Influence of Student Feedback on the Quality of Teaching among Clinical Teachers in Bahrain



The effect of student feedback on teaching quality has been well-documented. However, only a few studies have examined the impact of feedback on clinical teachers delivering cross-border medical education in this geographical region. The aim of this study is to investigate (i) the quality of teaching among clinical teachers in a cross-border medical education setup, (ii) the impact of student feedback on teaching effectiveness, (iii) the differences in ratings among different groups of students, and (iv) factors that improve clinical teaching.


Fifty-seven clinical teachers and 140 students participated in this study. Teachers received feedback on their performance and were allowed to reflect on them. Six months later, the teachers received feedback again. Additionally, semi-structured individual interviews were conducted with 5 selected clinical teachers working in 2 different hospitals to explore the factors that influenced clinical teaching.


Overall, nearly half of the clinical teachers (n = 25) showed a trend of greater scores in the second assessment, while most of the remaining teachers (n = 24) continued to have more or less the same score or marginal fall in the second assessment. Even though few clinical teachers demonstrated significantly lesser scores, careful observation of data showed that the mean value of the second score either remained above (n = 5) or closer (n = 2) to the cut-off value of 3.74, except one teacher who recorded the least mean score of 3.17 in the second assessment. In qualitative analysis, teachers emphasised that the student feedback allowed them to develop more effective teaching approaches and strategies.


The pattern of results suggests that the effect of student feedback on teaching quality can have multiple outcomes, mostly positive or neutral, and very rarely negative. This study also advocates that feedback can be more beneficial if strengthened by other interventions like faculty training.

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Fig. 1



modified systematic evaluation of teaching qualities

RCSI Bahrain:

Royal College of Surgeons in Ireland–Bahrain


  1. 1.

    Aaronson D, Barrow L, Sander W. Teachers and student achievement in the Chicago public high schools. J Labor Econ. 2007;25(1):95–135.

    Article  Google Scholar 

  2. 2.

    Marsh HW, Roche L. The use of students’ evaluations and an individually structured intervention to enhance university teaching effectiveness. Am Educ Res J. 1993;30(1):217.

    Article  Google Scholar 

  3. 3.

    Gould B, Grey M, Huntington C, Gruman C, Rosen J, Storey E, et al. Improving patient care outcomes by teaching quality improvement to medical students in community-based practices. Acad Med. 2002;77(10):1011–8.

    Article  Google Scholar 

  4. 4.

    Rivkin S, Hanushek E, Kain J. Teachers, schools, and academic achievement. Econometrica. 2005;73(2):417–58.

    Article  Google Scholar 

  5. 5.

    Rockoff J. The impact of individual teachers on student achievement: evidence from panel data. Am Econ Rev. 2004;94(2):247–52.

    Article  Google Scholar 

  6. 6.

    Baker K. Clinical teaching improves with resident evaluation and feedback. Anesthesiology. 2010.

  7. 7.

    Bok H, Teunissen P, Spruijt A, Fokkema J, van Beukelen P, Jaarsma D, et al. Clarifying students’ feedback-seeking behaviour in clinical clerkships. Med Educ. 2013;47(3):282–91.

    Article  Google Scholar 

  8. 8.

    Branch W, Paranjape A. Feedback and reflection. Acad Med. 2002;77(12, Part 1):1185–8.

    Article  Google Scholar 

  9. 9.

    Stalmeijer R, Dolmans D, Wolfhagen I, Peters W, van Coppenolle L, Scherpbier A. Combined student ratings and self-assessment provide useful feedback for clinical teachers. Adv Health Sci Educ Theory Pract. 2009;15(3):315–28.

    Article  Google Scholar 

  10. 10.

    Kember D, Leung D, Kwan K. Does the use of student feedback questionnaires improve the overall quality of teaching? Assess Eval High Educ. 2002;27(5):411–25.

    Article  Google Scholar 

  11. 11.

    Hattie J, Timperley H. The power of feedback. Rev Educ Res. 2007;77(1):81–112.

    Article  Google Scholar 

  12. 12.

    Clynes, Mary P., and Sara E.C. Raftery. Feedback: an essential element of student learning in clinical practice. Nurse Educ Pract 2008; 8 (6): 405–411.

  13. 13.

    Telio S, Ajjawi R, Regehr G. The “educational alliance” as a framework for reconceptualizing feedback in medical education. Acad Med. 2015;90(5):609–14.

    Article  Google Scholar 

  14. 14.

