59 Changes in student appreciation of small-group active learning RESULTS Participant characteristics In 2018 (12), fifty-two students participated and we identified four factors (understandingoriented students, assessment-oriented students, group-oriented students, and practiceoriented students). In this 2021 follow-up study, 20 students of that original sample participated (38.5%). Compared to the original study, this follow-up study included participants from all four original factors, including one participant who did not fit in one of those factors and one participant who loaded significantly on multiple factors. The mean age of the twenty students was 21.8 years old (range 20-26). Seventy percent were female (78.8% in the original sample), which is representative of the student population at our medical school. Two students were finishing their Bachelor’s, one took a gap year before starting their Master’s, while the other participants had just started their Master’s. Seven students agreed to the optional interview. Factor analysis and profile description A two-factor solution best fitted our criteria for evaluating factor solutions. As each factor represents a group of students with similar viewpoints, instead of a group of items, we will use the word ‘profile’ instead of factor from this point onwards. The profile descriptions below are the result of the factor interpretation process described in Part 1: identifying factors and thus an integration of quantitative and qualitative data. Between brackets are the number of a statement and their position on the distribution grid. For example, 25 +4, means statement 25 (see Table 3.1) was placed on position +4 of the distribution grid. Profile 1: Success-oriented Role of students Students in this profile focus on study success. They want to do well on their exams (25 +4) and in their upcoming internships (34 +2). As exams in year 3 test clinical reasoning skills, and their internships require them to demonstrate this skill, understanding and practicing the reasoning process behind (clinical) questions is important to these students. They understand that the specific outcomes or answers to questions are less important. When these students cannot see the link between learning activities and exams or internships, they disengage from learning. Role of study group Students in this profile value active (33 +4) and collaborative (9 -5) learning. They feel that engaging with each other is a good way to learn the clinical reasoning and interpersonal skills necessary for medical careers. For optimal learning in a group setting, they feel it is important to have a safe learning environment (19 +4), with a good group atmosphere (48 +5), in which every student feels free to share their thoughts (28 +5). Although students in this profile are open to hearing different viewpoints, they dislike it when their group 3
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