In total, 50 students were invited to participate in the study. Students were asked to complete 3 surveys in open-ended question format at the end of each trimester (repeated measures design, Figure 1). These surveys asked the same questions but were specific to each trimester. Invited students were asked to provide feedback on the RSTO 311 course. This study focused on first-year dental students enrolled in their introductory dental course, which serves as their initial exposure to fundamental dental concepts, including tooth anatomical landmarks, cavity preparation techniques, and restorative procedures in both theoretical and simulated clinical environments. Each survey consisted of 5 questions, adopted by Hajhamid and Somogyi‐Ganss [16]. The first question was to indicate the 2-digit number assigned to each student by a research assistant who never interacted with the students to ensure anonymity. The second question was about the lectures given during the trimester. The third question was about the practical sessions taken during the trimester. The fourth question was about the quizzes, written and practical exams taken during the trimester. The fifth and last question was about the overall course (Multimedia Appendix 1). Based on the course learning outcomes, the students are expected to meet minimum criteria of knowledge and understanding as well as practical skills; thus, the survey focused on these aspects of the course.

At the beginning of the course, an invitation was sent to all students taking the RSTO 311 course. The students were offered a bonus (2 grades) if they participated in the study. If they wished not to participate, they could write an essay about a topic related to their course and get the same bonus grades. The survey was designed using Google Forms and was sent by email to all participating students; the survey link was sent by the same research assistant who assigned the 2-digit numbers to participating students. Consent was obtained from all participating students at the beginning of each survey. Before completing the first survey at the end of the first trimester, no coaching or instructions were given to the students on how to receive and provide feedback. Before completing the second survey at the end of the second trimester, students were coached by reading a 2-page handout on how to receive and provide feedback, which can be covered in approximately 10 minutes (Multimedia Appendix 2). The handout explains the different types of feedback, as well as steps and examples for giving constructive feedback. Before completing the third and last survey at the end of the third trimester, students were coached by attending a 1-hour workshop on how to receive and provide constructive feedback. The workshop was given by a faculty member who was not involved in the course or the research study. The workshop similarly explained different theories on giving and receiving feedback and demonstrated to the students how to improve feedback with examples. Both the handout and the workshop were based on a previously published paper [16].

All 3 surveys’ answers were evaluated independently by 2 raters, the course director and the co-course director of the course. The answers were rated as either neutral, positive, negative, or constructive feedback. Any disagreement between the 2 evaluators’ ratings of the survey answers was discussed and agreed upon before the analysis. Answers were considered neutral feedback if there were no positive, negative, or constructive comments. Answers were deemed positive if general praise was included. Answers were considered negative if the provided nonconstructive criticism. Finally, answers were considered constructive if there were any suggestions to improve the course in any aspect, even if they contained any positive or negative comments. When rater disagreement was noted in cases where responses were not clearly considered as positive or negative feedback and did not include any constructive comment or intent for improvement, responses were rated as neutral. Data were collected and analyzed based on the ratings given by the 2 evaluators and then compared between surveys.

Student feedback was collected in textual form and subsequently coded into 4 categories: positive, negative, neutral, and constructive. The reliability of this coding process was ensured through independent assessments by 2 raters. Kappa statistics was used to assess inter-rater reliability between the 2 raters. The ratings followed a nominal scale (1=neutral, 2=positive, 3=negative, and 4=constructive); hence, frequency and proportions were reported for the ratings as descriptive statistics. Inferential statistical analysis was used to test rating changes over time (McNemar test). The level of significance of .05 was used for inferential analysis with P values <.05 reported as statistically significant. Analysis was performed combined for 4 questions as well as separately for each question. IBM SPSS Statistics software (version 29) was used for descriptive and inferential analysis.

