Table 1 Subthemes and representative quotes for the theme “Setting and atmosphere of ISS courses” from focus groups with students (n = 14) and lecturers (n = 13) at University Medical Center Hamburg-Eppendorf

Teaching in small groups

• Reduces inhibition

• Is learner-centered

• Enables formation of study groups

Reduces inhibition:

“There is a big advantage for weak students. They know: “In the ISS courses we are amongst each other, and now I dare to ask a seemingly stupid question”.

Learner-centered:

“It is nice that the ISS courses are not affected by the pressure of an exam. Thus, the lecturer is able to react more flexibly to the students” questions, wishes and needs than in the core curriculum”.

Enables formation of study groups:

“Learning in small groups is good for team building and for the ability to discuss with each other”.

Reduces inhibition:

“For me it’s difficult to ask questions in front of four hundred people during a lecture when I have trouble following. In contrast, in the ISS courses, I can ask more specific questions if I want to know more”.

Learner-centered:

“I liked that one could also shape the conversation and that it was not necessarily focused on the scheduled topics, but that we rather checked “Where are we now? Is there still need to repeat, or could we dig in a little deeper?”

Enables formation of study groups:

“The ISS courses often are like study groups. Explaining [things to] each other, helping each other. I’m a fan of study groups”.

“In this case, the study group is like a speaking textbook”.

Voluntary participation:

• Participation of interested students

• Encourages the students to express their demand

• Promotes personal responsibility and self-organization

• Disadvantage: Not all students of the target group participate.

Participation of interested students

“Students who attend the ISS courses are interested and dedicated. This has a positive effect on the atmosphere and on the whole [learning] progress”.

Encourages the students to express their demand:

“Students who participate in the ISS course more pronouncedly articulate their needs”.

Disadvantage: Not all students of the target group participate:

“A disadvantage is that some students who could benefit from the courses miss the chance because it’s voluntary”.

Participation of interested students

“Because the ISS courses were voluntary, only interested people attended. Those who were there were all motivated and wanted to learn something”.

Promotes personal responsibility:

“Having courses to choose from independently is an advantage because you get the feeling that you are granted individual responsibility”.

Promotes self-organization:

“In our core curriculum, we don’t have many choices, so I think it’s very important that students can decide by themselves how to organize their learning during the course of studying”.