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Differences in medical students’ academic interest and performance across career choice motivations

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Kyong-Jee Kim
Kyong-Jee Kim
Kyong-Jee Kim
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Jee Young Hwang
Jee Young Hwang
Jee Young Hwang
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Bum Sun Kwon
Bum Sun Kwon
Bum Sun Kwon
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Abstract

Objective: To investigate medical students' career choice motivation and its relationship with their academic interest and performance. Methods: We conducted a cross-sectional study in a sample (n=207) of medical students at a private medical school in Korea, stratified by year of medical course. Data about participant demographics, career choice motivation and academic interest were collected using a self-report questionnaire. The item on career choice motivation enquired about the respondents' main reason for applying for medical school among 8 possible response options, which comprised two components of career choice motivation: intrinsic and extrinsic. The participants' levels of academic interest were measured in a Likert-type question. Participants' academic interest and Grade Point Averages (GPAs) were compared across the groups of different career motivations along with analyses of their admission scores for baseline comparisons. Results: A total of 195 students completed the questionnaire (94%response rate). Seventy-four percent, (n=145; the intrinsic group) of the participants chose reasons related to intrinsic motivation, 22% (n=42; the extrinsic group) chose reasons pertaining to extrinsic motivation, and 4% (n = 8) chose other reasons for applying to medical school. The intrinsic group outperformed the extrinsic group in their GPAs, although their prior academic achievements did not differ significantly. The intrinsic group showed significantly higher levels of academic interest and also performed better in the admission interviews. Conclusions: Our study illustrates differences in medical students' academic interest and performance across career choice motivations. Further research is warranted to establish the predictive power of medical students' career choice motivation and academic interest on their academic performance.
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International Journal of Medical Education. 2016;7:52-55
ISSN: 2042-6372
DOI: 10.5116/ijme.56a7.5124
Differences in medical students’ academic
interest and performance across career choice
motivations
Kyong
-Jee Kim1, Jee Y. Hwang1, Bum S. Kwon2
1Department of Medical Education, School of Medicine, Dongguk University, Korea
2
Department of Rehabilitation Medicine, School of Medicine, Dongguk University, Korea
Correspondence:
Bum Sun Kwon, Department of Rehabilitation Medicine, School of Medicine, Dongguk University, Korea.
E-mail: bskwon@dumc.or.kr
Accepted: January 26, 2016
Abstract
Objectives: To investigate medical students’ career choice
motivation and its relationship with their academic interest
and performance.
Methods: We conducted a cross-sectional study in a sample
(n=207) of medical students at a private medical school in
Korea, stratified by year of medical course. Data about
participant demographics, career choice motivation and
academic interest were collected using a self-report ques-
tionnaire. The item on career choice motivation enquired
about the respondents’ main reason for applying for medi-
cal school among 8 possible response options, which
comprised two components of career choice motivation:
intrinsic and extrinsic. The participants’ levels of academic
interest were measured in a Likert-type question. Partici-
pants’ academic interest and Grade Point Averages (GPAs)
were compared across the groups of different career motiva-
tions along with analyses of their admission scores for
baseline comparisons.
Results: A total of 195 students completed the
questionnaire (94%response rate). Seventy-four percent,
(n=145; the intrinsic group) of the participants chose
reasons related to intrinsic motivation, 22% (n=42; the
extrinsic group) chose reasons pertaining to extrinsic
motivation, and 4% (n = 8) chose other reasons for applying
to medical school. The intrinsic group outperformed the
extrinsic group in their GPAs, although their prior academ-
ic achievements did not differ significantly. The intrinsic
group showed significantly higher levels of academic
interest and also performed better in the admission inter-
views.
Conclusions: Our study illustrates differences in medical
students’ academic interest and performance across career
choice motivations. Further research is warranted to estab-
lish the predictive power of medical students’ career choice
motivation and academic interest on their academic per-
formance.
