Plain Language and Teachback: Keys to Safe, Quality Healthcare

Health literacy is a major challenge to all health professions and health organizations. Only 12% of American adults have proficient health literacy skills — the ability to read, write, compute, understand and use health information. Seniors, the highest users of health services, have the lowest health literacy skills. 

By age 75, 70% of adults have below basic or basic health literacy and just 1% have proficient skills.

Plain language is the first best solution. Major national health policy groups, including the Institute of Medicine, National Safety Patient Council and the Joint Commission urge health organizations to use plain language in patient/consumer communication. Plain language requires using evidence-based standards for patient teaching, as well as writing and designing information for print, web, or media.

For verbal patient teaching, using teachback is the evidence-based quality standard of care. Asking all patients to explain or show back how they will carry out medical instructions is the only way to assure their understanding.

Health Literacy & Plain Language: Skills for Clear Health Communication Online Course

The UNE-Maine GEC online health literacy course helps build knowledge and skills. The 3 course modules will help you learn:

  • More about both the problem and the solution
  • What plain language looks like so you’ll know it when you see it
  • About ‘grade levels’ of print materials and how to compute one
  • To register for this course at no cost, contact Marilyn Amoroso for a user name and password. Contact her at: (207) 221-4460 or

additional resource: 

more information  and teaching resources:


  • Jack B et al. A Reengineered Hospital Discharge Program to Decrease Rehospitalization. Annals of Internal Medicine, 2009, 150:178-187

  • Schillinger D et al. Closing the Loop: physician communication with diabetic patients who have low health literacy. Arch Int Med, 2003. 163:83-90

  • McCarthy DM etc. What Did the Doctor Say? Health Literacy and Recall of Medical Instructions. Medical Care, 2012. 50(4):277-282

  • The Joint Commission. Advancing Effective Communication, Cultural Competence, and Patient-and Family-Centered Care: A Roadmap for Hospitals. Oakbrook Terrace, IL,2010. Access:

  • Weiss B. Health Literacy and patient safety: Help patients understand-Manual for clinicians, Oakbrook Terrace IL: American Medical Association, 2007. Access:

  • Op Cit, Joint Commission.

  • Wolf M et al. Literacy and Learning in Health Care. Pediatrics, 2009. 124:S275-S281

  • Kutner M. Greenberg E. Jin Y, Paulsen C. The Health Literacy of America's Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006-483). U.S. Department of Education.  Washington DC: National Center for Education Statistics, 2006. Access:

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