The most important aspect of an encounter between a patient and his or her provider is the patient's ability to understand and implement the treatment plan and self-care instructions conferred by the provider. However, the literature in the field of patient-provider communication reveals that there is a noticeable gap in health literacy in certain patient populations that impairs their ability to understand pre-, during, and post-encounter paperwork, terminology, treatment plan, and critical self-care instructions. This has been shown to have detrimental consequences on patient health outcomes. The teach-back method, in which providers request patients to repeat key information discussed during the encounter in their own words, has been shown to successfully improve patient satisfaction, self-efficacy, and knowledge post-encounter. This paper seeks to investigate the impact of health literacy and teach-back on patient satisfaction, self-efficacy, and knowledge, and to determine the effect of a teach-back training intervention on the usage of teach-back during a patient-provider encounter.

A total of 88 patients and 11 providers participated in this study over the course of two semesters. A pre- and post-encounter questionnaire was provided to patients and a post-encounter questionnaire to providers. Data regarding teach-back instances during the encounter were obtained via transcripts of encounter audio recordings. Training was given to 17 providers between semesters, 11 of whom were participating in a larger study data collection, and pre- and post-training teach-back instances were compared. The data were coded and statistically analyzed.

The results were that there was a statistically significant relationship between health literacy and patient satisfaction as well as patient self-efficacy. Additionally, there was a significant relationship between teach-back and patient self-efficacy with an upward trend observed on the knowledge measures post-teach-back. Teach-back interventional training was also seen to have a statistically significant impact on provider use of teach-back during the patient encounter. Additional research in this field observing fidelity of teach-back practice and observing impacts of teach-back on a separate non-student population could be beneficial in improving patient encounters.

Thesis Completion




Thesis Chair/Advisor

Miller, Ann


Zraick, Richard


Bachelor of Arts (B.A.)


Nicholson School of Communication and Media

Degree Program

Human Communication



Access Status

Open Access

Release Date