Keywords: Academic interest, medical students, perfor-
mance, career choice, motivations
Introduction
The learner’s motivation is a critical component of the
learning process and research indicates that it influences his
or her learning and performance.1,2 Motivation is also
known to be a predictor for students’ persistence or contin-
uation in a study and psychological well-being, such as
distress and burnout.2,3 Accordingly, research in medical
education has shown that medical students’ motivation is
associated with their academic achievement.4-6
Among several constructs on motivation is the student’s
motivation for pursuing a medical career when entering
medical school, which is referred to as career choice motiva-
tion.3 Career choice motivation is one of the attributes that
are often looked into in selecting medical students. As
healthcare students tend to bring more unique intentions
and motivations for learning than is commonly seen in
other university students,7 it can be argued that it is im-
portant to understand the impact of career choice motiva-
tion on their learning and performance. Although research
has shown that career choice motivation is related to
burnout in medical students3 and suggests a link between
their career choice motivations and approaches to learning,8
empirical evidence is lacking on the relationship between
medical students’ career choice motivation and their
academic performance.
The literature suggests career choice motivation in-
volves intrinsic and extrinsic motivations.1 Those intrinsi-
cally motivated pursue an activity for personal interest or
enjoyment, and those who are extrinsically motivated
52
© 2016 Kyong-Jee Kim et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use of
work provided the original work is properly cited. http://creativecommons.org/licenses/by/3.0
engage in an activity for a desirable outcome – i.e., to obtain
a reward - or because of pressure from others.9 In addition,
interest is closely linked to an individual’s intrinsic motiva-
tion.9,10 Accordingly, medical students’ academic interest is
instrumental to understanding their motivation. However,
research has not determined whether medical students’
career choice motivations are associated with their academ-
ic interest. This study therefore aimed to investigate differ-
ences in medical students’ academic interest and perfor-
mance across career choice motivations.
Methods
Participants and settings
We conducted a cross-sectional study in a sample (n = 207)
of medical students at Dongguk University medical school
(DUMS), a private medical school in Korea, stratified by
year of medical course. All of the students in the basic
medical program at DUMS were invited to participate in
the study. About one-third of the students were undergrad-
uate-entry, and two-thirds were graduate-entry students.
Students of both entry-levels were in the same four-year
medical curriculum, in which undergraduate-entry students
take a two-year premedical program that precedes the
medical program.
Institutional review board (IRB) approval was not re-
quested for the present study, because it was part of the
annual survey of students that pertain to their learning
outcomes, which fell under the general exemption from our
IRB for educational outcomes data. Participation was
voluntary and consent was implied with the return of the
survey as responses were collected anonymously.
Instrument and procedures
A self-report questionnaire was administered in April, 2014.
The questionnaire consisted of 7 items on participant
demographics, one item on the respondent’s levels of
academic interest, and one item on career choice motiva-
tion. The item on career choice motivation was adapted
from the instrument, “Career Choice Motivation” by
Pagnin et al.3 In this item, respondents are asked to choose
one main reason for applying for medical school among
seven possible response options. These response options
consist of two components of motivation for applying to
medical school: intrinsic motivation with three options
(interest in human relationships, intellectual curiosity, and
altruism) and extrinsic motivation with four options
(economic concern, professional profile, illness or death
experiences, and influence of someone). The original
English version had previously been translated into Korean
by one of the authors, reviewed by experts and pilot tested
in previous years for validation.
Some response options in the item on career choice mo-
tivation were modified from the original version for adapta-
tion to the Korean context. Two response options in the
extrinsic motivation component of the original version,
“good chance of financial gain”, and “self-employed profes-
sional and social prestige”, were merged into one category
and named “social prestige and good chance of financial
gain”. A new response option, “obtained a very good score
in the college entrance exam”, was added into the extrinsic
motivation component as it was a frequently selected
answer among reasons for entering medical school in
previous surveys. An “others” option was also added to
solicit responses that were not covered by the given re-
sponse options, which gives a total of 8 response options.
The item on academic interest was adapted from the
instrument developed by Kim et al.11 This item comprises
the question, “How would you rate your level of interest in
the study of medicine?” with responses given on a five-point
Likert scale ranging from 1 = “very uninterested”, to 5 =
“very interested”.
Independent t-test was performed to compare the stu-
dent’s level of academic interest, academic performance,
and admission scores between the two groups. Additionally,
distributions of participant backgrounds (i.e., gender, entry-
level, undergraduate majors) were compared across groups
of different career choice motivations using chi-square test.
IBM-SPSS version 20 was used and the significance level
was 0.05 for the statistical analysis.
