Using technology to increase student (and faculty satisfaction with) engagement in medical education.

Faculty dissatisfaction with diminishing levels of student engagement in lifestyle medicine sessions prompted this exploratory project that compared differences in students' substantive engagement in medical preclinical and clinical level lifestyle medicine sessions. The preclinical and clinical level sessions had the same learning objectives and learning tasks, properly aligned with that level of student learning, but were offered in different learning formats, either traditional classroom approaches or technology-enhanced approaches. At the preclinical level, we transferred a nonmandatory, face-to-face session to a nonmandatory, fully online session. At the clinical level, we introduced two novel technology tools. We utilized Zoom technologies, which afforded students the ability to access the session from anywhere, and employed Hickey's use of "promoting" student submissions as one method for increasing student-student interaction during the synchronous session. We used indicators of behavioral engagement of Henrie et al. (Henrie CR, Halverson LR, Graham CR. Comput Educ 90: 36-53, 2015) as the framework for determining applicable engagement behaviors, including attendance, assignment completion, interactions (responding/feedback/endorsements), and the quality of (and faculty satisfaction with) the face-to-face and/or online interactions. We expected to observe higher levels of engagement behaviors in the technology-enhanced approach and found that to be the case at both the preclinical and clinical levels, in both mandatory/nonmandatory and synchronous/asynchronous formats. However, it was the increase in both the level and substance of the students' interactions in the technology-enhanced sessions that provided surprising results. A review of the sessions with enhanced engagement highlight the role of student autonomy, a construct with strongly established associations to student motivation and engagement.