This paper explores how first-year students experienced emergency online teaching during COVID-19 and aims at understanding individual experiences related to basic psychological need satisfaction, considering different levels of contextual facilitators for learning activities involving technology in higher education derived from the C-flat model. Employing a case study approach, interviews of 15 chemistry students were qualitatively analyzed. The results show negative effects of lacking internet connectivity and concurrence of learning and home spaces but positive effects of ceased commute between home and campus. Teachers\' implementation of digital learning opportunities was perceived as adequate but did not sufficiently address the overwhelming increase in students\' autonomy and decrease in social relatedness. Students\' self-regulation skills as well as skills to initiate and maintain social contacts for interactive learning activities and for motivational support emerged as crucial aspects. Many students were not able to cope appropriately and students\' need satisfaction during emergency online teaching appeared to be related to students\' prior need satisfaction resulting in five groups of students, with two being relatively resilient and three being vulnerable to the disruptions of regular onsite teaching. Implications for further research and practice are discussed.

Medical student distress is an increasing concern in medical education. Addressing this issue requires a comprehensive understanding of what factors influence learners\' stress in medical school. Grounded in Self-Determination Theory (SDT), this study explores the relative association between medical students\' mindfulness, resilience, basic psychological needs, and perceived stress. Materials and methods: Of all year 1-4 medical students at our institution, 197 (49%) completed an online survey, measuring satisfaction and frustration of their basic psychological needs (autonomy, competence, relatedness), mindfulness, resilience, and perceived stress. Variables were assessed in relation to perceived stress, controlling for students\' gender and year.
Higher mindfulness, resilience, and need satisfaction were associated with lower perceived stress. Conversely, need frustration was associated with higher perceived stress. When students\' need frustration was included in the model, the association between mindfulness, resilience, and perceived stress weakened. Third years reported more autonomy frustration than all other years. Compared to males, females in second and fourth year reported higher stress, lower mindfulness and resilience, and less competence fulfilment.
Findings of this study suggest that, while mindfulness and resilience are important qualities for medical student well-being, their stress-protective benefits may diminish when students\' basic psychological needs are frustrated in medical school. Addressing potentially need-thwarting aspects of the learning environment is therefore recommended, to help reduce student stress and promote their well-being. Preliminary suggestions on how this might be achieved are discussed, from an SDT perspective.

We aimed at exploring the underlying mechanisms and contextual conditions by which leadership may influence \'public service motivation\' of health providers in Moroccan hospitals.
We used the realist evaluation (RE) approach in the following steps: eliciting the initial programme theory, designing the study, carrying out the data collection, doing the data analysis and synthesis. In practice, we adopted a multiple embedded case study design.
We used purposive sampling to select hospitals representing extreme cases displaying contrasting leadership practices and organisational performance scores using data from the Ministry of Health quality assurance programmes from 2011 to 2016.
We carried out, on average, 17 individual in-depth interviews in 4 hospitals as well as 7 focus group discussions and 8 group discussions with different cadres (administrators, nurses and doctors). We collected relevant documents (eg, performance audit, human resource availability) and carried out observations.
Comparing the Intervention-Context-Actor-Mechanism-Outcome configurations across the hospitals allowed us to confirm and refine our following programme theory: \"Complex leaders, applying an appropriate mix of transactional, transformational and distributed leadership styles that fit organisational and individuals characteristics [I] can increase public service motivation, organisational commitment and extra role behaviours [O] by increasing perceived supervisor support and perceived organizational support and satisfying staff basic psychological needs [M], if the organisational culture is conducive and in the absence of perceived organisational politics [C]\".
In hospitals, the archetype of complex professional bureaucracies, leaders need to be able to balance between different leadership styles according to the staff\'s profile, the nature of tasks and the organisational culture if they want to enhance public service motivation, intrinsic motivation and organisational commitment.