Qualitative Content Analysis Research Articles

Student Reactions to Just-in-Time Formative and Summative Feedback in a Tablet-Based Family Medicine MCQ Exam

(1) Background: While the benefits of digital assessments for universities and educators are well documented, students’ perspectives remain underexplored. (2) Methods: This study employed an exploratory mixed-methods approach. Three examination cohorts were included (winter semester 2022/23, summer semester 2023, and winter semester 2023/24). Written emotional responses to receiving just-in-time summative or formative feedback were analyzed, as well as examining the impact of formative feedback on learning attitudes. All cohorts completed qualitative open-ended research questions. The responses were coded using Kuckartz’s qualitative content analysis. Descriptive statistics were generated using jamovi. (3) Results: Students generally responded positively to formative and summative feedback. The majority expressed a desire to receive feedback. The categories created for formative feedback indicate a tendency toward self-reflection and supported the learning processes. In contrast, the summative feedback categories suggest that students primarily value feedback’s transactional aspect. (4) Conclusions: Integrating formative and summative feedback in digital just-in-time assessment offers the potential to capitalize on the “sensitive periods” of study reflection that occur during assessment. This approach enables assessment for learning while simultaneously reducing emotional distress for students.

Debunking a politically motivated rumour on Reddit: the context of the 2024 U.S. Republican presidential campaign

PurposeThis study aims to elaborate on the picture of the informational credibility of rumours and the ways in which false political rumours are debunked in online discussion.Design/methodology/approachDescriptive quantitative analysis and qualitative content analysis of 1,775 posts submitted to 37 Reddit discussion threads focussing on the debunking of the rumour about pet eating among Haitian immigrants during the 2024 U.S. Republican presidential campaign. It was examined how and by what criteria the online participants debunked the rumour.FindingsThe participants employed seven approaches to rumour debunking: (1) drawing on prior refutations of the rumour; (2) presenting personal opinion about the rumour; (3) condemning rumourmongering; (4) demanding responsibility from rumourmongers; (5) indicating negative consequences of rumour dissemination; (6) joking about the rumour and its disseminators and (7) expressing emotional reactions. In rumour debunking, person-related criteria such as the honesty of the rumour disseminator were particularly significant, while criteria dealing with the content of the rumour, for example, the provision of evidence, were used less frequently. The findings suggest that rumour debunking occurring in online discussion draws heavily on the participants’ personal opinions, as well as appeals dealing with the blameworthiness of rumour dissemination.Research limitations/implicationsAs the study focusses on a sample of posts dealing with a particular rumour, the findings cannot be generalized to concern the rumour debunking occurring in online discussions.Originality/valueThe study pioneers by providing an in-depth analysis of the rumour debunking in online discussion. The findings highlight the significance of opinion-based approaches to rumour debunking.

Adapting and providing a virtual psychosocial intervention, iSibWorks, for siblings of youth with disabilities, a qualitative acceptability study.

The objectives included: (1) Adapt the SibWorks group intervention for use on a virtual platform with siblings; and (2) Assess the acceptability of the adapted intervention, iSibWorks. Participants were youth aged 8 to 12 years who had a sibling with a disability, and their caregivers. iSibWorks was implemented with siblings on a weekly basis for six weeks. Sessions were conducted using Zoom for Healthcare and lasted approximately 60 min each. One week after the final session, siblings and their caregivers were invited to participate in separate semi-structured interviews. Qualitative content analysis of interview transcripts was utilized to assess intervention acceptability. Adapting SibWorks to iSibWorks was achieved. Three categories were developed based on sibling and caregiver feedback. First, participants shared their satisfaction with the delivery of iSibWorks, reporting enjoyable experiences and valuing its interactive design. Next, participants perceived their involvement in the intervention as beneficial, due to opportunities to connect with others, learn applicable coping strategies, and improve self-esteem and mood. Finally, participants provided suggestions regarding the intervention's future delivery, content, and participation. iSibWorks is an acceptable virtual group intervention for siblings of youth with a disability. Families noted positive experiences and perceived benefits with intervention participation.

