Certified Medical Assistant (CMA AAMA)Communication and Legal/EthicalMedium

A medical assistant is providing pre-operative instructions to a patient scheduled for a colonoscopy. The patient repeatedly nods their head and says "mm-hmm" but avoids eye contact and has a furrowed brow. Which of the following responses by the medical assistant is most appropriate?

  1. AContinue with the instructions, assuming the patient understands.
  2. BAsk, "Do you have any questions about what I've explained so far?"
  3. CRethink the explanation, and simplify the language used.
  4. DSay, "It seems like something is unclear. Can you tell me in your own words what you understand?"
Show answer & explanation

Correct answer: D. Say, "It seems like something is unclear. Can you tell me in your own words what you understand?"

The patient's non-verbal cues indicate potential confusion or misunderstanding despite verbal affirmation. Using the 'teach-back' method (asking the patient to explain in their own words) is the most effective way to assess comprehension and address any gaps in understanding.

Why the other options are wrong

  • A. Assuming understanding based on superficial cues can lead to poor patient outcomes if instructions are not followed correctly.
  • B. A direct 'do you have questions?' often elicits a 'no' even when confusion exists, as patients may not want to appear unintelligent.
  • C. While simplifying language might be necessary, it's a guess without first assessing the specific area of misunderstanding.

Teach-Back Method

A communication technique where a healthcare provider asks a patient to explain in their own words what they need to know or do.

  • Confirms patient understanding, not provider's teaching skill.
  • Identifies gaps in communication and learning.
  • Empowers patients and reduces medical errors.

Memory trick: Don't just teach, ask them to preach.

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