Autonomy as both challenge and development in clinical education

This study examines autonomy in learning, related to medical and health care students perception of learning and development in clinical education. An understanding of the ways in which students learning and professional development is facilitated by autonomy, and a qualitative different understanding of the concept is vital for future development of learning and teaching strategies in medical and health care education. Self-directed learning and management of the learning process have been, and still are, stressed within health care and medical education, thus paying less interest to internal processes of learning involving responsibility and independence. The aim of the study was to investigate the relationship between autonomy in learning and narratives of personal challenge and development in the context of student experiences in clinical education. The study was undertaken using narrative inquiry. Findings consist of four themes; Dependence of the clinical supervisor, Feelings of ambivalence, Professional becoming and Need for authenticity. Through our analysis of findings we suggest that autonomy should be regarded as something that develops in relation to others and not as a merely individual phenomenon and that an authentic clinical situation enhances students' experiences of autonomy. (C) 2014 Elsevier Ltd. All rights reserved.