Saudi Cultural Missions Theses & Dissertations
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Item Restricted Using qualitative feedback data to support educators for providing quality feedback to the undergraduate medical students(Saudi Digital Library, 2025) Alsahafi, Akram; Kropmans, Thomas; Newell, MicheálIntroduction Assessments in medical education are essential for evaluating the competencies of future healthcare professionals. Among these, Objective Structured Clinical Examinations (OSCEs) play a pivotal role by offering a structured and objective approach to evaluating clinical skills. Despite OSCEs' widespread use, significant discrepancies between observed scores and global rating scores have emerged, raising concerns about the process of reliability and validity of these assessments. These discrepancies often lead to the provision of generic, non-specific feedback, which fails to offer students actionable guidance for improvement. This thesis investigates how qualitative feedback data can better support educators in providing actionable, high-quality feedback. This exploration includes addressing discrepancies between observed scores and global rating scores, aiming to develop a feedback system that is both specific and meaningful. This study intends to empower educators to guide undergraduate medical students toward clinical proficiency. Methods The thesis is organised into four interrelated studies, each contributing to developing a novel structured feedback tool for OSCEs. The first study, A comparative analysis of OSCE observed scores and global rating scores using a novel approach, involved a retrospective observational analysis of scoring discrepancies between these two systems. Data were collected from 1,571 anonymised undergraduate medical students across nine cohorts. Statistical methods, including ordinal regression models and raincloud plots, were employed to identify and analyse the discrepancies between observed scores and global rating scores in OSCE assessments. The second study, A retrospective feedback analysis of objective structured clinical examination performance of undergraduate medical students, utilised text-mining techniques to analyse written feedback from 1,034 anonymised OSCE performance records. R software was used to identify common descriptors in the feedback, revealing a reliance on generic and non-specific terms. Thus, the study emphasised the need for more detailed and actionable feedback. In response to the identified feedback gaps, the third study, A Systematic Review of effective quality feedback measurement tools used in Clinical Skills Assessment, systematically reviewed existing feedback measurement tools in clinical education. Databases such as PubMed, Medline, and Scopus were searched, including 14 studies. From these, ten key determinants of effective feedback—such as specificity, balance, and behavioural focus—were identified to inform the design of a new feedback tool. In the fourth study, Development and preliminary validation of a content validity index for an OSCE feedback tool in medical education , An expert panel of seven medical educators evaluated the tool's relevance and clarity across domains, including communication, task knowledge, and professionalism, and the CVI score was calculated to evaluate the structured feedback tool through the content validity index (CVI) lens, assessing its potential effectiveness in capturing and conveying essential feedback elements within the OSCE framework. Results The findings of this thesis highlighted significant discrepancies between observed scores and global rating scores in OSCEs, particularly in mid-range scoring categories, which emphasised the uncertainty in current assessment practices. Additionally, a retrospective analysis of the feedback provided to medical students revealed that much of it was generic, lacking the depth and specificity required to offer actionable guidance. The final studies introduced and validated an enhanced feedback tool, demonstrating its potential to address these gaps by providing medical students with more detailed, constructive, and actionable feedback that supports their clinical development. Discussion The identified discrepancies between observed scores and global rating scores highlight limitations of the current OSCE assessment framework. Although OSCEs remain an essential tool for evaluating clinical competencies, their effectiveness maybe may be undermined by scoring inconsistencies and generic feedback provision. These findings emphasise the need to recalibrate the feedback process, ensuring that it reflects student performance and is directive for future improvement. The introduction of a structured feedback tool offers a solution that enhances the specificity and relevance of feedback and aligns more closely with the educational goals of developing clinical proficiency in medical students. Conclusion This thesis stresses the need for a more structured, actionable feedback system within OSCEs. By addressing the identified discrepancies between observed scores and global rating scores and by introducing an enhanced feedback tool, this research can enhance the accuracy and relevance of feedback provided to medical students. The developed tool aims to bridge the gap between assessment and actionable feedback, ultimately improving the educational value of OSCEs and fostering the development of more competent and prepared healthcare professionals.22 0Item Restricted Implementation of a Competency Framework in Saudi Undergraduate Medical