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ABSTRACT Introduction To address placement capacity issues in the face of rising medical student numbers, there has been a move towards simulation and technology enhanced learning. However, observing and learning from real clinical practice remains valuable to students. Can we prioritise the finite resources of the clinical environment by identifying what works best for medical students when learning on clinical placements? Methods Q methodology is a qualiquantological approach that determines the diversity of viewpoints held within a population into groups (factors). A Q concourse, a compendium of all the thoughts that the participant population might have on clinical placements, was collected from published literature, grey literature, four interviews and three focus groups with final year medical students and undergraduate educational faculty members. Forty‐six statements were constructed from the concourse to be sorted by our foundation year one participants. Results Analysis of 25 participant Q‐sorts resulted in a three‐factor solution. Factor 1 saw value in nearly all learning opportunities. Factor 2 needed support to find learning opportunities, enjoyed teacher‐led activities such as simulation and were critical of activities where they were not directly engaged. Factor 3 strongly valued real patient interaction over simulation and preferred more independence with their timetable. All factors confirmed that students need preceptors to explore the reasons behind clinical decisions with them. Conclusion The replacement of real patient experience with simulation divides opinion. When allocating resources for students on clinical placement, there is educational potential in all clinical activities, but it varies with each factor.