Beyond Motivation: Applying A Behavior Model to Promote Self Directed Learning in New Residents

Background The transition from medical school to residency presents challenges for self-directed learning (SDL), as residents must balance clinical responsibilities with consistent study habits. Because SDL largely occurs outside of clinical duties, relying on motivation alone is often insufficient under the demands of residency. The Fogg Behavior Model (FBM) proposes that behaviors depend not only on motivation but also on prompts and ability. Objective To evaluate whether an FBM-based intervention could improve In-Training Examination (ITE) scores and SDL engagement among first-year obstretrics and gynecology (OB/GYN) residents. Methods This quasi-experimental study was conducted at the University of Missouri-Kansas City OB/GYN residency program from 2016 to 2021. Forty-eight first-year residents participated, with 24 in the intervention group and 24 controls. Both groups participated in a structured SDL program, including assigned study topics and a shared Google Drive spreadsheet for tracking progress. The intervention group also received a workshop on how to create effective prompts (external cues) and increase ability by lowering activation barriers through habit stacking and categorizing tasks by energy level. The primary outcome was ITE score. The secondary outcome was SDL engagement, defined as completion of assigned reading topics and logging of self-directed study sessions. Results Intervention group residents had significantly higher ITE scores (206±3.13) than controls (194±3.11, P=.006). They also logged more weekly study sessions (4.8±1.2 vs 3.2±1.0, P=.02) and completed more assigned reading topics (104 of 120, 87% vs 74 of 120, 62%, P=.01). Conclusions An FBM-based intervention emphasizing prompts and ability improved ITE scores and SDL engagement among first-year OB/GYN residents.