Changes in student appreciation of small-group active learning: A follow-up q-methodological study

Background: Differences in students’ epistemic beliefs and approaches to learning influence how they appreciate small-group active learning methods. As students develop and advance through their study program, it is likely that their epistemic beliefs and approaches to learning change. However, it is unclear how these changes influence their appreciation of small-group active learning, and what this means for teachers who want to motivate and engage students at various stages of their study program. In a previous paper, we published findings of first-year medical students. In the present study, we followed up on the original student sample as they entered their fourth year. Methods: We repeated the Q-methodological study procedure from the previous study to explore change in appreciation of small-group active learning. Participants rank-ordered 54 statements, answered open-ended questions about their rank-ordering, and completed a demographic questionnaire. We also invited participants to take part in a subsequent interview to reflect on changes in their beliefs about small-group active learning since their start of medical training. Results: Twenty students participated (38.5% of the original sample). We decided on a 2-profile solution. Profile 1 students were ‘success-oriented’, while profile 2 students were ‘development-oriented’. Students’ appreciation of small-group active learning remained fairly stable over time, although key aspects related to students’ epistemic beliefs and approaches to learning developed. Seven students took part in the subsequent interview and reported personal, group, tutor, and medical program reasons for changes in their appreciation of small-group active learning. Discussion: This study showed how and why medical students’ appreciation of small-group active learning changed over time along with development of their 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 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.