150 Chapter 7 The methods we used were all primarily based on self-report. We asked students about active learning and their engagement in active learning methods. We asked expert teachers how they taught in ways that engaged their students. We asked new teachers how the faculty development initiative stimulated them to transfer the lessons they learned to their actual teaching practices. Self-report is known for bias, in that participants can give, for example, social-desirable answers (66,67). Moreover, using complementary data collection methods may have yielded additional or different results. Lastly, the methods we used limited us in claiming causality or effectiveness in our findings. We could only report on what the participants said. For the Q-Studies in particular, there could be a response bias, as certain parts of the student population are more likely to participate in educational studies. More specifically, students who are not interested in active learning are likely to avoid participating in a study on this topic. The snowballing procedure we employed might have yielded more participants who are more alike, rather than representing a different viewpoint. We used sampling strategies to include participants who may be less likely to participate, but we are unsure of how successful this was. Future research Student engagement in active learning is a complex and dynamic process with a large contextual component. What works in one setting, for one teacher, in one course, with one group of students, might be less effective in another. We encourage teachers, faculty developers, researchers, and other educational professionals to apply our findings to their contexts, to test them, and to further develop them. Although this research has been conducted in medical education, other study programs have also adopted active learning in their curricula. It would be interesting to determine if the results are applicable in those settings. Our research has been constructivist in design, trying to understand student engagement in active learning from different perspectives. Although implications have been given, to make causal claims or claims about (comparative) effectiveness, our findings need to be tested. Therefore, we suggest that future research use our findings to develop and implement strategies to stimulate student engagement, and measure their effects. Lastly, although we researched students in three of our studies, included students as stakeholders in the design-based research study, and incorporated a recommendation in this chapter to further their position as partners in education, our focus was on supporting teachers in the implementation of small-group active learning. However, students play an increasingly important role in education (56). Therefore, future research can ask a question, similar to the one we asked: “How can medical students be supported in engaging in small-group active learning in such a way that their learning is optimized?” Just as our research has yielded theoretical and practical insights for educational professionals, such a research endeavor could yield equally valuable insights for students.
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