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Over the years, many medical school curricula have started implementing diverse student-centred teaching and learning methodologies. Previous studies, however, have indicated that students prefer more traditional and directive methodologies instead, raising questions on which training approach should be advocated. This study contrasts the effects of a student-centred (i.e. facilitative) training approach on students’ clinical skills learning with students’ perceptions. More specifically, a quasi-experimental study was set up in which students experienced either a directive or facilitative training approach. Data were collected by means of an OSCE on the one hand, and a questionnaire on students’ perceptions of the training sessions, and two open-ended questions about students’ likes and dislikes on the other hand. While no general differences were found in terms of clinical knowledge and understanding, and actual clinical performance, an interaction between students’ course-specific prior knowledge and the training approach was found. Especially students with low levels of knowledge benefited more from the facilitative training approach in terms of clinical knowledge, while highly knowledgeable students experienced a negative effect of this training approach. Moreover, students’ perceptions revealed that facilitative-trained students reported more deep-level learning, while the directive training approach turned out to score higher in terms of quality and perceived effects.

The present study aimed to shed light on students' appraisal and reported learning gains in two differently-tutored learning environments (i.e. directively and facilitatively tutored). In order to investigate this, a quasi-experimental study was set up in the context of a clinical skills learning environment. Not only were participating students asked to rate their appraisal of the tutored learning environment, but they were also interviewed in-depth about their learning gains and experiences within both tutored learning environments. Results showed that directively-tutored students were more positive about the tutored learning environment. With regard to experienced learning gains, it was found that, although both groups of students experienced practical learning gains, only facilitatively-tutored students acknowledged gains in their clinical understanding. Also, in terms of deep-level learning and self-efficacy beliefs, different trends between both groups emerged. Finally, diverse approach-specific strengths and drawbacks were experienced by students. While directively-tutored students were generally more positive about their learning environment, facilitatively-tutored students were more critical about their peer tutors' approach to tutoring because this led to a lack of clarity and overview. Nevertheless, these latter students reported more deep-level learning and thinking. The current results urge educators to take into account several practical implications, both with respect to peer tutors and to students.