First-year composition multilingual students’ academic writing practices: the impact of reflective reading response journals

ABSTRACT Multilingual learners often struggle with academic writing because of their diverse intercultural rhetorical backgrounds, limited content knowledge, lexical resources, genre awareness, and reference and citation skills (Ferris & Hedgcock, 2023; Grabe & Kaplan, 2014). The study examines to what extent weekly reading response journals (RRJ) enhance first-year composition (FYC) multilingual students’ academic writing skills. Using qualitative content analysis and thematic analysis (Vaismoradi et al. 2016), the case study examines 11 FYC multilingual students’ semester-long weekly RRJs along with three phases of reflections on those written artifacts and a 10-minute-long one-on-one conference with each student participant. Despite the challenges students faced in comprehending authentic reading texts and connecting them to personal experience, the study’s findings indicate that the weekly RRJ enhances foundational academic writing skills. Specifically, it supports the development of learners’ cognitive, metacognitive, linguistic, citation, and content knowledge, while also fostering reflective writing habits. Based on the findings, the study suggests providing feedback along with enough space for actual reading instruction with a careful selection of reading texts addressing diverse learners’ backgrounds since it leverages critical evaluation of learners’ own thoughts and experiences, leading to more nuanced and insightful reflections.

From awareness to integration: a qualitative interview study on the impact of digital therapeutics on physicians’ practices in Germany

BackgroundThe integration of digital therapeutics (DTx) into the German statutory healthcare system marks a significant shift in medical practice through the introduction of innovative, reimbursable digital interventions for patient care. While DTx can bridge therapy gaps and enhance patient care, the number of prescriptions is increasing slowly. This study aims to explore the challenges physicians face when integrating DTx into their treatment options and the changes this integration entails for their medical workflows.MethodsA qualitative approach was adopted, gathering data from semi-structured interviews with 46 physicians across Germany. Participants, sampled for diversity in specialty, experience, and region, were interviewed between June 2022 and August 2024. The interviews explored physicians’ knowledge, experiences, and perspectives on DTx. Data were analyzed using qualitative content analysis, combining deductive and inductive coding.ResultsThe introduction of DTx into physicians’ workflows impacts their practice on multiple levels. First, physicians must become aware of the new regulations and therapeutic possibilities, requiring significant information intake and time to feel adequately prepared for prescribing DTx. Second, DTx add complexity to patient assessment, as physicians must evaluate factors such as digital literacy, motivation, and cognitive conditions, necessitating a deeper understanding of their patients. Third, the integration of DTx reshapes the physician‒patient relationship, as it alters interaction dynamics, redistributes responsibilities, and poses new communication challenges. Fourth, DTx expand therapeutic options, particularly by bridging therapy delays and enabling more personalized care. Finally, the integration of DTx has the potential to drive long-term changes in physicians’ workflows and mindsets, fostering alignment with multimodal and patient-centered treatment approaches.ConclusionsDTx offer opportunities for patient care but also pose challenges, such as the development of digital skills or familiarization with new regulations, that necessitate adjustments in physicians’ workflows. Physicians are generally confronted with an innovation that demands time, reliable information on effectiveness, practical experience, and openness to adopting digital health tools as complementary treatment options. However, the reception and integration of DTx into treatment vary among physicians, reflecting individual preferences and approaches. Further research should explore these diverse adoption strategies and examine the long-term effects of DTx on care delivery and patient outcomes.

