137 General discussion Table 7.1. Overview of the main findings of each study (continued) Chapter Research Question Results 3 How and why does student appreciation of smallgroup active learning change during the Bachelor program? • Two new student profiles were identified: 1) Success-oriented and 2) Development-oriented, describing how student appreciation of smallgroup active learning changes. • Students reported that changes in their viewpoint could be attributed to personal growth, realization of the importance of interpersonal aspects of learning, experiences with different teachers, and curricular factors. Jointly, these factors translated into different expectations from the learning process. 4 1) How do the three dimensions of student engagement interrelate in a classroom setting? 2) How do antecedents of student engagement influence student engagement in class? 3) How can the multidimensional view of student engagement help us to understand why it can be difficult for teachers to engage their students? • In-class student engagement followed a spiral-like pattern. Once students engaged or disengaged on one dimension, other dimensions were likely to follow suit. • Students decided on their willingness to engage in class before the start of class, depending on their perception of several personal, social, and educational antecedents of engagement. • Distinguishing engagement from disengagement appeared to be difficult for teachers, because the intention behind student behavior was not always identifiable. 5 How do expert medical teachers stimulate high levels of student engagement in small-group active learning sessions? • A grounded theory of expert teaching practice was constructed, describing student engagement as an integrated process consisting of three components: 1) Aiming for a supportive learning environment; 2) Employing a personal educational approach; and 3) Facilitating the active learning process. 6 How can a Faculty Development Initiative, aimed at enhancing medical teachers’ competencies in facilitating smallgroup active learning, be designed so that transfer is stimulated? • Teachers were trained in facilitating small-group active learning. • Autonomy in creating personal learning objectives and learning processes increased teachers’ motivation to transfer. • Peer, supervisor, and student support encouraged teachers to adopt new teaching strategies. • Integrating on-the-job experiences and off-the-job meetings promoted a continuous learning cycle of experiencing, reflecting, understanding, and applying for teachers. 7
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