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Medical student motivation remains higher internally than externally driven, but declines throughout training. Curricula changes can support sustained motivation in medical education.

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Area of Science:

  • Medical Education
  • Psychology
  • Student Well-being

Background:

  • Motivation is crucial for medical student engagement, learning, and well-being.
  • Self-Determination Theory guides the understanding of intrinsic and extrinsic motivation.
  • The Work Extrinsic and Intrinsic Motivation Scale (WEIMS) measures motivational factors.

Purpose of the Study:

  • To examine intrinsic and extrinsic motivational contributions in medical students throughout their curriculum.
  • To analyze changes in self-determined motivation over the course of medical training.
  • To identify factors influencing motivation using the Work Self-Determination Index (W-SDI).

Main Methods:

  • A longitudinal study surveyed 1828 medical students at five time points using the 18-item WEIMS.
  • Motivational types included Intrinsic, Integrated, Identified, Introjected, External, and Amotivation.
  • The Work Self-Determination Index (W-SDI) was calculated to assess the balance of autonomous versus controlled motivation.

Main Results:

  • Self-determined motivation was consistently higher than non-self-determined motivation across all time points.
  • W-SDI scores significantly decreased from matriculation to later stages of training (18, 30, and 48 months).
  • This decline was associated with significant increases in external regulation and amotivation.

Conclusions:

  • Medical student motivation is dynamic and tends to decrease throughout training.
  • While self-determined motivation remains dominant, its slight decline suggests a need for supportive educational environments.
  • Curricula should focus on enhancing autonomy, competence, and relatedness to foster sustained intrinsic motivation.