Flagship Artifact

Teach-Back Checklist

A clinic-facing teach-back checklist designed to help staff and interpreters confirm Khmer-speaking LEP patients' understanding of GI procedure preparation, consent, day-of expectations, post-procedure care, and when to ask for help.

In development Teach-Back | Patient Education | Health Literacy | Language Access | Accessibility | GI Procedures

Artifact Overview

This teach-back checklist is part of the Khmer GI Patient Education Design Framework & Learning Toolkit. It is designed to help nurses, interpreters, providers, and clinic staff confirm that Khmer-speaking LEP patients understand key colonoscopy and endoscopy instructions before and after the procedure.

The checklist is not meant to replace clinical judgment, provider explanation, consent processes, or professional interpretation. It is a learning-support tool that helps staff identify confusion, repeat key points, and make patient education more accessible.

Why Teach-Back Matters

For GI procedures, patient understanding directly affects preparation quality, appointment completion, safety, and recovery. If a patient misunderstands diet restrictions, bowel prep timing, sedation instructions, ride-home requirements, or warning signs, the procedure may be delayed, cancelled, rescheduled, or followed by unsafe recovery decisions.

Teach-back helps confirm understanding by asking patients to explain instructions in their own words. For Khmer-speaking LEP patients, teach-back should be supported by plain language, culturally respectful communication, visual aids, interpreter support, and enough time for questions.

How to Use This Checklist

  • Use after the patient reviews the toolkit module, handout, or video.
  • Use with a qualified interpreter when needed.
  • Ask the patient to explain the instruction in their own words.
  • Avoid asking only "Do you understand?"
  • Normalize confusion by saying, "I want to make sure we explained this clearly."
  • If the patient cannot explain the instruction, repeat the information using visuals, audio, or interpreter support.
  • Document or flag areas where the patient may need additional support according to clinic policy.

Checklist Section 1: Procedure Understanding

Patient can explain:

  • The name or general purpose of the procedure.
  • Why the provider recommended the procedure.
  • Whether the procedure is colonoscopy, endoscopy, or both.
  • That the procedure may involve sedation or medicine to help them relax.
  • That they can ask questions before the procedure.

Staff/interpreter prompt: "Can you tell me in your own words what procedure you are having and why?"

Checklist Section 2: Consent, Risks, Benefits, and Questions

Patient can explain:

  • That consent means they are being informed and asked for permission.
  • That they can ask questions before signing or agreeing.
  • One basic benefit of the procedure.
  • That there may be risks, even if serious risks are uncommon.
  • Who to ask if they feel unsure.

Staff/interpreter prompt: "What questions do you still have before the procedure?"

Note: This checklist does not replace the formal consent process. It supports patient understanding and question-asking.

Checklist Section 3: Diet and Prep Instructions

Patient can explain:

  • What foods or drinks they should avoid.
  • What clear liquids mean, if applicable.
  • When to stop eating solid food.
  • When to drink the prep medicine, if prescribed.
  • Why completing the prep matters.
  • What to do if they feel unable to finish the prep.
  • Who to call if they are confused about prep instructions.

Staff/interpreter prompt: "Can you walk me through what you will do the day before your procedure?"

Checklist Section 4: Day-of-Procedure Expectations

Patient can explain:

  • What time they need to arrive.
  • What they should bring.
  • That they may need someone to drive them home if sedation is used.
  • That they should not drive after sedation if instructed.
  • That an interpreter can support communication when needed.
  • What may happen during check-in and recovery.

Staff/interpreter prompt: "Can you tell me what you need to remember for the day of your procedure?"

Checklist Section 5: Post-Procedure Care

Patient can explain:

  • What symptoms may be normal after the procedure.
  • What symptoms are warning signs.
  • When to call the clinic.
  • When to seek urgent or emergency care.
  • Any diet, activity, medication, or follow-up instructions given by the clinic.
  • How they will get results or next-step information.

Staff/interpreter prompt: "After you go home, what symptoms would make you call the clinic or get help right away?"

Checklist Section 6: Patient Confidence Check

Ask the patient:

  • Do you feel ready for the procedure?
  • Which part is still confusing?
  • Do you want the instructions explained again?
  • Would you like interpreter support?
  • Do you want a printed copy, audio/video review, or help from staff?
  • Who will help you at home, if needed?

Response options:

  • I feel ready.
  • I understand some parts but need review.
  • I am confused and need help.
  • I want interpreter support.
  • I want printed or audio/video instructions.

Accessibility Notes

This checklist should be used flexibly based on patient needs. Some patients may prefer spoken Khmer explanation instead of written instructions. Some may need large print, audio, captions, high contrast visuals, interpreter support, or family/caregiver involvement when appropriate and permitted. The goal is to reduce shame and confusion while confirming understanding in a respectful way.

Relationship to the Toolkit

This teach-back checklist connects the toolkit modules to real patient understanding. It supports the larger design goal of helping Khmer-speaking LEP patients prepare correctly, reduce anxiety, avoid preventable cancellations or rescheduling when possible, and recover safely after GI procedures.

It also supports future toolkit features such as patient confidence surveys, staff-facing prompts, interpreter support notes, and quality-improvement feedback.

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