{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T06:52:58Z","timestamp":1781679178471,"version":"3.54.5"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n Effective retraining programs for medical caregivers (i.e., patient care assistants who primarily assist nurses with daily patient care) are critical to ensuring patient safety and care quality. However, traditional lecture-based methods often fail to promote durable knowledge retention and skill application. The aim of this study was to assess the effectiveness of a retraining program integrating the Teach-Back method with the Know\u2013Want to know\u2013Learned (KWL) strategy and loose-leaf teaching materials.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Medical caregivers undergoing retraining at a hospital between January and June 2025 were randomly assigned to either an experimental group (\n n<\/jats:italic>\n =\u202f25) or a control group (\n n<\/jats:italic>\n =\u202f25) using a random number table. The experimental group received instruction through loose-leaf materials incorporating the Teach-Back method guided by the KWL strategy. This approach involved structured guidance to activate prior knowledge (Know), define learning goals (Want to know), and consolidate learned content (Learned), along with real-time feedback delivered through the Teach-Back process. The control group received conventional lecture-based instruction. Outcomes were compared between the groups using theoretical examination scores, practical skill assessment scores, and self-reported competence ratings.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The experimental group demonstrated significantly higher theoretical knowledge and practical skill scores compared with the control group (both\n p<\/jats:italic>\n &lt;\u202f0.05). Self-evaluated competence indicated notable improvements in theoretical knowledge, operational skills, social competence, and professional attitude within the experimental group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n A retraining program that integrates the Teach-Back method and the KWL strategy with loose-leaf teaching materials can substantially improve learning outcomes, skill application, and self-perceived competence among medical caregivers. This model holds promise for broader application in clinical training for medical caregivers and can also inform continuing education programs in nursing and other healthcare disciplines.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1785892","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:56:41Z","timestamp":1781675801000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of Teach-Back method based on KWL strategy: a randomized controlled trial in medical caregiver retraining"],"prefix":"10.3389","volume":"14","author":[{"given":"Xintong","family":"Zhang","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Nantong First People\u2019s Hospital, Southeast University","place":["Nantong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunmei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Nantong First People\u2019s Hospital, Southeast University","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufei","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Emergency, Nantong First People\u2019s Hospital, Southeast University","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinxia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infection Management, Nantong First People\u2019s Hospital, Southeast University","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhong","family":"Ji","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Nantong First People\u2019s Hospital, Southeast University","place":["Nantong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Nantong First People\u2019s Hospital, Southeast University","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"ref1","volume-title":"New State of the World\u2019s Nursing Report for 2025","year":"2023"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1186\/s12960-025-01028-w","article-title":"Causes and effects of hospital nursing shortages to consider potential feedback effects: an umbrella review","volume":"23","author":"Jones","year":"2025","journal-title":"Hum Resour Health"},{"key":"ref3","volume-title":"Notice on the Issuance of the Pilot Work Plan for Hospital Care Services Without Escort","year":"2025"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/GWTT8143","article-title":"Relationship between staff and quality of care in care homes: StaRQ mixed methods study","volume":"12","author":"Spilsbury","year":"2024","journal-title":"Health Soc Care Deliv Res"},{"key":"ref5","volume-title":"Notice on Strengthening the Training and Standardized Management of Medical Caregivers","year":"2021"},{"key":"ref6","volume-title":"National Plan for the Development of Nursing Services","year":"2022"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"151431","DOI":"10.1016\/j.apnr.2021.151431","article-title":"Patient satisfaction with non-clinical nursing care provided by the nursing assistant under different management models in Chinese public tertiary hospital","volume":"67","author":"Zhi","year":"2022","journal-title":"Appl Nurs Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e14455","DOI":"10.1111\/1475-6773.14455","article-title":"Addressing staffing shortages in nursing homes: does relaxing training and licensing requirements increase nurse aide staffing?","volume":"60","author":"Mehboob","year":"2025","journal-title":"Health Serv Res"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.1097\/NNA.0000000000001393","article-title":"An intervention to enhance recognition of nursing assistant roles and enhance information-sharing","volume":"54","author":"Saiki","year":"2024","journal-title":"J Nurs Adm"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"100200","DOI":"10.1016\/j.ijnsa.2024.100200","article-title":"A nurse by any other name? 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