70 Chapter 3 notable disadvantages associated with its use. We encountered a technical issue in which one participant could not complete their Q-sort because a button would not appear on their screen. Fortunately, they made a screenshot and emailed it to us. We also encountered participants who provided superficial or unclear answers to the open-ended questions after the Q-sorting procedure. For those that had agreed to the interview, we could ask questions to clarify and deepen their answers at a later time. Last, we conducted the interviews after all Q-sorts had been completed. This meant a delay between Q-sorting and the interview between 14 and 64 days. Although showing statements and their positions on the grid served as a reminder for participants in the interviews, they sometimes were searching their memories for reasons why they placed a statement in a specific place. In a future study with the same (online) design, we would reduce the time between Q-sorting and interviewing. Conclusion This study showed changes in students’ appreciation of small-group active learning over time, along with development of epistemic beliefs and approaches to learning. These findings contribute to the study of active learning in medical education because they highlight the development of students as they advance through their studies. What motivates and engages first-year students is not necessarily what is motivating and engaging for students in later stages. Our findings support the development of interventions that can help teachers to teach in active learning settings. Furthermore, this study provides an additional way to study change in subjectivity. The formulated guidelines can help future Q-researchers with a repeated measures design. Acknowledgments We would like to thank our colleagues in the Research in Education team for their feedback on the paper, the Q-method Listserv and Prof. Dr. Job van Exel (Erasmus School of Health Policy & Management, Erasmus University Rotterdam, the Netherlands) for answering questions on the analyses of longitudinal Q-data, and ZoomQ Research Seminar Committee’s Dr. Mustafa Aydogan (Department of Guidance and Psychological Counseling, Sinop University, Sinop, Turkey) and Dr. Miku Lenentine (Research Center for Resilient Neighborhoods, Kapi’olani Kula Nui Kaiāulu, Kapi’olani Community College, University of Hawai’i, United States of America) for demonstrating Easy HtmlQ and KADE.
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