Results
Participants’ demographics and their career choice
motivations
A total of 195 students completed the questionnaire (94%
response rate) comprising of 78 (40%) female and 117
(60%) male; 76 (39%) undergraduate-entry and 119 (61%)
graduate-entry. Participant ages ranged from 19 to 37 years
(M=25.4, SD = 3.58).
For the main reason for applying to medical school, 74%
(n=145; the intrinsic group) of the participants chose those
related to intrinsic motivation, 22% (n=42; the extrinsic
group) chose those pertaining to extrinsic motivation, and
4% (n=8) chose other reasons. The most frequently selected
answer was “intellectual curiosity (n=76, 39%)”, followed by
“personal illness / illness or death of family members (n
=36, 18%)”, and “social prestige and good chance of finan-
cial gain (n=27, 14%)”.
There were no differences in the distributions of partici-
pants’ career choice motivation across gender (χ2 = 0.99, p =
0.61) or across entry-levels (χ2=15.30, p=0.23). Participant
ages did not differ between the intrinsic and extrinsic
groups (M=26.7 vs. 26.8, t =0.07, p=0.94).
Comparisons of participants’ academic interest and
performance
Table 1 compares the participants’ Grade Point Averages
(GPAs) across groups of different career choice motivations
by year of study. The intrinsic group outperformed the
extrinsic group in all years in the medical program, as
Int J Med Educ. 2016;7:52-55 53
Kim et al. Career choice motivation
measured by mean GPA. This difference was significant in
Years 2 and 3, although the effect sizes were moderate to
small (d = 0.48 and 0.12, respectively). Additionally, the two
groups differed in their levels of interest in the study of
medicine (t = 2.94, p < 0.01) with a moderate effect size
(d = 0.51).
Participants’ admission scores were compared between
the two groups to investigate differences in their baseline
performance. Admission scores were obtained for graduate-
entry students (n=119) only, because such data were not
available for undergraduate-entry students. The two groups
did not differ in their undergraduate GPAs and Korean
medical school entrance exam (Medical Education Eligibil-
ity Test: MEET) scores, but interview scores were signifi-
cantly higher in the intrinsic group (t=3.00, p < 0.01).
Table 1. Comparison of participants’ academic interest, GPAs,
and admission scores across different career choice motivations
(n = 195)
P
articipants
The intrinsic
group
(Mean± SD)
The extrinsic
group
(Mean ± SD)
t
(
p
)
Interest in the study of
medicine
4.03 ± 0.83
3.60 ± 0.84
2.94 (< 0.01)
Medical School GPAs
Year 1
3.13 ± 0.54
3.05 ± 0.51
0.56 (0.57)
Year 2
3.27 ± 0.52
3.03 ± 0.49
2.03 (0.04)
Year 3
3.51 ± 0.38
3.31 ± 0.31
1.93 (0.05)
Year 4
3.64 ± 0.30
3.46 ± 0.25
1.86 (0.65)
Admission
scores*
Undergraduate GPAs
91.56 ± 3.30
91.29 ± 2.91
0.96 (0.34)
Medical School Entr ance
Exam (MEET) Scores
167.32 ± 20.08
171.82 ± 24.02
0.51 (0.61)
Interview scores
100.76 ± 1.08
93.77 11.60
3.00 (< 0.01)
*Admission scores are for graduat e-entry students only (n = 119)
Discussion
Our study investigated the relationship between medical
students’ career choice motivation and their academic
performance. With the distributions of individual back-
grounds (i.e., gender, entry-levels, and ages) and prior
academic achievements not being different between stu-
dents with different career choice motivations, our findings
indicate that career choice motivation in medical students
may account for differences in their academic performance.
Approximately two-thirds of the students in our study
reported they were intrinsically motivated in applying for
medical school. This finding is similar to that of the study of
Brazilian students by Pagnin et al.3 Still, there were differ-
ences in the distributions of student responses across these
two studies. In our study, the most frequently selected
answer to the reason for applying to medical school was
intellectual curiosity, whereas in Pagnin’s,3 it was profes-
sional profile. These findings suggest that there are differ-
ences in medical students’ career choice motivations ac-
cording to the cultural or social contexts that they are in.