Stigmatisation of gambling disorder in social media: a tailored deep learning approach for YouTube comments

BackgroundThe stigmatisation of gamblers, particularly those with a gambling disorder, and self-stigmatisation are considered substantial barriers to seeking help and treatment. To develop effective strategies to reduce the stigma associated with gambling disorder, it is essential to understand the prevailing stereotypes. This study examines the stigma surrounding gambling disorder in Germany, with a particular focus on user comments on the video platform YouTube.MethodsThe study employed a deep learning approach, combining guided topic modelling and qualitative summative content analysis, to analyse comments on YouTube videos. Initially, 84,024 comments were collected from 34 videos. After review, two videos featuring a person who had overcome gambling addiction were selected. These videos received significant user engagement in the comment section. An extended stigma dictionary was created based on existing literature and embeddings from the collected data.ResultsThe results of the study indicate that there is substantial amount of stigmatisation of gambling disorder in the selected comments. Gamblers suffering from gambling disorder are blamed for their distress and accused of irresponsibility. Gambling disorder is seen as a consequence of moral failure. In addition to stigmatising statements, the comments suggest the interpretation that many users are unaware that addiction develops over a period of time and may require professional treatment. In particular, adolescents and young adults, a group with a high prevalence of gambling-related disorders and active engagement with social media, represent a key target for destigmatisation efforts.ConclusionsIt is essential to address the stigmatisation of gambling disorder, particularly among younger populations, in order to develop effective strategies to support treatment and help-seeking. The use of social media offers a comprehensive platform for the dissemination of information and the reduction of the stigmatisation of gambling disorder, for example by strengthening certain models of addiction.

Cultural Brokering in Pregnancy Care: A Qualitative Study.

Cultural brokers bridge cultural and linguistic differences between patients and healthcare teams, but their role in pregnancy care is not well understood. We aimed to identify and describe the roles cultural brokers fulfill throughout pregnancy care, moments of impact when they enhance care for patients with limited English proficiency (LEP), and how to integrate cultural brokering into pregnancy care teams. We conducted a descriptive qualitative study nested within a human centered design process. We conducted 21 semi-structured, qualitative interviews among Spanish-speaking pregnancy care patients with LEP, cultural brokers, and pregnancy care clinicians in the Boston metropolitan area between December 2022 and May 2023. Data were coded and analyzed using qualitative content analysis to summarize themes about cultural brokering within pregnancy care. Data were used to create a journey map of an illustrative pregnancy experience. Cultural brokers played five key roles in pregnancy care for Spanish-speaking patients with LEP: cultural bridging, language support, social support, health system navigation, and advocacy. The journey map highlighted moments of impact when cultural brokers enhanced patient care: connecting patients to care, meeting the care team, making informed decisions, connecting to resources, childbirth, and transitioning to parenthood. Most participants wanted cultural brokers to be integrated into pregnancy care teams to diversify teaming and enable shared decision-making; however, additional training, clarifying cultural broker roles, and adequate compensation for cultural brokers would be needed to achieve integration. Cultural brokers fulfill a critical role during pregnancy care for patients with LEP. However, more work is needed to recognize, value, and integrate cultural brokering into pregnancy care.

Hallmarks of nursing students exhibiting unsafe clinical practices: a qualitative study

BackgroundMaintaining and promoting patient safety is a shared responsibility among all participants in the health care system. Educators are required to balance patients’ rights to receive safe care and create a suitable and safe environment for nursing students to learn. Therefore, early identification of students with unsafe clinical practice and intervention may be important measures for improving patient safety. Therefore, the present study was conducted with the aim of identifying the main hallmarks of nursing students with unsafe clinical practice.MethodsThis qualitative study was conducted with 19 faculty members, nursing students, and supervisors of medical centers. Data collection was performed through purposive sampling and semi structured interviews. Data analysis was performed via conventional qualitative content analysis via MAXQDA10 software.ResultsThe results of the study led to the identification of 2 main categories, “Underdeveloped knowledge and cognitive capacity” and “Underdeveloped personal-professional capacity”, and 6 and 4 subcategories, respectively, as the main hallmarks for identifying students with unsafe clinical practice.ConclusionThe findings of this qualitative study expand our understanding of the hallmarks of nursing students with unsafe clinical practice. Undergraduate nursing students with unsafe clinical practice may not have acquired sufficient development and progress in terms of knowledge, skills, and personal-professional characteristics or may not be able to demonstrate them in their practices. Nursing schools must ensure that students have the necessary knowledge, skills, competencies, and personal-professional characteristics to participate in clinical training programs. It is recommended that students with unsafe clinical practices be identified early so that patient safety is maintained and that students are supported in order to correct their weaknesses and improve.

