Abstract:

Introduction:
The Clinical Internship Program (PAI) at Universidad Francisco de Vitoria, in contrast to the lecture centered model common in Spanish medical schools, is grounded in the integration of extended clinical rotations, structured tutorials, and a strong component of self-directed learning. For independent study to be effective in a clinical environment, it is essential to bridge the gap between theoretical instruction and practical experience. During the 2022–2023 academic year, an enhanced study-support system was implemented to optimize this transition.

Objective:
To describe and evaluate a structured self-directed learning model designed to coordinate student study with clinical rotations and tutorial sessions, thereby facilitating theoretical preparation aligned with the students’ daily clinical experience within the PAI framework.

Materials and Methods:
A cohort comparison study was conducted to assess the new structured self-directed learning model implemented during clinical rotations. The intervention cohort consisted of 23 fifth- and sixth year medical students enrolled in the 2022–2023 academic year. The control group comprised 23 academically equivalent peers, matched individually according to their academic transcript from the preceding year.
The new model included three components:
(1) curricular prioritization to distinguish between content assigned to autonomous study and material addressed in tutorials, based on clinical prevalence and conceptual difficulty;
(2) weekly instructional planning that enabled students to anticipate the content required for group sessions and independent study; and
(3) a rotation manual containing a study guide and a day by day plan of clinical activities.
At the end of the 2022–2023 academic year, final academic grades and ECOE (OSCE) competency scores were compared between the two cohorts using parametric and non parametric analyses.

Results:
Students who engaged in the structured self-directed learning model within the PAI achieved theoretical academic performance comparable to that of the conventional cohort, while demonstrating superior performance in the practical competencies assessed through the ECOE.

Conclusions:
This structured and clinically aligned self-directed learning model, when combined with supportive tutorials and extended clinical exposure, enhances medical students’ practical competence while ensuring the acquisition of essential theoretical knowledge. Integrating study materials with daily clinical activity transforms autonomous study into an efficient learning tool promoting a deeper understanding of medical practice. Moreover, this proposal differs from the traditional lecture based model predominant in Spain, offering a more clinically integrated and active learning approach.

Keywords:

Medical education, self-directed learning, autonomous learning, clinical internship, theory practice integration, educational planning.