This study aimed to examine how students' perceptions of research and learning change through participation in undergraduate research and to identify the factors that affect the process of their engagement in re-search projects. This qualitative study has drawn on phenomenography as research methodology to explore third-year medical students' experiences of undergraduate research from participants' perspectives (n=14). Data included semi-structured individual interviews conducted as pre and post reflections. Thematic analysis of pre-course interviews combined with researcher-participant observations in-formed design of end-of-course interview questions. Phenomenographic data analysis demonstrated qualitative changes in students' perceptions of research. At the beginning of the course, the majority of students ex-pressed a relatively narrow definition of research, focusing on the content and outcomes of scientific research. End-of-course reflections indicated increased attention to research processes including researcher autonomy, collaboration and knowledge construction processes. Furthermore, acknowledgement of the linkage between research and learning processes indicated an epistemological change leading them to take a deep approach to learning in undergraduate research. Themes included: an inquiring mind, synthesis of knowledge, active participation, collaborative and reflective learning. However, they also encountered some difficulties in undertaking group research projects. These were attributed to their prior learning experiences, differences in valuing towards interpersonal communication, understanding of the research process, and social relationships with others. This study provided insights into the potential for undergraduate research in medical education. Medical students' awareness of the linkage between research and learning may be one of the most important outcomes in the undergraduate research process.

Interdisciplinary problem-based learning (PBL) aims to provide students with opportunities to develop the necessary skills to work with different health professionals in a collaborative manner. This discourse study examined the processes of collective knowledge construction in Japanese students in the tutorials. Analyses of video-recorded data elicited from three multidisciplinary cohorts and their learning portfolios provided insights into their participation and introspection during the discussions. The results indicate there were two patterns of knowledge construction: (a) co-constructions between students from different disciplines and (b) elaborations between students from the same discipline. Their learning processes were mediated by their cultural assumptions, professional identities, understanding of other professionals, and perceptions of collaborative learning. The finding suggests that interdisciplinary PBL has the potential to enhance students’ collaborative learning skills, and students’ participation is situated within a cultural context.

Interprofessional collaboration is an essential approach to comprehensive patient care. As previous studies have argued, interprofessional education (IPE) must be integrated in a stepwise, systematic manner in undergraduate health profession education programmes. Given this perspective, first-year IPE is a critical opportunity for building the foundation of interprofessional collaborative practice. This study aims to explore the first-year students’ learning processes and the longitudinal changes in their perceptions of learning in a year-long IPE programme. Data were collected at a Japanese medical university, in which different pedagogical approaches are adopted in the IPE programme. Some of these approaches include interprofessional problem-based learning, early exposure, and interactive lecture-based teaching. The students are required to submit written reflections as a formative assessment. This study conducted an inductive thematic analysis of 104 written reflections from a series of e-portfolios of 26 first-year students. The themes related to learning outcomes from student perspectives included communication (e.g., active listening and intelligible explanation), teams and teamwork (e.g., mutual engagement and leadership), roles/responsibilities as a group member (e.g., self-directed learning and information literacy), and roles/responsibilities as a health professional (e.g., understanding of the student’s own professional and mutual respect in an interprofessional team). The study also indicated three perspectives of students’ learning process at different stages of the IPE, i.e., processes by which students became active and responsible learners, emphasised the enhancement of teamwork, and developed their own interprofessional identities. This study revealed the first-year students’ learning processes in the year-long IPE programme and clarified the role of the first-year IPE programme within the overall curriculum. The findings suggest that the students’ active participation in the IPE programme facilitated their fundamental understanding of communication/teamwork and identity formation as a health professional in interprofessional collaborative practice.

