Teach-Back in Clinical Communication: A Systematic Review and Meta-analysis.

Judith B Vick; Rachel Pace; Patrycja Klimek-Johnson; Sharron Rushton; Mikaela Roberts; Allison Lewinski; Joseph H Neiman; Dazhe Chen; Letha Joseph; Tatyana Der; Adelaide M Gordon; Morgan Jacobs; Ryan Crossgrove; Helen Hoenig; Sarah Cantrell; Catherine Sims; Neesha Namasingh; Deirdre Thornlow; Amir Alishahi; Paul A Dennis; Jennifer M Gierisch; Karen M Goldstein

doi:10.1007/s11606-026-10678-y

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Teach-Back in Clinical Communication: A Systematic Review and Meta-analysis.

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Abstract

BACKGROUND: Teach-back has been identified as a high-quality clinical communication strategy. Our aim was to synthesize current literature on teach-back effectiveness. METHODS: We searched MEDLINE, Embase, and CINAHL Complete databases to identify relevant studies published between 2018 and 2026. We also included pre-2018 studies identified in prior systematic reviews. Studies were eligible for inclusion if they involved adult patients and/or care partners, delivered teach-back in a single encounter, had a comparator group, and reported proximal/intermediate patient outcomes (as defined in our conceptual model). Two independent investigators screened each citation at the title/abstract and full-text levels and assessed risk of bias. Study characteristics and results were extracted. When meta-analysis was performed, we used standardized mean differences (SMD) to estimate summary effects. We assessed certainty of evidence (COE) using Grading of Recommendations Assessment, Development and Evaluation (GRADE) domains. RESULTS: Our systematic review included 18 randomized controlled trials (RCTs) involving 1985 participants. Across 9 RCTs assessing knowledge acquisition, conceptual inconsistencies precluded meta-analysis. Overall, there was no clear pattern of the effect of teach-back on knowledge (very low COE). In a meta-analysis of 5 RCTs assessing self-efficacy (416 participants), we found that teach-back interventions led to a large increase in self-efficacy relative to usual care (SMD = 2.40; 95%CI 0.37-4.44) (very low COE). In a meta-analysis of 7 RCTs assessing adherence to health behaviors (571 participants), teach-back interventions led to a large increase in adherence (SMD = 1.04; 95%CI 0.45-1.64) (low COE). Meta-analyses for both self-efficacy and adherence had large confidence intervals that ranged from small to large effect sizes and had substantial heterogeneity. DISCUSSION: In this systematic review and meta-analysis, we did not identify a clear benefit of teach-back on knowledge acquisition but did find evidence that teach-back improves self-efficacy and self-reported, short-term adherence to health behaviors.

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Judith B Vick, Rachel Pace, Patrycja Klimek-Johnson, Sharron Rushton, Mikaela Roberts, Allison Lewinski, Joseph H Neiman, Dazhe Chen, Letha Joseph, Tatyana Der, Adelaide M Gordon, Morgan Jacobs, Ryan Crossgrove, Helen Hoenig, Sarah Cantrell, Catherine Sims, Neesha Namasingh, Deirdre Thornlow, Amir Alishahi, Paul A Dennis, Jennifer M Gierisch, Karen M Goldstein. 2026-09-03. Teach-Back in Clinical Communication: A Systematic Review and Meta-analysis.. https://doi.org/10.1007/s11606-026-10678-y

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