76 Chapter 4 ABSTRACT Background Active learning relies on students’ engagement with teachers, study materials, and/or each other. Although medical education has adopted active learning as a core component of medical training, teachers have difficulties recognizing when and why their students engage or disengage, and how to teach in ways that optimize engagement. With a better understanding of the dynamics of student engagement in small-group active learning settings, teachers could be facilitated in effectively engaging their students. Methods We conducted a video-stimulated recall study to explore medical students’ engagement during small-group learning activities. We recorded one teaching session of two different groups, and selected critical moments of apparent (dis)engagement. These moments served as prompts for the fifteen individual semi-structured interviews we held. Interview data were analyzed using Template Analysis style of thematic analysis. To guide the analysis, we used a framework that describes student engagement as a dynamic and multidimensional concept, consisting of behavioral, cognitive, and emotional components. Results The analysis uncovered three main findings: 1) In-class student engagement followed a spiral-like pattern. Once students were engaged or disengaged on one dimension, other dimensions were likely to follow suit; 2) Students’ willingness to engage in class was decided before class, depending on their perception of a number of personal, social, and educational antecedents of engagement; 3) Distinguishing engagement from disengagement appeared to be difficult for teachers, because the intention behind student behavior was not always identifiable. Discussion This study adds to the literature by illuminating the dynamic process of student engagement and explaining the difficulty of recognizing and influencing this process in practice. Based on the importance of discerning the intentions behind student behavior, we advise teachers to use their observations of student (dis)engagement to initiate interaction with students with open and inviting prompts. This can help teachers to (re-)engage students in their classrooms.
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