Currently submitted to: JMIR Medical Education
Date Submitted: Jan 28, 2026
Open Peer Review Period: Jan 30, 2026 - Mar 27, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A systematic review of engagement in medical education
ABSTRACT
Background:
Ask any educator, and they will respond that engagement is an important factor in their teaching. However, engagement is a complex, multidimensional construct comprising behavioural, cognitive, emotional, and agentic dimensions. Despite growing interest in this area, the conceptualisation and measurement of engagement in medical education remain inconsistent.
Objective:
This systematic review aims to examine how engagement is defined, conceptualised, and measured in studies involving medical students.
Methods:
A systematic literature search was conducted in February 2025 across five databases for peer-reviewed studies published within the last decade. Studies were included if they focused on medical students, collected original data, and measured engagement within the context of a medical curriculum. Data extraction and screening were performed independently by two reviewers following PRISMA guidelines. Studies were analysed for their conceptual framework, dimensions of engagement measured, data collection methods, and study design.
Results:
A total of 26 studies that met the eligibility criteria were included in this systematic review. Most studies measured behavioural (n=21), cognitive (n=19), and emotional engagement (n=17), while agentic engagement was least frequently measured (n=4). Most studies employed a quantitative approach, using survey instruments (n=14) and engagement metrics (n=5) to measure engagement, while a small number of studies adopted a qualitative approach, including interviews (n=4) and observations (n=4) to measure engagement. Engagement was mainly measured as a multidimensional construct, but some studies treated it as a unidimensional construct
Conclusions:
Engagement remains inconsistently and often poorly defined, as evidenced by the exclusion of more than half of initially screened studies for lacking rigorous measurement of engagement. The rise of technology-driven interventions has led to an increasing interest in ensuring that students are engaged in learning to achieve the desired learning outcomes successfully. Future research should systematically incorporate behavioural, cognitive, emotional, and agentic engagement dimensions to advance understanding and enhance educational practices. Clinical Trial: Not applicable
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.