Identifying Behaviours Representative of Agentic Engagement in Pre-clinical Medical Education PBL Groups Based on Literature and Observations.

Introduction: In this study we aimed to identify behaviours representative of agentic engagement in pre-clinical medical education problem-based learning (PBL) groups. Agentic engagement is defined as the proactive, intentional contributions students make to their flow of instruction. This concept, developed in secondary education, appears relevant for benefitting optimally from PBL in higher medical education. Methods: We followed a four-step process to identify any behaviours representative of agentic engagement in our PBL setting. Following a literature search on agentic engagement scales, proactive behaviour, PBL practices and adult learning, we listed behaviours that could denote agentic engagement in our context. We fine-tuned this list through exploratory observations and tailored it to our specific context of second-year PBL groups. Results: We identified ten observable student behaviours representative of agentic engagement within medical PBL groups. Some aligned with previous literature (asking questions, telling the teacher what they (dis)like, telling the teacher what they are interested in, defending opinions, expressing expectations, suggesting co-operation), and others had not been identified before as representative of agentic engagement (making learning as interactive as possible, creating alternative ways of covering the material, correcting content and enriching others' insights); thereby introducing novel behaviours unique to our setting. Discussion: In medical PBL groups, we identified both known agentic engagement behaviours and distinctive behaviours specific to our context, thereby highlighting that the expression of agentic engagement is context-bound.