Introduction: In health professions education, assessment is increasingly viewed not merely as a tool for grading, but also as a means of shaping a productive learning environment. This shift promotes student-centered learning and enhances students’ self-regulated learning (SRL). Consequently, faculty members are expected to take on the role of facilitators, providing rich feedback and coaching to support student learning. However, this is not easy in practice, and these underlying mechanisms are not yet fully understood. The research question of this exploratory study is: How do faculty perceive their roles and the tensions in supporting student learning and self-regulation through feedback and coaching in programmatic assessment?

Methods: This study adopted a qualitative constructivist paradigm. Seventeen faculty members participated in five semi-structured focus group interviews. Thematic analysis was employed, integrating both inductive and deductive approaches.

Results: The analysis produced four key themes: (1) Providing feedback at the task level is easier than giving suggestions for further development of competencies; (2) Tailoring narrative feedback to personalized learning paths is challenging; (3) The primary role of coaching is to foster students’ reflection and autonomy, while adapting to students’ needs when necessary; (4) Coaching requires a balance between stimulating autonomy and fulfilling graduation requirements.

Discussion: This study shows that faculty believe that programmatic assessment enhances learning, but they experience challenges and tensions in stimulating students’ SRL in practice. It is not easy to tailor feedback to meet students’ individual needs and to align coaching for SRL with graduation requirements.