Introduction International placements challenge students to find the right level of participation, as local practices, language and time pressure may affect their engagement in patient-related tasks or team activities. This study sought to unpack the initiation process during international clinical placements with the ultimate aim to achieve active student participation. Methods Following a constructivist grounded theory approach, we conducted two individual interviews with 15 undergraduate healthcare students (before departure and whilst on placement). To identify emerging themes, we applied an iterative process of data collection and constant comparative analysis. Several team discussions informed further analysis, allowing us to reach a more conceptual level of theory. Results From our findings we constructed a fourphase model of healthcare students' initiation of international clinical placements, which brings into focus how the phases of 'orientation', 'adjustment' and 'contribution to patient care' build up towards Note: For purposes of enhanced coherence and legibility, quotes have been subject to light editing before journal submission. The authors, however, based their analysis on the original, raw transcripts. Original transcripts are available upon request from the first author. The authors alone are responsible for the content and writing of this article.
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