Education(Saudi Digital Library, 2025-06-24) Alqarni, Mohammed; Roberts, Trudie; Farnsworth, Valerie; Goddard-Fuler, RikkiIn 2011, a competency-based medical education (CBME) framework called SaudiMEDs was developed in Saudi Arabia to serve the community with medical graduates who can competently fulfil society’s health needs. SaudiMEDs serves as a guide to designing, developing, and evaluating medical school curricula. Despite the widespread implementation of SaudiMEDs, no research has been conducted on how medical education has been shaped as a result of SaudiMEDs. This study’s primary aim is, therefore, to investigate the real-time implementation of SaudiMEDs and its impact on Saudi medical schools. Qualitative case studies with two medical schools across the country were conducted to investigate how SaudiMEDs had been implemented. Documentary analysis of the medical schools’ documents, semi-structured interviews with academic leaders, and focus groups with faculty members and students were carried out for each school. Framework analysis for documents and Reflexive thematic analysis for interviews and focus groups were used to identify patterns and concepts and to conceptualise and construct meaning from the data. Analysis revealed a complex network of mixed perceptions of SaudiMEDs which, based on identified variations in teaching strategies, ways of learning and assessment methods, are considered as a key influence shaping implementation of SaudiMEDs. The perceptions of faculty members and students provide insight into the culture of each medical school and how it mediates implementation. The study also identifies different challenges in the SaudiMEDs implementation, which could provide further explanation for the variation in each medical school context. A key finding was the challenge of translating curriculum innovation developed in and for Western, specifically North American, contexts to the distinct organisational and institutional culture of Saudi Arabia. One consequence of this was that schools in this study approached implementation as a mapping activity and focused on the short-term accreditation standard requirement rather than a longer-term evaluation. This limited the ability of SaudiMEDs to achieve its stated aims. The research helps to identify what needs to be done to enable the fruitful transformation of SaudiMEDs into robust curricula: a) a rigorous review of SaudiMEDs to contextualise community health needs and b) support for CBME implementation through the enactment of the legislation, training, and establishment of appropriate information technology infrastructure to provide authentic experiences for learners.26 0Item Restricted Clinical Feedback in Emergency Medical Service (EMS) Education: Identifying and resolving the training needs of clinical supervisors in Saudi Arabia(Cardiff Univeristy, 2024-03) Algabgab, Mohammed Fahad; Tombs, Michal; Riley, StephenClinical supervision and feedback are crucial in Emergency Medical Services (EMS) education, as they play a significant role in enhancing the competence and professional growth of EMS students . Supporting and addressing the training needs of supervisors is essential to ensuring they can provide effective feedback and guidance. However, there is no existing literature on the specific training needs of EMS supervisors in the unique cultural context of Saudi Arabia, highlighting the need for focused research in this area. Grounded in the Clinical Performance Feedback Intervention Theory (CP-FIT), the research navigated through a comprehensive examination of clinical feedback’s perceptions, challenges, and training needs from the perspectives of both EMS students and clinical supervisors. The thesis begins with a scoping review, finding that only twelve studies specifically targeted clinical feedback in EMS education over the past two decades, highlighting its importance but also underscoring gaps in the literature. Notably, existing studies fail to explore the perceptions of clinical feedback between students and supervisors and largely focus on the general context of clinical placements, thus diluting the potential insights into feedback’s effectiveness, challenges, and impact on learning and performance. Furthermore, it notes a lack of research in EMS education, especially within Saudi Arabia. To address these gaps, the thesis delves into the perceptions of EMS students and clinical supervisors in Saudi Arabia, thereby filling a regional research void. It investigates the specific challenges in feedback provision and receipt, emphasising the training needs of supervisors, including effective communication, personalised feedback, constructive methods, emotional intelligence, feedback follow-up, technology use, understanding feedback differences, and promoting a positive feedback environment. Furthermore, the thesis employs a Delphi study to consolidate expert consensus on the best approaches to address identified challenges and needs in clinical feedback, including the particular training needs of clinical supervisors. The findings highlight the need for a structured feedback approach that considers the diverse needs and perceptions of both students and supervisors. The thesis proposes a comprehensive strategy, including tailored training programmes and quality assurance and ongoing support, to improve clinical feedback standards. This strategy aims to bridge perceptual gaps, and to foster the students’ learning and professional growth.21 0Item Restricted Using Design Thinking to Develop and Improve Health Profession