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This study took a person-centered perspective to investigate students’ engagement profiles and examined potential antecedents and outcomes of these profiles. A total of 111 medical students solved a clinical reasoning task in a computer-simulated environment. Behavioral engagement was extracted from trace data, and cognitive and emotional engagement was measured by questionnaires. Students also answered achievement goal orientation, academic self-efficacy, and task difficulty scales. The latent profile analysis was performed and identified four engagement profiles: Disengaged, Behaviorally Engaged, Moderately Engaged, and Cognitively and Emotionally Engaged. Multinomial logistic regressions revealed that mastery-approach goals, self-efficacy, and perceived task difficulty increased the likelihood of being Cognitively and Emotionally Engaged. Furthermore, Cognitively and Emotionally Engaged students realized more accurate diagnoses.