3-25-26
Heather Miller Kuhaneck
Active Engaged Learning: What is it?
If traditional lecturing is like handing students a neatly wrapped package of knowledge, active engaged learning is asking them to unwrap it, shake it, question it, and maybe even repackage it themselves. At its core, active engaged learning is any instructional approach that requires students to do something meaningful with information—not just listen to it. This might include discussing, applying, analyzing, reflecting, or creating. A recent definition of active learning suggests it is “a student-centered approach to the construction of knowledge focused on activities and strategies that foster higher-order thinking (Doolittle, Wojdak, & Walters, 2023 pp 1).
Instead of:
“Here are the steps of a cognitive assessment…”
We shift to:
“Here’s a client scenario—what assessment would you choose, and why?”
Active learning doesn’t mean abandoning structure or content—it means repositioning the learner as an active participant rather than a passive recipient.
In OT terms, think of it like this:
- Would we expect a client to regain function by listening to us explain a task or just watching us demonstrate a task?
- Or by engaging in the occupation themselves?
Exactly. We already believe in this—now we apply it to our classrooms.
Why do it?
Let’s gently bust a myth: lectures are not the gold standard for learning—they’re just the most familiar. A meta-analysis by Freeman et al. (2014) examined 225 STEM studies and found that:
- Students in active learning environments had higher exam scores
- Students in traditional lectures were 1.5 times more likely to fail
Other research consistently shows that passive listening leads to:
- Lower retention
- Reduced ability to transfer knowledge
- Illusions of competence (“I understood that in class!” → “Wait…why can’t I apply it?”)
Meanwhile, active engagement supports:
- Deeper processing
- Clinical reasoning development
- Long-term retention
- Improved metacognition (students actually know what they don’t know)
And here’s the kicker for OT educators:
- Active learning mirrors how we expect students to practice clinically
- It supports ACOTE standards around clinical reasoning and application
- It aligns beautifully with constructivist learning theory (knowledge is built, not delivered)
So no, we’re not “watering down rigor” by reducing lecture. We’re actually turning the rigor up—just in a more meaningful direction.
How to do it
Alright, let’s get practical. Because “just make it active” is about as helpful as telling a client to “just be independent.” Here are strategies you can plug into your courses:
1. Flip the Classroom
Have students review foundational content before class (short videos, readings, or mini-lectures), and use class time for application.
- Before class: Students watch a video on the Allen Cognitive Levels
- In class: Present 3 client cases and ask:
- What level do you estimate?
- What interventions are appropriate?
- What safety concerns arise?
Keep pre-work short and focused on what they need for the application activity in class. This is not a 60-minute lecture in disguise.
2. Think-Aloud Clinical Reasoning
Model your thinking out loud, then have students practice doing the same.
- You walk through how you’d choose between the COPM and AMPS
- Then students work in pairs to “think aloud” through a new case
This builds clinical reasoning transparency, which students desperately need.
3. Role Play + Simulation
Because nothing says “learning” like a slightly awkward but highly memorable role-play.
- One student = client with low vision
- One student = OT practitioner
- Task = teach safe meal prep strategies
Add layers:
- Time pressure
- Environmental distractions
- Unexpected client responses
Now we’re cooking 🍳 (safely, with adaptations).
4. Case-Based Learning
You are likely already using cases in some aspects of your teaching, but you can use them even more for in class activities to apply information.
Instead of lecturing about and listing stroke interventions:
- Provide a client profile (home setup, roles, goals)
- Ask students to:
- Prioritize 3 interventions
- Justify choices
- Predict outcomes
Bonus: Have groups compare / debate their answers—this sparks rich discussion.
5. Retrieval Practice + Low-Stakes Quizzing
Learning isn’t what happens when we put information in—it’s what happens when we pull it out.
- Start class with 3 quick questions:
- “List two signs of unilateral neglect”
- “What’s one occupation-based intervention?”