Moreover, we found differences in students’ perceived
levels of academic interest between the groups of different
career choice motivations. Motivational theories suggest
that intrinsic motivation is positively associated with
academic performance.12 Therefore, it can be interpreted
that those who are intrinsically motivated in their career
choice in medicine likely have higher intrinsic interest in
learning medicine than those who are extrinsically motivat-
ed, and that higher intrinsic interest in learning may be
linked to higher academic achievement. Still, our study did
not explore reasons for the differences in the students’ levels
of academic interest across different career choice motiva-
tions as it was beyond the scope of this study. Future
research is warranted to investigate relationships between
medical students’ career choice motivation and their
academic interest.
Our study had several limitations. First, this was a pre-
liminary study into career choice motivation using a rela-
tively small sample from one institution. Therefore, future
research with a larger sample from multiple institutions is
warranted to enhance the generalizability of this study.
Second, our study sample is relatively unique in that two
different tracks of students – i.e., undergraduates and
graduates - are in the same cohorts. Although our study
revealed no differences in baseline performance between
graduates and undergraduates, past studies suggests there
are differences between these two groups in their motiva-
tional profiles and learning outcomes.13 Therefore, readers
need to take this into account in generalizing our findings
into their own contexts. Third, although this study found a
relationship between medical students’ career choice
motivation, their academic interest and performance, it
does not reveal the extent to which career choice motivation
and academic interest account for the differences in their
academic performance. Further multivariate analysis is
recommended to establish the predictive power of the
medical students’ career choice motivation and academic
interest on their academic performance.
Conclusions
Our study illustrates differences in medical students’
academic interest and performance across career choice
motivations. Our findings suggest that understanding
medical students’ career choice motivation may enhance
our knowledge of factors that influence medical students’
learning and performance. Such an understanding can shed
us light on how to select students who are likely to succeed
in medical school and how to better facilitate their learning.
Conflict of Interest
The authors declare that they have no conflict of interest.
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Background and objectives: The aim of this study was to investigate in the millennium medical student generation the influence of the curriculum (problem-based curriculum [PBC] vs science-based curriculum [SBC]), gender and semester level on medical students' motives to study medicine, their attitudes toward their career and in this regard their view about their study condition in university. Methods: Semi-structured qualitative interviews with 28 medical students were performed and analyzed using Mayring's content analysis. Based on these results, a quantitative questionnaire for a nationwide survey was developed using a mixed-method-approach and send to most medical faculties in Germany. Data from n=1053 students entered statistical analysis. Results: Humanistic ideals prevailed in the choice to enter medical school and to become a physician. PBC students were found to be significantly (p<0.001) more idealistic and patient oriented, and they regard their curriculum more competitive than SBC-students (p<0.001). A balanced work and family life is essential for all students but particularly important for the PBC - group, male and undergraduate students. The majority of students wanted to work with patients and omitted patient-distant line of work. Undergraduate SBC-students saw their studies as old-fashioned citing lack of patient contact (p<0.001 compared to PBC), which eased in the graduate study part. Conclusion: This study found major differences in student's perceptions depending on curriculum type. PBC-students were more idealistic, and humanistic ideals prevailed in comparison to SBC. For both, close patient contact is essential in their training. Particularly for female students, lifestyle factors and a balanced work-life-integration outweigh career ambitiousness. This study offers an important insight to policy makers and educators to understand the motivation and perceptions of the millennial student generation regarding their studies and future career plans, which should be considered in educational policies.
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... This pyramid consists of a first level of basic needs, such as eating or sleeping (i), on which follows a need for security, stability and protection (ii), being part of a community or to have a family (iii), and a fourth level with two segments: respect and prestige (a) and trust in oneself and personal development (b). In high-income countries [4][5][6][7][8][9], the principal motivations for studying medicine are an interest for science/medicine, social and professional independence, and the anticipated variety of the work as physician. In countries with moderate incomes, social factors, such as influence from the family and expectations with regard to the social status, as well as scientific interest determine study choice [3]. ...
