Patient communication
Teach-back for a home exercise program: explain, show, clarify
Direct answer
As a physical therapist (PT), use teach-back to check what your patient can explain about their home exercise program (HEP). Ask them to describe the plan in their own words and show the setup or movement. Clarify anything unclear, then check again. This checks your explanation and what you observe in clinic. It is not a memory test or proof of exercise at home.
A hypothetical handoff
Imagine this clinic conversation, not a report about an actual patient. You have explained the home plan and handed over the written instructions. The patient says it makes sense. Before they leave, you invite them to show how they will get started, using the handout. They describe the intended movement, but their setup differs from what you taught. You demonstrate the setup again, using different words, then ask them to try it. They now show the setup you intended. You have clarified something specific. You have not established what they will do at home, or whether another part of the plan needs explaining.
What the guidance supports
The Agency for Healthcare Research and Quality (AHRQ) describes this process in Use the Teach-Back Method: Tool 5.
AHRQ distinguishes teach-back, an explanation in the patient's own words, from show-me, a demonstration of following instructions. It recommends non-shaming prompts rather than questions that invite a yes or no. Patients can use handouts, but reading the words aloud is not the same as explaining them.
When something is unclear, AHRQ recommends a different explanation and another check. It also recommends checking small pieces throughout a visit, rather than waiting until the end.
This is general healthcare communication guidance, not a PT teach-back trial. The HEP examples and card below adapt that procedure. They do not establish better adherence or recovery.
Ask about the plan, then watch the relevant part
Start with the instructions you have chosen for this patient. You still decide the exercises and all patient-specific instructions. Teach-back does not choose a treatment plan.
These prompts are suggested wording, not quotations from the source:
- "Let's check how I explained this. Walk me through what you'll do at home."
- "You can use your instructions. Show me how you'll get into the starting position."
- "That part wasn't clear enough. I'll show it another way, then we'll look at it together again."
Listen for what the patient means, not whether they use your terminology. Watch the part you asked them to demonstrate. If the description and demonstration differ, clarify that difference rather than treating either as a complete check.
Work in small pieces as you teach. At the handoff, revisit the parts that were unclear or changed. Asking about unanswered concerns is useful, but it does not replace explanation or demonstration.
Match what you notice to what you clarify
These are possible observations, not patient labels. Choose the response that fits what you actually hear or see.
| What you notice | What you do next | What you recheck |
|---|---|---|
| The patient reads the handout back verbatim. | Invite a description in their own words while keeping the handout available. | How they explain carrying out the instructions. |
| They describe the movement, but the setup differs. | Demonstrate the starting position using a different explanation. | The setup they show afterward. |
| The demonstration matches, but the next step is unclear. | Explain that part of the plan differently. | What they describe doing next. |
| They cannot use the planned setup at home. | Ask about the space or equipment, then reconsider the patient-specific plan. | Their explanation and demonstration of the revised setup. |
| The same point remains unclear after another explanation. | Change your approach again and name the unresolved point. | Whether that specific point is now clear, not whether they agree with you. |
A practical barrier is not necessarily a misunderstanding. If the patient understands your instructions but cannot use them at home, repeating them does not address the barrier.
A small card for the handoff note
This HEP card is an adaptation of the guidance, not a validated intervention. Use it as a note prompt, not a score or certification.
Plan or instruction checked: ___
Patient explanation in their own words: ___
Setup or movement observed in clinic: ___
Unclear point: ___
What I clarified or changed: ___
Recheck, including what the patient explained or showed afterward: ___
Open question and agreed next step: ___
Record what you heard and saw. If only the setup was checked, name the setup. Do not turn that into a claim that the whole program was demonstrated. Keep any open question visible, rather than ending with a blanket statement that the patient understood.
Keep understanding separate from home follow-through
A patient can explain a plan in clinic and later encounter a different problem at home. This check does not tell you whether the exercises happened. If you need to discuss a later gap, ask what happened rather than treating today's demonstration as proof. Our guide to what to say after missed home exercises addresses that later conversation.
For product information, visit the HepBuddy overview.
Source note: AHRQ's Tool 5 was created in February 2024 and last reviewed in April 2024. Its full page text was checked on October 7, 2026, through a reader proxy.