Student evaluation of teaching (SET) only becomes an effective tool for improving teaching and learning when the relevant stakeholders seriously consider and plan appropriate actions according to student feedback. It is common practice in medical education to provide clinical teachers with student feedback. However, there is limited evidence about how teachers in higher education, and medical education in particular, systematically apply student feedback to improve the quality of their teaching practice. The focus of this case study was to examine clinical teachers' perceptions of and responses to SET with respect to its purposes and uses for enhancing their teaching. An explanatory sequential mixed methods approach was employed to collect both quantitative and qualitative data from the clinical coaches. These clinical coaches perceived the main purpose of student evaluation as quality assurance, and were moderately receptive to student feedback. Four key factors enabling or inhibiting their responses were revealed: institutional requirements, operational practices, personal biases and provision of support. Future research should further explore the interrelationships among the above factors as the core mechanism in influencing clinical teachers' perceptions of and responses to student evaluation.