Evaluating medical student engagement during virtual patient simulations: a sequential, mixed methods study

BMC Medical Education

Table 5 Classroom photographs by level of engagement and modality of instruction

Level	Level of engagement	Category/code	VPS	Transition	Traditional
		Total photographs taken	Photo n = 165	Photo n = 34	Photo n = 93
High Engagement	Very High	Highly Engaged— at least one student	37	4	1
		Pleased expression
		Rapt concentration
	High	Leaning In—all students	51
	High	Focused on Task – all students in the team	64		22
	High	Interactive-at least one student	42	6	11
		Gesturing to illustrate joint
		Pointing to the simulation on laptop
		Discussing with tutor
		Taking notes
		Discussing with peers
Medium	Medium	Transition Activities^a		34
		Some teams finishing the simulation
		Completing Competency Task
		Waiting while others finish VPS
		Discussing with tutor
	Medium	Passive Pose— all students			25
Low	Low	Low Enthusiasm but Focused on Task: at least one student	13		22
		Head in hand leaning down
		Lethargic demeanor
	Low	Low Enthusiasm-Less Focused on Task: at least one student	5		13
		Not paying attention to PPT
		Difficult to see VPS screen
		Leaning away
	Very Low	Reserved: at least one student			21
	Very Low	Sitting with arms crossed.			21

Student N = 107. Photo N = 292. Some photographs were cross-coded to more than one category
^aThere was a period of transition between VPS and traditional small group instruction

ISSN: 1472-6920