Measuring medical students' reflection on their learning: modification and validation of the motivated strategies for learning questionnaire (MSLQ)

Promoting Self-Efficacy of Nursing Students in Academic Integrity Through a Digital Serious Game: A Pre/Post-Test Study

BACKGROUND

Academic integrity is an important component of nursing education, bridging academic ethics with professional practice. This study evaluated the effectiveness of a co-designed Academic Integrity digital serious game in improving nursing students' self-efficacy related to academic integrity, academic offenses, professionalism, and artificial intelligence use.

METHODS

A pre-test/post-test design was employed, using a bespoke questionnaire to assess 303 first-year nursing students' self-efficacy before and after playing the game. The questionnaire covered five subscales: academic integrity standards, academic offenses, professional values, feedback processes, and AI use in academic work.

RESULTS

Statistically significant improvements were observed across all subscales following the intervention, indicating enhanced self-efficacy in understanding and applying academic integrity principles, recognizing academic offenses, demonstrating professional behaviors, utilizing feedback, and appropriately using AI in academic contexts.

CONCLUSIONS

The Academic Integrity digital serious game has the potential to be an effective tool for enhancing nursing students' self-efficacy in the areas of academic and professional ethics. This approach shows promise for integrating academic integrity-based education in nursing curricula and preparing students for the ethical challenges of modern healthcare practice. This study was not registered.

Comparison of the adequacies of the OSCE and vOSCE to assess the competencies required under Brazilian medical curriculum guidelines: a multicenter study

BACKGROUND

The COVID-19 pandemic has led to the popularization of information and communication technology in medical education. This study aimed to compare the objective structured clinical examination (OSCE) and the virtual objective structured clinical examination (vOSCE), based on expert opinion, as tools for assessing the competencies needed under medical curriculum guidelines in Brazil.

METHODS

In this multicenter study, the suitability levels of the OSCE and vOSCE for assessing the competencies needed under the Brazilian National Curriculum Guidelines (DCNs) were compared. The DCNs encompass five groups of domains, namely, health education; general; health management; public health needs; and individual health needs. Sixteen teaching experts served as judges. They responded to a questionnaire with the provided Likert scores indicating the ability of the OSCE and vOSCE to assess each type of competency. Virtual meetings were held via the Delphi method and a focus group-based approach to enable the experts to reach a consensus.

RESULTS

A total of 200 items included in the guidelines (100 for the OSCE and 100 for the vOSCE) were evaluated across a total of 3,200 responses. Analysis via the Likert scale revealed a high proportion of positive evaluations for the use of the vOSCE, with kappa values ​​ranging from 0.4 to 0.72. The values ​​of the absolute agreement (positive view) between examiners and equivalence with the kappa statistic for the adoption of the vOSCE ranged from 0.38 to 0.72. Via the use of virtual meetings (Delphi and focus groups), consensus was reached regarding the capacity of the OSCE and vOSCE to evaluate 97% and 92% of these items, respectively.

CONCLUSION

The vOSCE can be employed to assess relevant competencies. However, it faces limitations regarding 8% (8/100) of the items, and some items (3%) cannot be assessed via either method. The difference in results between the two assessment methodologies (OSCE and vOSCE) is 5%. It is necessary to invest in the creation of instruments that can be used to apply the vOSCE and to conduct cost‒benefit analysis of its broader application in health education institutions. We conclude that the vOSCE is an effective tool for assessing most competencies of medical professionals and students required under Brazilian guidelines.

Surveying Undergraduate Medical Students' Motivational Orientations and Learning Strategies in the First and Last Year of Medical School

Motivation to learn has been linked to learning outcomes, academic performance, learner well-being, and choice of medical specialty. Previous studies showed successful educational interventions to optimize students' levels of motivation and learning strategies. The purposes of this study are (1) to describe undergraduate medical students' motivational orientations and learning strategies in the first and last year at a Canadian university and (2) to analyze possible differences between undergraduate medical students' motivational orientations and learning strategies in those two academic years. An online cross-sectional survey was conducted using the Motivated Strategies for Learning Questionnaire (MSLQ). The survey was sent to a total of 207 first-year and 203 third-year students. We received a total of 58 surveys, 32 of them were complete and analyzed. The overall response rate was 14.1%. The internal consistency for all the scales varied from 0.61 to 0.904. The overall score for the survey was 4.97 on a 7-point scale for all students. Highest scales' scores were obtained for elaboration (mean 5.68) and learning beliefs (mean 5.64), with the lowest scores obtained for rehearsal (3.82) and test anxiety (3.94). The total scores did not differ by students' academic year (p = 0.764), except for the effort regulation scale in which first-year students scored higher (p = 0.01). The largest differences between first- and last-year students were found in effort regulation, where first-years scored higher (difference of 0.99), followed by peer learning (difference of - 0.51), and then test anxiety (- 0.36). Our results showed a sample of students that are highly motivated, mostly driven by intrinsic goals, and are confident that they will master the tasks given to them. They rely more on elaboration strategies building connections between new and prior information, and less in rehearsal strategies used for simple tasks and memorization. The MSLQ showed to be a reliable instrument in our sample, and it could be use as an instrument to identify students' adaptive changes to enhance students' motivation to learn. A portrayal of medical students' attitudes in learning could guide educators to develop instructional programs that would help students to optimize their own learning.

