Refining and Looking for Gaps: A Study of Adaptability in Preclinical Medical Students

Adaptability is an essential element of professional healthcare practice, yet little is known about how medical students understand and engage with adaptability during their preclinical training. Insight into these early experiences can help uncover the fundamentals of later adaptive expertise. This study explored how preclinical medical students perceive their own adaptability in the context of their academic work. From December 2024 to January 2025, seventeen third-year medical students from three universities in Belgium, the Netherlands, and Portugal participated in semi-structured interviews. We conducted interviews in person or online and recorded, transcribed verbatim, and analyzed them using thematic analysis. A constructivist orientation informed the approach to data collection and interpretation. Coding was iterative and supported by regular team discussions and memo writing. Students described adaptability in two distinct but related ways. The first theme, refining, occurred in situations that were different but came with clear expectations, such as examinations, course structures, or explicit or inferred teacher requirements. In these situations, students described adaptability as adjusting established study strategies and seeking guidance from peers to meet goals they could define clearly. Their actions were cautious and deliberate, influenced by a desire to avoid failure and remain within a context that felt manageable. The second theme, looking for gaps, reflected experiences in situations that were unfamiliar or ambiguous, including early clinical encounters or unexpected challenges. In these situations, students realized their usual strategies were insufficient and described adaptability as stepping back, observing before acting, and asking targeted questions to understand how to proceed. Although these situations often prompted significant learning, students also reported discomfort, uncertainty, and vulnerability, which sometimes led to hesitation or avoidance. These findings highlight the importance of educational environments that acknowledge adaptability as part of learning and provide structured support to help students navigate less predictable situations. Such environments may encourage students to move beyond optimizing familiar strategies and toward the forms of adaptability that underpin the development of adaptive expertise.