78 Chapter 4 Fredricks, Blumenfeld, and Paris (37) have described a framework that may help to expand our understanding of student engagement in medical education. They propose that student engagement is a multidimensional concept that includes behavioral, cognitive, and emotional components (37). Behavioral engagement describes the learning-related conduct of students. It is concerned with the activities that students participate in, for example verbal participation in class, but also completing homework, and complying with the rules of a class. Cognitive engagement describes the willingness and effort that students put in to learn the content of a course. It is concerned with (self-regulatory) learning strategies, like paying attention in class and use of metacognitive skills (planning, monitoring, and evaluating study approaches). Emotional engagement describes the feelings that students have towards study content, teachers, and peers. It is concerned with affective reactions, like interest in the content and sense of belonging. Likewise, Fredricks et al. (37) also describe behavioral disengagement (e.g., being late or disturbing other students), cognitive disengagement (e.g., redefining parameters for assignments to make it easier or being distracted from the learning process), and emotional disengagement (e.g., boredom or feelings of loneliness). In other words, student engagement is how students behave, think, and feel (37). In this study, we will research three currently unknown aspects of the student engagement framework to achieve our aim of a) better recognizing when and why students engage or disengage in small-group active learning settings and b) positively influencing this process. First, according to the framework, the three dimensions of engagement are dynamically interrelated within an individual. However, it has not yet been described how this relation can be identified or observed in practice. Second, in-class student engagement results from a variety of personal, social, and educational antecedents (i.e., factors that influence engagement). However, it is unknown how these antecedents jointly influence the engagement in a classroom. Third, the framework describes engagement as malleable. However, the framework does not provide an explanation for the difficulty that teachers experience in engaging their students. Therefore, we sought to answer the following research questions: 1. How do the three dimensions of student engagement interrelate in a classroom setting? 2. How do antecedents of student engagement influence student engagement in class? 3. How can the multidimensional view of student engagement help us to understand why it can be difficult for teachers to engage their students? METHODS Study design Given the nature of the research questions, we needed data on how engagement occurs in real time and in a natural setting. Therefore, we conducted a video-stimulated recall study to research medical students’ engagement in a small-group active learning setting. Video-
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