Cesar Orsini

Determinants and outcomes of motivation in health professions education: a systematic review based on self-determination theory

Purpose: This study aimed at conducting a systematic review in health professions education of determinants, mediators and outcomes of students’ motivation to engage in academic activities based on the self-determination theory’s perspective. Methods: A search was conducted across databases (MEDLINE, CINHAL, EMBASE, PsycINFO, and ERIC databases), hand-search of relevant journals, grey literature, and published research profile of key authors. Quantitative and qualitative studies were included if they reported research in health professions education focused on determinants, mediators, and/or outcomes of motivation from the self-determination and if meeting the quality criteria. Results: A total of 17 studies met the inclusion and quality criteria. Articles retrieved came from diverse locations and mainly from medical education and to a lesser extent from psychology and dental education. Intrapersonal (gender and personality traits) and interpersonal determinants (academic conditions and lifestyle, qualitative method of selection, feedback, and an autonomy supportive learning climate) have been reported to have a positive influence on students’ motivation to engage in academic activities. No studies were found that tested mediation effects between determinants and students’ motivation. In turn, students’ self-determined motivation has been found to be positively associated with different cognitive, affective, and behavioural outcomes. Conclusion: This study has found that generally, motivation could be enhanced by changes in the educational environment and by an early detection of students’ characteristics. Doing so may support future health practitioners’ self-determined motivation and positively influence how they process information and their emotions and how they approach their learning activities.

How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self-determination theory

Purpose: Internalization of students’ motivation towards an intrinsic form is associated with increased interest, commitment, learning, and satisfaction with education. Self-Determination theory postulates that intrinsic motivation and autonomous forms of self-regulation are the desired type of motivation; as they have been associated with deep learning, better performance and well-being. It claims three basic psychological needs have to be satisfied in order to achieve intrinsic motivation. These are the needs for autonomy, competence and relatedness. This study aims to provide a review on how these basic psychological needs are encouraged in undergraduate students so they can be transferred to the clinical teaching environment. Methods: Electronic searches were performed across four databases (Medline, Embase, PsycINFO, and ERIC), relevant journals, and retrieved bibliography of selected articles. In total, searches produced 4,869 references, from which 16 studies met the inclusion criteria. Results: Main themes were coded in three categories: The support of autonomy, competence and relatedness. The research-based evidence appears to be of reasonable quality, and indicates that teachers should work to satisfy students’ basic psychological needs to foster internalization of self-regulation. Our findings suggest that teachers should interact with students in a more ‘human centred’ teaching style, as these actions predict motivational internalization. Several themes emerged from different contexts and further investigation should expand them. Conclusion: This review identified actions that clinical teachers could implement in their daily work to support students’ self-determination. Autonomy supportive teaching in health professions educations would benefit students and may actually result in more effective health care delivery.

Curriculum content and assessment of pre-clinical dental skills: A survey of undergraduate dental education in Europe

INTRODUCTION Since 1981, the qualifications for various healthcare professionals across the European Union have enjoyed mutual recognition in accordance with the EU Directive 81/1057/EEC. Whilst the directive includes dental practitioners, it is recognised that significant variation exists in curriculum structure, content and scope of practice across institutions. This article aimed to explore pan-European practice in relation to curriculum content, teaching and learning strategies and assessment of pre-clinical dental skills. METHOD A request to complete an online questionnaire, in English, was sent electronically to skills leads at all Association of Dental Education in Europe member schools. The questionnaire collected information in relation to institution and country, regulatory requirements to demonstrate safety, details of specific pre-clinical skills courses, learning materials and teaching staff. RESULTS Forty-eight institutions, from 25 European countries responded. Seven countries (n=7, 28%) reported no requirement to demonstrate student operative safety prior to patient treatment. Several core and operative clinical skills are common to the majority of institutions. The most commonly taught core skills related directly to the clinical environment such as cross-infection control and hand washing. The least common were skills that indirectly related to patient care, such as communication skills and working as a team. CONCLUSION There are clear differences within European pre-clinical dental education, and greater efforts are needed to demonstrate that all European students are fit to practice before they start treating patients. Learning outcomes, teaching activities and assessment activities of pre-clinical skills should be shared collaboratively to further standardise curricula.

