Development and Evaluation of the Joseph-RATA (Rubrics Ask-Tell-Ask) Structured Feedback Model in Undergraduate Pharmacology

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BACKGROUND: Effective feedback is central to competency-based medical education (CBME), yet structured formats for delivering formative feedback remain uncommon in many undergraduate settings. At our institution, students reported dissatisfaction with existing feedback practices, which were largely limited to the communication of marks without actionable guidance. A transparent, standardized, and learner-centered feedback framework aligned with CBME principles was therefore required. OBJECTIVE: The objective of this study is to develop, validate, and implement a structured feedback method for formative assessment in undergraduate pharmacology and to evaluate the perceptions of students and faculty regarding its use. METHODS: This prospective interventional study was conducted over six months in the Department of Pharmacology at Christian Medical College and Hospital, Ludhiana, India. All students of the 2023 and 2024 MBBS batches (n = 200) were included. A structured Rubric-Ask-Tell-Ask (RATA) feedback model was developed by a departmental core committee, validated by Medical Education Unit members and by students of the 2022 MBBS batch, and implemented across six formative assessments. Perceptions were assessed using a 14-item Likert-type questionnaire, a single binary recommendation item, focus group discussions with students, and semi-structured interviews with faculty. Quantitative data were summarized using descriptive statistics, while qualitative data were analyzed thematically. RESULTS: Dissatisfaction with the previous feedback practice was reported by 168 of 200 students (84.0%), with a mean item score of 2.02 ± 0.69 out of 5. After implementation of the structured model, students reported consistently positive perceptions across all evaluated domains following implementation of the structured feedback model. Continuation of the model was recommended by 193 of 200 students (96.5%). All five participating faculty members endorsed continuation, with a mean faculty rating of 4.69 out of 5. Qualitative themes included improved clarity of performance expectations, transparency in marking, facilitation of self-directed learning, and acceptability of the model within large-group teaching. CONCLUSIONS: The Joseph-RATA structured feedback model demonstrated high acceptability, feasibility, and perceived educational value among both students and faculty, supporting its integration into competency-based undergraduate curricula.

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