148 Chapter 7 that consistently engage their students. Additionally, by adhering to the theory, faculty development initiatives can appreciate the complex and contextual nature of student engagement and create opportunities for teachers to develop their personal educational approach. Focus on transfer Faculty development initiatives are frequently limited in time and scope (44–47). Sometimes they are as short as one hour and focus on one active learning strategy. Although they can be effective in developing the knowledge and skills of participants, such approaches may not be sufficient to change the behavior of teachers and influence student engagement (36). Student engagement, as investigated in this thesis, seems to be an interactive, dynamic, and contextually dependent process. Therefore, teachers must translate the general workings of an active learning strategy into their context (36). From the expert teachers in this thesis, we learned that once they acquired a skill or strategy, they personalized it for use in their teaching practice. After each use, they reflected on their experiences and perhaps modified some aspects to better fit their needs and those of their students (29). As confirmed in the Design-Based Research study we conducted in this thesis, faculty development initiatives can support this transfer of knowledge and skills, and along with it, increase their impact (36,48,49). Based on our research, we have two suggestions to stimulate transfer. First, our suggestion is to design initiatives in such a way that participants can learn a strategy or skill, prepare to use it in their context, apply it, gain experience, and offer opportunities to discuss and reflect on their findings with peers and trainers. Second, the combination of Self-Directed Learning, off-the-job learning, and on-the-job learning can stimulate transfer by strengthening teachers’ autonomy and flexibility to pursue personally relevant goals, and creating structured learning environments that use authentic experiences as a foundation (36,49–51). Both these suggestions imply ongoing support and coaching, which we acknowledge might be difficult to implement (45,46). For students Finally, the students. We are hesitant to propose a recommendation for medical students. First, because students are not a target audience for this thesis. This thesis might therefore not be the right place to suggest a course of action for them. However, we have gained valuable insights from speaking with and about students. We have heard how medical students care about their education and foresee futures in which teaching is a part of their career. This thesis might then be a valuable resource for them. Second, although progress has been made, the perception of students as consumers or clients is pervasive (52,53). This viewpoint suggests that faculty has to do the work and perhaps even do their best to please students, and that it is not appropriate for students to be responsible for their learning. This notion fits a traditional, teacher-centered approach to education: teachers teach, and students receive that teaching (53,54). However, as was the foundation of this thesis, for active learning to be effective, students need to be involved in the learning process. This requires a student-centered approach in which students share in the responsibility
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