Table 2. Elements of the Steinert's framework12 and their operational definitions created through the data analysis
Elements Operational Definition Inclusion Criteria Exclusion Criteria
Knowledge Concerns about factual understanding orinformation gaps necessary for patient safety. Comments referencing lack of knowledge, unfamiliarity with concepts, or need forfurther learning. General learning difficulties not attributed to knowledge deficits.
Attitude Concerns about beliefs, values, motivation, or perceptions regarding patient safetyeducation. Comments referencing skepticism,resistance, uncertainty about value, or role identity conflicts. Knowledge gaps presented as factual deficits.
Skills Concerns about technical abilities orpsychomotor capabilities. Comments referencing inability to perform specific technical procedures. Teaching skills (coded to Teacher); cognitive abilities (coded to Knowledge).
Teacher Concerns about instructor preparation,teaching competence, or facilitation skills. Comments referencing faculty experience, facilitation skills, confidence, or training needs. System-level staffing issues (coded toSystem).
Student Concerns about learner characteristics,readiness, or engagement patterns. Comments referencing student preparation, prior experience with methods (e.g., peerreview), or psychological safety. Student knowledge/attitude deficits (coded to those themes).
System Concerns about organizational structures,resources, policies, or institutionalconstraints. Comments referencing staffing, timeallocation, curriculum space, assessmentrequirements, or admin support. Individual educator capabilities (coded to Teacher).
Int J Med Educ. 2026; 17:42-60; doi: 10.5116/ijme.69f0.78c6