First-year medical students' expectations and early experiences of learning critical thinking: a qualitative study

Developing critical thinking (CT) is important in medical education because it supports clinical reasoning and decision-making. However, students may struggle to engage with these skills when students' learning expectations are unclear or inconsistent with their educational experiences. Understanding how students' expectations shape their early learning encounters is important for supporting successful transition into medical education. This study explored first-year medical students' expectations of learning critical thinking and how those expectations were reflected in their subsequent experiences in a science course.

A qualitative descriptive design, situated within an interpretivist epistemology, was employed. Seven first-year undergraduate medical students at a medical school were recruited through purposive sampling and interviewed individually. Data were analysed using reflexive thematic analysis.

Four themes were identified: (1) expectations before entering the course, (2) early encounters with course reality, (3) alignment and misalignment between expectations and experience, and (4) shifting interpretation of critical thinking over time. Students expected critical thinking to involve analytical reasoning and problem-solving. Early course experiences either confirmed or challenged these expectations. When expectations and experiences diverged, students reported uncertainty about course aims. Over time, students actively reinterpreted what critical thinking meant in their specific course context.

The findings suggest that expectations appeared to operate as interpretive filters, shaping how students engaged with early learning activities, and that clarity about learning aims reduces uncertainty during early course engagement.