Context Transformative learning (TL) has been described as learning that challenges established perspectives, leading to new ways of being in the world. As a learning theory it has resonated with educators globally, including those in the health professions. Described as a complex metatheory, TL has evolved over time, eliciting divergent interpretations of the construct. This scoping review provides a comprehensive synthesis of how TL is currently represented in the health professions education literature, including how it influences curricular activities, to inform its future application in the field. Methods Arksey and O'Malley's six‐step framework was adopted to review the period from 2006 to May 2018. A total of 10 bibliographic databases were searched, generating 1532 potential studies. After several rounds of review, first of abstracts and then of full texts, 99 studies were mapped by two independent reviewers onto the internally developed data extraction sheet. Descriptive information about included studies was aggregated. Discursive data were subjected to content analysis. Results A mix of conceptual and empirical research papers, which used a range of qualitative methodologies, were included. Studies from the USA, the UK and Australia were most prevalent. Insights relating to how opportunities for TL were created, how it manifests and influences behaviour, as well as how it is experienced, demonstrated much congruency. Conceptions of TL were seen to be clustered around the work of key theorists. Conclusions The training of health professionals often takes place in unfamiliar settings where students are encouraged to be active participants in providing care. This increases the opportunity for exposure to learning experiences that are potentially transformative, allowing for a pedagogy of uncertainty that acknowledges the complexity of the world we live in and questions what we believe we know about it. TL provides educators in the health professions with a theoretical lens through which they can view such student learning.

Background Central to clinical education is the teaching–learning (T-L) relationship that evolves between the clinical educator (CE) and the student. Within this T-L relationship, CEs may be expected to fulfil dual roles as mentors and assessors of students. Challenges for both parties may arise when CEs take on these different roles. Objectives The goal of this study was to ascertain how CEs perceived the influence of their dual roles as mentors and assessors on their T-L relationships with physiotherapy students. Method Individual interviews were semi-structured with nine CEs during this qualitative descriptive study at the Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University. A content analysis followed to analyse the data obtained. An iterative process, aimed to understand the phenomena under study, was conducted via an interpretive approach in context. This revealed main themes that were identified and refined. Results Clinical educators experienced challenges when their role changed from being a mentor to that of assessor. These challenges affected the learning of students, as they influenced the T-L relationship. Clinical educators experienced ambiguities regarding their dual roles and, as a result, their expectations were often not fulfilled. Conclusion Students’ learning processes were negatively affected by the changing roles of CEs, who acted as mentors and later as assessors of clinical competence during the students’ clinical rotations. The positioning theory was offered as a framework to resolve the challenges created by the dual roles and to manage expectations between CEs and students. The T-L encounters could be enhanced if students and CEs aligned themselves to a learning-centred paradigm where the focus was on learning and where the needs of the diverse students and the expectations of CEs were balanced. Further research should explore how a workshop with role play, demonstrating to CEs in practice how to reposition themselves, would impact the relationships between both parties. Clinical implications It is essential to ensure a positive T-L relationship between a CE and a student as this will improve the quality of learning in the clinical environment and, therefore, directly influence student’s patient management. Implementing faculty development programmes to address this, should be further explored. Keywords physiotherapy; clinical education; teaching–learning relationship; learning-centred; dual roles.

BackgroundClinical education is widely considered to be the cornerstone of health care professionals’ education. Clinical educators (CEs) fulfil many roles and act as both mentors and assessors in the learning process of students’ undergraduate health care professions education. However, changing from being a mentor to being an assessor may present particular challenges for both the CE and the students.ObjectiveTo explore students’ perceptions of how the dual role of a CE as mentor and assessor influenced the teaching–learning (T-L) relationship.MethodA qualitative descriptive study, involving seven individual semi-structured interviews and two focus group discussions, was conducted with students in the Division of Physiotherapy, Stellenbosch University. A contextualised interpretive content analysis was used to analyse the data. By following an iterative process, themes were identified and categories were reviewed and refined.ResultsChallenges were experienced when CEs had to act and change as both mentors and assessors to the needs of the students. This influenced the T-L relationship and consequently impacted the learning of students. The expectations of students and CEs were often not fulfilled. Contradictions were disclosed regarding the dual role of CEs.ConclusionThe findings of the study, grounded in the perceptions and experiences of students on the dual role of the CE, are highlighted. It is important to consider the challenges that the students face in order to minimise any negative effects these challenges could have on students’ learning processes.