Table 3 List of themes, sub-themes and sample quotes

Reflective engagement with the purpose of problem solving and active thinking

active, persistent, and focused thinking engagement

Everyone knows what they want to do, what tasks they have to accomplish, and how they can cooperate with others. In this way, our way of thinking is dedicated towards what we take the initiative to think about, what we want to do. We also take the initiative to complete our own tasks, start proactive communication and cooperation with others. In this sense, everyone’s way of thinking has become more active.

self-directed-learning thinking engagement with the purpose of problem solving

I feel more self-driven to solve the problems if they come up. I do not rely on facilitators to guide me to solve the problem. After all, I cannot just leave the problem there without doing anything … what is more important is the way of thinking. That is, how to find problems and how to find better ways to solve problems.

active “voice” in class

When the student listens to the facilitator very carefully and asks questions; or when analysing the case, the student can politely interrupt others in a timely manner, and give their own opinion... especially when the questions they ask are constructive, or if they really help others to think more about the questions.

Performance engagement characterised by strong emotional expression and leadership

strong emotional experience and disclosure

When we perform a live simulation in the laboratory, first of all, there is a sense of tension. You have to complete the tasks given by the facilitator. You don’t know if you can do it well. Second, when we engage in this work, we can easily reveal our emotions regarding whether the work progresses well, whether the result is good, and what has happened in the process. For example, if something goes wrong or when we make a mistake, we will be very anxious, there may be a sense of shyness and even shame. In short, our moods are fully revealed.

demonstration of professional leadership

When the leader is directing the group, the leader will do their job meticulously. This includes how many people should be allocated to every activity and what every member should do... when the leader organises everything very thoroughly, I can tell that the leader is very engaged at that time.

Interactive engagement as a result of multidimensional interactions between learners, learning communities and the environment

interaction with realistic learning situations

Children can survive by double-compression. I feel that I have to do a good job... and then I would carefully read the materials given by the facilitator and then delve deeper into the textbooks. I want to successfully rescue the baby... because the baby would cry despairingly, that would make the atmosphere very intense... and then the sense of urgency in that situation is much stronger than the pressure imposed by facilitators or exams in reality.

support from teammates

In order to complete a group task, we need mutual encouragement and support. I feel that someone is listening and someone is willing to respond to you. This sense of mutuality is very fulfilling and very encouraging. During interaction, I can feel the kind of enthusiasm of the classmates. They are motivated to do the task because they really value the patient and imagine what if the same experience should happen to them.

collegial facilitator-student interaction

The facilitator, as an observer and a questioner, is not an answerer, um, is a helper, a prompter. The facilitator is more easy-going. The sense of distance and barriers are eliminated.