Table 6. Joint Display integrating quantitative CIPP evaluation results with qualitative implementation barriers based on Steinert’s framework
CIPP Items QuantitativeFindings Qualitative Findings Mixed Methods Interpretation and Action
Mean Range Key Barriers Themes  
Context CO 1–4 3.51–3.91 -  Effort management challenges System While the quantitative results confirmed that the session objectives align with curriculum goals, qualitative themes revealed a systemic gap in organizational clarity (e.g., job descriptions, dual roles of safety managers). This indicates that the barrier is not the content itself, but the lack offormal recognition of educational duties.(Action) The final implementation guide was revised toinclude clear role definitions and workload allocationmodels to support administrators in legitimizing theseeducational activities.
-  Disconnection between daily duties and academic insight Teacher
Input IN1–4 3.66–3.76 -  Shortage of teachers System Although materials were rated as sufficient quantitatively, qualitative data exposed critical resource constraints—specifically, a shortage of trained facilitators and variability in students' prior knowledge. This suggests that "content readiness" does not equal "implementation readiness."(Action) The final package was reinforced with introductory modules for students (to level baseline knowledge) and recruitment strategies for external lecturers to address staffing shortages.
-  Need to engage external lecturers System
-  Difficulty securing curricular slots System
-  Insufficient competence in patient safety education Teacher
-  Variation in prior knowledge Knowledge
-  Variation in learner readiness Attitude
-  Unfamiliarity with group learning Attitude
Process PC 1–3 3.74–3.82 -  Insufficient competence in patient safety education Teacher High feasibility scores for instructional methods were nuanced by qualitative concerns regarding psychological safety and facilitation difficulty (e.g., managing group dynamics, peer review). This implies that even well-designed processes can fail without skilled execution.(Action) Comprehensive teaching scripts and frequently asked questions were embedded into the instructor manual to scaffold non-expert facilitators and ensure a safe learning environment.
-  Context-specific adjustments Teacher
-   Concerns about psychological safety Student
-  Psychological safety concerns Student
-  Consideration of appropriate-  sequence of learning Knowledge
Product PD1–3 3.58–3.72 -  Misalignment with formal assessment requirements System Quantitative ratings affirmed that learning outcomes are measurable, but qualitative feedback highlighted the administrative burden of assessment (e.g., grading requirements). This reveals a tension between "ideal assessment" and "practical feasibility." (Action) Streamlined assessment guidelines aligned with institutional grading policies were added, offering optional simplified formats to reduce faculty workload while maintaining academic rigor.

All quantitative findings met consensus criteria. Note: Some subthemes, such as 'Difficulty securing curricular slots', have implications for both Input and Context dimensions but are categorized here based on their primary impact.

Int J Med Educ. 2026; 17:42-60; doi: 10.5116/ijme.69f0.78c6