Introduction Research shows active learning is an effective teaching method. However, few qualitative studies explore medical student perceptions of the active learning process. The present study explored what students thought about while completing paper puzzles, an active learning tool used at the University of Utah School of Medicine, to understand what and how medical students think while engaged in active learning. Materials and MethodsTo investigate second-year medical students' attitudes toward these active learning exercises, three Zoom-based focused groups were held and recorded throughout the course. Recordings were transcribed and coded using thematic analysis. Results Students reported that peer interactions were of high value, and that while some interactions and thought processes were action-oriented, others were more metacognitive. Other benefits of the activity included promotion of learning, provision of structure, and designation of high-yield concepts. Challenges included feelings of confusion, problems with timing or difficulty of the tasks, and low utility without adequate preparation. Discussion These findings reflect student-acknowledged pros and cons of active learning described in education literature and add further insight into the thoughts and conversations students have during active learning activities. These include practicing metacognitive skills, triaging information, and learning from peers. Conclusions These data further elucidate student perceptions of active learning activities in medical education. Though focused on a specific activity, the data can help medical educators understand what students appreciate about active learning and what they think about while engaged in such activities.

Purpose Developing a professional identity requires learners to integrate themselves into the medical profession and take on the role of doctor. The impact of COVID-19 on medical education has been widely investigated, but little attention has been paid to the impact of students’ professional identify formation (PIF). The goal of this study was to investigate the impact that the onset of the COVID-19 pandemic had on medical students’ PIF. Materials and Methods An embedded mixed-methods design was utilized. Focus groups were conducted with a subset of year 1–4 students and coded using thematic analysis. Year 1–2 students were surveyed about their professional identity integration in the spring of 2020. Responses were analyzed using descriptive statistics and Wilcoxon signed rank and Mann–Whitney U tests. Results Qualitative data were organized into six themes that touched on losses and challenges, reflection, and reevaluation of the physician career. Roughly 50% of MS1s and MS2s reported a change in their professional identity integration, but this was not statistically significant. Conclusions Medical education does not occur in isolation and is influenced by disruptive local and global events. Students perceived challenges when in-person community interaction and hands-on clinical experiences were interrupted. Additionally, students reflected upon their own role and their future career goals. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-022-01652-4.