43 Appreciating small-group active learning Approaches to learning We identified aspects of deep learning (predominantly in profile 1), surface learning (predominantly in profile 2), and vocational learning (predominantly in profile 4). These findings correspond with Mattick and Knight’s study on medical students’ approaches to learning (36). Mattick and Knight also describe the importance of social factors for learning. In our study, we identified one profile that places social motivation at the very center of their learning (profile 3). In this profile, social motivation was seen as important and was positive (social support and opportunity for making friends). This differs from the findings by Mattick and Knight, who found that social motivation only became important in clinical stages of medical training, and comprised of humiliation-avoidance, showing off to others and feeling negative emotions when not doing what is required. Mattick and Knight (36), along with other studies into approaches to learning, recommend teachers to stimulate deep learning as it is supposed to be associated with academic achievement (37). However, a recent systematic review of meta-analyses shows deep learning to “have no systematic relation with achievement” (3). On the contrary, it is suggested that teachers help their students to employ a strategic approach to learning; to regulate their learning strategies as required from a task or activity combined with a motivation for achievement (3). Related to the current study, this means that teachers can help their students by relating students’ motives and preferences to the course’s learning and assessment activities, and elaborate on what is needed for success. Most often, students will probably have to employ a combination of approaches: engaging with peers to construct meaning from a learning activity, or understanding how an exam helps to prepare for future practice. As especially students’ perception of assessment requirements affect how students approach learning, we do recommend teachers to design sound (formative and summative) assessment activities (38). Implications for practice As stated before, student engagement in small-group active learning is the result of many interacting factors, ranging from curriculum design to teacher behaviors to student sociodemographic characteristics. This study gives more insight into the students’ perspective: when and why do they appreciate active learning? We identified four profiles to answer that question. Teachers could use knowledge of the profiles to make better decisions when designing and teaching their class. When designing a class, teachers can reflect on the active learning methods they employ and anticipate which students might engage more easily (and why), and which students might be reluctant to engage (and why). To give some examples: students in profile 1 (understandingoriented) usually engage easily in in-depth group discussions when it sparks their interest, while students in profile 2 (assessment-oriented) might want to understand the relevance for the assessment first. Students in profile 3 (group-oriented) usually engage easily in collaborative exercises that strengthen their relationships, like escape rooms, while students 2
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