Dear Dr. Albeitawi,

I would specifically advise you to restructure the paper for improve its coherence and  attach the survey questionnaire as an appendix for transparency and reproducibility.

Please submit your revised manuscript by Sep 05 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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We look forward to receiving your revised manuscript.

Kind regards,

Mariam Shadan, MBBS, MSc, MD

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: N/A

Reviewer #2: N/A

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3. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1:  This paper provides insights into variables that may impact clinical preceptor effectiveness in teaching. While limited to one country, the study had the advantage of studying six medical schools with significant numbers of preceptor and student participants to make the conclusions justified. I did not see that a copy of the written survey was readily available and readers may find this to be a useful appendix if they desire to investigate their own institution. Perhaps it was included and I somehow glossed over it in my reading of the manuscript.

The term 'clinical simulation' is intuitively obvious but I think a few sentences to describe what they mean might be helpful as a guide to this training need priority.

Table 3 outlining preferences for preceptor day and time for participation takes up a lot of space and could be reduced to a few sentences. The findings are an important variable but may likely differ among institutions/countries.

Reviewer #2:  Overall, this paper represents an important attempt to define the gaps in clinical teaching in medical schools in Jordan, to inform preceptor training. The study design is appropriate, with use of both qualitative data from a survey instrument, and focus groups. The sample size is impressive.

The paper would benefit from some reorganization, so that the study part is clearly separated from the resulting curriculum development part. The analysis is limited to descriptive frequencies, which seems like a missed opportunity to me. With the range of respondents representing students, as well as faculty in two different settings, surely some meaningful comparisons could have been made. Did all the groups agree in their responses? I imagine that analysis of the student responses in the focus groups would yield some important differences from the responses of the faculty. If the focus groups were mixed, with students and preceptors together (which needs clarification), then would your participant coding permit any analysis by type of participant? I also think the work setting of the preceptors might have led to some differences in identified challenges and needs addressed in both the survey and the focus groups. With 400 survey respondents, you should be able to perform some analysis of respondent differences by health sector.

Another problem for me as a reader is lack of familiarity with the Jordanian medical education system. An introduction of the system would be helpful to readers who may make assumptions based on the system they know. This could perhaps be provided in a graphical timeline format.

I will now provide detailed line-by-line comments and suggestions.

1. The word “Based” in the title is unnecessary, and the flow suggests that the assessment may also include assessment of the design of the curriculum. I recommend changing the title to: “Assessment of Clinical Medical Education Needs to Inform Design of a Preceptor Development Program in Jordan: A National Mixed Method Study.”

2. The funding details statement appears to be missing some important required details.

3. The data availability statement does not appear to meet the PLOS One requirements.

4. The abstract appears in two versions, the first starting on Page 2, line 32 and ending on page 3, line 58, and the second version starting on page 3, line 59 and ending on page 4, line 79. Even the key words are different. Please decide which abstract content you want to keep as your final.

5. Page 3, lines 61-63 in Background: “In this study,…” could be reworded for clarity to: “In this study, we explored the challenges faced by preceptors and students, and measured the educational needs of preceptors, to inform the design of a syllabus for a preceptor development program.”

6. Page 4, line 65, the words “questionnaire” and “survey” are redundant. Please choose one.

7. The introduction needs an overview of the medical education system in Jordan, including the time spent by students (do students enter medical school after college, or do the early years of medical school serve as college? Is the education divided into preclinical (classroom) training and then clinical training? Do the 6 years of medical school education include internship/residency? Are there required rotations and electives? Who are the preceptors? There is mention of some being community and some being academic and some Ministry of Health. In my country, medical students in their 3rd and 4th year have required inpatient rotations, mostly at the main teaching hospital, but also have outpatient rotations (some with academic faculty and some with community preceptors), and can take rotations at community hospitals. As you may imagine, the teaching skills and approaches vary immensely. This paper needs a better description of the preceptors, their sites/settings and their representation as teachers of the students. (If most of the precepting is done by community preceptors but most of your respondents were academic faculty, this would be an important weakness.)

8. On page 6 and 7, study design, I would like to see more granularity about the participants and their work settings. On lines 124-126, you state that “The study included clinical preceptors (academic faculty and Ministry of Health hospital staff)…” But elsewhere you refer to community preceptors (introduction, lines 83-86)? On page 7, lines 139-140, you refer to clinical instructors? Who are they? Are all the preceptors included in this study teaching in inpatient settings? Perhaps a graphic or at least a paragraph describing the preceptor types and their work settings is needed.