Background: Clinical decision-making skills are essential for providing high-quality patient care. To enhance these skills, many institutions worldwide use case-based learning (CBL) as an educational strategy of pre-clinical training. However, to date, the influence of different learning modalities on students’ clinical decision-making processes has not been fully explored. This study aims to explore the influence of video and paper case modalities on the clinical decision-making process of midwifery students during CBL. Methods: CBL involving a normal pregnant woman was provided for 45 midwifery students. They were divided into 12 groups; six groups received the video modality, and six groups received the paper modality. Group discussions were video-recorded, and focus groups were conducted after the CBL. Transcripts of the group discussions were analysed in terms of their interaction patterns, and focus groups were thematically analysed based on the three-stage model of clinical decision-making, which includes cue acquisition, interpretation, and evaluation/decision-making. Results: The students in the video groups paid more attention to psychosocial than biomedical aspects and discussed tailored care for the woman and her family members. They refrained from vaginal examinations and electric fetal heart monitoring. Conversely, the students in the paper groups paid more attention to biomedical than psychosocial aspects and discussed when to perform vaginal examinations and electric fetal heart monitoring. Conclusion: This study clarified that video and paper case modalities have different influences on learners’ clinical decision-making processes. Video case learning encourages midwifery students to have a woman- and family-centred holistic perspective of labour and birth care, which leads to careful consideration of the psychosocial aspects. Paper case learning encourages midwifery students to have a healthcare provider-centred biomedical perspective of labour and childbirth care, which leads to thorough biomedical assessment.

Health professions learners are taught by full-time university faculty and by clinicians who teach alongside their clinical practice. This distributed healthcare education model ensures high-quality education but is at risk due to high learner demand, shortage of educators, and economic pressures. Understanding what factors influence clinical educators' motivation to teach may contribute to the model's sustainability and educator retention. The present review therefore aimed to systematically search and synthesise factors influencing clinical educators' motivation to teach. Multiple databases, relevant journals, and the grey literature were searched for studies reporting on clinical educators' motivation to teach. Data were analysed using a framework synthesis method, based on self-determination theory's amotivation (e.g. disinterest or unachievable challenges), controlled (e.g. interest in rewards or pressure avoidance), and autonomous (e.g. personal importance and interest) concepts, and nested within a motivation from 'above' (i.e. interactions with stakeholders and societal expectations), 'within' (i.e. personal beliefs and personality dispositions), and 'below' (i.e. perception on learners' motivation and engagement) framework. Twenty-nine studies were included, published between 1998 and 2022, which reported on educators from diverse disciplines and settings. Educators reported autonomous over controlled motivation to teach, favouring enjoyment, connectedness, professional development, feeling valued for their teaching efforts, and altruistic reasons to teach, over being motivated by incentives and rewards. These results are presented in relation to their origin, as factors influencing motivation 'above', 'within', and 'below'. Results from this study have important implications for the development of contextual strategies to optimise learning/work environments and maximise autonomous reasons to teach, enhancing clinical educators' job satisfaction and retention.

International electives are recognized as a high-impact practice in clinical education. However, medical students’ actual learning experiences during electives have not been explored fully. Specifically, drawing on language management theory, this exploratory case study investigates students’ perceived learning outcomes and the managing processes by which they gained benefits from cross-cultural learning experiences in international electives. Written reflective reports in a series of e-portfolios were collected from 43 Japanese medical students who participated in a four-week international elective. Moreover, to further explore their emotions and the reasons behind adopting a particular adjustment behaviour, follow-up interviews with 12 students were undertaken soon after they returned home. Using reflexive thematic analysis, the qualitative data were analysed. Their perceived learning outcomes were categorized into seven themes: medical knowledge and skills, communication, career management and development, international healthcare, society and culture, medical education, and personal development. During the programme, they experienced linguistic, sociolinguistic, and sociocultural difficulties, and attempted to overcome them by employing various adjustment strategies, such as meaning-focused coping, social relationship building, management of learning opportunities, communication management, and developing approaches to learning. Managing problems in academic contact situations is not a linear process; it is iterative and cyclical. Since the combination of several strategies was needed depending on the situation, the management process is a context-dependent and complex phenomenon. The findings in this study provide new insights into student participation in short-term international elective programmes in order to develop academic and social support strategies for educators at both home and host institutions.