title: Medical students' experiences of their own professional development during three clinical terms: a prospective follow-up study.
abstract: BACKGROUND
  A modern competency-based medical education is well implemented globally, but less is known about how the included learning activities contribute to medical students' professional development. The aim of this study was to explore Swedish medical students' perceptions of the offered learning activities and their experiences of how these activities were connected to their professional development as defined by the CanMEDS framework.
  
  
  METHODS
  A prospective mixed method questionnaire study during three terms (internal medicine, scientific project, and surgery) in which data were collected by using contextual activity sampling system, i.e., the students were sent a questionnaire via their mobile phones every third week. All 136 medical students in the 6th of 11 terms in the autumn of 2012 were invited to participate. Seventy-four students (54%) filled in all of the required questionnaires (4 per term) for inclusion, the total number of questionnaires being 1335. The questionnaires focused on the students' experiences of learning activities, especially in relation to the CanMEDS Roles, collaboration with others and emotions (positive, negative, optimal experiences, i.e., "flow") related to the studies. The quantitative data was analysed statistically and, for the open-ended questions, manifest inductive content analysis was used.
  
  
  RESULTS
  Three of the CanMEDs Roles, Medical Expert, Scholar, and Communicator, were most frequently reported while the four others, e.g., the role Health Advocate, were less common. Collaboration with students from other professions was most usual during the 8th term. Positive emotions and experience of "flow" were most often reported during clinical learning activities while the scientific project term was connected with more negative emotions.
  
  
  CONCLUSIONS
  Our results showed that it is possible, even during clinical courses, to visualise the different areas of professional competence defined in the curriculum and connect these competences to the actual learning activities. Students halfway through their medical education considered the most important learning activities for their professional development to be connected with the Roles of Medical Expert, Scholar, and Communicator. Given that each of the CanMEDS Roles is at least moderately important during undergraduate medical education, the entire spectrum of the Roles should be emphasised and developed during the clinical years.
authors.affiliation: Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. susanne.kalen@ki.se.
authors.forename: Susanne
authors.identifier: http://orcid.org/0000-0001-7177-4722
authors.initials: S
authors.lastname: Kalén
authors.affiliation: Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.|Sophiahemmet University, Stockholm, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Lachmann
authors.affiliation: Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Varttinen
authors.affiliation: Dept of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Riitta
authors.initials: R
authors.lastname: Möller
authors.affiliation: Dept of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Tomas S
authors.initials: TS
authors.lastname: Bexelius
authors.affiliation: Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sari
authors.initials: S
authors.lastname: Ponzer
mesh_terms: D003162:Competency-Based Education / Q000458:organization & administration / Q000592:standards; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000458:organization & administration / Q000592:standards; D005500:Follow-Up Studies; D006801:Humans; D011361:Professional Competence; D011446:Prospective Studies; D036301:Qualitative Research; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Academic emotions; CanMEDS; Contextual activity sampling; Medical students; Professional development