Student engagement in undergraduate medical education: A scoping review

Abstract

Introduction Student engagement is defined as behavioural, cognitive and emotional aspects of students' academic experience in teaching, learning and research through interacting with other students, faculty and community. Despite the growing interest in the field of student engagement, medical education research in this area is still fragmented. This scoping review aims to contribute to the understanding of measurements, drivers and outcomes of medical student engagement. Methods The authors searched MEDLINE, PubMed, ProQuest, SCOPUS, ERIC, Science Direct and EBESCO for English articles published from 1990 until October 2021. In addition, we hand‐searched key medical education journals and references in recently published articles. Using specific selection criteria, two authors independently reviewed the articles for eligibility, followed by data extraction using both quantitative and qualitative analysis. Results Of the 2136 retrieved articles, 51 studies were selected for the review, and 94% of them were published in the past 8 years. The prevailing measures of student engagement failed to cover the multidimensionality of the construct with more focus on the behavioural dimension. Quantitative methods represented two thirds of the studies with a higher frequency of cross‐sectional designs and using self‐reports. The identified drivers of medical students' engagement are directed mainly to modifying the context of the learning environment. These factors increased student engagement by fostering relevance of learning, positive student relationships with peers and faculty, and enhancing student agency, and sense of competence. Cognitive engagement appears to be a positive predictor of academic achievement, but the relationship with other dimensions of engagement is controversial. Conclusions Student engagement in undergraduate medical education is an important, yet under‐researched construct. The research that does exist suggests engagement to be malleable, something that can be modified by different types of interventions taking into consideration the context of education and practice. Further research is required, however, to address the gaps identified in this review.

When I say … engagement

“…In this way, motivation does not guarantee a high degree of action or desire for deeper cognitive challenge. Rather, motivation is the catalyst or fuel for these, and while it may ultimately lead to engagement, it is not in and of itself engagement 1 …”

“…For example, a student engaged with their clinical clerkship assessments would be actively self‐reflective of their own performance, genuinely pursuant of feedback on their observed performance and persistently absorbed in an effort to improve their future performance. This dedication and vigour that defines engagement has been shown to lead to positive outcomes in knowledge‐based assessments and clinical competencies 1,4 …”

“…This makes recognising student engagement easy, but difficult to measure and effectively study. Furthermore, a recent scoping review in Medical Education echoed this, citing a significant gap in our understanding of engagement as a construct in its own right 1 …”

“…Similarly, student engagement is an important predictor of academic performance. [1][2][3][4] Often defined as how students think, feel and act within their classrooms and learning communities, the construct of engagement in health professions education remains ill defined. This makes recognising student engagement easy, but difficult to measure and effectively study.…”

“…Furthermore, a recent scoping review in Medical Education echoed this, citing a significant gap in our understanding of engagement as a construct in its own right. 1 To conceptualise what we mean by engagement, let us take a trip to our local cafe. Beyond the aroma of brewing coffee, the hissing of the espresso machine and the chatter of customers, you will see two baristas.…”