110 Chapter 5 Figure 5.1. Grounded theory of how expert teachers stimulate high levels of student engagement The blue arrow illustrates how expert teachers cultivate an increasingly supportive learning environment through their personal educational approach. As this process unfolds, they observe their students, analyze cues related to their aims and approach, and decide on a course of action. Limitations and strengths Although this study provides useful insights for faculty development, there are several issues to consider when interpreting the results. The selected expert teachers were medical teachers from one Dutch university in a course employing a case-based (years 1 and 2) and team-based (year 3) learning approach. Thus, the sample selection, geographic context, and teaching method may have influenced our findings. Additionally, the teachers’ educational values in this study aligned well with active learning. Future research could explore whether such an alignment is a key factor for successful active learning implementation. Lastly, we based our grounded theory on teacher interviews and used a limited ‘theoretical sampling’ procedure. An extended theoretical sampling procedure in which other methods (like classroom observations or student interviews) are integrated could further advance our understanding. A main strength of this study lies in the application of appreciative inquiry. This method has been identified as an ‘exciting potential’ for medical education research due to its focus on ‘what is going well’ and its generative process (36). We experienced the interviews to be characterized by high positive energy and rich information. Participants spoke openly
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