“Clinical placement logbooks: how do they shape medical student learning behaviours?”

Abstract

Clinical placement logbooks are widely used to guide learning, document clinical exposure, and support student–tutor feedback. Despite their ubiquity, little is known about how logbooks shape medical students’ learning behaviours, particularly the tension between their reflective and administrative functions. This study explores how students and tutors experience logbooks and how these experiences influence engagement during clinical placements. A qualitative study was conducted at a single university-affiliated teaching hospital. Six third-year medical students and two clinical tutors participated in one-to-one semi-structured interviews. Convenience sampling was used for students and purposive sampling for tutors. Interviews were transcribed verbatim and analysed inductively using reflexive thematic analysis, supported by NVivo. A reflexive, interpretivist approach underpinned the analysis, with iterative development of themes informed by an audit trail and researcher positionality. Three themes were generated. Logbooks as reflective tools versus administrative tasks captured the tension between students’ desire for narrative reflection and the restrictive, checklist-driven format of logbooks. The Goldilocks balance of structure described how logbooks provided orientation early in placements yet later constrained learning by directing behaviour toward predefined tasks. Logbooks as motivators for participation illustrated how signatures and checklist completion prompted engagement, particularly among less confident students, but also fostered superficial documentation and extrinsic motivation, with meaningful feedback often limited by clinical workload. Logbooks influence learning behaviours in complex and sometimes unintended ways. While they can support orientation and prompt participation, their administrative demands may constrain autonomy, limit meaningful reflection, and contribute to task-driven engagement. Redesigning logbooks to separate administrative tracking from reflective practice, supported by deliberate, structured feedback conversations, may better align their use with the realities of clinical learning and the needs of students.