Evidence map›Paper›PMID 42904377›Full record

ArticleJMIR medical education2026

Addressing the Engagement Blind Spot: 12-Tip Tutorial to Make Reasoning Audible in Health Professions Education.

Inthrani Raja Indran, Dujeepa D Samarasekera

Abstract read
In one paragraph

Article in JMIR medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Inthrani Raja Indran *Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, MD3, 16 Medical Drive, Singapore, 117600, Singapore, 65 96832935.ORCID http://orcid.org/0000-0002-3487-3948
Dujeepa D Samarasekera *Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.ORCID http://orcid.org/0000-0002-6916-6741

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Unlabelled: Student engagement reforms have increased active learning in higher education. However, visible participation does not always require students to rehearse the spoken, interactive forms of reasoning central to professional practice, such as explaining one's thinking, responding to challenges, building on others' ideas, and working through uncertainty in real time. We describe this gap as an engagement blind spot. We define audible reasoning as the deliberate externalization of disciplinary or professional reasoning through spoken interaction so that its assumptions, evidence, uncertainty, and justification can be examined, challenged, revised, and developed collaboratively. It is particularly relevant in health professions education and also applies to laboratory-based and scientific disciplines where students must communicate their reasoning under conditions of uncertainty, scrutiny, and collaboration. Digital, hybrid, asynchronous, and AI-enabled learning environments sharpen this blind spot. Shared documents, online quizzes, discussion boards, and generative AI tools can support participation and access; however, they can also allow students to engage without speaking or to produce polished answers without making the underlying reasoning visible. In this context, educators need to ask not only whether students are engaged but also what behaviors they are rehearsing and whether their reasoning is available for examination and development. This tutorial offers 12 practical, evidence-informed tips developed iteratively from recurring challenges encountered in teaching, curriculum design, and faculty development and refined against selected literature. The tips are organized around 4 clusters covering the design of activities that require audible reasoning, the elicitation of reasoning in practice, the development of reasoning through listening and response, and the preservation of audible reasoning in digital and AI-enhanced environments. Across these 4 clusters, we suggest small but intentional shifts that help educators move from silent, constructive tasks toward audible, dialogic, and professionally relevant participation. These include designing tasks around uncertainty, creating low-stakes opportunities for spoken reasoning, using digital tools to surface and organize contributions for further discussion, structuring active listening and peer feedback, reviewing group dialogue formatively, and using conversational AI as a rehearsal partner rather than an authority. These strategies require attention to psychological safety, cultural responsiveness, accessibility, equity, privacy, data governance, and ongoing monitoring. Audible reasoning is not synonymous with speaking more, volunteering more frequently, or sounding fluent. Designing for audible reasoning is not simply an engagement strategy. It is a way of helping students practice the communicative and collaborative behaviors needed to explain, defend, question, and revise human judgment in clinical, scientific, and other professional contexts.

Indexed as

Health OccupationsProblem-Based LearningThinkingCurriculumHumansartificial intelligenceclinical reasoningcollaborative learningeducational technologystudent engagement

Identifiers

PMID42904377
PMCPMC13684349

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.