How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self-determination theory

Purpose: Internalization of students’ motivation towards an intrinsic form is associated with increased interest, commitment, learning, and satisfaction with education. Self-Determination theory postulates that intrinsic motivation and autonomous forms of self-regulation are the desired type of motivation; as they have been associated with deep learning, better performance and well-being. It claims three basic psychological needs have to be satisfied in order to achieve intrinsic motivation. These are the needs for autonomy, competence and relatedness. This study aims to provide a review on how these basic psychological needs are encouraged in undergraduate students so they can be transferred to the clinical teaching environment. Methods: Electronic searches were performed across four databases (Medline, Embase, PsycINFO, and ERIC), relevant journals, and retrieved bibliography of selected articles. In total, searches produced 4,869 references, from which 16 studies met the inclusion criteria. Results: Main themes were coded in three categories: The support of autonomy, competence and relatedness. The research-based evidence appears to be of reasonable quality, and indicates that teachers should work to satisfy students’ basic psychological needs to foster internalization of self-regulation. Our findings suggest that teachers should interact with students in a more ‘human centred’ teaching style, as these actions predict motivational internalization. Several themes emerged from different contexts and further investigation should expand them. Conclusion: This review identified actions that clinical teachers could implement in their daily work to support students’ self-determination. Autonomy supportive teaching in health professions educations would benefit students and may actually result in more effective health care delivery

Development and Implementation of a Learning Community in the Curriculum for Undergraduate Medical Students

Learning communities in medical education have demonstrated favorable outcomes in terms of students' learning, professional development, and wellness. Despite these strengths and the widespread adoption of learning communities in US medical schools, there has been little interest in medical learning communities in Korea. In this context, the present study examined the development and implementation of the Yonsei Medical Learning Community (YMLC) and analyzed its outcomes and areas of improvement. The Yonsei University College of Medicine has operated a learning community as part of the undergraduate medical education curriculum since 2014. The YMLC is the first program of its type in Korea. The overall structure of the YMLC consists of four distinct communities (pillars), which are named after four distinguished alumni, and each pillar is organized into five learning community classes. Each class is vertically integrated across students in different medical school years, and one faculty advisor is matched to about 30 students. As the YMLC focuses on fostering reflective practice in students and providing them with opportunities to build teamwork and experience social relatedness, two educational approaches have been adopted: reflective writing and mentoring and community activities. In this study, we obtained and analyzed second-year students' feedback on the YMLC curriculum and identified its achievements, merits, and areas that need improvement. The results have shown that over 75% and 60% of respondents reported satisfaction with reflective writing and mentoring and community activities, respectively. The educational activities of the learning community helped students regularly reflect on their learning and progress and establish close relationships with faculty advisors. However, several areas of improvement regarding content, format, and logistical issues were also identified. The present findings may provide valuable information for other institutions to develop learning communities relevant to their own context.ope

Using megaproject performance outcomes to enhance decision-making behaviours in civil engineering graduates

A comprehensive review of megaproject performance propositioned the issues leading to project failure as behavioral. Project failure linked cost overruns and schedule delays to acts of delusion and deception, citing the ability to learn lessons, and the misalignment of incentives as influencing factors. A mixed-methods study was designed to gain insight into the decision-making behaviors of undergraduate civil engineers, and the role that education could play in enhancing decision-making. A co-curricular intervention led to qualitative exploration of decision-making in civil engineering undergraduates. Motivation featured heavily, particularly a conflict between interest and enjoyment, and the reward structures of traditional education and industry. Results led to a quantitative measure of intrinsic motivation and critical thinking ability. Findings from the educational environment have implications for industry and led to recommendations regarding the importance of autonomy and relatedness, to a megaproject environment

Determinants and outcomes of motivation in health professions education: a systematic review based on self-determination theory

Purpose: This study aimed at conducting a systematic review in health professions education of determinants, mediators and outcomes of students’ motivation to engage in academic activities based on the self-determination theory’s perspective. Methods: A search was conducted across databases (MEDLINE, CINHAL, EMBASE, PsycINFO, and ERIC databases), hand-search of relevant journals, grey literature, and published research profile of key authors. Quantitative and qualitative studies were included if they reported research in health professions education focused on determinants, mediators, and/or outcomes of motivation from the self-determination and if meeting the quality criteria. Results: A total of 17 studies met the inclusion and quality criteria. Articles retrieved came from diverse locations and mainly from medical education and to a lesser extent from psychology and dental education. Intrapersonal (gender and personality traits) and interpersonal determinants (academic conditions and lifestyle, qualitative method of selection, feedback, and an autonomy supportive learning climate) have been reported to have a positive influence on students’ motivation to engage in academic activities. No studies were found that tested mediation effects between determinants and students’ motivation. In turn, students’ self-determined motivation has been found to be positively associated with different cognitive, affective, and behavioural outcomes. Conclusion: This study has found that generally, motivation could be enhanced by changes in the educational environment and by an early detection of students’ characteristics. Doing so may support future health practitioners’ self-determined motivation and positively influence how they process information and their emotions and how they approach their learning activities

Predicting Students’ Physical Activity and Health-Related Well-Being: A Prospective Cross-Domain Investigation of Motivation Across School Physical Education and Exercise Settings \ud

