Factors Influencing Effective Feedback in Underperforming Medical Students: A Scoping Review Protocol

Abstract

Feedback is essential in medical education, especially for supporting underperforming students. Despite its importance, no standardised feedback model has been developed to address the needs of underperforming students in undergraduate medical education. Therefore, this scoping review protocol outlines a structured approach to identify, screen, and synthesise studies published in the past decade to map existing feedback practices for underperforming undergraduate medical students. It also explores the extent and nature of the current literature to inform the development of future support strategies. This review will be conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. The review will include original qualitative and quantitative studies, along with relevant reviews, to examine feedback strategies or interventions for undergraduate medical students who are struggling academically. Eligible studies must have been published between June 2015 and May 2025 and report clear qualitative or quantitative outcomes related to feedback. Studies focusing on postgraduate learners, lacking defined outcomes, or not addressing underperformance will be excluded. A three-step search strategy will be implemented. First, an initial limited search of PubMed and Scopus will be conducted to identify relevant keywords and indexing terms. Second, a comprehensive search using the refined strategy will be applied across four databases: PubMed, Web of Science, PsycINFO, and Scopus. Third, the reference lists of all included studies and relevant reviews will be hand-searched to identify additional sources. Five reviewers will independently conduct title and abstract screening and full-text assessment in accordance with the predefined eligibility criteria. Data extraction will be conducted using a standardised form developed in line with JBI methodology. The review is expected to identify gaps in structured feedback mechanisms tailored to underperforming medical students. Findings will inform the development of evidence-based strategies, which will be communicated via peer-reviewed publications and presentations at national and international conferences.