Qualities of an effective teacher: a cross-cultural study on the perspectives of students and faculty in two medical programs in Cyprus and Sweden

Abstract

Background

The introduction of new teaching methodologies and technologies in medical education emphasizes the evolving roles of educators. Teachers are now expected to act as knowledge providers, mentors, assessors, and role models, supporting both the academic and personal development of students. This study explores the perspectives of teachers and medical students from two medical schools in Cyprus and Sweden regarding the characteristics that make teachers engaging and effective in maintaining student interest while effectively imparting knowledge.

Methods

A cross-sectional study was conducted using an online questionnaire distributed to medical students and teachers at Örebro University (ORU), Sweden, and the University of Nicosia (UNIC), Cyprus. The questionnaire was developed based on existing literature on teacher characteristics as evaluated by students and teachers at other institutions in other studies. Data were collected anonymously, and statistical analysis was performed.

Results

Surveys of 511 students and 55 teachers at medical schools in Sweden (ORU) and Cyprus (UNIC) compared perceptions of effective lecture delivery and general teacher qualities. Good time management was the only lecture attribute rated extremely important (median 5) by all three groups except ORU teachers, which rated no characteristic with a median of 5; dress code and humour ranked lowest. Subject knowledge and respect for students topped general qualities, with UNIC respondents additionally valuing approachability, cultural competence, passion for teaching, and feedback. ORU participants assigned consistently lower scores than UNIC peers. Gender differences were noted for cultural competence, and punctuality, females ranking these attributes higher. UNIC teachers alone agreed that teachers should entertain while ORU and UNIC students, and ORU teachers were rather neutral.

Conclusion

The study results provide valuable insights into cross-cultural perspectives on engaging teaching practices, which can inform faculty development programs at medical schools, enhancing the skills that both students and faculty recognize as important.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12909-026-08797-5.

Introduction

Medical education, encompassing both foundational and clinical sciences, has undergone continuous development in the recent years due to the integration of new learning technologies and the promotion of innovative educational methods [1, 2]. These changes in medical education have placed greater emphasis on the multifaceted role of the teacher. Educators are now considered not only as sources of information, but also as assessors, planners, mentors, and role models [3].

Medical educators should aim to support the professional and personal growth of their students and foster a sense of responsibility in students for themselves, their patients, and the wider community. Additionally, they must promote ethical standards among medical students [2]. Several previous studies have sought to identify the traits of effective educators. Sutkin and colleagues identified five key qualities that an effective teacher possesses, and these include recognition of relationships, emotional engagement, responsibility generation, self-awareness, and competence [4]. Non-cognitive traits, such as encouraging self-confidence in students, promoting creativity, and demonstrating fairness, empathy, and humor, have also been recognized as key attributes of effective educators [5].

Singh et al., 2013 investigated the viewpoints of medical educators on essential qualities of a competent teacher. According to their results, the top three attributes of an effective teacher, ranked from highest rated quality, included subject-matter expertise, enthusiasm, and strong communication abilities [5]. Additional studies have reported an emphasis on other characteristics such as ability to motivate and inspire students and a passion for teaching. Since teachers play a crucial role in student learning, identifying the factors that make them effective is essential to improving the overall quality of medical education [6].

In contemporary medical education, student engagement is increasingly recognized as a key mechanism linking educational experiences with learning outcomes, motivation, and academic achievement. Empirical evidence indicates that engagement is strongly influenced by students’ perceptions of the educational environment and the quality of teaching interactions. Cognitive and behavioral engagement, in particular, have been identified as central predictors of achievement, underscoring the importance of teaching approaches that actively sustain students’ attention and participation. Strategies suggested to support engagement include active learning methods, constructive feedback, and supportive teacher–student relationships. Importantly, cultural factors can shape how students perceive learning environments and engage with teaching, highlighting the need for culturally responsive and inclusive pedagogical practices in increasingly diverse medical programs [7]. For the most part, teacher effectiveness has been primarily evaluated through student outcomes or student perceptions [8, 9]. However, the focus has now shifted to include self-evaluation by teachers and peer evaluations as part of the overall evaluation of medical educators [10, 11]. This study is one of the very few that developed and distributed questionnaires to both medical students and faculty at two universities, Örebro University (ORU) and the University of Nicosia (UNIC) simultaneously examining what both students and faculty consider effective teaching, particularly across different educational cultures. As medical programs become increasingly international, understanding whether expectations of engaging teaching are shared or context-dependent becomes educationally important. Both universities collaborate closely under the EU-funded alliance NEOLAiA, and this collaboration initiated the conception of this project.