Curricula(University of Rochester, 2024) Matbouly, Ghassan; Daley, MichaelIn recent years, there has been a notable shift towards student-centered education, with an increasing adoption of Design Thinking (DT) frameworks in educational settings to achieve this objective. DT methodology offers a novel approach to address longstanding and complex educational challenges, emphasizing collaborative curriculum co-design with key stakeholders in health professions education (HPE). Past research has highlighted the effectiveness of DT in fostering innovative ideas that enhance learning outcomes and critical thinking skills among students. However, successful implementation of DT requires thorough preparation, ongoing monitoring of group dynamics, and continuous engagement of stakeholders. This study explores the application of DT in the development of HPE curriculum, revealing its potential to improve both the education and healthcare sectors through enhanced collaboration and innovation.25 0Item Restricted Assessment of Clinical Competence: Implementation of the Objective Structured Clinical Examination (OSCE) in Saudi Medical Schools(University of Leeds, 2023-02-08) Almisnid, Khaled; Homer, MatthewAssessment of clinical skills is essential in determining the competency of health professionals. The Objective Structured Clinical Examination (OSCE) is a performance assessment tool that is widely adopted for this purpose. Despite its widespread use in Saudi medical schools, the implementation and impact of the OSCE in Saudi Arabia (SA) have not been widely investigated. The aim of this research is to provide an in-depth understanding of OSCE usage in Saudi medical schools, the opportunities and challenges offered by its adoption, and to develop recommendations to improve implementation. Using a qualitative constructivist philosophy, this research employs a case study design in two different Saudi medical schools, integrating document review with interviews and focus groups with medical school leaders and their Faculty. Reflexive thematic analysis and codebook methods were applied to interviews/focus groups and documents, respectively. The analysis generated a series of key themes that impacted the OSCE implementation in Saudi medical schools. These themes constitute a conceptual framework that requires careful consideration in order for them to function harmoniously to produce a high-quality OSCE. This research also highlights that each stage of OSCE implementation in the investigated medical schools involves a series of dilemmas and compromises. Analysis suggests that funding sources (public or private schools), accreditation status, faculty experience, and resource availability all influence the quality of OSCE implementation. The research findings are consistent with the international OSCE literature; however, this work brings new insights into the use of the OSCE in SA, a non-western culture, and sheds light on the integrative nature of the factors that contribute to successful implementation. It concludes with a series of recommendations that individual medical schools and organisational networks can employ to improve the OSCE in SA, and beyond.39 0Item Restricted Women, Men, and Medical Education During the COVID-19 Pandemic: The Shift to Online Learning and Gender’s Influence(Saudi Digital Library, 2022-12-15) Alturki, Mona Mohammed; Patel, RakeshIntroduction: In the time of COVID-19, various disciplines have moved to online learning, including medicine. Online learning, in the pandemic context, has allowed students to continue studying despite isolation requirements and quarantines being implemented in various countries, including the Kingdom of Saudi Arabia. The primary aim of this research was to determine how gender influences male and female medical students’ sudden shift to online learning in the context of the COVID-19 pandemic. Methodology: Through Microsoft Teams, the researcher was able to collect data via semi-structured interviews with the study participants. Purposive sampling was used to access a sample of male and female medical students in Saudi Arabia. The participants, 18 male and female undergraduate students studying medicine, attended Umm Al-Qura University or King Saud bin Abdulaziz University for Health Sciences. this study employed a qualitative phenomenological approach to investigate the research question. Results and analysis: the thematic analysis of the interview transcripts revealed a total of nine themes that emerged from the collected data: shift to online learning and students' learning, shift to online learning and students' health-related behaviours, shift to online learning and students' dress, shift to online learning and students' commuting, shift to online learning and students' family responsibilities, gender differences in university regarding education, gender differences in university outside of the classroom, gender differences in dealing with patients as a student, and societal expectations and stereotypes regarding doctors. Conclusion: , the results suggest that there are some significant differences in how male and female students experience medical education, particularly with regards to how students are treated by their professors inside and outside of the classroom and doctors in the clinical setting. Educators and administrators should strive to promote greater gender equality in medical education programs. Future experimental research should consider exploring what strategies might be employed to achieve greater gender equality in medical education.22 0