Kusurkar Rashmi A, Croiset Gerda
Research in Education, VUmc School of Medical Sciences, Amsterdam, The Netherlands;
Research in Education, VUmc School of Medical Sciences, Amsterdam, The Netherlands.
Med Educ Online. 2015 May 6;20:27951. doi: 10.3402/meo.v20.27951. eCollection 2015.
Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT) classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education.
Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning.
Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.
医学生常常只为在考试中取得好成绩或追求某一特定专业而学习，或者只学习那些他们认为在医学实践中有用的主题。在这些情况下，学习的动机来自外部或内部压力，或者来自获得奖励的愿望。自我决定理论（SDT）将这种动机类型归类为受控动机，而将来自真正兴趣或个人价值观的动机类型归类为自主动机。与受控动机相比，自主动机与更好的学习、学业成就以及更少的疲惫感相关。SDT支持自主动机，并表明自主性支持对自主动机很重要。自主性的含义被许多人误解了。本文试图聚焦于如何在医学教育中提供自主性支持。
自主性支持指的是在学习中对选择的感知。在医学教育中支持自主性的一些方式包括小组教学、基于问题的学习以及逐步增加对患者的责任。支持自主性的教学行为不是一种特质，而是可以习得的。医学教育中的自主性支持并不局限于为学生改变医学课程；它关乎医学院校思维和工作方式的全面改变，这种改变能在参与教育的人员中培养自主性。对医学教育中自主性的研究有限。一些需要调查的主题包括学生和教师对学习自主性的想法和看法。
医学教育中的自主性支持可以增强学生对医学学习和实践的自主动机，并使他们在未来的医学实践和教学中支持自主性。