Calling situated: a survey among medical students supplemented by a qualitative study and a comparison with a surveyed sample of physicians
Article
Full-text available
  • Aug 2022
  • BMC Med Educ
Background Calling within the medical context receives growing academic attention and empirical research has started to demonstrate its beneficial effects. The purpose of this study is to investigate what motivates students to enter medical school and what role calling may play (i), to evaluate if calling influences the way in which they experience their studies (ii), and to compare medical students’ experience of calling with those of physicians. Methods A questionnaire survey was distributed among medical students (N = 1048; response rate above 60%) of the University of Lausanne in Switzerland. It was supplemented by a group discussion between bachelor medical students (N = 8) and senior physicians (N = 4), focusing on different facets of calling. An existing data set of a survey among physicians, addressing calling with the same questionnaire, was used to compare students’ and physicians’ attitudes towards calling. Survey data were analyzed with the habitual statistical procedures for categorical and continuous variables. The group discussion was analyzed with thematic analysis. Results The survey showed that experiencing calling is a motivational factor for study choice and influences positively choice consistency. Students experiencing calling differed from those who did not: they attributed different definitions to calling, indicated more often prosocial motivational factors for entering medical school and perceived the learning context as less burdensome. The analysis of the group discussion revealed that the concept of calling has a fluid definition. It was conceived as having the characteristics of a double-edged sword and as originating from within or outside or from a dialectic interplay between the inner and outer world. Finally, calling is experienced less often by physicians than by medical students, with a decreasing prevalence as the immersion in the clinical years of the study of medicine progresses. Conclusions Calling plays an important role in study choice and consistency of medical students. Given its relevance for medical students and its ramifications with the learning context, calling should become a topic of the reflexive parts of the medical curriculum. We critically discuss the role played by calling for medical students and provide some perspectives on how calling could be integrated in the reflection and teaching on physicianhood.
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Attitudes, Motivations and Academic Performance in English among the Junior High School Students in Sulangon National High School
Article
  • Jan 2024
This study aimed to assess the attitudes, motivations and their relationship to academic performance in English among the Junior High School Students in Sulangon National High School during the school year 2022-2023.The data were obtained from 352 Grade 8, 9 and 10 students respectively in Sulangon National High School. A quantitative descriptive-correlational research design was employed in this study. Using frequency counting and percent, weighted mean, standard deviation, Mann-Whitney U test, Kruskal-Wallis H test, and Spearman Rank-Order Correlation Coefficient were the statistical tools used in the study. The study found out that the respondents' perceived level of positive attitude toward English was high. The respondents' perceived level of negative attitude toward English was low. Standard deviations less than 3.0 supported a high degree of homogeneity in their responses. In addition, the respondents’ perceived level of intrinsic motivation was highly motivated and the respondents’ perceived level of extrinsic motivation was also highly motivated. Additionally, the study found out that the respondents' level of academic performance was very satisfactory, which indicated that the students of Sulangon National High School experienced moderate learning in English. Standard deviations less than 3.0 supported a high degree of homogeneity in their responses. Moreover, the study found out that the respondents’ perceived level of attitude was affected by their sex. However, the respondents’ perceived level of attitude was unaffected by their age and grade level. It was also found out that perceived level of motivation was affected by their sex, age and grade level. Furthermore, data analysis revealed a significant relationship between attitudes, motivation and students' academic performance. This indicated that attitudes and motivations were significantly related to the Junior High School students' academic performance in Sulangon National High School. Hence, it is recommended that the top officials of the Department of Education in the Schools Division of Dapitan City would provide some techniques of communicative language to enhance students’ English learning and encourage them to be optimistic about the English skills practices.
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Mental Health Matters: From Cross-Cultural Perspectives
Book
Full-text available
  • Aug 2023
Awareness of mental health has been increasing rapidly worldwide in recent years, and even more so since the outbreak of COVID-19. Depression is now regarded as one of the most debilitating diseases, and wellbeing is incorporated into the United Nations’ Sustainable Development Goals. In order for all of us to have a happy life, mental health cannot be ignored. As announced by the UK government, our health cannot be achieved without good mental health. Likewise, in Asia, the word ‘health (健康)’ in Chinese and Japanese encompasses both a healthy body and a calm mind. The Japanese government has implemented a work-style reform to protect employees’mental health. While these movements suggest the importance of mental health worldwide, a universal definition of mental health remains to be defined. This is partly attributed to a lack of understanding of mental health from different cultures. How an individual regards mental health can differ significantly according to their culture. Therefore, this Special Issue aims to address this problem by introducing alternative views to mental health through discussion of cross-cultural psychiatric matters.
