Protection, preparation or processing support for medical students’ emotional challenges in work-based learning—a grounded theory

Research shows that students experience emotional challenges during work-based learning that may affect their professional becoming and well-being, but they seldom feel supported by clinical supervisors in coping with or learning from these situations. The aim of this study was to explore clinical supervisors' role in supporting medical students' experiences of emotional challenges in work-based learning. We conducted a constructivist grounded theory analysis based on interviews with 20 physicians from different medical specialties, including residents working in Swedish healthcare who had experiences of supervising medical students. The findings illuminate how supervisors use different strategies in regard to students' experiences of emotional challenges. As constraints in healthcare make it difficult to find room for reflective conversations, support is often provided on an ad hoc basis. Not all supervisors considered themselves to be responsible for providing students with emotional support, believing instead that such activities should be scheduled into the curriculum offered by universities. Our findings suggest that, despite evidence that medical students hide emotional affect, a major part of the responsibility to signal need and be open for emotional support still rests on students. Clinical supervisors can contribute to a permissive climate, allowing for emotional reflections; and supervisor training can foster discussions on the types of situations medical students may experience as emotionally challenging.