Table 3

Summary of facilitators and barriers

FactorsFacilitatorsBarriers
Time and quality improvement processFour-week timescale encourages students to remain focused.
Completing online courses on models for improvement provides a structured framework and helps students to engage in the process more quickly.
Setting clear expectations with students from the outset helps to make projects achievable and realistic within the timeframe.
Multidisciplinary clinical team engagement while developing projects.
Competing priorities for students: their top priority is passing core modules for ‘getting into next year’, which can limit their enthusiasm for elective modules.
Students lack confidence in unfamiliar clinical environment, particularly in second and third year.
Students are not always sufficiently aware of the complexity of the clinical environment or the competing priorities for clinical staff.
Students as change agentsStudents are valued within the clinical team as bringing fresh eyes and new ideas.
Staff respond well to students who are self-motivated and enthusiastic.
Students lack experience and credibility to challenge and influence decisions. They perceive themselves to be ‘only medical students’.
Impact: now and in the futureFor both student and mentors, even small changes make a difference.
Sharing shared goals between the academic and clinical supervisors supports students and enables a balanced assessment of impact.
Empowering students to think about becoming effective change agents in their future careers.
Efforts to communicate or disseminate project impact are limited.