1. Confusion: You don't know when to be where. You don't know what you're supposed to do, what you're allowed to do, and what you can't touch. You don't know the right terms for anything. You don't know who to talk to. You don't know where the patients are. You don't know when to leave.
2. Productivity: You got the logistics down. You've gotten to know how the system works. You're actually being useful to the team. You're actually learning from your patients. You know when to go home without asking.
3. Burn out: You're getting tired of the routine. You're getting tired of the busy work. You're less excited about the day. There are less learning opportunities during the day. You look forward to going home.
4. Numbness: Your mind is elsewhere and your goal is to just get through the day. Unless something really exciting happens, you're not gaining much from the rotation. You find ways to get out early.
This is kind of a tongue-in-cheek thing, but for some rotations it's definitely true.