Cultural influences on non-Western health profession trainees seeking and receiving feedback: A Scoping Review

Abstract Background: Feedback is recognised as key to learning and development of health professionals. However, most literature in this area originates in Western contexts, leaving a significant gap in understanding how Cultural factors influence feedback practices elsewhere. This scoping review focuses on Asian contexts, where Cultural values and educational traditions shape the ways in which feedback is sought, provided, and received. The review explores how Culture in non-Western settings influences health professions trainees’ engagement with feedback during clinical training, as well as how supervisors' feedback practices are influenced by Cultural contexts. Methods: Four databases — CINAHL, ERIC, MEDLINE and PsychINFO — were searched. The search, conducted up to June 2024, yielded 1241 citations, with an additional 51 identified through citation searching. Thirty-seven studies met inclusion criteria and were analysed. A coding framework was developed and iteratively refined through team discussions to ensure analytic rigour. Results: The review identified three key, but interconnected, themes. 1) Impact of Culture: Culture particularly power distance and collectivism, strongly influenced how feedback was perceived and enacted. 2) Diverse perspectives and preferences about the place of feedback: Trainees had diverse perspectives and preferences regarding the place of feedback. The role of group versus individual feedback appeared to be a significant difference from existing literature focussed on Western experiences. 3) Feedback is seen as error identification, influenced by hierarchy and workload: Rather than fostering learning, feedback is viewed as shaped by hierarchical relationships and competing service demands. Conclusions: Feedback is valued by health professions trainees in Asian contexts, but its conception and practice differ from those typically described in existing literature (primarily of Western origin). Cultural dimensions such as high power distance and collectivism contribute to variations in how feedback is sought, delivered, and understood. Recognising and adapting to these cultural influences is crucial for designing feedback practices that are meaningful and educationally effective in non-Western settings.