Abstract
Introduction The importance of motivation in learning behaviour and education is well-researched and proven in general education, but much less 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 gather insights
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and investigate medical students’ motivation, particularly the importance of quality of motivation, factors influencing and outcomes and to explore how these can be applied to make medical education better suited to support motivation. The main research questions were: 1. Is motivation a predictor for learning and academic performance in medical students? 2. What factors affect motivation? 3. How can intrinsic motivation be stimulated among students? Methods The literature on development of medical education curricula was reviewed to explore whether these developments were geared towards stimulating student motivation. The literature was also reviewed to determine how motivation was investigated as a dependent and an independent variable in medical education. The validity of a scale (Strength of Motivation for Medical School) to measure the strength of motivation for medical school was investigated. Two research studies investigated motivation as an independent variable, the relationships of student motivation with their learning strategies and efforts and their academic performance were investigated through structural equation modeling analysis and cluster analysis. An approach towards investigating motivation, which combined quantity and quality of motivation, was proposed. 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 an independent variable in medical education and intrinsic motivation is significantly associated with deep study strategy, high study effort and good academic performance. 3. Motivation is also a dependent variable in medical education and is significantly affected by age, maturity, gender, educational background, intrinsic motivation is specifically enhanced by providing students autonomy, feedback about competence and emotional support.4. Strength of motivation for medical school can be reliably measured by Strength of Motivation for Medical School questionnaire. Discussion Student motivation has been given low consideration in medical education as indicated by the gap in the literature on this topic. Medical curricula have undergone major reforms, but these reforms are not geared towards enhancing student motivation. An approach towards studying motivation in medical students is to give importance to both, the quality and quantity of motivation. Intrinsic motivation (learning for the sake of learning) as compared to extrinsic motivation (learning for reward), leads to better learning and performance. Intrinsic motivation 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 among medical students because intrinsic motivation leads to better learning and performance and because it can be enhanced by providing autonomy, feedback and emotional support to students
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