Teach-back improves confidence and adherence

Teach-back improved patient confidence and short-term adherence, but did not clearly improve knowledge.
*Systematic review/meta-analysis of randomized trials; Level 1a.

Citation

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:10.1007/s11606-026-10678-y

Background

Teach-back asks patients to explain health information in their own words, helping clinicians check and clarify understanding. It is widely promoted, but its measurable benefits have been uncertain.

Patients

Adults or care partners in 18 randomized trials, 1985 participants. Studies excluded pediatric patients, nonclinical educators, longitudinal multi-visit programs, and studies without a comparator.

Intervention

Single-encounter teach-back during inpatient or outpatient care.

Control

Usual care or other clinician-delivered education.

Outcome

Patient knowledge, self-efficacy, adherence, and satisfaction. Standardized mean difference was used for pooled continuous outcomes.

Follow-up Period

Immediate post-visit to 3 months.

Results

Outcome Evidence Effect Certainty
Self-efficacy 5 trials, 416 participants SMD 2.40 (95% CI 0.37 to 4.44) Very low
Adherence to health behaviors 7 trials, 571 participants SMD 1.04 (95% CI 0.45 to 1.64) Low

SMD: standardized mean difference.

Nine trials found no clear pattern of knowledge improvement. Satisfaction evidence was insufficient. Adherence findings were mostly self-reported and short-term.

Limitations

Evidence certainty was low or very low because studies varied widely, often used unvalidated measures, and had bias concerns. Most adherence outcomes were self-reported. Results may not apply to patients with cognitive impairment, traumatic brain injury, or other major communication needs.

Funding

U.S. Department of Veterans Affairs; no commercial funding reported.

Clinical Application

Use teach-back to reinforce behavior plans, but do not assume it reliably improves knowledge without clear, focused education and follow-up.