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Teach-back is a low-risk health education strategy that improves patient self-efficacy and adherence to recommended health behaviors, including self-care. Areas of residual uncertainty include impact on health knowledge and skill acquisition, how to successfully implement routine use of teach-back, duration of effect, and the populations or settings in which teach-back would be most useful. Studies of the real-world impact of teach-back that also evaluate which strategies are most effective at increasing the routine use of teach-back are needed. Such findings could improve the incorporation of this communication approach across clinical settings and ultimately impact meaningful patient and population outcomes.
While patients often forget or misremember a significant proportion of health information conveyed during medical encounters, teach-back has been identified as a strategy to promote patient and family understanding of health-related information. Teach-back involves a health care professional providing information (verbally or by demonstration), followed by a request for the recipient to fully repeat or redemonstrate this information. Prior systematic reviews suggested a beneficial impact on multiple outcomes, although findings were limited by study design and risk of bias. This review will inform efforts of the VHA's National Center for Health Promotion and Disease Prevention to impact patient education.
Sixteen randomized trials addressed effectiveness of teach-back and 7 pre-post, single site studies evaluated the effect of efforts to increase clinician use of teach-back. While we identified 8 trials (N = 721) that evaluated the effect of teach-back on short-term patient knowledge acquisition, all had significant methodologic limitations, making it difficult to draw strong conclusions. Teach-back led to a moderate increase in short-term health behavior adherence in 6 trials (N = 497), all but 1 of which used a self-reported measure. Teach-back led to a large increase in self-efficacy in 4 trials (N = 412), all with significant methodologic limitations. There were minimal data exploring differences in the effect of teach-back across different clinical settings, methods of delivering teach-back, or patient-level characteristics. Limited evidence on the implementation of teach-back suggests that most sites use staff training along with additional strategies to encourage clinicians to use teach-back. Future studies of teach-back should continue to evaluate its short- and long-term effectiveness in the real world using validated measures, as well as evaluate different approaches to supporting implementation and sustainability.
Effectiveness and Implementation of Teach-Back as an Approach to Patient Education: A Systematic Review (Management Brief)
Vick JB, Pace R, Klimek-Johnson P, et al. Teach-Back in Clinical Communication: A Systematic Review and Meta-Analysis. Journal of General Internal Medicine. 2026. DOI: https://doi.org/10.1007/s11606-026-10678-y.
