What Really Matters: A Qualitative Study of Student Perspectives on Exceptional Teaching.

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.