Emergency medicine clinical teachers in Taiwan rarely name the Institute of Medicine’s six healthcare quality domains explicitly, yet their self-described teaching feedback substantively reflects those domains, according to a qualitative study published in BMC Medical Education. The research examined how experienced emergency physicians understand and describe the quality domains—patient-centeredness, safety, effectiveness, timeliness, equity and efficiency—within their feedback discourse, addressing the shift toward competency-based medical education.
The study used a qualitative phenomenological design. Researchers conducted semi-structured interviews with 14 emergency physicians, each with more than five years of teaching experience. The transcripts were analyzed thematically and categorized according to the six IOM quality domains using a dual-metric approach that counted both the number of participants addressing each domain and the number of references made to it. This method allowed the team to distinguish between broad consensus across teachers and the depth of discussion each domain received.
The results showed a clear pattern of prioritization. Patient-centeredness and safety were addressed most frequently in the teachers’ feedback, demonstrating the highest consensus and depth of discussion. Effectiveness and timeliness shared a high level of consensus but appeared with lower reference frequencies, suggesting that while most teachers recognized these domains, they discussed them less extensively. Equity and efficiency showed relatively lower consensus among participants, indicating less agreement on how these domains fit into everyday teaching feedback.
The authors interpret this distribution not as simple neglect of particular domains but as practical teaching adjustment. Clinical teachers, they argue, make trade-offs amid the resource constraints of emergency care, where high-pressure conditions shape what can realistically be emphasized when supervising trainees. The feedback language teachers describe reflects a practical value prioritization perceived within those constraints, even though formal IOM terminology is rarely used.
By aligning teaching feedback with the quality domains, the findings address a literature gap regarding quality-oriented feedback in emergency medicine, an area the authors identify as previously underexplored.
The study is limited by its qualitative design and its focus on self-reported perspectives from 14 physicians in Taiwan, so the findings describe how these particular teachers characterize their own feedback rather than measuring the actual content or effects of feedback delivered to trainees. As a phenomenological study, it captures the participants’ described experiences rather than objective observations of teaching practice.
The authors suggest that future faculty development programs could explore how to enhance clinical teachers’ understanding of the diverse quality domains and develop contextualized feedback strategies. Such efforts, they propose, could help bridge the gap between quality frameworks and teaching applications, ultimately balancing educational effectiveness with clinical feasibility in the emergency department setting. The article was published as an open-access research paper on 28 October 2026 and is citable with a permanent DOI, with the published version subject to further editorial edits.
Subject of Research: How emergency medicine clinical teachers in Taiwan describe the six Institute of Medicine healthcare quality domains in their teaching feedback
Article Title: Clinical teaching feedback on institute of medicine quality domains: self-reported perspectives of emergency physicians in Taiwan
Article References: Wang, Y.-F., Huang, M.-Y., Lee, Y.-H., & Lee, C.-W. (2026). Clinical teaching feedback on institute of medicine quality domains: self-reported perspectives of emergency physicians in Taiwan. BMC Medical Education. https://doi.org/10.1186/s12909-026-10711-y
Image Credits: AI Generated
DOI: 10.1186/s12909-026-10711-y
Keywords: emergency medicine, clinical teaching, teaching feedback, Institute of Medicine quality domains, patient-centeredness, patient safety, competency-based medical education, qualitative research, faculty development, hidden curriculum, Taiwan, medical education
News Source: Courtney Benton. (October 28, 2026). Emergency physicians in Taiwan describe how they weave quality domains into teaching feedback. Scienmag.