Closing the gap between business undergraduate education and the organisational environment: A Chilean case study applying experiential learning theory

ABSTRACT In response to the continuous changes in Latin American higher education and the increasing demands for better prepared professionals, the Learning Connected to the Organisational Environment method was introduced in the course of Marketing at one public University in Chile. This was aimed as an integrated approach to education, providing pedagogical and social value by connecting organisations and real challenges with the learning objectives. This paper describes its design, implementation and initial impact on students’ learning process. Results on the impact of the LCOE method show that students valued learning with this new initiative (n = 158) and showed higher performance and improved quality of their written reports, along with higher evaluations of the teaching staff compared to students in the same course learning with traditional methods (n = 158). Discussion is centred on the value of this initiative and on suggestions for transference and future research.

Motivational profiles and their relationships with basic psychological needs, academic performance, study strategies, self-esteem, and vitality in dental students in Chile

Purpose To determine dental students’ motivational profiles through a person-centred approach and to analyse the associations with the satisfaction of their basic psychological needs, study strategies, academic performance, self-esteem, and vitality. Methods A total of 924 students from the University of San Sebastian (Chile) participated in this cross-sectional cor¬relational study in spring 2016. Data were collected through 5 self-reported instruments, in addition to students’ academic performance. The Cronbach alpha, descriptive statistics, and correla¬tion scores were computed. A k-means cluster analysis with intrinsic and controlled motivation was conducted to identify different mo-tivational profiles. Subsequently, multivariate analysis of covariance controlling for the effects of gender and year of study was carried out to assess differences among the retained motivational profiles and learning variables. Results All instruments showed acceptable Cronbach alpha scores. A 4-cluster solution was retained for the motivational profile over a 3- or 5-cluster solution. Students’ motiva-tional profiles were characterized by different degrees of intrinsic and controlled motivation. The high intrinsic motivation groups showed higher perceptions of their basic psychological, a greater propensity for a deep rather than surface study strategy, better academic performance, and higher scores for self-esteem and vitality than the low intrinsic motivation groups, regardless of the degree of controlled motivation. Conclusion Students with a high intrinsic motivation profile, regardless of their controlled motivation scores, reported better learning characteristics. Therefore, special attention should be paid to students’ motivational profiles, as the quality of motivation might serve as a basis for interventions to support their academic success and well-being.

Evaluation criteria for competency-based syllabi: a Chilean case study applying mixed methods

Abstract In recent decades, higher education institutions worldwide have been moving from knowledge-based to competence-based curricula. One of the greatest challenges in this transition is the difficulty in changing the knowledge-oriented practices of teachers. This study evaluates the consistency between syllabus design and the requirements imposed by a competence-based learning environment. To make this comparison, the study sets four criteria (C1: explicit relationship between syllabus and graduate profile; C2: precision of the learning outcomes and assessment criteria; C3: contents that mobilise the learning outcomes; and C4: learning and assessment activities) derived from the literature and a thematic analysis of competence-based learning in higher education. Afterwards, a sample of 150 syllabi from different disciplines of five Chilean public universities were analysed, all of which stated the use of learning outcomes and competences in their learning models. Using a three-point Likert scale derived from the aforementioned criteria and their indicators, a comparison was made between the actual practices reflected in the syllabus design and the previously established criteria. Results show a gap between the declaration of a competency-based curriculum and actual syllabus outlines. Moreover, there are important differences among disciplines. Although all disciplines present high levels of accomplishment for Criteria 1 and 3, only the discipline of health sciences presents an acceptable level for Criteria 2 and 4. It is recommended that further research be undertaken towards identifying effective competency-based syllabus design.