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EDs and AMUs are potentially a rich source of learning for medical students. Spending time in emergency departments has been shown to be a great motivator for student learning, however these areas can be difficult environments for students to learn. Students are regularly asked to provide feedback on teaching. Little is known, however, about the factors students find important in providing high quality teaching. We aimed to complete a pilot study to ascertain which factors students consider to be important in delivering high and low quality teaching in busy clinical environments.We decided on a sample size of 70, as it was felt this would represent a reasonable cross section of opinion.This is a 2 centre, multi department study of final year medical students in Warwickshire.A voluntary, anonymous questionnaire was given to each of the students undertaking the block.Demographics and free text responses around both the positive and negative experiences of the students were collected.Three clinical teaching fellows conducted a qualitative thematic analysis of the responses. Comments were coded through iterative discussion and consensus among the panel.The ED was cited most frequently as the most valuable learning experience (84%) with majors the most popular area (38%).Being involved in patient care and friendly enthusiastic staff were most commonly cited as reasons for these being good learning experiences.Reasons for poor clinical experiences included a perceived lack of learning opportunities, being too busy and not feeling involved.Positive experiences included history taking, patient assessment and management/knowledge of specific conditions.Where students had a negative learning experience 13% stated that they did not learn anything, although others noted they learned of the life of a junior Dr.Through this pilot study a number of themes have emerged. Students wish to feel involved in patient care and friendly, enthusiastic staff have been identified as facilitators to student learning. The most frequently cited barrier to learning appears to be staff not helping identify the opportunities. This could be overcome by encouraging a culture where staff actively identify opportunities for the medical students, promoting interactive, inductive training in the acute setting.