherence, and satisfaction

Immediate postoperative period

1 visit (in-person)

Follow-up

Participants are monitored for satisfaction, recall, and adherence up to 180 days post-operation

Up to 180 days

Questionnaires administered

Treatment Details

Interventions

• Educational Teach Back

Trial Overview The study tests if education after trauma surgery can improve patient knowledge about their injury and treatment ('recall'), adherence to treatment recommendations, and satisfaction with care. Some will receive educational interventions while others won't.

Participant Groups

Group I: Postoperative teach-back educational program Experimental Treatment 1 Intervention

Patients will receive teach-back education while they fill out questionnaires.

Group II: Control Active Control 1 Intervention

Patients will not receive any teach-back education while filling out questionnaires.

Who Is Running the Clinical Trial?

University Hospitals Cleveland Medical Center

Lead Sponsor

Trials

348

Recruited

394,000+

John Sontich

Lead Sponsor

Trials

1

Recruited

220+

Findings from Research

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]

A new integrated teaching model for orthopedic residents at Université de Montréal was developed, focusing on specific behavioral objectives for each 6-month rotation to enhance learning outcomes.

The model shifted the role of surgeons from traditional teachers to facilitators, using simulated cases to improve problem-solving skills and allowing for more frequent and objective assessments of resident learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrated curriculum model for a residency program. Des Marchais, JE.[2007]

The teach-back method of education has been identified as a potentially effective technique for reinforcing patient education, helping ensure that patients understand their health information.

This review highlights the importance of using interactive teaching strategies, like teach-back, to improve patient comprehension and retention of medical information.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes. Yen, PH., Leasure, AR.[2020]

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]

Telehealth can enhance preoperative and postoperative education for orthopedic patients, making it more personalized and accessible, which may lead to better outcomes like reduced pain and improved mobility.

The proposed framework combines the EDUCATE model and Bashshur's Taxonomy of Telehealth to create a patient-centered approach that improves comprehension and retention of important health information, addressing varying levels of health literacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Model for Delivery of Orthopaedic Perioperative Education via Telehealth. Keener, AS., Howell, DM.[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]

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]

Patients who experienced the teach-back method during healthcare interactions had a 15% lower risk of hospitalization for ambulatory care sensitive conditions (ACSCs) compared to those who did not, indicating its potential efficacy in improving patient outcomes.

The teach-back method was also associated with a 23% lower risk of readmission for ACSC-related conditions, particularly benefiting patients with hypertension, diabetes, and heart disease, suggesting that this communication strategy can enhance patient understanding and management of their health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teach-Back Experience and Hospitalization Risk Among Patients with Ambulatory Care Sensitive Conditions: a Matched Cohort Study. Hong, YR., Cardel, M., Suk, R., et al.[2021]

Orthopaedic surgeons face unique challenges in trauma care education, requiring knowledge of patient resuscitation and the treatment of injuries across multiple organ systems, especially in complex cases like adult respiratory distress syndrome.

The current healthcare landscape, particularly the managed care movement, threatens the quality of trauma education and research by limiting referrals to trauma centers and potentially compromising patient care, necessitating collaboration among educators, institutions, and healthcare organizations to maintain high standards in trauma education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Education in orthopaedic trauma. Chapman, MW.[2019]

The orthopedic teaching program significantly improved learners' confidence in their knowledge and skills, with a median confidence score rising from 8 to 9 after the program, indicating its effectiveness in enhancing educational outcomes.

Tutors found the program highly useful, with median scores of 9 for the usefulness of feedback and relevance of topics, suggesting that near-peer teaching can effectively address learner diversity and improve the overall educational experience in a clinical setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lessons From a Near-Peer Junior Doctor Teaching Program in Trauma and Orthopedics. Anazor, F., Uthraraj, NS., Bakti, NI.[2023]

Cognitive apprenticeship is a teaching model that focuses on developing internal thought processes necessary for mastering complex skills, distinguishing it from traditional apprenticeships that emphasize observable tasks.

This model can be effectively applied to orthopedic education, providing a framework for developing curricula that enhance both practical skills and critical thinking in medical training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive Apprenticeship in Orthopaedic Surgery: Updating a Classic Educational Model. Butler, BA., Butler, CM., Peabody, TD.[2020]

The 'Hand as Foot teaching method' significantly enhances medical students' understanding and retention of complex concepts related to motion system injuries, as evidenced by positive feedback from students.

This innovative teaching approach fosters better teacher-student interaction and creates a more engaging classroom environment, making it a valuable complement to traditional teaching methods like PPT presentations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The innovation and practice of "Hand as Foot teaching method" in the teaching of motion system injury course. He, B., Li, Q., Zhao, J., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of Discharge Education With the Teach-Back Method on 30-Day Readmission: A Systematic Review. [2023]

2. Canada pubmed.ncbi.nlm.nih.gov

Integrated curriculum model for a residency program. [2007]

3. United States pubmed.ncbi.nlm.nih.gov

Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes. [2020]

4. United States pubmed.ncbi.nlm.nih.gov

Utilizing Teach-Back to Reinforce Patient Education: A Step-by-Step Approach. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

A Model for Delivery of Orthopaedic Perioperative Education via Telehealth. [2022]

6. United States 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. [2022]

7. United States 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. [2023]

8. England pubmed.ncbi.nlm.nih.gov

The "teach-back" method improves surgical informed consent and shared decision-making: a proof of concept study. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Teach-Back Experience and Hospitalization Risk Among Patients with Ambulatory Care Sensitive Conditions: a Matched Cohort Study. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

Education in orthopaedic trauma. [2019]

11. United States pubmed.ncbi.nlm.nih.gov

Lessons From a Near-Peer Junior Doctor Teaching Program in Trauma and Orthopedics. [2023]

12. United States pubmed.ncbi.nlm.nih.gov

Cognitive Apprenticeship in Orthopaedic Surgery: Updating a Classic Educational Model. [2020]

13. England pubmed.ncbi.nlm.nih.gov

The innovation and practice of "Hand as Foot teaching method" in the teaching of motion system injury course. [2023]