Background: Clinical clerkship training does not always provide an ideal environment for self-regulated learning (SRL) among medical students, and how students manage their learning during this period remains unclear. This study aims to explore how medical students perceive their SRL during clinical clerkship training in the emergency medicine department.　Methods: Semi-structured interviews were conducted with 28 fifth-year medical students at University A. Thematic analysis was performed using the SRL cyclical model as a theoretical framework.　Results: Eight themes were identified, including the emergence of professional identity through clinical training, the flexible selection of learning goals and tools in uncertain environments, and the appropriate planning of next-day goals and learning strategies through dialogue.　Discussion: The findings suggest that dialogue with colleagues, participation in team-based care, and clerkship structures grounded in the cyclical SRL model positively influence the transformation of students' perceptions of SRL.

Clinical clerkships in medical school requires an educational approach that integrates medical students into the medical team and progressively assigns medical tasks to them based on their competencies. However, it is challenging for supervisors to delegate tasks to medical students gradually while considering medical safety. This paper outlines the design of an emergency department clinical clerkship program based on the Four Component Instructional Design (4C/ID) model. This model enables students to learn complex task performance skills in stages while developing a schema, considering the cognitive load involved in learning complex tasks. The 4C/ID model is anticipated to be an effective instructional design for constructing clinical clerkship programs.