Knowledge Transfer

How to use teach-back for effective communication

October 22, 2023

Today, I’ve asked Kelly Fradin to share her Tip of the Week. 

In the school nurse’s office, I loved chatting with Sarah, a vivacious 9-year-old who had been managing her Type 1 diabetes for years. Several times a day, she stopped in to check her blood sugar and adjust her insulin dose. I asked her why one day, just to see how she answered.

“Because I’m always eating too much sugar and too many cookies, and I can’t keep my blood sugar down,” she said.  

This response made me profoundly sad because she had somehow assumed she was to blame for her condition. In Type 1 diabetes, the body attacks the pancreas, keeping it from producing sufficient insulin. Even if Sarah ate a perfectly healthy diet, she would depend on insulin injections to process carbohydrates.

When I talked to Sarah’s parents, they were upset—they never realized that she thought about the disease as her fault. But this kind of hidden miscommunication is common. One way to uncover it: a technique called teach-back, which research has shown to be effective for learning. 

Here’s how it works: After you explain something important, ask your child to repeat what you’ve told them in their words—to “teach back.” Inevitably, you’ll learn something about what they‘ve heard or what you could have explained better. 

I use teach-back all the time, both as a pediatrician and as a parent. With my own children, sometimes the goal is to make sure they understand me—for example, I’ll say, “Remind me, what’s the plan for after school today?” Other times, it can spur a conversation instead of an argument. When I start to lecture my son on why it’s important to put laundry in the hamper, I’ll catch myself and say instead: “Can you recap what I’m asking you to do and why?” 

Don’t assume people heard and understood everything you said the first time. 

Do use teach-back to figure out what part of a message might need clarification. Teach-back shouldn’t feel like a test. Rather, you want to acknowledge your humility and potential for growth by saying, “Did I explain this well? How did you understand it?” Inviting participation makes communication more effective—and facilitates learning.     

With humility and gratitude, 


About the author

Kelly Fradin is a mother of two, pediatrician, and author of Advanced Parenting: Advice for Helping Kids Through Diagnoses, Differences, and Mental Health Challenges.