Factors Influencing Feedback in a Problem-Based Learning Curriculum: A Mixed Methods Study in the Context of the Saudi Arabian Medical Schools

Purpose: Even though there is extensive literature about good practice in feedback, it is currently unclear how to sustain a good quality feedback experience in a problem-based learning (PBL) curriculum. This research aims to explore students' and tutors' experiences of the feedback process in a PBL curriculum in the local context of Saudi medical schools, and to identify factors that influence perceived feedback quality. Method: A mixed methods approach was adopted. First, 856 students from six medical schools completed a survey, followed by 12 student focus groups and 11 tutor semi-structured interviews across four schools. Results: Verbal feedback was reported to be the most effective. Communicating feedback in the students' native language and students' previous experiences of teacher-centred education in secondary school were key factors affecting feedback experiences. Most student and tutor participants believed that feedback in PBL was for promoting student-centred and self-directed learning (SDL); however, these groups differed in their perceptions of what was good feedback practice in facilitating SDL. Conclusion: Even though most student participants received feedback, their experience was variable, and the quality was inconsistent. Learner and tutor characteristics and beliefs impacted on the feedback process. A data informed model was developed to summarise key factors that influence feedback quality in a PBL curriculum in Saudi Arabian Medical Schools. A key recommendation is appropriate cultural adaptation of the feedback in a PBL curriculum when implemented in different global contexts. Specific recommendations for Saudi-medical schools include incorporating staff development to address best practice in facilitating SDL and where practical tutor feedback given in person using the student's native language.