Medical Students’ Perceptions of Clinical Learning Environments in Public and Private Hospitals in Jeddah: A Mixed-Methods Study

Purpose: The clinical learning environment (CLE) is essential in shaping the professional growth, competence, and well-being of medical students. Insufficient evidence exists on how medical students in Saudi Arabia perceive the CLE across diverse hospital settings, particularly in comparison between the public and private sectors. This study examined medical students' perceptions of the CLE during clerkship rotations in both public and private hospitals in Jeddah, using the Undergraduate Clinical Education Environment Measure (UCEEM) and qualitative thematic analysis. Methods: A Convergent mixed-methods study was conducted among all clerkship-phase students (Years 4-6) at Fakeeh College for Medical Sciences (FCMS), during the academic year 2024-2025. The quantitative component used a repeated- measures cross-sectional design using the UCEEM questionnaire, while the qualitative component consisted of open-ended questions exploring students' experiences. 52.2% of participants completed the qualitative component. This mixed-methods approach enabled both the measurement of overall perceptions and the exploration of contextual factors influencing the CLE. Students provided informed consent before participation. Results: The study included 255 students. Overall, UCEEM scores did not differ significantly between public and private placements across all years. Higher academic year and male gender were associated with more positive perceptions of the CLE. Qualitative findings revealed that private placements were characterized by supportive supervision, more structured organization, and adequate resources, whereas public placements offered broader clinical exposure but faced challenges in organization and feedback provision. Both settings were viewed as generally positive. Conclusion: Medical students generally have a positive view of their clinical learning environments, and older students are more confident and satisfied. Improving clinical education and planning clinical placements and curriculum development requires better supervision, more efficient organizations, and solutions to logistical problems. It's just as important to make sure that all students, including girls, feel welcome and supported. To make sure that clinical placements prepare skilled and caring doctors to work in a variety of healthcare systems, they need to be evaluated and given feedback on a regular basis.