Introduction: Placements are considered vital in promoting theory-to-practice learning. With role-emerging placements increasingly being offered, the learning processes experienced by students warrants further investigation. This research explored the learning experiences of students, from both supervisor and student perspectives, over the duration of a role-emerging placement in schools, to contribute to our understanding of this important student learning process. Method: Action research was used across four cycles with 14 students and 11 supervisors. Data were collected through reflective field notes, placement documentation and semi-structured interviews. Findings were analysed using template analysis. Findings: Limited established occupational therapy procedures and role models meant that the students created and used knowledge differently from role-established placements. The procedural knowledge upon which students most heavily relied in previous placements was largely inaccessible to students. Students relied on occupational therapy conceptual and dispositional knowledge, with the support of their peer and supervisor to guide practice. Tensions were seen between providing a service for the school and taking the necessary time to understand and implement the occupational therapy process systematically. Conclusion: Role-emerging placements are valuable for transformational student learning. These placements do, however, present challenges that require careful negotiation and structured guidance.