Objective: Group health education is an important aspect of medical rehabilitation. While interaction and active involvement are important characteristics of group health education, little is known about patients' understanding of their role in this form of education. This study explored patients' understanding of their role in group health education as part of inpatient rehabilitation. Design: Qualitative, in-depth study. Setting: Six orthopaedic rehabilitation facilities in Germany. Methods: A total of 30 patients participated in six focus groups, and data were analysed using interpretative phenomenological analysis. Results: Findings reveal a complex picture concerning patient role both during and after group health education. Participants expected that patients should fulfil an active patient role and be good patients, but also said that some patients did not always comply with these expectations. Participants perceived that personal, group health education-related and environmental factors can affect the fulfilment of their role. Conclusion: Group health education should not be seen in isolation but in the context of the complex network of personal, group health education-related and environmental factors. Engagement with these factors can contribute to patients' fulfilment of an active patient role and sustainable success after rehabilitation.