Patients say they understand you, but do they?

Here’s another reason to evaluate understanding of your patient education through teach-back and return demonstration.  If you ask a patient if he understands or if he has any questions, he may express confident comfort in his knowledge, but may actually not understand at all.

In one study, 140 adult English-speaking patients discharged from emergency departments in 2 health systems were asked to rate their subjective understanding of their (1) diagnosis and cause, (2) care in the ED, (3) care after the ED, and (4) return instructions.  Researchers compared the patients’ recall of those details with their charts.  The researchers found that many patients don’t understand their ED care or discharge instructions, and most of them were not aware that they didn’t understand.  They were inappropriately confident in their comprehension and recall.

Source:  Engel, K. G., Heisler, M., Smith, D. M., Robinson, C. H., Forman, J. H., & Ubel, P. A. (2009). Patient comprehension of emergency department care and instructions: are patients aware of when they do not understand? Ann Emerg Med, 53(4), 454-461 e415.