What Aspects of Supervised Patient Encounters Affect Students' Perception of Having an Excellent Learning Outcome? A Survey Among European Medical Students.

Background: To investigate whether supervisor behavior, students' participation and approach, and psychological safety were associated with self-reported excellent learning outcome from supervised encounters with patients among European medical students. Methods: A cross-sectional, online survey among European medical students asking about their latest clinical supervision experience. Associations were examined with logistic regression. Results: Students (N=908) from >25 countries reported on experiences from supervised patient encounters in most types of hospital departments and general practice. One out of six (17%) students perceived the learning outcome as excellent. In the multivariable logistic regression, this was independently associated with supervisor role modelling (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.5-3.0) and addressing learning goals (OR 1.4, 95% CI 1.1-1.7), students' approach to learning (OR 1.7, 95% CI 1.0-3.0) and psychological safety (OR 1.5, 95% CI 1.1-2.0). Supervisors being present during the patient encounter, coaching students or asking questions to have students express their thinking, and student participation in examination and/or history taking was not associated with perceived excellent learning outcome. Conclusion: We encourage supervisors to recognize that students are beginners in most supervised clinical settings and often appreciate having learning goals addressed, behavior and thinking role modelled, and psychological safety established before they participate more fully.