How first-year medical students perceive changes in their approach to learning science.

Background: Students enter medical education with established learning approaches shaped by years of prior schooling. How first-year medical students articulate perceived changes in these approaches during a course emphasizing critical thinking is not well understood. Understanding such perceptions offers insight into how students make sense of new academic demands, irrespective of whether behavioral change is measurable. Methods: This study used a qualitative descriptive design. Nine first-year medical students enrolled in a critical thinking-focused science course participated in semi-structured interviews lasting 30-50 min. Data were analyzed using reflexive thematic analysis applied at the semantic level, remaining close to participants' own language and meanings. Results: Analysis generated four themes. First, most participants described a gradual shift from surface-level memorization toward attempts at deeper under standing. Second, the majority of participants reported developing more questioning stances toward course material. Third, several participants described efforts to map conceptual connections across lectures, finding these efforts meaningful but cognitively demanding. Fourth, most participants modified study habits, including increased use of self-testing, after discovering that prior methods were insufficient. Conclusion: These findings suggest that first-year medical students can articulate nuanced awareness of how their learning approaches may be shifting, even when the extent or permanence of such shifts remains uncertain. Perceived changes appear to reflect ongoing sense-making about what effective engagement with medical education requires.