Introduction
The importance of motivation in learning behavior and performance is not well substantiated in medical education. There is sometimes focus on increasing the quantity of motivation, but the how and why need more evidence. The aims of this thesis were to investigate the outcomes of motivation in medical students and to determine the factors influencing motivation and ways to enhance it. The main research questions were: (1) Is motivation a predictor for learning and academic performance? (2) What factors affect motivation? (3) How can intrinsic motivation be enhanced?
Methods
The literature was reviewed to explore whether the developments in medical curricula were geared towards student motivation. It was also reviewed to determine how motivation was investigated as a dependent and an independent variable in medical education. The validity of a scale to measure the strength of motivation for medical school was investigated. Two research studies investigated the relationships of student motivation with study strategy, effort and academic performance through structural equation modelling and cluster analysis. Studying motivation using an approach which combined quantity and quality of motivation was proposed through a review of the literature. As a dependent variable the relationships of age, maturity, gender, and educational background with motivation were investigated through multiple regression analysis. Applications of this research were described and recommendations were made.
Results
1.
Developments in medical education appear to have undervalued student motivation.
2.
Motivation is both an independent and a dependent variable in medical education.
3.
Motivation as an independent variable, particularly intrinsic motivation, is significantly associated with deep study strategy, high study effort, and good academic performance.
4.
Motivation as a dependent variable is significantly affected by age, maturity, gender and educational background, and intrinsic motivation is enhanced by providing students autonomy, feedback, and emotional support.
5.
Strength of motivation for medical school can be reliably measured by the Strength of Motivation for Medical School questionnaire.
Discussion
Student motivation has been given low consideration in medical education and medical curricular reforms are not geared towards enhancing student motivation. Studying motivation through an approach giving importance to both the quality and quantity of motivation is recommended. Intrinsic motivation (learning for the sake of learning) leads to better learning and performance as compared with extrinsic motivation (learning for reward), and can be enhanced by providing students with autonomy in learning, feedback on their performance, and emotional support.
Conclusions
It is important to give consideration to motivation in medical students because intrinsic motivation leads to better learning and performance and it can be enhanced through teaching–learning practices.
Acknowledgments
I would like to thank my promoters Prof. Dr. Olle ten Cate, UMC Utrecht and Prof. Dr. Gerda Croiset, VUmc Amsterdam, for giving me the opportunity to pursue a PhD in medical education and for their guidance, encouragement, and support during my research period. I would also like to thank Prof. Dr. Karen Mann for her guidance in scientific writing.
Conflict of interest
None.
Open Access
This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.