9. Page 8 line 149, I think you mean “adapted” rather than “adopted”.

10. On page 8, line 153, I recommend clarifying that the prioritization used a Likert type scale (rather than a ranking). In the same line, it would improve reading comprehension to separate the training competency topics with semicolons.

11. Page 8 line 161, I recommend change “among” to “during” and delete “up” In the date range.

12. The dissemination should be better explained. How many preceptors were on the list? How many responded? Any response bias based on practice setting?

13. It would be helpful to know whether there were any research incentives for either the students or the preceptors.

14. Page 9 Lines 166-171, I would like more information about the approach to thematic analysis. Did you use or adapt any specific approach to coding the focus group themes? If so, please explain and provide a reference.

15. Page 9, lines 160-171, this sentence is confusing: “These themes made us aware of the modification of the questionnaire and the design of the training program syllabus needed.” Do you mean: “These themes informed needed revisions in the questionnaire and the eventual design of the training program syllabus.”?

16. Page 9 lines 172-175 seems out of place and the section title is confusing. I think this belongs at the end (it is not really part of your study) as it describes the approach to designing the curriculum based on your study results. I recommend changing the header to “Syllabus Design Process”.

17. The results section would benefit from more comparative analysis, as addressed in my introductory paragraphs.

18. On page 14, line 218, please clarify what you mean by “certification,” In my world, this has a very specific meaning, based on taking a board exam following specialty training. From context here, I believe you mean providing a training certificate.

19. Page 15, lines 226-227 – description of the eventual curriculum development does not belong in results.

20. Page 17, line 251, do you really mean that your training program would prepare preceptors to design simulation scenarios? This seems more ambitious than you can likely accomplish in the amount of time you have planned, and is likely beyond reach of many clinical preceptors. Perhaps you mean that they would be expected to use, adapt, deploy simulation scenarios that are provided to them?

21. Page 18, line 229, I recommend deleting the word “reflective”, which is redundant with “self-reflection a few words later.

22. Page 19, lines 19-282, I recommend rewording this to describe the study, designed to inform the curriculum, as the study is not really about the curriculum.

23. I recommend reorganizing the discussion and shortening it. There is a great degree of redundancy. Discuss the results in reference to other related papers, then discuss how the results were applied in the planned curriculum.

24. There may be limitations based on selection bias of respondents, if the distribution of those responding did not reflect the range of preceptors. What is the risk that those who need the development course least are the most likely to take it (because they love to teach and are interested in it)?

25. There are citations to several papers missing from the reference list: 16-19.

26. Page 22 Conclusion. You state: “By addressing challenges like over-enrollment and feedback deficiencies, the program aims to enhance medical education quality.” How does your study or your curriculum plan address the problem of over enrollment?

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Reviewer #1: No

Reviewer #2: No

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Dear Dr. Albeitawi,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

==============================

Thank you for responding to the reviewer comments appropriately.

1. Please remove the word "national" in front of the mixed-method study.

2. Secondly, since the final outcome of the study is from an expert panel who developed the syllabus. The results of preliminary studies, focus group discussions and surveys were sequential, with the focus group discussion providing data used to contextualise an existing questionnaire for the subsequent phase. Thus, the study is best characterised by a sequential, multimethod design. have a look at these exaples to guide you-https://pubmed.ncbi.nlm.nih.gov/32554723/,   https://books.google.co.za/books?hl=en&lr=&id=F8BFOM8DCKoC&oi=fnd&pg=PA189&dq=sequential+multimethod+design&ots=gXgMyBoxJg&sig=l1bh8zh6jyYBJazHH3WuuL_m72I#v=onepage&q=sequential%20multimethod%20design&f=false

Please rewrite the methodology session 

==============================

Please submit your revised manuscript by Dec 11 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols .

We look forward to receiving your revised manuscript.

Kind regards,

Christmal Dela Christmals, PhD, MSc, BSc, RN

Academic Editor

PLOS ONE

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Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

**********

Reviewer #1: (No Response)

Reviewer #2: Thank you for accepting my recommended changes and addressing my concerns. Good luck with your planned training program!

**********

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Reviewer #1: No

Reviewer #2: No

**********

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Assessment of Clinical Medical Education Needs Inform Design of a Preceptor Development Program in Jordan: A Multi Method Study

PONE-D-25-26793R2

Dear Dr. Albeitawi,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Academic Editor

PLOS ONE

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Congratulations on your excellent work.

Despite meeting all scientific requirements, it is crucial to proofread the paper. For example, the term "competency based" should be made a compound word (competency-based).

Reviewers' comments: