Between Autonomy and Structure: The Influence of Clerkship Format on Undergraduate Training in Radiology

For many medical students, radiology clerkships represent their first intensive exposure to the clinical workflow of diagnostic imaging. However, the organizational design of such clerkships varies considerably, ranging from structured rotation-based concepts to largely self-directed training formats. This study aimed to compare the impact of these two educational approaches on medical students' clerkship experiences.

This single-center prospective cohort study included medical students who completed a radiology clerkship during a two-year study period at a university radiology department. In the first study year, students participated in a self-directed clerkship format, whereas in the second study year, a structured clerkship concept was implemented under otherwise comparable conditions. Evaluation was performed using an anonymous questionnaire. Group differences were analyzed using the Mann-Whitney U-test.

A total of 92 questionnaires were included in the analysis, with 46 from the self-directed and 46 from the structured clerkship. Students in the structured clerkship reported greater exposure to imaging modalities than those in the self-directed clerkship (4.85 ± 0.42 vs. 4.33 ± 1.06; p = 0.002) and lower perceived monotony (1.70 ± 0.84 vs. 3.61 ± 1.33; p < 0.001). By contrast, students in the self-directed clerkship rated the opportunity to pursue personal interests higher (4.78 ± 0.42 vs. 3.48 ± 0.98; p < 0.001) and reported greater interest in pursuing radiology as a future specialty (4.04 ± 0.99 vs. 3.46 ± 1.07; p = 0.008).

Both clerkship formats demonstrated distinct educational strengths. While structured clerkships appear to facilitate orientation and reduce stress, self-directed formats seem to foster autonomy and motivation. Hybrid educational concepts may offer a promising approach to combining the benefits of both formats.

· Structured clerkships improve the overview of imaging modalities.. · Structured formats reduce perceived monotony and stress.. · Self-directed clerkships promote autonomy and individual focus setting.. · Self-directed formats increase interest in pursuing radiology.. · Hybrid models may combine the strengths of both formats..

· Horr A, Sarikaya MM, Öing H et al. Between Autonomy and Structure: The Influence of Clerkship Format on Undergraduate Training in Radiology. Rofo 2026; DOI 10.1055/a-2901-0798.