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S6 said: "I'm a poor talker by nature, and I don't want to bother others by sharing my uncertain idea. When I was not fully confident, I tended to hesitate to make contribution to the discussions.

Practical difficulties during the research process include information searching, literature review, data collection and analysis. It was hard for them to obtain a clear image of what research is and what to do next during the course. S7 commented: This was the first time to conduct qualitative research, so we couldn't even imagine what it is, and I didn't know what to do next in the research process.

If we had to carry out research project by ourselves, I had no idea, like what I should do. S7, Group 2, Final week, The fourth factor is social relationships with tutors and peers. They sometimes felt that their participation was restricted by tutors' presence and instruction.

S11 said: "I think tutors had a strong presence. I know a tutor's opinion can be better than ours. I wasn't confident enough to express a thoughtful opinion in group discussions.

So, sometimes I waited for tutor's suggestions rather than sharing my idea. For instance, S1 who was a more experienced member struggled to find a way to effectively contribute to the group work.

S1 said: "I have to find a suitable position in the group. It was difficult to identify my own role in this group. I felt other members were getting more independent, not relying on me.

So, I need to think about how I can contribute to this group. Discussion This study has drawn on phenomenography as research methodology to explore students' experiences in undergraduate research from the lens of study participants.

Specifically, the focus of this study was on examining how research experiences informed students' perceptions of research and approaches to learning. Whilst all students were originally identified as aligning to a 'content-oriented' approach to studying, by the final week of the research project, ten out of 14 students in this study changed perceptions of research to a process-oriented view.

By tracing changes in perception over time, data analysis revealed that, through participation in research project, their approaches to learning became qualitatively deeper, -an inquiring mind, synthesis of knowledge, active participation, collaborative learning and reflective learning.

Although four students' perceptions of research remained content-oriented, their strategic approaches to learning were also qualitatively changed. Although students took different approaches to learning in the undergraduate research, this study fully described the processes of changes in their perceptions of research and approaches to learning. This study found that students' perceptions of research were re- formed through their actual research experiences, and these epistemological changes led to the adoption of deep approaches to learning in this course.

The findings concurred with the previous studies which specified the key learning outcomes related to research skills.

Our Daily Bread 2013

Students in this study could regard research as an activity with inquiring mind and mutual engagement within the context of "Research Experience" course. Thus, a given context, perception, and approaches to learning are reciprocally related. Therefore, introduction of research-based education into the early undergraduate curriculum allows medical students to cultivate both research-specific skills and transferable skills, which are basically necessary for continuing professional development.

Findings from this study also demonstrate that students' awareness of the links between research and learning is an important outcome in undergraduate research. For instance, S2 mentioned in a final reflection that "I feel research can include not only scientists' work but also our daily activity of learning".

As development of research skills is seen as an underlying principle in all education, learning through research is also pivotal to health professional development.

Research activity promotes students' active and reflective learning. In this study, some students were regularly reflecting on the progress of their research project and their own contributions to collective learning.

Branch and Paranjape stated that "reflection leads to growth of the individual-morally, personally, psychologically, and emotionally, as well as cognitively".

In particular, provision of feedback from tutors is essential for promoting students' deep approach to learning. Learners' cultural assumptions in relation to a collective activity are considered one of the elements that shape new learning process. Students addressed some difficulties in self-expression during the discussions, for instance, S6 said that "I don't want to bother others by sharing my uncertain idea".

Such a tendency came from not only their limited experience of student-initiated learning but also their values that prioritise a collective activity.

However, as they recognised the importance of active self-expression in the group, the influence of their cultural assumptions gradually diminished. Medical educators need to understand that learning is shaped through students' ongoing participation, and they can adapt to the new learning context.

Therefore, Japanese students, like other Asian students, cannot simply be categorised into a stable perception of quiet, passive and dependent learners. Exploring the process of individuals' participation allows for better understanding variation in their ways of knowing, doing and being a member in a context of student-centred classroom. An important aspect of facilitating students' active participation in research lies in keeping a balance between tutors' intervention and students' autonomy at each step of the research process.

Conclusion Medical education studies in undergraduate research to date have tended to focus on students' perceptions of research and curriculum descriptions of research-based education. This phenomenographic study revealed qualitative changes in students' perceptions of research and approaches to learning over time through observation of and reflection on their on-going participation in the research project.

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Although the sample size appeared to be relatively small, these findings could provide insights into the potential for undergraduate research in health professions education, which can further enhance students' deeper approach to learning and cultivate their basic skills necessary to continuing professional development. Furthermore, this evidence in this study can be a springboard for making more elaborative exploration of students' learning process in undergraduate research.

Acknowledgments We are grateful to the students who participated, and shared their experiences with us. Conflict of Interest The authors declare that they have no conflict of interest. References 1. Becoming a scientist: The role of undergraduate research in students' cognitive, personal, and professional development. Sci Ed. Healey M, Jenkins A. Developing undergraduate research and inquiry.

York: Higher Education Academy; Kuh GD. High-impact educational practices: What they are, who has access to them, and why they matter. Zimbardi K, Myatt P.

Embedding undergraduate research experiences within the curriculum: a cross-disciplinary study of the key characteristics guiding implementation.

Studies in Higher Education.

Our Daily Bread 2013

Willison J, O'Regan K. Commonly known, commonly not known, totally unknown: a framework for students becoming researchers. High Educ Res Dev. Brew A, Boud D.

Teaching and research: Establishing the vital link with learning. High Educ.

Brew A, Ginns P. The relationship between engagement in the scholarship of teaching and learning and students' course experiences. Assessment and Evaluation in Higher Education.

General Medical Council. Tomorrow's doctors: recommendations on undergraduate medical education. London: General Medical Council; Tomorrow's doctors: outcomes and standards for undergraduate medical education. Evidence-based medicine workbook: how to practice and teach EBM.

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Edinburgh: Livingstone; Henegham C, Glasziou P. Evidence-based medicine. In: Dent J, Harden R, editors.

A practical guide for medical teachers. London: Elsevier; Shuler CF. Comparisons in basic science learning outcomes between students in PBL and traditional dental curricula at the same dental school.

Problem-based learning in clinical education: The next generation. Dordrecht: Springer; What do medical students understand by research and research skills? Identifying research opportunities within undergraduate projects. Med Teach. Student-selected components in the undergraduate medical curriculum: a multi-institutional consensus on assessable key tasks.

Association of Japanese Medical Colleges. Japanese medical education.

Tokyo: Association of Japanese Medical Colleges; Cortazzi M, Jin, LX. Culture of learning: language classrooms in China. In: Coleman H, editor. Society and the language classroom. Cambridge: Cambridge University Press; Marton F, Booth S.

Learning and awareness. Discontinuities and continuities in the experience of learning: An interview study of high-school students in Hong Kong. Learning and Instruction. Memorising and understanding: the keys to the paradox?

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