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Background  Medical education is characterized by numerous features that are different from other higher education programmes, and evaluations of teaching quality are an integral part of medical education. Although scholars have made extensive efforts to enhance the quality of teaching, various issues unrelated to teaching that interfere with the accuracy of evaluation results remain. The purpose of this study is to identify the barriers that prevent objective and reliable results from being obtained during the evaluation process.    Methods  This study used mixed methods (3 data sources) to collect opinions from different stakeholders. Based on purposive sampling, 16 experts familiar with teaching management and 12 s- and third-year students were invited to participate in interviews and discussions, respectively. Additionally, based on systematic random sampling, 74 teachers were invited to complete a questionnaire survey. All qualitative data were imported into NVivo software and analysed using thematic analysis in chronological order and based on grounded theory. Statistical analyses of the questionnaire results were conducted using SPSS software.    Results  Sixty-nine valid questionnaires (93.24%) were recovered. A total of 29 open codes were extracted, and 14 axial codes were summarized and divided into four selective codes: evaluation preparation, the index system, the operation process, and the consequences of evaluation. The main barriers to obtaining reliable evaluation results included inadequate attention, unreasonable weighting, poor teaching facilities, an index without pertinence and appropriate descriptions, bad time-points, incomplete information on the system, lagged feedback, and disappointing result application. Almost all participants suggested lowering the weight of students as subjects, with a weight of 50–60% being appropriate. Students showed dissatisfaction with evaluation software, and the participants disagreed over the definition of good teaching and the management of student attendance.    Conclusions  This study reveals the difficulties and problems in current evaluations of teaching in medical education. Collecting data from multiple stakeholders helps in better understanding the evaluation process. Educators need to be aware of various issues that may affect the final results when designing the evaluation system and interpreting the results. More research on solutions to these problems and the development of a reasonable evaluation system is warranted.

Barriers to obtaining reliable results from evaluations of teaching quality in undergraduate medical education