161 Appendices objectives and learning processes increased motivation to transfer. Second, the support of peers, supervisors, and students encouraged the adoption of new teaching strategies. Third, combining on-the-job and off-the-job learning activities promoted a continuous learning cycle of experiencing, reflecting, understanding, and applying. We concluded that the design was feasible, effective, and responsive to the needs of the participants, stimulating the transfer of active learning competencies to educational practice. Faculty development can use the approach we used, as teaching a small-group active learning course can be challenging, especially for new teachers. Chapter 7 The final chapter is the general discussion of this thesis. We summarize the findings from the students’ perspectives, teachers’ perspectives, and faculty development perspective on active learning. These findings are synthesized into an integrated perspective that emphasizes the importance of the interaction between students and teachers in optimizing student engagement in active learning, and describes how faculty development can offer support. The integrated perspective addresses the central research question of this thesis and provides a way forward for the three challenges identified in the general introduction. Practical implications are provided for the three perspectives we studied: students, teachers, and faculty development. Subsequently, methodological reflections on the strengths and limitations of our approach are provided. The main strengths focus on the use of various research designs to study the three perspectives to gain a comprehensive and actionable understanding of student engagement in active learning, while the main limitations acknowledge the scope, transferability, and potential bias in the studies. This chapter finishes with suggestions for future research, which hopefully inspire others to apply and test the findings in other contexts, as well as suggest a shift from researching teachers to researching students. Conclusions The findings presented in this thesis contribute to the implementation of active learning in medical education by optimizing student engagement. The investigation of the students’ perspectives clarifies why medical students, who are generally appreciative of active learning, can be reluctant to engage. They have different and sometimes conflicting active learning needs, which also change over time, necessitating a modified educational approach as students progress through their studies. They also require the support of their teachers to stimulate, maintain, and regulate their engagement. The investigation of the teachers’ perspectives illuminates how expert teachers fulfill their pivotal role in student engagement. It identifies the importance of cultivating a supportive learning environment and the need for extensive competencies to facilitate an active learning process. It identifies the need for teachers to employ a reflective and context-sensitive approach that balances their educational values and competencies, their knowledge and beliefs about students, and design elements of the course they are teaching. Finally, the investigation of a faculty development perspective demonstrates how a teacher training on active learning, that A
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