“…Students reported feeling empowered to be self-directed learners and critical thinkers 88,131,133,168,194 , increased understanding of relevance of knowledge to career 52,76,102,131,150,190 , increased confidence 70,93,107,131,138,141,161 and motivation 76 . Those studies with level 3 outcomes indicated positive changes in improved communication skills 151 , greater uptake of specialty 121 and improved performance in clinical placements 172 . Some negative perceptions and disadvantages were also reported.…”