Determinants of effective clinical learning: A student and teacher perspective in Saudi Arabia

Context: Graduating clinically competent medical students is probably the principal objective of all medical curricula. Training for clinical competence is rather a complex process and to be effective requires involving all stakeholders, including students, in the processes of planning and implanting the curriculum. This study explores the perceptions of students of the College of Medicine at King Abdul-Aziz Bin Saud University for Health Sciences (KASU-HS), Riyadh, Saudi Arabia of the features of effective clinical rotations by inviting them to answer the question: "Which experiences or activities in your opinion have contributed to the development of your clinical competence?" This college was established in 2004 and adopted a problem-based learning curriculum. Methods: This question was posed to 24 medical students divided into three focus groups. A fourth focus group interview was conducted with five teachers. Transcriptions of the tape-recorded focus group interviews were qualitatively analyzed using a framework analysis approach. Findings: Students identified five main themes of factors perceived to affect their clinical learning: (1) the provision of authentic clinical learning experiences, (2) good organization of the clinical sessions, (3) issues related to clinical cases, (4) good supervision and (5) students' own learning skills. These themes were further subdivided into 18 sub-themes. Teachers identified three principal themes: (1) organizational issues, (2) appropriate supervision and (3) providing authentic experiences. Conclusion: Consideration of these themes in the process of planning and development of medical curricula could contribute to medical students' effective clinical learning and skills competency.