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In vocational education, workplace simulations (WPS) have been implemented to ensure a better connection between the educational setting and the labour market. Moreover, WPS are supposed to motivate students and promote self-directed learning. So far, however, not much is known about the way students experience these WPS. The aim of the present exploratory case study was to investigate students' perceptions and preparedness for WPS and explore what factors they perceive to be relevant for their learning in these simulations. Forty students from three different pre-vocational secondary schools participated. Semi-structured group interviews were conducted and thematic analysis was used to examine the qualitative data. The results revealed that authentic WPS can increase student motivation and engagement. Learner characteristics regarded as relevant in WPS were motivation, responsibility, independence and discipline. For students, the presence and guidance of the teacher played an essential role in their working and learning effectively. They felt limited in making choices to direct their own learning. Assessment criteria were not transparent enough for students. Concluding, we found that students perceived factors closely related to self-regulated and self-directed learning to be relevant for their learning; however, these learning activities and processes have not yet been sufficiently promoted and supported in the investigated vocational schools. The study highlights design dilemmas for vocational practice and offers indications in how to match both learning environmental characteristics and teacher support tailored to learners' needs.

Background: Family physicians perceive that gut feelings, i.e. a 'sense of reassurance' or a 'sense of alarm', play a substantial role in diagnostic reasoning. A measuring instrument is desirable for further research. Our objective is to validate a questionnaire measuring the presence of gut feelings in diagnostic reasoning. Methods: We constructed 16 case vignettes from real practice situations and used the accompanying 'sense of reassurance' or the 'sense of alarm' as reference labels. Based on the results of an initial study (26 family physicians), we divided the case vignettes into a group involving a clear role for the sense of reassurance or the sense of alarm and a group involving an ambiguous role. 49 experienced family physicians evaluated each 10 vignettes using the questionnaire. Construct validity was assessed by testing hypotheses and an internal consistency procedure was performed. Results: As hypothesized we found that the correlations between the reference labels and corresponding items were high for the clear-case vignettes (0.59 - 0.72) and low for the ambiguous-case vignettes (0.08 - 0.23). The agreement between the classification in clear sense of reassurance, clear sense of alarm and ambiguous case vignettes as derived from the initial study and the study population's judgments was substantial (Kappa = 0.62). Factor analysis showed one factor with opposites for sense of reassurance and sense of alarm items. The questionnaire's internal consistency was high (0.91). We provided a linguistic validated English-language text of the questionnaire. Conclusions: The questionnaire appears to be valid. It enables quantitative research into the role of gut feelings and their diagnostic value in family physicians' diagnostic reasoning. [ABSTRACT FROM AUTHOR]