Decision-Making During Asynchronous Electives: Insights From Emergency Medicine-Bound Medical Students

Introduction While asynchronous learning is gaining popularity, little is known about learners' decisions regarding compliance with assigned asynchronous material. We sought to explore how medical students make decisions about the use of their time when engaging in asynchronous learning during the residency interview season.  Methods After implementing a four-week blended elective for emergency medicine-bound fourth-year medical students, we conducted a mixed methods study with an explanatory sequential design. We analyzed weekly surveys regarding accountability and barriers to assignment completion and conducted semi-structured focus groups exploring the decisions students made regarding compliance with asynchronous assignments. Using a constructivist approach, we performed a thematic analysis of the transcripts. Results The average assignment completion rate was 36%, with the highest rates for podcasts (58%) and the lowest rates for textbook readings (20%). Compliance with assignments was enhanced by a desire for increased ownership of learning but was hindered by a lack of accountability, learner burnout, and higher prioritization of interviews. Students preferentially selected resources that were shorter in length, entertaining, and more convenient for travel. Conclusion Our study highlights factors impacting student compliance when engaging in asynchronous learning and offers insights into educational and institutional strategies that can be utilized to enhance learner motivation.