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Introduction The COVID‐19 pandemic forced medical schools to rapidly transform their curricula using online learning approaches At our institution, the preclinical Practice of Medicine (POM) course was transitioned to large‐group, synchronous, video‐conference sessions The aim of this study is to assess whether there were differences in learner engagement, as evidenced by student question‐asking behaviors between in‐person and videoconferenced sessions in one preclinical medical student course Methods In Spring, 2020, large‐group didactic sessions in POM were converted to video‐conference sessions During these sessions, student microphones were muted, and video capabilities were turned off Students submitted typed questions via a Q&A box, which was monitored by a senior student teaching assistant We compared student question asking behavior in recorded video‐conference course sessions from POM in Spring, 2020 to matched, recorded, in‐person sessions from the same course in Spring, 2019 Results We found that, on average, the instructors answered a greater number of student questions and spent a greater percentage of time on Q&A in the online sessions compared with the in‐person sessions We also found that students asked a greater number of higher complexity questions in the online version of the course compared with the in‐person course Conclusions The video‐conference learning environment can promote higher student engagement when compared with the in‐person learning environment, as measured by student question‐asking behavior Developing an understanding of the specific elements of the online learning environment that foster student engagement has important implications for instructional design in both the online and in‐person setting
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