From observation to ownership: a qualitative study of medical students’ learning under distant clinical supervision

Abstract

Objectives This qualitative study explores the experiences of medical students involved in clinical work and learning under distant supervision, aiming to understand their adaptation, challenges and learning processes in the context of clinical uncertainty and reduced oversight. Design This study employed a constructivist grounded theory (CGT). CGT was chosen for its strength in examining complex social interactions and uncovering emergent themes that are not fully explained by existing theoretical frameworks. Data were collected through 13 semi-structured, in-depth interviews with medical students who actively participated in clinical care under conditions of limited supervision and high responsibility. Setting Faculty of Medicine, Switzerland. Participants We conducted interviews with 13 medical students who worked in Mobile SWAB Teams during the COVID-19 pandemic. Results Students described a shift from observation to actively taking on a professional role. This experience provided a unique opportunity for medical students to apply their knowledge and skills in real-world settings, develop a sense of autonomy and foster personal growth. Acknowledging the importance of effective communication, teamwork and decision-making in providing patient care, they embraced the concept of self-regulated learning (SRL). Conclusions Creating a supportive learning environment that promotes SRL encourages collaboration and enables medical students to take on clinical tasks with increasing autonomy. In our study, working under distant supervision promoted reflection, strengthened communication and supported both clinical development and identity formation. This approach highlights the value of integrating supported responsibility and guided reflection into future models of clinical education.