- No grades, just discussion
This strengthens memory and reduces test anxiety. If you’re unfamiliar- check out the Leitner System and teach it to your students!
6. Visual Thinking Strategies (VTS)
Perfect for observation and interpretation skills. This research backed approach has been used successfully with OT students (see this paper) as well as medical students and nursing students.
Show a photo and ask:
- “What’s going on here?”
- “What do you see that makes you say that?”
- “What more can we find?”
This sharpens:
- Observation
- Clinical inference
- Perspective-taking
Final Thoughts: Small Shifts, Big Impact
Here’s the good news: you don’t need to do this all at once. Active engaged learning isn’t a complete overhaul—it’s a mindset shift. And honestly? It’s a lot more fun. Because when students are engaged, thinking, debating, and applying…You’re no longer just teaching OT….You’re helping them become occupational therapists.
Additional Resources
Flipped Learning
Think Aloud
https://www.sciencedirect.com/topics/computer-science/think-aloud-protocol
Simulation
Case-Based
https://instructionalmoves.gse.harvard.edu/cbcl
Retrieval practice
https://www.retrievalpractice.org/why-it-works
Visual Thinking Strategies
References
Alonso, R. K., Vélez, A., Martínez-Monteagudo, M. C., & Rico-González, M. (2023). Flipped learning in higher education for the development of intrinsic motivation: A systematic review. Education Sciences, 13(12), 1226.
Doolittle, P., Wojdak, K., & Walters, A. (2023). Defining active learning: A restricted systematic review. Teaching and Learning Inquiry, 11.
Ericsson, K. A. (2017). Protocol analysis. A companion to cognitive science, 425-432.
Freeman S, Eddy SL, McDonough M, Smith MK, Okoroafor N, Jordt H, Wenderoth MP. (2014). Active learning increases student performance in science, engineering, and mathematics. Proc Natl Acad Sci U S A, 10;111(23):8410-5. doi: 10.1073/pnas.1319030111.
Güss CD. (2018) What Is Going Through Your Mind? Thinking Aloud as a Method in Cross-Cultural Psychology. Front Psychol. 13;9:1292. doi: 10.3389/fpsyg.2018.01292.
Hailikari, T., Virtanen, V., Vesalainen, M., & Postareff, L. (2022). Student perspectives on how different elements of constructive alignment support active learning. Active Learning in Higher Education, 23(3), 217-231.
Kozanitis, A., & Nenciovici, L. (2023). Effect of active learning versus traditional lecturing on the learning achievement of college students in humanities and social sciences: A meta-analysis. Higher Education, 86(6), 1377-1394.
Li, R., Lund, A., & Nordsteien, A. (2023). The link between flipped and active learning: A scoping review. Teaching in Higher Education, 28(8), 1993-2027.
McLean SF. (2016). Case-Based Learning and its Application in Medical and Health-Care Fields: A Review of Worldwide Literature. J Med Educ Curric Dev. 27, doi: 10.4137/JMECD.S20377.
Miller, C. J., McNear, J., & Metz, M. J. (2013). A comparison of traditional and engaging lecture methods in a large, professional-level course. Advances in physiology education, 37(4), 347-355.
Nurbavliyev, O., Kaymak, S., & Sydykov, B. (2022). The effect of active learning method on students’ academic success, motivation and attitude towards mathematics. Journal of Language and Linguistic Studies, 18(2).
Opdal, P. A. (2022). To do or to listen? Student active learning vs. the lecture. Studies in Philosophy and Education, 41(1), 71-89.
Phillips, R. (2005). Challenging the primacy of lectures: The dissonance between theory and practice in university teaching. Journal of University Teaching and Learning Practice, 2(1), 1–12.
Saleem M, & Khan Z. (2023). Healthcare Simulation: An effective way of learning in health care. Pak J Med Sci, 39(4):1185-1190. doi: 10.12669/pjms.39.4.7145.
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