These institutions were selected because they reflect distinct medical education contexts in Europe with differences in student demographics and faculty educational trajectories. Such contrasts provide an opportunity to examine whether perceptions of engaging teaching are broadly shared or context dependent, and how teacher and student perspectives align within each setting. The educational significance of this comparison is practical: faculty development initiatives increasingly aim to strengthen engagement, communication, and feedback practices, yet the priorities for such initiatives may differ depending on local expectations and teaching cultures [12].

Learners’ expectations of teacher behaviour, the acceptability of humor or informality, and the meaning of ‘respect’ or ‘approachability’ may vary across contexts. Recent research on cultural factors in educational interactions suggests that perceptions of hierarchy, fairness, and authority influence how teaching and feedback are received and interpreted [13].

The aim of this paper was to explore the qualities, features, and abilities that both medical students and medical teachers of two medical schools deem essential for an educator to possess to deliver an ‘entertaining’ lecture and to attempt to provide a response to the question “should teachers entertain?”. The phrase ‘Should teachers entertain?’ is not intended to suggest that medical education should prioritize amusement or performance. Rather, it reflects an ongoing debate in medical education about the extent to which teachers should adopt engaging, attention-sustaining approaches, to support student learning. Here, ‘entertaining’ is conceptualized as the ability to capture and maintain student’s attention while facilitating meaningful understanding of complex medical content. Additionally, the surveys examined the general attributes that both students and faculty consider essential for an effective teacher.

Accordingly, this study was guided by the following research questions: ‘Which teaching qualities and behaviors do medical students and faculty perceive as most important for maintaining engagement during lectures and for teaching to be considered effective?’ and ‘How do students and teachers’ perceptions of these qualities differ within and between two medical education contexts?

Materials and methods

This study employed a cross-sectional, comparative survey design, performed in accordance with the Declaration of Helsinki. The survey was conducted between January and February of 2024. The target population consisted of all enrolled medical students and teaching faculty from the Medical Schools of University of Nicosia and Örebro University Participation was invited from medical students and faculty members at both institutions. A convenience sample was recruited through institutional mailing lists. Study participation was anonymous and informed consent was obtained before study enrollment. Evolve, University of Nicosia’s in-house AI platform was used to review and edit the text with the primary aim in reducing the word count to be within the journals requested word count.

The structure and content of the questionnaire

Two similar questionnaires were developed in English: one for medical students and one for medical faculty (Appendix I). The design of the questionnaires was guided by an extensive literature review on teacher effectiveness and student engagement in medical education [6, 9, 11, 14, 15]. Relevant characteristics and teaching features were extracted from published studies focusing on those most pertinent to assessing a teacher’s ability to maintain student attention and deliver meaningful lectures.

The questionnaires included demographic questions, followed by statements asking respondents to rate various qualities, features, and abilities of teachers that contribute to maintaining attention during a 45–60-minute lecture. Additional items addressed general teacher characteristics and perceptions regarding the statement: “In class, the teacher should be an entertainer.” A final open-ended question invited participants to list any other characteristics they believed were important for effective teaching. All ratings used a 5-point Likert scale.

The finalized questionnaires were administered online to medical students and teachers to systematically capture and compare their perceptions of effective teaching in medical education.

Dissemination

The questionnaires were uploaded to Qualtrics (Qualtrics International Inc., Provo, Utah, US). Invitations to participate were sent twice in February 2024, with the second serving as a reminder for non-responders. The survey was available for four weeks from the first invitation. Only one response per person was allowed, and answers were collected anonymously without traceable IP addresses.

All active medical students and faculty at Örebro University and the University of Nicosia received the survey link via email, with addresses obtained from public university documents. To ensure anonymity, invitation emails were sent simultaneously, concealing recipients’ email addresses.

Data analysis

Data were analyzed using IBM SPSS Statistics (version 28.0). Descriptive statistics are presented as proportions for categorical variables and as median and 95% confidence intervals (95%CI) for Likert items. Chi-square tests or Fisher’s exact tests compared baseline characteristics between groups. For each survey item, Kruskal-Wallis one-way ANOVA with Dunn’s post hoc test and Bonferroni correction were used to identify statistically significant differences, amongst respondents’ groups and by socio-demographic characteristics within each respondents’ group with a significance level set at p < 0.05. A thematic analysis was conducted on the open-ended question, categorizing responses with shared themes under the same code and allowing for multiple codes where applicable.

