Perspective: successfully negotiating the clerkship years of medical school: a guide for medical students, implications for residents and faculty.

Medical students face significant learning and cultural challenges during the transition from the classroom to the clinical setting. The authors recommend that students be proactive in preparing themselves for this difficult journey by understanding and applying principles of adult learning. To guide students in this preparation, the authors propose a model that incorporates adult learning principles into a cycle emphasizing reflective practice. This model, based on the Kolb learning cycle, consists of five sequential steps: (1) preparing for the clinical setting, (2) experiencing the clinical setting, (3) reflecting on experience, (4) conceptualizing new approaches, and (5) testing new approaches on return to the clinical setting. This fifth stage in the cycle completes the first iteration. The cycle never ends, however; experimentation leads to new reflection, which in turn leads to new approaches and new experience.