Table 3.

Summary of qualitative findings.

Categories and themes		Illustrative quotations
Reasons for limited or no use during consultations
	Low confidence or resistance to accessing (medical evidence through) the EHR (electronic health record) during consultations	“During the history taking, I definitely didn’t go through all alarm signals...because you sometimes have the feeling that you spent too much time on your computer, reading rather than talking to the patient.” (student 3)
	Supervisor’s influence: time pressure, performing part of consultation, asking clinical questions, mimicking habits	“I never decided on the duration of incapacity to work...because often the supervisor decided that.” (student 3)
	Patient’s influence: patient knows back pain, resistance to EHR, patient’s individual situation	“Often it was the patients who were known to have back pain...and knew themselves what was going on...You cannot tell each time the same thing to that patient.” (student 1)
	Practical limitations	“I didn’t use it [aids] much...because I often couldn’t access it due to problems logging into the EHR.” (student 12)
Reasons for limited or no use in general
	Limited consultations; content was known	“I think that if I had more patients with lower back pain, I would have had more opportunities to use it [the aids].” (student 5)
Reasons for use of learning aids (before, during, and/or after consultations)
	To refresh acquired competences	“You can definitely not miss the alarm signals...and then you check that [the aid about alarm signals] an extra time.” (student 13)
	To check	“For me, it also serves as reassurance...because I’ve got a bit of stress about how you need to handle it...just because it is visible on my computer...it gives you something to hold on to...just to have some security...I find it really gives me peace of mind.” (student 3)
	Interested: curiosity, participation in study	“I was unsure of the management plan I proposed there [pretest] but if you check the aids, then you remember again how you should do it. That helped me.” (student 6)
Characteristics of learning aids that stimulate transfer
	Content reflected what was learned before; practice-based information; user-friendly; easily accessible format; just-in-time information	“That you don’t need to look at it for a long time...that you don’t need to fully concentrate...I mean, you just read it and it comes back to you.” (student 4)
Learned from the whole study design
	More independence; Pretest as extra practice moment; feedback sheet stimulated supervisors to give more feedback	“That we had to do that test [pretest], then you have repeated it [learning content] very well for yourself and then you spent much time on it...the fact that it is a test and it will be video recorded and it is with a simulation patient, you really would like to perform well.” (student 7)