Introduction: Engaging students in small-group active learning methods is essential for their development. Yet, medical teachers frequently face difficulties in stimulating this engagement, resulting in students remaining passive or detached from the learning process. The aim of this study was to uncover ways in which expert medical teachers, proficient at cultivating high levels of student engagement, stimulate such engagement. This knowledge might inform faculty development initiatives, so that medical teachers can be better equipped to teach in a way that engages students.

Methods: We conducted an interview study using a constructivist grounded theory approach, integrating elements from appreciative inquiry. The eleven participants were qualified medical teachers who repeatedly received high scores on student engagement. Each interview was transcribed, coded, and analyzed using constant comparison until theoretical saturation was achieved.

Results: We constructed a grounded theory of expert teaching practice, describing student engagement as an integrated process consisting of three components: 1) aiming for a supportive learning environment; 2) employing a personal educational approach; and 3) facilitating the active learning process.

Discussion: This study uncovered that there are multiple ways to stimulate high levels of student engagement. Although there was consensus on the importance of a supportive learning environment and the ability to facilitate the active learning process, participants recognized the contextual nature of student engagement and took on a reflective mindset to adapt strategies to their specific situations. These findings highlight the need for faculty development initiatives to adopt a comprehensive, context-sensitive approach that considers the complexity of student engagement.