Results

Response rate and characteristics of the study population

A total of 175 out of 644 students (27.2%) and 29 out of 76 teachers (38.2%) from Örebro University (ORU) Medical School responded, while 336 out of 1,031 students (32.6%) and 26 out of 93 teachers (28.0%) from the University of Nicosia (UNIC) participated. UNIC students were significantly younger than ORU students (Table 1): 75.0% of UNIC students were aged 18–23 years compared to 53.7% of ORU students. Conversely, more ORU students were in older age categories: 24–29 years (33.1% for ORU vs. 23.2% for UNIC), 30–35 years (9.1% for ORU vs. 1.2% for UNIC), and 36–41 years (4.0% for ORU vs. 0.3% for UNIC).

Table 1.

Characteristics of the student population of the study

	ORU students1 N (%)	UNIC students1 N (%)	p-value
Total	175	336
Age			< 0.001
18–23	94 (53.7)	252 (75.0)
24–29	58 (33.1)	78 (23.2)
30–35	16 (9.1)	4 (1.2)
36–41	7 (4.0)	1 (0.3)
> 42	0	1 (0.3)
Gender			0.206
Male	60 (34.3)	137 (40.8)
Female	114 (65.1)	196 (58.3)
Non-binary – n (%)	1 (0.6)	0
Prefer not to say	0	2 (0.6)
Other	0	1 (0.3)
Year of study			< 0.001
Year 1	33 (18.9)	91 (27.1)
Year 2	33 (18.9)	87 (25.9)
Year 3	29 (16.6)	52 (15.5)
Year 4	15 (8.6)	37 (11.0)
Year 5	61 (34.9)	44 (13.1)
Year 6	4 (2.3)	25 (7.4)
Prior degree			0.028
Yes	24 (13.7)	73 (21.7)
No	151 (86,3)	263 (78.3)

¹ORU Örebro University, UNIC University of Nicosia

A higher percentage of females participated in the ORU group (65.1%) compared to UNIC (58.3%), however this was not statistically significant and there were no differences in gender distribution in any group. Significant differences were noted in the distribution of respondents across years of study, with more senior students from ORU. Additionally, significantly more UNIC students (21.7%) reported having a prior degree than ORU students (13.7%), reflecting UNIC’s inclusion of both undergraduate and graduate-entry MD programs, despite graduate-entry students making up less than 10% of the sample (Table 1). Among teachers, a key difference was their country of study; all ORU faculty studied within the EU (primarily Sweden), while many UNIC faculty studied in non-EU contexts (e.g., the U.S. or Canada) or a mix of both (Table 2).

Table 2.

Characteristics of the teacher population of the study

	ORU teachers1 N (%)	UNIC teachers1 N (%)	p-value
Total	29	26
Age			0.170
25–35	0	1 (3.8)
36–45	8 (27.6)	13 (50.0)
46–55	8 (27.6)	7 (26.9)
56–65	10 (34.5)	3 (11.5)
66–75	3 (10.3)	2 (7.7)
Gender			0.898
Male	15 (51.7)	13 (50.0)
Female	14 (48.3)	13 (50.0)
Position			0.108
Lecturer/Asst. Prof.	13 (44.8)	11 (42.3)
Assoc. Prof.	14 (48.3)	8 (30.8)
Professor	2 (6.9)	7 (26.9)
Country of study
EU	29 (100)	13 (52.0)	< 0.001
Non-EU	0	6 (24.0)
Mixed	0	6 (24.0)
Teaching years			0.107
2–5	2 (6.9)	3 (11.5)
6–10	2 (6.9)	8 (30.8)
11–15	11 (37.9)	7 (26.9)
> 15	14 (48.3)	8 (30.8)

¹ORU Örebro University, UNIC University of Nicosia

The most and least important characteristics of teachers

Of the ten qualities assessed regarding maintaining students’ interest in lectures, only “good time management” received a median score of 5 (extremely important) from students at both Örebro University (ORU) (95%CI: 4–5) and the University of Nicosia (UNIC) (95%CI: 5–5), as well as from UNIC teachers (95%CI: 4–5). Overall, ORU respondents reported lower scores than UNIC counterparts. When comparing groups, ORU students rated 9 out of 10 characteristics significantly lower than UNIC students; the exception was “good time management,” where both groups agreed (Fig. 1, Supplementary Table S1).

