102 Chapter 5 Despite the reported challenges and insufficient support from faculty development, certain medical teachers have successfully implemented active learning and mastered student engagement. These ‘experts’ could possess valuable insights that could advance our understanding of student engagement. Currently, it is not known what these teachers do in their classrooms. In this study, we set out to learn how successful teachers approach their tasks. Aim and research question Our study aimed to construct a theory of student engagement in small-group active learning settings. This theory could inform faculty development initiatives so that medical teachers can be better equipped to teach in ways that engage students. Our guiding research question was: how do expert medical teachers stimulate high levels of student engagement in smallgroup active learning sessions? METHODS Research design We conducted an interview-based study to explore how expert teachers stimulate high levels of student engagement. We used a constructivist grounded theory approach, which is a qualitative research methodology that seeks to understand social processes (29). It employs an inductive approach to theory development, with data collection and analyses occurring simultaneously in an iterative fashion, making use of constant comparison methods (30,31). We aimed to include participants who could contribute to the richness of the collected data (31). To enhance transferability, we carefully described the study context (32, 33). Consistent with constructivist epistemology and the methodology, we viewed student engagement as a social construct shaped by experiences and contextual factors. This stance acknowledged our preconceptions and preexisting beliefs, while the constructivist grounded theory approach guarded against being solely determined by them. We adhered to the GUREGT (Guideline for Reporting and Evaluating Grounded Theory Research Studies) to ensure the quality and rigor of our study and accurately report its process and findings (34). Study population and setting We defined expert teachers as individuals: 1) having obtained, or nearing completion of, a formal teaching qualification (nationally recognized, incorporating training in active learning and student engagement); and 2) attainment of a score of at least 4.0 (on a 1–5 scale) from minimum two study groups on student evaluations concerning student engagement. In constructivist grounded theory, initial and theoretical sampling procedures are used to collect data (29). The participants, selected through purposive sampling, were eleven
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