A three-wave prospective design was used to assess a model of motivation guided by self-determination theory (Ryan & Deci, 2008) spanning the contexts of school physical education (PE) and exercise. The outcome variables examined were health-related quality of life (HRQoL), physical self-concept (PSC), and 4 days of objectively assessed estimates of activity. Secondary school students (n = 494) completed questionnaires at three separate time points and were familiarized with how to use a sealed pedometer. Results of structural equation modeling supported a model in which perceptions of autonomy support from a PE teacher positively predicted PE-related need satisfaction (autonomy, competence, and relatedness). Competence predicted PSC, whereas relatedness predicted HRQoL. Autonomy and competence positively predicted autonomous motivation toward PE, which in turn positively predicted autonomous motivation toward exercise (i.e., 4-day pedometer step count). Autonomous motivation toward exercise positively predicted step count, HRQoL, and PSC. Results of multisample structural equation modeling supported gender invariance. Suggestions for future work are discussed.\ud \u

A Mixed Methods Approach to Using Collaborative and Proactive Solutions with Students with Emotional and Behavioral Disorders while Applying the Self-Determination Theory

Students with emotional and behavioral disorders (EBD) that lack social skills and problem solving have stronger features of depression, higher drop-out rates and struggle with peer relations. With such an emphasis on academics in high school, students still need strategies taught to compensate for skill deficits in problem solving, relationship- building and choice making. This pragmatic mixed methods study used pre-and post-assessment data from the self-determination theory and examined the implementation of collaborative and proactive solutions through focus groups of teachers and mental health practitioners that work with students with EBD in a special education high school. While quantitative data was not significant, focus group findings specified changes in restructuring the current schedule, trust, time, buy-in and predominantly leadership implications. Recommendations for future studies include additional data sets to be included in the study; choosing elementary or middle school student populations; and applying a leadership frameworks at the onset of implementing collaborative and proactive solutions. Limitations of this study consisted of a small sample size and typical limitations of a focus group. This study adds to current gaps in high-school students with EBD, self-determination, and collaborative and proactive solutions

The effect of an intervention to improve newly qualified teachers’ interpersonal style, students motivation and psychological need satisfaction in sport-based physical education

Recent developments in self-determination theory research in the educational setting (e.g., Reeve, Deci, & Ryan, 2004), suggest that teachers’ interpersonal style should be considered as consisting of three dimensions: autonomy-support, structure and interpersonal involvement. Based on this theoretical proposition, the purpose of the present study was to test the effects of a training program for three physical education newly qualified teachers on the aforementioned teachers’ overt behaviors and students’ psychological needs satisfaction, self-determined motivation and engagement in sport-based physical education. After a baseline period of four lessons, the teachers attended an informational session on adaptive student motivation and how to support it. The training program also included individualized guidance during the last four lessons of the cycle. Results revealed that from pre- to post-intervention: (1) teachers managed to improve their teaching style in terms of all three dimensions, and (2) students were receptive to these changes, as shown by increases in their reported need satisfaction, self-determined motivation and engagement in the class

Implications of motivation differences in preclinical-clinical transition of dental students:A one-year follow-up study

Background Patient contact and clinical-based learning have been suggested as positive determinants of student motivation. However, few studies have been conducted on how this impacts dental student motivation. Based on the self-determination theory, this study aims to explore differences in the quality of motivation of dental student transition from preclinical (no previous patient contact) to clinical courses. Methods A longitudinal study was conducted with 95 Chilean students who completed the Academic Motivation Scale in two iterations over a one-year period. Results Paired t-test showed a significant increase in relative autonomous motivation as well as in amotivation. Discussions This suggests that while clinical contact supports student self-determination, an abrupt transition might be associated with maladjustment, which could lead to feelings of inadequacy and anxiety. Future research could usefully explore if early and gradual clinical experiences enhance student adaptation to the clinical context, thus increasing relative autonomous motivation and decreasing amotivation in the time

How dental students’ course experiences and satisfaction of their basic psychological needs influence passion for studying in Chile

Purpose: This study aimed to determine how the general course experiences of dental students in Chile and the satisfaction or frustration of their basic psychological needs influenced their passion for studying, and how passion influenced students’ study strategies. Methods: A correlational cross-sectional study was conducted at 3 Chilean dental schools between April and June 2018, in which 935 undergraduate students participated. Students responded to Spanish-language versions of 4 psychological scale tools: the Course Experience Questionnaire, the Basic Psychological Needs Satisfac¬tion and Frustration Scale, the Passion Scale, and the Revised Study Process Questionnaire. Data were analysed with bivariate correlations and structural equation modelling, controlling for age, gender, year of study, and type of university. Results: Students’ general course experiences (i.e., good teaching, clear goals and standards, appropriate assessment, and appropriate workload) positively predicted basic need satisfaction and negatively predicted need frustration. Need satisfaction positively predicted passion in students, with stronger scores for harmonious passion. Basic need frustration positively predicted obsessive passion and negatively predicted harmonious passion. Harmonious passion positively predicted deep study strategies and negatively predicted surface study strategies, while obsessive passion positively predicted both deep and surface study strategies. Conclusion: Dental students’ optimal course experiences positively influenced the satisfaction of their basic psychological needs, which favoured harmonious over obsessive passion. In turn, harmonious over obsessive passion positively influenced deep study strategies. Therefore, efforts should be made to provide course experiences that support students’ basic needs and harmonious passion for studying, both in classroom and chair-side teaching