Using the ‘teach back’ or ‘show me’ technique

You are familiar with using the teach back technique from your experience of Remote DAFNE facilitation. In face-to-face DAFNE you have the opportunity to use the ‘show me’ method as well as teach back, as a communication confirmation method designed to improve health literacy. You can use it to confirm whether a participant has understood what you have been teaching by inviting them to ‘show you’ how they would put the teaching into practice, for example, demonstrate how to use digital scales to weigh their food without including the weight of the plate.

If a participant understands, they will be able to ‘show you’ the technique or process accurately. The technique also enables you to check that you have clearly explained information in a way that the participant understands.

The following teaching tip shows how to use digital scales. Once demonstrated, participants can show you that they understand how to use scales at lunchtime, and in the session counting CPs in everyday foods.

Teaching tip

Download this video clip.Video player: nc3612_dafne_2018_vid006.mp4

Show transcript|Hide transcript

Transcript

SUE

Fiona, it's really surprising, isn't it, how many participants are not aware of how to use digital scales?

FIONA

Oh, absolutely, especially if you've got some older participants who are used to the old scale system where they have a bowl and they just pour the ingredients in. I think with the digital scales, the important thing to remember is that you need to weigh the plate or the bowl or whatever you're using before you actually put the food on it, and then zero the scale, and then weigh the food. So, I'll just show you very briefly and very simply how that can be done.

SUE

Thank you.

FIONA

So we need to switch the scale on. And then it doesn't matter the size of the plate or the dish, you would just put the dish onto the scale. When it's on and balanced well, you would then press to zero it so you've then got a zero weight, and then you can add whichever food you're going to add. And the weight that you get will be just the weight from the food, and not the weight of the food and the plate added together. What would happen if somebody weighed the plate and the food?

SUE

One course participant did talk about the fact that she actually included the plate in the weight with the food, so she actually took double the amount of insulin that she needed to take.

FIONA

Yeah, quite easily done.

SUE

Very easily done.

FIONA

Because half the weight would have been the plate, and the other half would have been the food, so she'd have taken double the amount of insulin.

SUE

Yes.

FIONA

Yeah. Again, an easy lesson to learn and an easy mistake to make.

SUE

And it’s part of the group discussion.

FIONA

And group learning again.

SUE

It is another learning experience for everyone.

FIONA

Yeah.

End transcript

Download

 

Interactive feature not available in single page view (see it in standard view).

This technique goes beyond asking closed questions such as, ‘Is what I have explained to you clear?’ or ‘Have you understood everything that you have heard?’ because you are asking the participant to demonstrate that they have heard and understood what has been communicated.

Watch the video to see how the show me technique is used as part of activity 35 in the session, mild hypos and driving. The activity is outlined in the lesson plan with reference to the course book and activities book to demonstrate an understanding of how to measure out an appropriate amount of a number of hypo treatments.

There is accompanying audio so ensure you have your headphones or speakers on. Click on the square icon below the video to watch in full screen.

Click 'Start' to begin.

Active content not displayed. This content requires JavaScript to be enabled.

Show transcript|Hide transcript

Transcript

Slide 1 narration:

Teach back, also known as the 'show me' technique, is a key element in the session ‘mild hypos' because it enables the participants to achieve one of their main learning outcomes – to show you that they can measure out the correct amount of an appropriate hypo treatment. The learning outcome does not relate to you demonstrating this as an educator. Provide scales, measuring jugs and calculators for the participants to use and choose a variety of different hypo treatments for them to weigh and measure. Ask your participants to use their Carb portion list or the food labels to work out the weight / volume of 1 ½ CPs then measure this out for each hypo treatment. If you’re using liquid hypo treatments, such as orange juice or cola, provide different sized cups, glasses and mugs so the group can visualise the required quantity in something they might use at home.

Slide 2 narration:

You can see an excerpt of the lesson plan for this session here. The lesson plan outlines the relevant activities for your participants to complete in order to achieve their learning outcomes. It also includes suggested resources as well as the relevant DAFNE flipcharts you may wish to use to support the group’s learning.

Slide 3 narration:

When facilitating this activity, your participants can use a number of different resources. Firstly, they’re going to measure out the amount of hypo treatment needed from those available to them on the DAFNE course. Encourage the participants to record the correct amount needed for orange juice, jelly babies, dextrose tablets and cola in activity 35 in the activities book. Refer to note 9 in the activities book. When they discuss the need to keep hypo treatments with them all the time, and after looking at the options, ask them to record in note 9 which ones they would prefer to keep with them, in their bag or pocket, at work, in the car and when they’re exercising. Allow time for feedback and reflect responses back to the group verbally. Recap the DAFNE guidelines using the Hypo treatment flowchart, Figure 31, if necessary.

End transcript

 

A downloadable version [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)]   is also available in a PowerPoint format.

Depending on the participant’s response, you will be able to clarify or modify information and use the ‘show me’ approach again, as necessary, to confirm that the participant has understood. Asking for explanations from other group members can be a helpful way of introducing peer support. Participants may understand each other more clearly than they understand you.

It is good practice to check that people understand the information they have been given regardless of their health literacy levels, so this technique can be used as a matter of routine with everyone in the group.

The 'show me' technique can also be used to confirm participants have understood how to:

• weigh out 1 CP of a food to aid visual estimation
• perform an accurate blood glucose or blood ketone check
• count their CPs accurately at lunchtime
• calculate and inject the appropriate dose of quick-acting insulin at lunchtime, based on their Glucose check and CP count.