Fig. 1.

Qualities/abilities of a teacher with regards to maintaining student’s interest in a lecture, ranked on a Likert scale. Presented are the ranking median of each group of respondents. 1 – Not at all important, 2 – Neither important nor not important, 3 – Important, 4 – Very important, 5 – Extremely important. ORU - Örebro University, UNIC - University of Nicosia

Additionally, a median of 5 was found for “providing tips/advice” (95% CI: 5–5), “correlating lecture material with real life” (95% CI: 4–5), and “good social and communication skills” (95% CI: 5–5) among UNIC students. The latter two qualities also received a median of 5 (95% CI: 4–5) from UNIC teachers. Notably, ORU teachers did not rank any qualities at a median of 5. Conversely, the least important qualities showing a median rank of 2 were “following an appropriate dress code” and “telling jokes” with ORU students (95% CI: 2–2, both) and teachers (95% CI: 2–3 and 95% CI 2–2, respectively), while UNIC students and teachers rated them with a median of 3 (95% CI: 2–3 and 95% CI 3–3, respectively). “Telling jokes” received a median of 2 also from UNIC teachers (95% CI: 2–3) (Fig. 1, Supplementary Table S1).

ORU students reported significantly lower scores for “body language and facial expressions,” “following an appropriate dress code,” “sharing personal experiences,” and “correlating lecture material with real life” compared to UNIC both students and teachers, and for “including in-class activities” compared to both UNIC and ORU teachers and UNIC students. Conversely, ORU students rated “providing tips/advice” and “good time management” higher than ORU teachers, but “providing tips/advice” lower than UNIC students (Fig. 1, Supplementary Table S1).

ORU teachers also reported significantly lower scores than UNIC teachers for “following an appropriate dress code,” “providing tips/advice,” “correlating lecture material with real life,” “good time management,” and “good social and communication skills.” The latter four characteristics were ranked lower than those by UNIC students, along with “providing tips/advice.” Lastly, UNIC students reported significantly lower scores for “following an appropriate dress code” compared to their teachers (Fig. 1, Supplementary Table S1).

Differences based on demographic factors

Results were examined by age, gender, and prior degree of students (Supplementary Figures S1-S3). Rankings for ORU students on “providing tips and mnemonics” (p = 0.016) and “correlating lecture material with real life” (p = 0.020), as well as for UNIC students on “including in-class activities” (p = 0.029) varied by age, all ranked highest in the age group 24–29 years. Fewer females than males at ORU considered “telling jokes” important (p = 0.004), while females at UNIC ranked “body language, facial expressions” (p = 0.013) higher than males. Additionally, “correlating lecture material with real life” was more important for UNIC students with prior degrees compared to those without (p = 0.010).

For teachers (Supplementary Figures S4-S6), “good time management” was valued higher by female compared to male ORU teachers (p = 0.045), and increased with age (p = 0.041). For UNIC teachers, “correlating lecture material with real life” was more important for females (p = 0.025), with variability across age groups (p = 0.029). Gender differences were also noted in “including in-class activities” (p = 0.019) and “providing tips and mnemonics” (p = 0.013), with higher scores from women among UNIC teachers. “Providing tips and mnemonics” varied by age group among UNIC teachers (p = 0.044). No differences by years of teaching were found; however, professors scored higher than associate professors on “telling jokes” (p = 0.017) among UNIC teachers. There were no differences in these scorings based on training/study location among UNIC teachers (data not shown).

General characteristics of the teacher

Respondents rated 11 teacher qualities on a five-point scale. ORU students deemed two extremely important (median 5): subject knowledge (95%CI: 4–5) and respect for students (95%CI: 4–5). UNIC students reported the same (both 95%CI: 5–5) and added three more—approachability (95%CI: 5–5), cultural competence (95%CI: 4–5), and passion for teaching (95%CI: 5–5). UNIC teachers rated all five (subject knowledge 95%CI: 5–5; approachability 95%CI: 5–5; cultural competence 95%CI: 4–5; passion for teaching 95%CI: 5–5 and respect for students 95%CI: 5–5) plus constructive feedback (95%CI: 4–5) at 5. ORU teachers gave no 5s but scored those six traits and punctuality at 4 (very important). “Effort to get to know students” ranked lowest across groups (Fig. 2, Supplementary Table S1).