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Critical review: medical students' motivation after failure
Article
Full-text available
  • Aug 2016
  • ADV HEALTH SCI EDUC
About 10 % of students in each years' entrants to medical school will encounter academic failure at some stage in their programme. The usual approach to supporting these students is to offer them short term remedial study programmes that often enhance approaches to study that are orientated towards avoiding failure. In this critical review I will summarise the current theories about student motivation that are most relevant to this group of students and describe how they are enhanced or not by various contextual factors that medical students experience during their programme. I will conclude by suggesting ways in which support programmes for students who have encountered academic failure might be better designed and researched in the future.
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What is different about medical students interested in non-clinical careers?
Article
Full-text available
  • Jun 2013
  • BMC Med Educ
Background The proportion of medical school graduates who pursue careers other than full-time clinical practice has increased in some countries as the physician’s role has evolved and diversified with the changing landscape of clinical practice and the advancement of biomedicine. Still, past studies of medical students’ career choices have focused on clinical specialties and little is known about their choice of non-clinical careers. The present study examined backgrounds, motivation and perceptions of medical students who intended non-clinical careers. Methods A questionnaire was administered to students at six Korean medical schools distributed across all provinces in the nation. The questionnaire comprised 40 items on respondents’ backgrounds, their motivation for and interest in the study of medicine, their perceptions of medical professions, and their career intentions. Data was analyzed using various descriptive and inferential statistics. Results In total, 1,388 students returned the questionnaire (60% response rate), 12.3% of whom intended non-clinical careers (i.e., basic sciences, non-clinical medical fields, and non-medical fields). Those who planned non-clinical careers were comparable with their peers in their motivation for studying medicine and in their views of medical professions, but they were less interested in the study of medicine (P < 0.01). The two groups also differed significantly on their perceptions of what was uninteresting about the study of medicine (P < 0.01). The two groups were comparable in gender and entry-level ratios but their distributions across ages and years of study differed significantly (P < 0.01). A majority of respondents agreed with the statements that “it is necessary for medical school graduates to pursue non-clinical careers” and that “medical schools need to offer programs that provide information on such careers.” Still, our finding indicates that medical school curricula do not address such needs sufficiently. Conclusions Our study found some differences in backgrounds and perceptions of the study of medicine in medical students interested in non-clinical careers from their peers. Future studies are suggested to enhance our understanding of medical students” choice of non-clinical careers.
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Burnout and career choice motivation in medical students
Article
Full-text available
Background: Burnout is a stress-induced syndrome, which affects medical students. Some environmental and personal factors can favor burnout onset and its serious consequences as dropping out, sleep disorders, depression, and suicide. The motivation for choosing medicine is a personal aspect that can modulate the distress with academic demands. Methods: We applied self-administered questionnaires in 277 medical students to investigate the predictive role of career choice motivations on burnout dimensions. Specifically, we studied the influence of the main reasons for choosing medicine on emotional exhaustion, cynicism, and academic efficacy. Results: Intellectual curiosity, professional autonomy, altruism, and interest in human relationships were the most common reasons for choosing medicine. However, the medical students motivated by personal illness or family member's illness or death revealed a significant greater emotional exhaustion when compared with the students with other motivations. Conclusion: The students who apply for medical school motivated by illness/death experiences are at a great risk for burnout. We suggest that students who are at risk for emotional exhaustion can be identified at the admission of medical school. Primary prevention strategies for burnout should consider this risk group.
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The relation of interest to the motivation of behavior: A self-determination theory perspective
Article
Full-text available
  • Jan 1992
explore the motivating aspects of interest and the relation of interest to other motivational processes / present a conceptualization of interest from the perspective of self-determination theory self-determination theory in brief / intrinsic motivation and interest / interest and extrinsic motivation: self-determination / social contexts / persons, activities, contexts: a summary / educational outcomes review research that relates intrinsic motivation and interest to [school] learning and adjustment (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Motivation as an independent and a dependent variable in medical education: A review of the literature
Article
Full-text available
Motivation in learning behaviour and education is well-researched in general education, but less in medical education. To answer two research questions, 'How has the literature studied motivation as either an independent or dependent variable? How is motivation useful in predicting and understanding processes and outcomes in medical education?' in the light of the Self-determination Theory (SDT) of motivation. A literature search performed using the PubMed, PsycINFO and ERIC databases resulted in 460 articles. The inclusion criteria were empirical research, specific measurement of motivation and qualitative research studies which had well-designed methodology. Only studies related to medical students/school were included. Findings of 56 articles were included in the review. Motivation as an independent variable appears to affect learning and study behaviour, academic performance, choice of medicine and specialty within medicine and intention to continue medical study. Motivation as a dependent variable appears to be affected by age, gender, ethnicity, socioeconomic status, personality, year of medical curriculum and teacher and peer support, all of which cannot be manipulated by medical educators. Motivation is also affected by factors that can be influenced, among which are, autonomy, competence and relatedness, which have been described as the basic psychological needs important for intrinsic motivation according to SDT. Motivation is an independent variable in medical education influencing important outcomes and is also a dependent variable influenced by autonomy, competence and relatedness. This review finds some evidence in support of the validity of SDT in medical education.
