The teach-back method to support informed consent among patients with aphasia: a mixed-methods evaluation

Document Type

Article

Publication Date

9-8-2026

Publication Title

Aphasiology

Abstract

Background: Ethical medical care requires that the healthcare provider obtain informed consent from the patient prior to any procedure through a process of patient education and joint decision-making. The teach-back method (TB) is the gold standard of patient education techniques, requiring the patient to repeat back medical information as they understand it so that providers can correct gaps in understanding, but it has never been tested in people with aphasia (PWA).

Aims: This exploratory research study aims to ascertain whether the use of a teach-back procedure could enhance the ability of people with aphasia to participate in a simulated informed medical consent procedure, and to explore potential supports.

Methods & Procedures: A quantitative approach was used to evaluate a teach-back intervention. Participants comprised two groups, an aphasia group (AG) (N = 8) and a non-aphasia group (NG) (N = 30). The first author completed all steps individually with each participant. Step 1: Both groups watched a scripted video simulating a provider’s explanation of cardiac ablation. Step 2: Each group completed a written test on their understanding of the explanation; however, the AG received a modified version of the test, which was shorter and presented in an aphasia-friendly format. Step 3: The NG was first split into intervention (NGI) (N = 15) and control (NGC) (N = 15) groups. AG and NGI received a teach-back intervention; the NGC had a quiet wait time. AG received a TB intervention with communication supports. Step 4: The written test was readministered to all participants. A between-group comparison of pretest and posttest scores for the treatment groups (i.e. AG & NGI), and a within-group comparison for the NG (i.e. NGI vs NGC) were completed. To address the second research aim, Multimodal Discourse Analysis (MDA) was used to describe how the social actions (Step 3) of three PWA were enhanced via the use of supports.

Outcomes and Results: Statistical comparisons revealed significantly higher pretest scores for the NG than AG; significantly higher posttest scores than pretest scores for AG; no significant improvement from pretest to posttest for NGC, and significantly higher posttest scores for NGI than NGC. MDA findings illustrated how the AG participated successfully (e.g. by using multimodal responses and demonstrating modal flexibility).

Conclusions: The results were consistent with general trends toward including multimodal communication supports to enhance participation opportunities for PWA. These supports, provision of additional time and training should be considered reasonable accommodations when healthcare professionals interact with PWA.

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Last Page

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