Fig. 2.

General characteristics of a teacher ranked on a Likert scale. Presented are the ranking median of each group of respondents. 1 – Not at all important, 2 – Neither important nor not important, 3 – Important, 4 – Very important, 5 – Extremely important. ORU - Örebro University, UNIC - University of Nicosia

Overall, ORU respondents assigned lower scores than UNIC participants. ORU students rated nearly every quality below UNIC peers and teachers, except punctuality (no difference from UNIC students) respect (no difference with UNIC students or teachers) subject knowledge (no difference with UNIC teachers) and cultural competence (no difference to UNIC teachers) (Supplementary Table S1). ORU teachers likewise scored subject knowledge, teaching passion, and valuing student feedback lower than both UNIC groups, while approachability and cultural competence were lower only relative to UNIC teachers (Supplementary Table S2).

Differences based on demographic factors

Age affected only a few ratings. Younger ORU students valued approachability more (p = 0.034), while older UNIC students emphasized subject knowledge (p = 0.045) and cultural competence (p = 0.014) (Supplementary Figure S7).

Gender differences were wider. Female students in both cohorts gave higher scores than males for respect (ORU p = 0.008; UNIC p = 0.019) and cultural competence (ORU p = 0.001; UNIC p = 0.012); ORU women also ranked punctuality (p = 0.015) and subject knowledge (p = 0.020) higher, while UNIC females valued caring and showing empathy higher than males (p = 0.019) (Supplementary Figure S8). No significant difference by prior degree among ORU or UNIC students were found (Supplementary Figure S9).

Among teachers, females rated punctuality above males at ORU (p = 0.015) and UNIC (p = 0.039), and its importance rose with age in both sites (ORU p = 0.020; UNIC p = 0.022). In addition, at UNIC female teachers gave higher scores for providing constructive feedback and for considering student views compared to males (p = 0.020 and p = 0.015, respectively) (Supplementary Figures S10 and S11).

Furthermore, older ORU teachers ranked subject knowledge higher (p = 0.024), while being approachable was higher ranked among younger UNIC teachers than older (p = 0.027) (Supplementary Figures S11). Finally, lecturers and associate professors at ORU gave more importance to being respectful to students compared to professors (p = 0.021) (Supplementary Figure S12).

Open ended responses

Further important characteristics were discovered when respondents were allowed to freely answer the optional question: “In your opinion, are there any other characteristics that a teacher should have in order to deliver a meaningful lecture?”. Being concise, having good communication, prioritizing and emphasizing what is important in a lecture, as well as being passionate and enthusiastic about their subject were deemed as essential characteristics. Also, many thoughts were provided with regards to PowerPoint presentations. Teachers’ engagement with students was also mentioned, such as being approachable, understanding and having good communication (Supplementary Table S3).

The teacher as an entertainer

Both student cohorts and ORU teachers were neutral on “A teacher should be an entertainer” (median 3; ORU students 95%CI: 3–3; UNIC students 95%CI: 3–4; ORU teachers 95%CI: 3–4), whereas UNIC teachers agreed (median 4, 95%CI: 3–4) (Fig. 3). Pairwise tests showed significant differences between the two student groups (p < 0.001) and between ORU students and UNIC teachers (p = 0.019), with ORU students scoring this statement lower.

Fig. 3.

Box-whisker-plot for “In class, a teacher should be an entertainer” by respondents’ group. ORU – Örebro University, UNIC – University of Nicosia, The total number of respondents per group were ORU students (n=152), UNIC students (n=295), ORU teachers (n=25) and UNIC teachers (n=24). *The line inside the box represents the median. The edges of the boxes marks the first quartile (Q1)/ 25th percentile, and third quartile (Q3)/75th percentile, respectively. The whiskers show the range from the minimum to Q1 and from Q3 to the maximum. Individual points that fall outside the whiskers represent outliers

Discussion

Cyprus and Sweden were selected because they represent two distinct European medical education contexts with differing educational traditions, levels of internationalization, and faculty training backgrounds. UNIC hosts a highly international student body (Supplementary Table S3) and faculty with diverse educational trajectories, whereas ORU primarily reflects a nationally educated faculty and student population. Comparing these contexts allows exploration of whether perceptions of engaging and effective teaching are shared across systems or shaped by local educational cultures. Identifying both shared priorities and context-specific differences can inform faculty development strategies that are sensitive to institutional and cultural contexts.