    Skeff K. Enhancing teaching effectiveness and vitality in the ambulatory setting. J Gen Intern Med. 1988;3(S1):S26–33.

    Article  Google Scholar 

  15. 15.

    Van der Leeuw R, Lombarts K, Heineman M, Arah O. Systematic evaluation of the teaching qualities of obstetrics and gynecology faculty: reliability and validity of the SETQ tools. PLoS One. 2011;6(5):e19142.

    Article  Google Scholar 

  16. 16.

    Al Ansari A, Strachan K, Hashim S, Otoom S. Analysis of psychometric properties of the modified SETQ tool in undergraduate medical education. BMC Med Educ. 2017;17(1):56.

    Article  Google Scholar 

  17. 17.

    Krackov S. Expanding the horizon for feedback. Med Teach. 2011;33(11):873–4.

    Article  Google Scholar 

  18. 18.

    Ramani S, Krackov S. Twelve tips for giving feedback effectively in the clinical environment. Med Teach. 2012;34(10):787–91.

    Article  Google Scholar 

  19. 19.

    Wilbur K, BenSmail N, Ahkter S. Student feedback experiences in a cross-border medical education curriculum. Int J Med Educ. 2019;10:98–105.

    Article  Google Scholar 

  20. 20.

    Field, A. P. Discovering statistics using SPSS (and sex and drugs and rock’n’ roll). Los Angeles [Calif.: SAGE]. 2005.

  21. 21.

    Violato C, Saberton S. Assessing medical radiation technologists in practice: a multi-source feedback system for quality assurance. Can J Med Radiat Technol. 2006;37(2):10–7.

    Article  Google Scholar 

  22. 22.

    Zamawe F. The implication of using NVivo software in qualitative data analysis: evidence-based reflections. Malawi Med J. 2015;27(1):13–5.

    Article  Google Scholar 

  23. 23.

    Khandkar, Shahedul Huq. “Open Coding.” University of Calgary 23. 2009.

  24. 24.

    Walsh M. Teaching qualitative analysis using Qsr Nvivo. Qual Rep. 2003;8(2):251–6.

    Google Scholar 

  25. 25.

    Ezzy D. Qualitative analysis. Taylor & Francis. 2013.

  26. 26.

    Holloway, I. Qualitative research in health care. Open University Press 2005.

  27. 27.

    Poulos A, Mahony MJ. Effectiveness of feedback: the students’ perspective. Assess Eval High Educ. 2008;33(2):143–54.

    Article  Google Scholar 

  28. 28.

    Fleming P, Heath O, Goodridge A, Curran V. Making medical student course evaluations meaningful: implementation of an intensive course review protocol. BMC Medical Education. 2015 Dec;15(1):99.

    Article  Google Scholar 

  29. 29.

    Novak L, & Purkey W. Invitational education. Bloomington, IN: Phi Delta kappa fastback. 2001.

  30. 30.

    Korthagen F, Vasalos A. Levels in reflection: core reflection as a means to enhance professional growth. Teach Teach Theory Pract. 2005;11(1):47–71.

    Article  Google Scholar 

  31. 31.

    Matthew-Maich N, Ploeg J, Jack S, Dobbins M. Transformative learning and research utilization in nursing practice: a missing link? Worldviews Evid-Based Nurs. 2010;7(1):25–35.

    Article  Google Scholar 

  32. 32.

    Doyle KO, Whitely SE. Student ratings as criteria for effective teaching. Am Educ Res J. 1974;11(3):259.

    Article  Google Scholar 

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Availability of Data and Material

The datasets used during the current study are available from the corresponding author on reasonable request.

Author information




AAA and KS contributed to the conception and design of the study. SAB and AAQ worked on the data accusation. AAA and SO contributed on the data analysis and interpretation of the data. AAA, SA, KS, SO, and AAQ contributed on the drafting of the manuscript. AAA gave the final approval of the version to be published.

Corresponding author

Correspondence to Ahmed Al Ansari.

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The authors declare that they have no conflict of interest.

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The research was approved by the Research and Ethics Committee at the RCSI–Bahrain and was conducted in accordance with the Declaration of Helsinki.

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Al Ansari, A., Strachan, K., Al Balooshi, S. et al. Influence of Student Feedback on the Quality of Teaching among Clinical Teachers in Bahrain. Med.Sci.Educ. 30, 253–262 (2020).

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  • mSETQ
  • Feedback
  • Clinical education
  • Teaching quality
  • Mixed method