Thank you for these insights on the challenges of TL activities in the clinical setting. The majority of us are teachers and also clinicians and when an emergency hospital call arises, the teaching and learning are somewhat compromised. I agree with you Doc that having a substitute / alternate teacher may solve the situation but may result in chaos or confusion of knowledge. This situation happened to me already several times, and what I did was bring 2-3 students with me inside the OR / DR / ER to have an actual learning experience. But in a big group, this is not feasible.