Feedback Literacy and Self-cognition Mechanisms Among BSc Medical Students: A Qualitative Analysis Based on the Johari Window Model

<ns3:p>Background Effective feedback is the cornerstone of clinical excellence in medical education. However, the transition from superficial compliance to deep internalisation remains a significant pedagogical challenge. This study investigates the mechanisms of feedback internalisation among Bachelor of Science (BSc) medical students, utilising the Johari Window model as a theoretical lens to understand how self-awareness dictates emotional, cognitive, and behavioural responses to negative critique. Methods A qualitative phenomenological study was conducted with fourteen BSc medical students. Semi-structured interviews explored students’ experiences with negative feedback. Data were analysed using reflexive thematic analysis, following Braun and Clarke’s six-step framework. Methodological rigour was ensured through adherence to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines, including member checking and investigator triangulation. Results The findings reveal that feedback internalisation is highly dependent on the quadrant of self-awareness into which the information falls. Feedback in the Open Area facilitates rapid internalisation through rational validation and emotional stability. Conversely, Blind Spot feedback triggers significant ego-shock and embarrassment, requiring cognitive dissonance resolution. Hidden Area feedback frequently fails due to information asymmetry and perceived threats to autonomy, leading to surface compliance. Teachers can enhance internalisation by adopting the Situation-Behaviour-Impact (SBI) model and fostering self-disclosure loops. Conclusions This research provides an innovative framework for diagnostic feedback delivery. By aligning pedagogical interventions with student self-cognition, medical educators can move beyond perfunctory compliance to foster genuine professional growth and patient safety.</ns3:p>