'Today's shook me up a lot inside…it's definitely changed me': emotional responses and transformative learning...

While undergraduate curricula should reflect populations' priority health needs and promote social accountability, evidence about the impact of such interventions is limited.

To gain insights into students' lived experiences of social engagement pathways and associated learning.

Medical and dental students spent four days with local organisations working with disadvantaged groups, recording audio-dairies after each session. These were transcribed, coded and analysed thematically.

Fourteen students produced 50 audio-reflections. Key themes included emotions, learning and critical reflection. Students reported improved communication skills, better appreciation of others' lives and having their assumptions challenged. They questioned issues underpinning inequalities. Analysis revealed a three-act pathway structure, with students' emotional responses changing as projects progressed.

Immersion in new contexts; connecting with others; having their views challenged and plans going wrong appeared to facilitate shifts in thinking, as did experiencing negative emotions. Feedback and support from organisations, facilitators and service users helped students overcome challenges, which was associated with positive emotion.

Educators often work hard to make learning 'easier' for students. This study suggests that when exploring the social determinants of health within community settings, supporting students to experience such unsettling contexts and negative emotions may facilitate transformative learning.