Towards characterizing subjective cognitive decline in older adults.

BackgroundSubjective cognitive decline (SCD), where older adults perceive a persistent decline of cognitive abilities without showing an objective cognitive impairment, may represent a preclinical stage of Alzheimer's disease (AD) in some individuals.ObjectiveThe complex characteristics of SCD cannot only be revealed by existing self-report questionnaires. Rather, it is necessary to involve individuals affected in the research process with methods like focus group discussions (FGDs).MethodsStudy conduction took place in three steps: telephone interview, neuropsychological assessment and questionnaires, four FGDs with 16 older adults (11 female, 5 male) affected by SCD. FGDs were analyzed with qualitative content analysis using an inductive - deductive code system.ResultsAlthough the neuropsychological assessments did not indicate a cognitive impairment, participants reported a decline for all cognitive domains within the FGDs, especially for the memory- and speech domain, with declining word-finding abilities as the most salient symptom. Participants reported strong concerns related to SCD and difficulties in social participation.ConclusionsSCD seems to go beyond age-related cognitive changes, but as individuals do not show an objective cognitive impairment (yet), their symptoms are often not taken seriously enough. The FGDs revealed information that questionnaires or neuropsychological tests do not capture. The gained insight into SCD symptoms, related coping strategies and concerns is important to be able to develop measures for identifying individuals at risk for a transition to AD and to develop intervention measures that aim at delaying a further decline and increasing the quality of life of individuals affected.

’We do not see the problem, but agree with your solution’: the European Court of Auditors and the politics of evaluation in EU development policy

ABSTRACT This article investigates to what extent the European Commission and the European External Action Service (EEAS) have contested evaluations by the European Court of Auditors (ECA). Adopting a constructivist framing approach, the article investigates key diagnostic and prognostic frames in ECA performance audits through a qualitative content analysis. The empirical findings point to a strongly critical engagement of the ECA with the EU’s development policy interventions, particularly on their efficiency. In turn, there is a strong pattern of contestation observable in the responses by the Commission and the EEAS to diagnostic frames. In contrast, the findings point to little contestation over prognostic frames, although the analysis also reveals that the institutions often engage with recommendations provided by the ECA only superficially. Overall, the analysis suggests that the acceptance of the validity of findings of ECA performance audits in EU development policy by the Commission and the EEAS is limited.

A Pathway to Reach Equity

Achieving gender equity in education is essential for national development, yet history education often reinforces gender bias. This study examines gender mainstreaming in the curriculum of Indonesian history, comparing the 2013 Curriculum and the Merdeka Curriculum through Nancy Fraser’s social justice framework on redistribution, recognition, and representation. This study aims to: (1) analyse the paradigm of history education in both curricula, (2) evaluate how gender discourse is integrated, and (3) assess the shift in historical narrative towards gender inclusivity. This study examines curriculum documents and history textbooks using a qualitative content analysis approach. The findings reveal that although both curricula emphasise national identity, the Merdeka Curriculum adopts a more progressive attitude towards gender equality by integrating feminist historiography and multidimensional narratives. This marks a shift towards redistributive justice and recognition, ensuring increased visibility of women’s contributions in history education. However, the extent of curriculum implementation remains untested, raising concerns about teacher readiness and classroom implementation. The study highlights the need for ongoing curriculum reform to better integrate gender perspectives across subjects. In addition, teacher training is essential to prevent unintentional reinforcement of gender bias. Future research should explore how gender-inclusive history education affects student perceptions and how educators interpret and implement these curriculum changes. Although the Merdeka Curriculum reflects progress, achieving gender justice in education requires systemic reforms in pedagogy, teacher training, and policy.

