Thoma Brent, Hayden Emily M, Wong Nelson, Sanders Jason L, Malin Greg, Gordon James A
MGH Learning Laboratory and the Division of Medical Simulation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Emergency Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
BMJ Simul Technol Enhanc Learn. 2015 Apr 22;1(1):19-23. doi: 10.1136/bmjstel-2015-000019. eCollection 2015.
While medical schools strive to foster students' lifelong learning, motivational theories have not played an explicit role in curricular design. Self-determination Theory is a prominent motivational theory. It posits that perceived autonomy, competence and relatedness foster intrinsic motivation. This study explores the effects of autonomy on intrinsic motivation in medical students participating in high-fidelity mannequin simulation.
A non-randomised crossover trial compared first-year medical students participating in (1) required simulation sessions with predetermined learning objectives and (2) extracurricular simulation sessions with student-directed learning objectives. An adapted Intrinsic Motivation Inventory (IMI) was used to assess intrinsic motivation, perceived autonomy, competence and relatedness. Each participant completed the IMI survey after each type of session. Variables were compared with signed-rank tests.
All 22 participants completed the IMI after both types of session. Perceived autonomy was significantly higher during extracurricular simulation (p<0.001), but intrinsic motivation, competence and relatedness were not. Intrinsic motivation correlated with autonomy (RS=0.57 and extracurricular simulation, ES=0.52), competence (RS=0.46 and ES=0.15) and relatedness (RS=0.51 and ES=0.64). The IMI subscales had good internal consistency (Cronbach's α=0.84, 0.90, 0.90 and 0.76 for intrinsic motivation, autonomy, competence and relatedness, respectively).
Extracurricular sessions increased students' perceived autonomy, but they were highly intrinsically motivated in both settings. Further study is needed to understand the relationship between perceived autonomy and intrinsic motivation in medical education learning activities. The IMI shows promise as a measurement tool for this work.
虽然医学院校努力培养学生的终身学习能力,但动机理论在课程设计中尚未发挥明确作用。自我决定理论是一种著名的动机理论。该理论认为,感知到的自主性、能力和关联性会促进内在动机。本研究探讨自主性对参与高仿真模拟训练的医学生内在动机的影响。
一项非随机交叉试验比较了一年级医学生参与的两种模拟训练:(1)具有预先确定学习目标的必修模拟课程,以及(2)具有学生自主导向学习目标的课外模拟课程。采用一份经过改编的内在动机量表(IMI)来评估内在动机、感知到的自主性、能力和关联性。每位参与者在每种类型的课程结束后完成IMI调查。使用符号秩检验对变量进行比较。
所有22名参与者在两种类型的课程结束后均完成了IMI调查。课外模拟期间,学生感知到的自主性显著更高(p<0.001),但内在动机、能力和关联性并非如此。内在动机与自主性(必修模拟课程中RS=0.57,课外模拟课程中ES=0.52)、能力(必修模拟课程中RS=0.46,课外模拟课程中ES=0.15)和关联性(必修模拟课程中RS=0.51,课外模拟课程中ES=0.64)相关。IMI分量表具有良好的内部一致性(内在动机、自主性、能力和关联性的Cronbach's α分别为0.84、0.90、0.90和0.76)。
课外模拟课程提高了学生感知到的自主性,但他们在两种情况下都具有很高的内在动机。需要进一步研究以了解医学教育学习活动中感知到的自主性与内在动机之间的关系。IMI有望成为这项工作的测量工具。