This study is one of few to survey both medical students and educators at two medical schools, capturing opinions from faculty at all ranks and students in every year. Singh et al. (2013) found that most faculty acquire teaching skills by watching their own mentors and peers, which makes it essential to identify the traits that support effective and lively instruction [5] .

In our data, “good time management” was rated as an extremely important lecture characteristic. This aligns with contemporary engagement research emphasizing that cognitive and emotional engagement are sensitive to the learning environment, including pacing and perceived organization [7]. Well-managed time and coherent structure may be especially important in medical lectures, where dense content can otherwise overload attention and working memory. Respondents also rated “providing tips/advice,” “linking content to real life,” and “strong communication skills” as very important. Research on expert medical teachers showed that high engagement is supported by how teaching is enacted; through active stimulation of participation, establishing relevance, and fostering safe relational conditions for interaction [16]. Prior studies likewise stress communication’s role in effective teaching [5, 6, 12], and our groups showed no differences on this point. Parveen (2023) found that 94% of students expect excellent communication from teachers yet only 33% experience it, revealing a persistent expectation-reality gap that warrants attention [17].

UNIC students with a prior degree rated “linking content to real life” higher than their classmates. Earlier academic experience may make them more attuned to how theory underpins clinical work, so explicit real-world connections improve recall and engagement. Showing practical relevance appears to boost motivation by demonstrating the value of turning theory into practice.

Benor (2000) predicted that by 2020 medical teachers would move from lecturing to guiding students toward resources and learning experiences, including clinical decision making [18]. Our data indicate that deep subject knowledge is still considered the most important teacher attribute, receiving top scores in all four cohorts. Singh et al. reported the same result [5]. Respect for students and strong subject knowledge likewise received top rankings across all cohorts. These highly ranked qualities, subject knowledge and respect for students, reinforce that even as medical education embraces interactive methods, learners still expect teachers to demonstrate expertise and professionalism as foundations for trust and learning. This mirrors Al-Mohaimeed’s finding that both students and teachers rate respect as an important quality of the teacher [6]. Like Singh et al., the current study also demonstrated enthusiasm for teaching as the second most important aspect [5] and cultural competence as another key attribute.

A Moroccan study ranked “information provider” as the top teacher role, reflecting a lecture-centered system where exams draw heavily on taught content [19]. In contrast, a Japanese qualitative study found that residents prioritized interaction and support over teachers’ medical knowledge or clinical skills [20]. Our data align with the latter view: participants placed “approachability” as the second most important trait overall.

A Singapore study of Years 1–5 medical students found that clinical-year learners value approachability and constructive criticism highly, likely because bedside tutorials and ward duties foster close teacher interaction [15]. Other research on bedside teaching echoed this focus on constructive feedback and approachability [21], and Althouse et al. reported that clinical tutors view regular feedback as a core aspect of role modeling [22]. These traits match our results, in which constructive feedback and punctuality received high ratings across all years, suggesting durable importance. Yet Parveen noted that only 17% of teachers give feedback consistently [17], highlighting a gap between expectations and current practice.

“Telling jokes” and “dressing appropriately” received the lowest rankings from all groups, suggesting they are viewed as non-essential teaching traits. Al-Mohaimeed’s study reached a similar conclusion, placing humor among the least valued qualities of good medical teachers [6]. “Getting to know students” and “providing academic, social, or mental support” likewise received very low scores. One interpretation is that many respondents may associate effective teaching primarily with academic facilitation rather than personal familiarity, especially in large-group lecture contexts. By contrast, a study of first-year students in early clinical settings found that tutors who learned students’ names and built rapport enhanced learning [14], suggesting that context — e.g. bedside teaching versus lecture halls — shapes how much this attribute matters.

Kikukawa et al. (2013) ranked “providing sufficient support” first among residents, mirroring Western studies that stress support’s role in clinical training [20]. Our undergraduate students placed it lower, likely because limited clinical exposure tempers its perceived value.