21st Century Skills Research Trends in Türkiye: Investigating Graduate Theses in Curriculum and Instruction

The internationalization of higher education institutions is a positive development, offering significant opportunities for growth and advancement. It is imperative that students are equipped with 21st-century skills. This paper presents the latest research trends on 21st-century skills in higher education, focusing on graduate theses in curriculum and instruction programs in Türkiye. This research examines the context in which these graduate programs study 21st-century skills from 2014 to 2024, along with the results of these studies. This study employs a qualitative content analysis method using MAXQDA. The analysis reveals an increasing academic focus on 21st-century skills, marked by a peak in dissertation completions in 2022, reflecting a response to evolving technological and societal needs. The emphasis on quantitative and mixed methods, alongside diverse research tools, illustrates the complexity of this research area and underscores a commitment to empirical study. These findings highlight the critical need for ongoing investigation, particularly at the doctoral level and within foundation universities, to further enrich understanding in this evolving educational field. The study suggests fostering diverse research approaches, particularly qualitative and interdisciplinary methods, to enrich insights into 21st-century skills. Expanding doctoral-level research and increasing contributions from foundation universities are recommended to broaden perspectives and strengthen theoretical frameworks. Additionally, the development of specialized data collection tools is encouraged to enhance accuracy and support detailed analysis in this complex field. These recommendations highlight pathways to deepen academic understanding and support the continued evolution of 21st-century skills research.

Experiences of participation in cardiorespiratory training among people with post-stroke fatigue: a qualitative study.

To explore the experiences of 8-week thrice-weekly supervised intense cardiorespiratory interval training at home in people with post-stroke fatigue. Qualitative, using semi-structured individual interviews. Eleven people with post-stroke fatigue were recruited from a study investigating the effects of supervised intense cardiorespiratory interval training. The interviews were conducted 1-2 weeks after the intervention period and analysed inductively with qualitative content analysis. The theme "Supervised cardiorespiratory interval training at home was perceived as feasible and safe, reducing fatigue and contributing to enhanced self-efficacy in both exercise and everyday life" was based on 4 main categories: "Experiences of performing the intervention and testing, "Perceived impact of the intervention on fatigue", "Perceived impact of the intervention on self-efficacy", and "The reinforcing experiences of exercise transfer to everyday life". The informants reported that participating in the intervention made them feel physically and mentally stronger and no longer restricted by a lack of confidence in performing activities that increased their heart rate. Participating in supervised intense cardiorespiratory interval training provided a model on how to train, which was transferable to other contexts in everyday life. The training improved exercise self-efficacy and gave the informants the confidence to challenge themselves in everyday life.

Influence of Indigenous data governance principles on Indigenous knowledge management: Lessons from the Southern African Intangible Cultural Heritage Project

The study investigates the impact of Indigenous data governance principles on managing Indigenous knowledge. Indigenous communities possess rich knowledge systems that are crucial for sustainable development and community well-being. However, managing this knowledge faces challenges, including inadequate data governance frameworks that fail to align with Indigenous values, protocols and ownership rights. This research explores how integrating Indigenous data governance principles into knowledge management practices enhances cultural autonomy, strengthens community resilience and fosters sustainable development. Drawing on a qualitative methodology including web content analysis, document analysis and personal experiences, a case study of the Southern African Intangible Cultural Heritage Project was carried out. The data was analysed using qualitative content analysis. The FAIR (findable, accessible, interoperable, reusable) and CARE (collective benefit, authority to control, responsibility, ethics) principles were utilized as the guiding data governance principles. The findings highlight the importance of culturally sensitive data protocols, community-driven decision-making processes, and reciprocal partnerships between Indigenous communities and database managers. This research offers insights into transformative approaches for advancing Indigenous knowledge sovereignty.

