Table 3

Themes and quotes of the stakeholders

Authentic tasks‘I recognise this(authenticity, eds.)in so far that patients tell you a lot of stories. So, in that sense, they are all very authentic stories and this is how patients present themselves to doctors’ – I10

‘If you look at the learning tasks, you do see a clear structure. From watching to an increasingly active role to eventually actually having a conversation with a patient, of course’ - I8

‘I would also pay more attention to a more diversified background,(…). The impression here is that it might be more about the classic white Dutch native than perhaps the Surinamese or Moroccan who gets into these problems and needs an essentially different approach’ – I7

‘(the clips, eds.)in the sense that the doctors who were talking, for example a [person] I have met in the clinic as well so that appeals more to the imagination. That actually makes it even more authentic’ - FG2

‘That there are not only videos but also something like a link to a wishlist, and a Volkskrant [newspaper] article so I think that’s already very authentic. You might want to make it a little more authentic by having students contribute cases they encounter’ – FG2
Reflective learning‘I believe, indeed, that in real life that might be better than on paper, especially because you sometimes have to put something on paper and then you are not really sure or you feel differently or have not enough time and if you are really working in such a group, then ideas emerge or feelings that other people then evoke in you or you hear it and you think, oh that’s right, I agree or I do not’ – FG1

‘What is also important here is that in your educational groups, or in the subgroup where you would discuss this, you have a bond of trust as well as feel safe’ - I11
IntegrationAnd what might also be good timing,(…), is the second half of the third year of medicine. Students are then very receptive to everything that is useful in their internships, so to speak, because then it is kind of a big thing that you will have to tackle soon and so you have to get started’ – FG2

‘I see no reason not to do it (integration as of year 1, eds.). And another advantage is that students will get an idea of - oh, yes, so this is part of the job as well? It soon makes it more normal, because students often enrol with a strong idea of: we are going to make everyone better… but accepting that you can't make someone better will become the reality… but it is not really part of the idea of beginning students so, in that sense, I think: maybe it’s also good to create some kind of awareness here’ -I12

‘I believe you could use that simulation interview as a go/no-go for having an interview with a patient. And, once again, they really are vulnerable patients, often in the final stage of life, who are often quite willing to contribute to the training, but who should also not be burdened disproportionately by oafs or students who are not interested or cut corners, and that such a patient is about to go home with a bad feeling after 45 minutes’ - I8
  • FG, Focus Group; I, Interview.