Submitted by Marianna Shershneva on

Haas AJ, Blackall GF, Osei-Bonsu W, Wu EY, Costigan H, Stuckey HL.What really matters: A qualitative study of student perspectives on exceptional teaching. Acad Med. 2025. doi: 10.1097/ACM.0000000000006172. [Online ahead of print.]

Abstract

Purpose: This study aimed to identify characteristics that define exceptional teachers and provide recommendations for teaching in medical education. Method: A total of 3,409 student narratives that described characteristics of exceptional teachers were curated from August 2017 to January 2022 at Penn State College of Medicine. Narratives were submitted voluntarily in response to a single, open-ended question: "Please tell us about what those teachers did that resulted in an exceptional educational experience and how it changed you?" Narrative lengths varied, with a mean (SD) of 78.4 (58.0) words (range, 2-776). A systematically selected subset (n = 872) was analyzed using an inductive approach. After codebook development, 3 independent coders analyzed data (pooled Cohen κ = 0.77), organizing codes into themes and subthemes. Results: Three key themes (8 subthemes) were identified: (1) challenging and practical learning opportunities were embraced by students as a source of growth (being challenged with progressive complexity while simultaneously feeling supported, making the most of natural learning opportunities, and growing from judicious, actionable, and frequent feedback); (2) being included and valued as part of the team encouraged learners to contribute, to exercise autonomy, and to work alongside others as a colleague (being accepted and integrated as part of the team, receiving guided autonomy in interactions and responsibilities with patient care, and feeling respected as a teammate and future colleague); and (3) demonstrating enthusiasm for teaching and patient care, combined with a humanistic approach to role modeling, was inspirational to students (witnessing passion for teaching and caring for students and drawing inspiration from authentic role-modeling). Conclusions: The study findings support 5 recommendations: (1) challenge students while maintaining psychological safety, (2) provide feedback that is frequent and specific, (3) give autonomy for growth, (4) make them part of the team, and (5) cultivate the trainee-to-teacher relationship.

Questions

  1. What problem or gap in medical education does this study address, and why is it significant for clinical teaching?
  2. Which findings resonate most with your own experiences as a clinical teacher, and which feel less applicable in your context?
  3. How might the study’s results inform faculty development programs at our institution?

Comments

Walter Baker replied on

This article discussion highlights important insights into what students value in exceptional teaching—especially the balance of challenge, support, meaningful feedback, and feeling genuinely included as part of the learning process. The recommendations for fostering psychological safety, autonomy, and strong teacher-student relationships are especially relevant for improving clinical teaching practices.

snow rider

Walter Baker replied on

William Boyer replied on

1. Problem or Gap Addressed

This study addresses a longstanding gap in medical education: although we often recognize “great teachers,” we rarely define in a systematic, learner-informed way what makes them exceptional. Clinical teaching is complex, fast-paced, and patient-centered, and faculty development often focuses more on content expertise than on relational and instructional qualities. 

William Boyer replied on

William Boyer replied on

2. Findings That Resonate (or Less So)

The theme of challenging learners while maintaining psychological safety strongly resonates with my experience. Learners grow most when expectations are high but support is visible for escape road. Progressive complexity paired with constructive feedback mirrors what we know about scaffolding in adult learning theory.

The emphasis on guided autonomy also aligns with clinical reality — learners need graduated responsibility to develop competence and confidence.

William Boyer replied on

cakorib cakorib replied on

i appreciate how this paper turns “great teaching” into concrete behaviors students actually notice: progressive challenge with real psychological safety, frequent actionable feedback, and being treated as a teammate. the “guided autonomy” point lands for me, because learners can’t develop judgment if they’re only observing, yet dumping responsibility without support backfires. our faculty development could focus less on generic “feedback skills” and more on micro-habits on rounds: ask one question that scales up, give one specific next step, and explicitly invite the student into the plan. small gripe: our discussion board keeps getting weird off-topic posts; i’ve even seen stray links such as https://lightningstormgame.org/ https://livedragontiger.org/ and https://powerup-roulette.com/ showing up, which makes it harder to keep the teaching conversation focused.

cakorib cakorib replied on