87 Medical student engagement in small-group active learning same spiral-like pattern of engagement. We did not identify a certain order in these spirals, and they could start from any dimension. The opposite, a spiral-like pattern of disengagement, was also identified in the interviews. Students who reported to disengage on one dimension, reported to consequently disengage on the other dimensions as well. Thus, disengagement also seemed to build upon itself. The next quote illustrates this finding. Student: I don’t like study group meetings. I would rather study on my own. That would be a more effective use of my study time. […] So I only go to study group meetings because they are mandatory. Interviewer: That is all? No other purpose for you to be there? Student: No there isn’t. I do not learn much from the meetings, because they are not going to my desired pace. Collaborating like this doesn’t work for me. It’s too slow and there is too much distraction in a large group. […] Also, all the questions are based on the lectures, and they assume you go there. But if you haven’t gone, you can automatically not answer the questions properly. So yeah, then it is just brainstorming with the rest of the group, but then I don’t have much to contribute. Interviewer: Is there anything the tutor could do to help you contribute or to partake more actively? Student: No, I don’t think so. (Student 7) In this quote, the student described how his dislike of the study group meetings, resulted in merely being present at the meetings because he had to, and not out of a motivation for learning. Finally, because of his emotional and cognitive disengagement, he also disengaged behaviorally. Influence of antecedents of engagement: Willingness to engage Students reported how their engagement varied across meetings. They indicated a number of factors that influenced whether they would be more or less likely to engage during a meeting (Table 4.1). Each of these factors could have a stimulating or limiting effect on their engagement. However, from the interviews we came to understand that the combination of these factors jointly influences how willing to engage a student will be during a meeting. The following quote gives a clear insight into how before-class factors jointly influenced a student’s willingness to engage: A large part of the study group is focusing on the questions and answers. Because the questions and answers will be part of the exam. And, in my opinion, passing the exam is not the most important. The most important thing to me is to be able to apply the knowledge you have. […] And that is what you could see [in the video recording]. What I am trying to do, is to say something controversial, […] so that the others actually start to think. On the one hand I am trying to stimulate them to think outside the box, but on the other hand I try to motivate them to say 4
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