ORU teachers scored every attribute below or the same as UNIC teachers. This gap may reflect educational backgrounds: all ORU faculty trained solely in Sweden, whereas most UNIC faculty studied partly or entirely outside the EU, along with other cultural influences.

Studies by Hofstede and Minkov [23, 24] provides a framework for understanding broad cultural tendencies that might influence how people evaluate or judge others, and there Sweden score relatively lower on power distance (egalitarian values) and masculinity, indicating they put less emphasis on competition and achievement. This might suggest that Swedish society values equality and cautious evaluation relatively higher, leading to a less positive, consensus-based rating behavior, i.e. conforming to norms and avoiding overly high praise being socially valued.

This study highlights several priorities for faculty development. All four cohorts consistently rated the same core teacher qualities—subject expertise, respect for students, approachability, constructive feedback, and punctuality—at the top. Building these traits into a foundational faculty-development curriculum would establish a shared standard that can be applied from pre-clinical classrooms to bedside teaching, maximizing the impact of training investments on instructional quality and learner outcomes.

These findings highlight educator traits that can enhance student engagement and interest during lectures. By showing which qualities students consider most useful for sustaining attention and enthusiasm, the study can guide teaching approaches that create a more lively and enjoyable learning environment.

The study’s design strengthens these recommendations. We employed a literature-based questionnaire and gathered perspectives from both students and faculty at two European medical schools, in Cyprus and Sweden. The sizeable sample—511 students and 55 teachers—provides a broad, credible basis for the conclusions drawn.

Conclusion

This study has several limitations. First, the study questionnaire utilized was newly developed based on extensive literature review. Although the items were theoretically grounded, the instrument has not yet undergone formal validation, which may affect the reliability and generalizability of the findings. Future studies should aim to assess its psychometric properties to strengthen the robustness of the findings. Second a sizable proportion of students chose not to participate, and non-respondents might hold different opinions from those reported here. Third, because the work is perceptual in nature, it does not test whether teachers who possess the highly valued traits actually improve learner performance. Finally, perceptions of effective clinical teaching are shaped by local curricula, cultural norms, and clinical settings; therefore, evaluation tools developed in some contexts (e.g. location) may not apply directly in others, where alternative criteria could be more relevant.

Future work should compare learning outcomes for students taught by educators who score highly on the key characteristics identified here with outcomes for students taught by educators who score lower on those traits. Such studies could clarify how these attributes influence engagement, knowledge retention, and professional development. Evidence from performance and satisfaction metrics would guide faculty-development priorities and refine hiring and training criteria. Expanding the research to medical schools in additional countries will also test the global relevance of these findings.

Students’ views on teachers’ roles provide actionable feedback for improving medical education. Teachers’ perspectives, in turn, reveal the attributes they regard as essential. By comparing these two viewpoints and identifying gaps, institutions can develop targeted faculty-development programs that strengthen teaching effectiveness.

Abbreviations

UNIC

University of Nicosia

ORU

Örebro University

Authors’ contributions

IK prepared the questionnaire, collected data, and made a significant contribution to writing the manuscript. EHH coordinated the project at Örebro University (ORU), drafted the first version of the manuscript and critically revised the manuscript. IP and VC prepared the questionnaire, collected data, and assisted in manuscript preparation. MM collected data, contributed to data analysis and drafted the first version of the manuscript. AQ contributed to statistical data analysis, manuscript preparation and critical revised the manuscript. CA conceived and designed the study, coordinated the project, prepared the questionnaire, and critically revised the manuscript. All authors reviewed and approved the final version of the manuscript.

Funding

Access to the Qualtrics and SPSS software packages was available through University of Nicosia Medical School.

Data availability

See supplementary figures and tables. Questionnaire and data are available upon request to the corresponding author.

Declarations

Ethics approval and consent to participate

This study was conducted complying with the principles outlined in the Declaration of Helsinki. Since survey data were collected anonymously and could not be linked to individuals, the study did not process personal data, nor were any interventions made involving participants. Consequently, the Swedish Ethical Review Authority determined that no ethical assessment was required and had no objections to the study (diary number 2023-07135-01). The study was also approved by the Cyprus National Bioethics Committee (diary number 2023.01.276). Informed consent for participation was obtained by participants as part of the survey and as indicated and approved in the application to the Cyprus National Bioethics Committee.

Consent for publication

not applicable.

Competing interests

The authors declare no competing interests.