128 Chapter 6 approach. Although this study provides a solid claim for this statement, additional research would be needed to further justify it. Another contribution to the FDI literature is that the combination of SDL, off-the-job, and on-the-job learning can alleviate some of the criticism of these concepts in isolation. SDL requires that learners be responsible for their own development, which can lead learners (and teachers) to think that they need to do it alone (21,37). In situations without proper guidance, SDL can be perceived by learners as a synonym for lack of support (38). On-the-job learning can provide peer and supervisor support through sharing on-the-job experiences, feedback, and coaching. However, on-the-job learning has been criticized for placing a high cognitive load on learners, especially on novices, resulting in less optimal learning (39). In situations with high cognitive load, the focus that SDL can bring might enhance learning by reducing the experienced load. Off-the-job learning takes place away from the workplace, in a focused, structured, and facilitated setting, thereby again reducing load. However, since off-the-job learning has been shown to create a gap between learning and application settings (17,18), it can benefit from the real-world experiences that on-thejob learning can deliver. Thus, the combination of the three concepts can stimulate transfer by providing a supportive, focused, and authentic learning experience. Limitations and strengths Like most DBR studies, the present study was not a (quasi) experiment. We therefore could not test hypotheses, compare groups, or quantitatively measure the effect of the FDI. Furthermore, we relied heavily on self-reported data and we had a relatively low number of participants. However, the use of DBR allowed us to study the impact of the FDI in a natural setting, with a diverse team, guided by theory, and using an iterative and mixed-methods approach. We conclude that the design was feasible, effective, and responsive to the needs of the participants, so that participants felt supported, prepared, and guided in their new tasks as facilitators of students’ active learning process. Future research Our results provide a foundation for future research on teaching medical teachers to implement active learning. Two main recommendations are: 1) Explore student feedback as an FDI component besides peer and supervisory support, as participants acquired valuable insights from students about their newly adopted strategies; 2) Explore just-in-time learning strategies for FDI design, as participants noted that lessons could not always be applied immediately, reducing their ability to transfer. CONCLUSION The integration of Self-Directed Learning with on-the-job and off-the-job learning can stimulate the transfer from FDI to educational practice. This strategy may be particularly
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