“The Learning Process Is Mutual”: Connecting Student Teachers and In-Service Teachers in Intercultural Virtual Exchange

This article reports on a case study where students of Initial Teacher Education in Spain and Germany collaborated with in-service teachers from around Europe on the theme of Foreign Language materials development. It examines to what extent engagement in this model of virtual exchange contributes to student teachers’ and in-service teachers’ intercultural and didactic competence development. The study also explores how students’ perspectives on teaching foreign languages and their future profession change through collaboration with in-service teachers and how the student teachers’ and in-service teachers’ roles unfold in this type of collaboration. It is based on a qualitative content analysis of focus-group interviews, learning portfolios, recordings of online meetings, and questionnaires with open-ended questions. The findings indicate that this type of collaboration can reduce the gap between theory and practice: through the classroom experiences of in-service teachers, student teachers gain intercultural, professional knowledge and motivation, while in-service teachers gain knowledge about recent methodologies and technology through the alternative perspective of student teachers. We use the findings of our study to make recommendations on how other teacher trainers can use this Virtual Exchange model in the classroom.

Experiences of women with threatened abortion: a qualitative study of pregnant women and health providers in Iran

BackgroundThere are significant health and psychological consequences associated with threatened abortion (TA). Women who lose desired pregnancies due to abortion are at risk of experiencing grief, anxiety, guilt, and self-blame. In Iranian society, psychological support for pregnant women is low, and as a result, women with TA experience high stress. This study aimed to investigate the experiences of pregnant women with TA and health providers in maternity healthcare services.MethodsThis exploratory-descriptive qualitative study was conducted using semi-structured interviews and purposive sampling. 13 pregnant women and seven key informants (husband and health care providers) were selected from February 2023 to July 2023. Data was analysed using qualitative content analysis with MAXQDA software (version 18).ResultsThe most critical causes of concern for women included medical, psychological, social, and financial issues and a lack of sufficient information about their current situation (spotting- bleeding). The participants used constructive coping strategies, such as regular visits to the doctor, and unconstructive coping strategies, like a lack of communication with others, to reduce their worries. Key informants proposed two methods for reducing the concerns of the women, including improving information sharing about abortion and therapeutic support available to pregnant women.ConclusionsThe study proposed that maternity healthcare providers, alongside medical care, should pay attention to techniques for improving the psychological support of women with TA.

Process evaluation of a co-design and implementation study to improve professional health literacy in a regional care hospital (PIKoG): a mixed-methods study

BackgroundIn connection with a hospital stay, patients have to make important health-related decisions. Adequately responding to the needs of patients requires good communication skills of healthcare professionals within healthcare organizations. The PIKoG project (As made for us – Improving professional health literacy in hospitals) aimed at improving professional health literacy by implementing participatory health literacy training and supporting measures in a hospital setting. This study aimed to analyze processes supporting and hindering the implementation of the complex intervention.MethodsA mixed-methods study was conducted, including focus group interviews and a paper-pencil survey with healthcare professionals. Data was combined and analyzed using categories derived from the Medical Research Council’s guidance on process evaluation: (1) Implementation, (2) Mechanisms of impact, and (3) Context. Interview data were analyzed using structured qualitative content analysis according to Kuckartz. Survey data were analyzed descriptively.ResultsOne of three on-site, full-day health literacy training sessions was offered weekly. Supporting measures were implemented step by step over the course of a year. Both the training and the supporting measures were rated positively overall, but they could not be effectively integrated into daily routines. The COVID-19 pandemic as well as resource constraints adversely affected implementation by altering workflows, increasing stress levels and shifting priorities. The participatory approach and individual change agents fostered the implementation of the complex intervention. Nurses were reached the most, while physicians engaged least in the interventions. Adaptations during the implementation increased the use of the implemented measures and gave rise to ideas for future improvements.ConclusionThe study highlights the challenges involved in implementing a complex intervention supporting professional health literacy in an organization and stresses the importance of considering available resources, recruiting opinion leaders, and being responsive to the needs of different groups. While the participatory co-design development approach was found to be valuable, it does not guarantee successful organizational change in times when hospitals face multiple challenges. Subsequent studies should therefore focus on investigating the capacities of healthcare organizations for organization-wide improvement processes and identify how healthcare organizations can be innovative and patient-centered even in the presence of extremely difficult contextual conditions.Trial registrationDRKS00019830, since 16th of April 2020.