An institutional review board ethical approval was obtained from King Abdullah International Medical Research Center for this cross-sectional study (IRB/3004/23). This study was conducted during the academic year 2023‐2024 among first-year dental students who took the Dental Anatomy and Operative Dentistry course (RSTO 311) at the College of Dentistry, KSAU-HS, a public dental school in Riyadh, Saudi Arabia. The RSTO 311 is a yearly course divided over 3 trimesters. The course has theoretical and practical components: 30 lectures and 40 practical sessions. The students were assessed based on weekly continuous assessment, 3 quizzes, 3 written exams, and 3 practical exams.

This study compared student responses without coaching, coaching using a feedback handout, or coaching using a feedback workshop before completing the surveys. Results demonstrate that handout coaching showed no significant difference compared with no coaching with respect to the number of neutral, positive, negative, or constructive ratings. However, workshop coaching significantly increased the number of constructive ratings compared with both no coaching and handout coaching (P<.001, Table 1). Therefore, the null hypothesis was rejected. The reason for these results could be due to the fact that handouts were distributed to the students, and they were asked to read the 2-page document independently. This method does not involve student and instructor interaction and is hence, less engaging. There was also no measure of whether the students in fact read the handout and grasped the information. Thus, no significant changes were noted between survey #1 and survey #2. Workshop coaching, on the other hand, was done in a classroom setting with 1 faculty member present, ensuring a 100% attendance rate of all participating students. Furthermore, the students were able to ask questions regarding the information presented in the workshop and were asked to fill out survey #3 immediately after the workshop, before leaving the classroom.

The proportion of constructive feedback, compared to nonconstructive feedback, significantly increased after workshop coaching (Table 2). The workshop-based format provided multiple examples in a story format from past student feedback, whereas the handout only stated the description of proper feedback writing without detailed examples compared with the examples presented in the workshop. The educational value of workshop coaching has been previously established, wherein the students are “active learners” and can engage in asking questions during the learning process [25,26]. Information presented in video format can also enhance information retention, owing to reduced student cognitive loading and optimized use of visual learner memory [27]. Furthermore, the key learning points are emphasized during the workshop, and audio-visual learning is more likely to keep the students more attentive and engaged in the content being delivered [28]. This is also demonstrated in Table 3, where the most frequently reported changes in feedback from survey #1 (no coaching) to survey #3 (workshop coaching) were from neutral and negative to constructive, reported in this study as “desired changes”.

The effectiveness of workshop coaching can also be understood through several educational and psychological frameworks. For example, the constructivist learning theory emphasizes the importance of social interaction and guided learning in developing cognitive skills [29]. The workshop format, which encourages active participation and immediate feedback from the instructor, aligns with this theory by fostering an environment where students engage with and construct their knowledge of feedback writing through scaffolding, wherein support is provided by a more knowledgeable person. This approach helps students internalize new feedback techniques through direct interaction and reflection on real examples. Furthermore, the importance of emotional intelligence in feedback delivery cannot be overlooked. According to Goleman [30], empathy and self-regulation are key components of emotional intelligence that influence how feedback is communicated. In the workshop setting, students are not only taught the mechanics of constructive feedback but also how to consider the emotional impact of their words, enhancing their ability to offer feedback that is both critical and supportive. This connection to emotional intelligence helps explain why the workshop coaching produced a higher proportion of constructive feedback compared with the handout coaching.

In any educational environment, student satisfaction is an essential criterion for quality assessment [31]. Student evaluations of teaching are surveys typically used to collect, analyze, and interpret teaching quality [32]. Hence, every year, students are asked to evaluate the course material and provide feedback. In this study, the survey questions provided to the students concerned the lectures, practical sessions, and examinations at KSAU-HS. They were distributed immediately after the end of each trimester to ensure the feedback was relevant and firsthand. The purpose of these distributed surveys was to gather information on the course teaching, practical sessions, and facilities so that an action plan may be set to ensure improvement. However, most student feedback tends to be general or rely on their personal experience rather than providing helpful information related to the learning experience [33]. As this study is based on open-ended questions, analyzing responses can be quite intricate unless the process is made more structured. Hence, this study evaluated student responses after a handout and workshop coaching.

Written comments add value to both students and educators when compared with scale-type questions [34]. The students are given the possibility to explain their perspective beyond Likert-type scales and raise further topics that may not have been covered in closed-ended questions [35]. Written comments are more informative for educators, and suggestions are beneficial when compared with receiving a statistical summary of quantitative results [36]. “Student evaluations of teaching” instruments can be a source of valuable thoughts from students and can help educators gain insight into how students perceive their learning experience and how different students learn best in a given setting [37]. However, these benefits can only be reliable after bringing a little order to the chaos of written responses.

The main purpose of the study was to improve the quality of feedback provided by the students. To the best of our knowledge, this is the first study introducing interactive workshop coaching for proper feedback among teaching institutes in Saudi Arabia. The workshop was able to improve the constructive criticism given by the students compared with self-learning using the handout. It is likely that the lower performance with handout coaching reflected less motivation, responsibility, or independence of the students [38]. These results are contrary to a previous similar study, in which both the handout and workshop coaching similarly improved student feedback [16]. The difference in results could be attributed to the nature of the dental school between both studies. This study was performed in a governmental dental school where students are not obliged to pay tuition fees. On the contrary, since their education is financed largely by loans, students from the Canadian private dental school may be more encouraged to commit to assigned tasks [39,40]. It is also worth noting that dental students at our institution are more familiar with lecture- and workshop-based learning as opposed to self-directed learning; as most dental schools in Saudi Arabia have not completely shifted from teacher-centered learning to a more interactive or evidence-based style [41]. Furthermore, culturally, expressing opinions, especially those with negative connotations or suggestive tones, may not necessarily be favored [42]. However, the results of this study clearly show the benefits of workshop coaching in directing students to provide their perception towards the course. This emphasizes the importance of including such a coaching approach for first-year students as part of the academic curriculum at the beginning of their studies.

One of the limitations of this study was the inclusion of only first year students, as students in older years may have responded differently to the handout coaching, likely being more familiar with independent self-learning. Students in older years may also be more exposed to course-based surveys compared with first-year students. This also reduced the sample size of the participants. Furthermore, the difference between the topics covered over the 3 trimesters of the course may have influenced the feedback given by the students. In addition, when the students were given the third survey, they had already been exposed to both handout and workshop coaching on proper feedback, and this emphasis on appropriate feedback writing may have led to the higher number of constructive comments in survey #3. Furthermore, self-reported student feedback is subject to various biases, such as recall bias, acquiescence bias, social desirability bias, and cultural influences, which could impact the accuracy of the responses. Finally, the incentive of the bonus grades may have introduced self-selection bias; however, as the incentive was offered to all students equally, whether they participated in the survey or chose to submit an essay assignment, this may have mitigated the bias.

This study compared the effectiveness of 3 approaches, no coaching, handout coaching, and workshop coaching, on improving the quality of feedback provided by dental students. The results show that workshop coaching significantly increased the number of constructive feedback ratings, compared with both no coaching and handout coaching. This study encourages a more expressive feedback culture that facilitates student or instructor interaction in a constructive manner, wherein instructors can receive and implement feedback to improve the educational process. This suggests that interactive, instructor-led workshops foster a more engaged learning environment, encouraging students to provide higher-quality feedback. Given these findings, educators can implement interactive workshops focused on teaching students how to provide constructive feedback. These workshops should encourage active engagement through real-life examples and peer discussions. Given that the study shows significant benefits in first-year students, feedback coaching can be introduced early in the academic program. Building on the concept of scaffolding, educators could start with guided feedback exercises during the workshop, gradually increasing the level of independence as students become more proficient. Educators can also integrate emotional intelligence training into feedback workshops by helping students understand how to express feedback empathetically and how to regulate their emotions while providing feedback. Further studies evaluating different coaching methods to enhance student feedback are needed, with consideration to assign different methods to each study group. Future research should also investigate the impact of standardized coaching protocols on the quality of student feedback and use the data to improve assessment and learning outcomes.