1) Informal learning through simulation-based self-directed learning (SBSL) was introduced for Japanese medical students prior to their clinical clerkships to supplement deficiencies in their formal education.
2) Students engaged in various informal learning activities using simulators such as spontaneous skills training and study groups across departments.
3) Interviews found that SBSL improved students' motivation, understanding of basic science, and prepared them for clinical skills and bedside learning. However, students wanted guidance on teaching methods to make sessions more effective.