I think it does just click after a bit of practice. Like when all of a sudden, the backside looks as good as the front! Enough so that you are even confident to flip it over and quilt around the design on the back as your quilting design. I still have uneven stitches now and then, but overall it's definitely more consistent than it used to be.
The things that helped me build confidence:
* Thread that matched the top/backing rather than contrasting thread
* Master a couple of designs before moving on to others (loops/stars were the easiest at first - meandering and being able to follow a line took a lot longer!)
* Practice before every quilt
* Sally Terry's book "Hooked on Feathers"...great starter method if you always dreamed of doing your own feathers. Awesome confidence builder. I am not afraid to try anything now!