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Intrinsic and Extrinsic Motivations: Classic Definition and New Directions
Article
  • Feb 2000
  • CONTEMP EDUC PSYCHOL
Intrinsic and extrinsic types of motivation have been widely studied, and the distinction between them has shed important light on both developmental and educational practices. In this review we revisit the classic definitions of intrinsic and extrinsic motivation in light of contemporary research and theory. Intrinsic motivation remains an important construct, reflecting the natural human propensity to learn and assimilate. However, extrinsic motivation is argued to vary considerably in its relative autonomy and thus can either reflect external control or true self-regulation. The relations of both classes of motives to basic human needs for autonomy, competence and relatedness are discussed.
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Assessing health care students' intentions and motivations for learning: The Healthcare Learning and Studying Inventory (HLSI)
Article
  • Jun 2012
  • ADV HEALTH SCI EDUC
Inventories that measure approaches to learning have revealed that certain approaches are associated with better academic performance. However, these inventories were developed primarily with higher education students on non-vocational courses and recent research shows they fail to capture the full range of healthcare students' intentions and motivations for learning. To develop a new inventory measuring approaches to learning that addresses these shortfalls and is relevant to students on vocational courses in healthcare. In depth interviews with healthcare students were performed to understand the full range of healthcare students' intentions and motivations. The data were used to create a draft inventory, which was reviewed by interview participants and then tested with medical students. The final inventory was piloted with 303 healthcare students across six disciplines. Exploratory factor analysis was used to identify groups of related items within the inventory. The research produced a 32 item scale based on rich qualitative data, with a four factor structure and good internal consistency. A desire to link theory and practice was a distinctive feature of healthcare students. The new inventory contains nuanced items that enable a better understanding of their common and distinctive intentions and motivations. This study suggests that healthcare student populations have some unique intentions and motivations for learning and therefore require a bespoke inventory to ensure that important aspects are not missed. It offers a new tool for meaningful future research, the Healthcare Learning and Studying Inventory (HLSI).
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Motivation, learning strategies, participation and medical school performance
Article
  • Jul 2012
  • MED EDUC
Medical schools wish to better understand why some students excel academically and others have difficulty in passing medical courses. Components of self-regulated learning (SRL), such as motivational beliefs and learning strategies, as well as participation in scheduled learning activities, have been found to relate to student performance. Although participation may be a form of SRL, little is known about the relationships among motivational beliefs, learning strategies, participation and medical school performance. This study aimed to test and cross-validate a hypothesised model of relationships among motivational beliefs (value and self-efficacy), learning strategies (deep learning and resource management), participation (lecture attendance, skills training attendance and completion of optional study assignments) and Year 1 performance at medical school. Year 1 medical students in the cohorts of 2008 (n = 303) and 2009 (n = 369) completed a questionnaire on motivational beliefs and learning strategies (sourced from the Motivated Strategies for Learning Questionnaire) and participation. Year 1 performance was operationalised as students' average Year 1 course examination grades. Structural equation modelling was used to analyse the data. Participation and self-efficacy beliefs were positively associated with Year 1 performance (β = 0.78 and β = 0.19, respectively). Deep learning strategies were negatively associated with Year 1 performance (β =- 0.31), but positively related to resource management strategies (β = 0.77), which, in turn, were positively related to participation (β = 0.79). Value beliefs were positively related to deep learning strategies only (β = 0.71). The overall structural model for the 2008 cohort accounted for 47% of the variance in Year 1 grade point average and was cross-validated in the 2009 cohort. This study suggests that participation mediates the relationships between motivation and learning strategies, and medical school performance. However, participation and self-efficacy beliefs also made unique contributions towards performance. Encouraging participation and strengthening self-efficacy may help to enhance medical student performance.
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