Unlocking Motivation of Trainees: Is It Up to Us? Medical Education for Gen Z

While the definition of motivation may vary, it is imperative to understand that a student’s motivation to learn is determined both by their individual selves and their environment. It begs the question whether we as educators, through influencing environment, may improve their motivation and amplify a student’s ability to learn.

It is well known that many medical students rely on coffee, as well as support from family and friends, to get through their studies, but they are also sustained by two forms of motivation: intrinsic and extrinsic. Intrinsic motivation is their intellectual curiosity and passion for medical science, and according to Deci & Ryan (2000), “intrinsic motivation has been shown to lead to better learning, performances and well-being among medical students.” Extrinsic motivation, however, is outcome-oriented, such as achieving great marks or earning a high salary as a physician. While extrinsic goalshavetheir place, it is important to focus stimuli on intrinsic motivators of student learning. One such way, according to a 2020 publication by Wu et al, is to ensure academic caliber and faculty support for the varying intrinsic motivations of students.

A review by Kusurkar et al in a 2012 article in Academic Medicine unfortunately showed that motivational theories have not guided medical education curricula reform and motivational processes are conspicuously undervalued. 

Reforming curricula to address motivation in adult learners would have a powerful impact on medical students and subsequently, the future of healthcare. 

There are several approaches to motivating adult learners in medicine. Rolland Viau’s Theory of Motivation for example, addresses the motives and mechanisms underlying an individual’s intrinsic drive to success through cognitive engagement. Viau’s model describes a dynamic model of motivation focusing on three elements: the individual’s perception of task value; their self-efficacy, or competence, in completing the task; and their controllability. Similarly, the self-determination theory (SDT) outlines that competence, autonomy, and relatedness are the three crucial needs for successful learners. Positive learning outcomes are linked to the pleasure or value students glean from learning activities, and allowing for autonomy avoids the pitfalls of student frustrations with being forced into controlled goals. SDT demonstrates that the degree to which learners are effective is related to the degree to which their needs for competence, autonomy and relatedness have been satisfied; needs that are not learned, but rather universal sources of intrinsic motivation. Understanding student motivations and their environment, including us as their teachers, is important to the fulfillment of such needs.

In future work with learners, consider teaching that incorporates exploring the learner’s expectations, explaining the activity’s purpose, and demonstrate task value by giving the learner an applicable problem to solve. Allow learners the autonomy to make choices for themselves and support their failures with compassionate and actionable feedback. Give opportunities for self-efficacy by offering them the temporary role as teacher and support their successes.

The key to success is through unlocking the resilient intrinsic drivers of motivation. Therefore, regardless of the ultimate form, an adaptation of curricula for adult learners to focus on the three targets of task value, self-efficacy, and controllability will stimulate motivation and positively impact students.