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BACKGROUND: Medical education in resource-constrained settings such as Pakistan faces significant challenges, including large class sizes, limited resources, and reliance on traditional teacher-centered pedagogies. These factors hinder effective learning and fail to equip students with the critical thinking and practical skills essential for modern medical practice. Educators play a fundamental role in shaping student experiences but often struggle to adopt student-centred methodologies due to insufficient training, resource limitations, and institutional constraints. This study aimed to explore medical educators' teaching approaches, their perceptions of their effectiveness, and the challenges they face in implementing modern pedagogical techniques. METHODS: A sequential explanatory mixed-method study was conducted. First, the Approaches to Teaching Inventory (ATI) was administered to 130 medical and dental educators in Karachi, Pakistan (71% response rate, n = 93), assessing teacher-centered (Information Transmission/Teacher-Focused, ITTF) versus student-centered (Conceptual Change/Student-Focused, CCSF) approaches. Second, semi-structured interviews were conducted with 25 educators purposively selected from the initial sample. Quantitative data were analysed using SPSS and Mann-Whitney U tests. Qualitative data were subjected to thematic analysis to identify key themes. RESULTS: The quantitative results demonstrated that educators often use a blended teaching approach. No significant gender differences were found in teaching experience or teacher-centric scores; however, female educators scored higher on the student-centric approach (p = 0.001). Qualitative analysis identified themes: (1) teachers as catalysts for student transformation, emphasising mentorship and practical learning; (2) curriculum challenges and the need for faculty development, highlighting dissatisfaction with outdated curricula and assessments focused on rote memorisation; and (3) teaching practices advocating for interactive methods and continuous assessment aligned with practical clinical skills. Educators expressed a desire for faculty development programs to support student-centered learning. CONCLUSIONS: Medical educators recognise the importance of student-centred approaches but face significant challenges due to institutional pressures, outdated curricula, and inadequate assessment methods. There is a critical need for curriculum reform, adoption of continuous formative assessments, and faculty development programs to enhance teaching effectiveness. Institutions should promote environments that value pedagogical excellence and support innovative teaching practices. Aligning educators' perceptions with actual teaching practices is essential to improve medical education and prepare students for professional practice.
Sukkurwalla et al. (Wed,) studied this question.