Strategies for adapting to clinical learning: the voice of students

Estrategias de adaptación para el aprendizaje de la clínica: la voz de los estudiantes

Maribel Calderón Sotoa, Denisse Zuñiga Paradab, Isabel Leiva Rodríguezc, Oslando Padilla Pérezd y Marcela Bitran Carreñob*

aEscuela de Psicología, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
bCentro de Educación Médica, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
cDepartamento de Enfermedades Respiratorias, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
dDepartamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile. Recibido: 15-febrero-2017. Aceptado: 20-julio-2017.

*Autor de correspondencia: Marcela Bitran Carreño. Avda. Diagonal Paraguay 362, Santiago, Chile. Tel.: 562 2354 3811 Correo electrónico:

Recibido: el 15 de febrero de 2017; Aceptado el 20 de julio de 2017.

Palabras Clave

Estudiantes de medicina, estrategias de adaptación, aprendizaje de la clínica, teoría fundamentada.


Medical students, adaptation strategies, clinic learning, grounded theory.


Introduction: Medical training gradually incorporates the participation of students in health centers, transforming the traditional teaching-learning space. In this transition to clinical learning, students experience increased stress levels and greater academic difficulties. However, little is known about what do students do to adapt to this new scenario.

Goals: Describe the strategies of adaptation that students declare to use for learning the clinic in new teaching environments.

Method: Descriptive study with a qualitative approach. There were 8 group interviews with students from third to sixth year of training (n = 54). Before starting the meeting, participants signed an informed consent document validated by the institution’s ethics committee. Data were analyzed through the generation of categories, with an open coding technique and axial analysis based on the Grounded Theory.

Results: The strategies reported were contextualized and cover the academic and personal realms. These revealed different attitudes: some with a more active orientation and others more reactive. In the academic context the strategies referred to the management of time, activities and relationships with others. In the personal realm to the control of basic needs and recreation. An interpretive model is proposed to explain the phenomenon of adaptation to the clinic and its implications in training. These adaptation strategies revolve around five areas of action: academic engagement, development of clinical skills, autonomy and responsibility, handling of error and relationships with others.

Conclusions: Students implement different strategies to address the challenges of this new learning scenario. It is considered that not all of them seem to go in a direction of vital self-care. It is suggested that the use of one or other strategies could influence the students’ preparation for and achievement in the next training cycle.