An industry or a sport: media framing of esports development in Hong Kong

PurposeThis paper aims to look at the case of esports in Hong Kong by content analysis of news between 2020 and 2022 to explore how esports development was being framed in the news and discuss the implications of the media framing of esports in Hong Kong’s context.Design/methodology/approachA qualitative content analysis approach is adopted to study the news framing of esports in selected news articles between 2020 and 2022.FindingsFindings of news framing of esports in Hong Kong suggested that esports were emphasized as an industry in Hong Kong’s context. Even though esports coverage emerged as the Asian Games approached, the absence of sporting elements in the news contributed to the consolidation of understanding of esports as discussed in previous studies, which hinders the social recognition of esports as a sport that could be further developed in the city.Originality/valueTo the best of the authors’ knowledge, this is the first study that focuses on the news framing of esports in Hong Kong, highlighting the important role of media in influencing the public perception of esports and its image in Hong Kong’s context.

The Impact of Corporate Social Responsibility (CSR) Messaging in Advertising Media on Consumer Trust and Brand Loyalty: A Comparative Analysis Across Digital and Traditional Media Platforms

This research investigates the effectiveness of Corporate Social Responsibility (CSR) messaging in advertising media and its impact on consumer trust and brand loyalty. Utilizing a mixed-methods approach, the study incorporates quantitative surveys with 300 consumers exposed to CSR advertisements across digital and traditional media, alongside qualitative content analysis of 100 CSR ads. Key findings reveal that CSR messaging significantly enhances consumer trust and brand loyalty, with digital media platforms proving more effective than traditional ones due to their interactive nature. The study offers recommendations for optimizing CSR communication, emphasizing authenticity and alignment with brand values.

What do readers need? Qualitative requirements of medical discharge summaries from the recipients’ perspective

BackgroundDischarge summaries (DSs) are the primary communication tools in clinical medicine. The transfer of information and plans is essential to ensure consistent patient safety and continuity of care. Therefore, DSs play a key role in population health. However, the overall quality of DSs is considered deficient, and there is a notable lack of scientific knowledge and research in this field, particularly regarding the needs of physicians as the primary recipients of DSs and key providers of ongoing patient care. The purpose of this study was to explore their requirements concerning the content, structure, and processing of DSs.MethodsA total of 159 outpatient primary care physicians (general practitioners, GPs) and specialists who refer patients to hospitals for various conditions were contacted across Germany using mixed sampling methods combining convenience, quota, and theory-driven sampling. Of these, 106 (66.67%) participated in telephone interviews. The interviews included nine open-ended questions, analyzed using Mayring’s qualitative content analysis, and a 43-item questionnaire, evaluated quantitatively with descriptive statistical methods to assess DS characteristics.ResultsQuantitative analysis revealed that recipients rated the prompt arrival of DSs, a clear treatment and diagnostic plan, and a coherent rationale as the most important requirements. The least important elements were newsletter-style content, patient contact information, patient ethnicity, and hospital logos or awards. Both quantitative and qualitative analyses identified similar priorities and challenges in DS content and structure. Sending a diagnosis list was considered a top priority by all physicians. While GPs placed high importance on diagnoses, treatment plans, and medication changes, specialists prioritized a logical line of reasoning.ConclusionThis recipient-focused study highlighted specific areas for improvement in the content, structure, and delivery of DSs. Tailoring DS formats to the distinct needs of GPs and specialists has the potential to enhance their overall quality and utility. Ultimately, optimizing DSs may strengthen population health outcomes by improving care transitions, reducing adverse events, and supporting effective outpatient management across the healthcare system.