Letter to the Editor Regarding the Article “What Aspects of Supervised Patient Encounters Affect Students’ Perception of Having an Excellent Learning Outcome? A Survey Among European Medical Students” [Response to Letter]

Dear editor

Thank you, Wasti, Vafapour and Irfan, for your input on our article “What Aspects of Supervised Patient Encounters Affect Students’ Perception of Having an Excellent Learning Outcome? A Survey Among European Medical Students”. You raise several relevant questions. We would like to comment on a few of them. You correctly point out that students’ perception of learning is not the same as what students have learned. Our argument for focusing on students’ perception of learning, is that how something is perceived is important. Perception of having learned is another way of describing perception of having acquired competence, a known necessary ingredient for motivation as described in Self-determination theory.¹ Also, knowing what students perceive positively or negatively affects their learning makes it possible for educators to address these perceptions.

It is furthermore pointed out that

…there is a risk of infantilising medical students and underestimating their prior capacities.

We believe this comment relates to our suggestion that supervised patient encounters are often novel to students because of the constellations of people, symptoms, and treatments in complex clinical environment. Interpreting such situation as novel is not the same as infantilising medical students. From our experience, novelty is common in medical practice, also for seasoned practitioners. We therefore see this as an important message to supervisors. For students to learn, they require adequate support.^2,3 Supervisors should therefore recognise what new challenges a situation poses for students and provide them with the required support (eg role modelling) for those challenges, while allowing them to do everything they are capable of for those aspects of the situation that are not new.