Use of Mini-CEX as Formative Assessment Tool in the Training of Undergraduate Medical Students in ENT Situation Analysis and the Way Forward

Background

Mini-CEX assesses clinical competency and is mainly used as a formative assessment tool. Its use in postgraduate training is well documented. However, Mini-CEX would play a significant role in training undergraduate medical students, especially with the commencement of competency-based medical education in India. This work reports the situational analysis of the Mini-CEX implementation in the department of ENT.

Methods and Material

The Department of ENT is using Mini-CEX for formative assessment of students' clinical competence since 2017. Each student had to complete a minimum of five Mini-CEX encounters before the summative assessment. We reviewed the Mini-CEX assessment records of 149 undergraduate medical students who appeared for the summative exam in 2018.

Results

We analysed the records of 874 Mini-CEX encounters. Each Mini-CEX encounter took 11 min on average. Each student completed five such assessments, which accounted for 55 min of one-to-one teacher-student interaction focused on clinical skills learning. The feedback time varied from 1 to 30 min. Feedback was focused on the cognitive (46%) and psychomotor (42%) domains. However, the majority of students reflected that they learned psychomotor skills during the Mini-CEX. Students selected only a few skills for the Mini-CEX, ignoring many must-know skills.

Conclusions

Mini-CEX is feasible as a formative assessment tool for medical undergraduates' ENT training. It improves the assessor-student interaction, provides effective feedback, and develops the practice of reflection among students. However, regular review and training of the assessors and students are needed as a quality assurance measure.

Validation of the motivated strategies for learning questionnaire and instructional materials motivation survey

PURPOSE

To validate the Motivated Strategies for Learning Questionnaire (MSLQ), which measures learner motivations; and the Instructional Materials Motivation Survey (IMMS), which measures the motivational properties of educational activities.

METHODS

Participants (333 pharmacists, physicians, and advanced practice providers) completed the MSLQ, IMMS, Congruence-Personalization Questionnaire (CPQ), and a knowledge test immediately following an online learning module (April 2021). We randomly divided data for split-sample analysis using confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and the multitrait-multimethod matrix.

RESULTS

Cronbach alpha was ≥0.70 for most domains. CFA using sample 1 demonstrated suboptimal fit for both instruments, including 3 negatively-worded IMMS items with particularly low loadings. Revised IMMS (RIMMS) scores (which omit negatively-worded items) demonstrated better fit. Guided by EFA, we identified a novel 3-domain, 11-item 'MSLQ-Short Form-Revised' (MSLQ-SFR, with domains: Interest, Self-efficacy, and Attribution) and the 4-domain, 12-item RIMMS as the best models. CFA using sample 2 confirmed good fit. Correlations among MSLQ-SFR, RIMMS, and CPQ scores aligned with predictions; correlations with knowledge scores were small.

CONCLUSIONS

Original MSLQ and IMMS scores show poor model fit, with negatively-worded items notably divergent. Revised, shorter models-the MSLQ-SFR and RIMMS-show satisfactory model fit (internal structure) and relations with other variables.

Exploring how Australian general practice registrars define cultural safety with Aboriginal and Torres Strait Islander patients: a mixed method study

BACKGROUND

Understanding how the general practice medical workforce defines cultural safety may help tailor education and training to better enable community-determined culturally safe practice. This project seeks to explore how Australian general practice registrars define cultural safety with Aboriginal and Torres Strait Islander patients and alignment with an Australian community derived definition of cultural safety.

METHODS

This mixed method study involved a survey considering demographic details of general practice registrars, questionnaire, and semi-structured interviews to explore how general practice registrars defined cultural safety and a culturally safe consultation.

RESULTS

Twenty-six registrars completed the survey. Sixteen registrars completed both the survey and the interview.

CONCLUSION

This study shows amongst this small sample that there is limited alignment of general practice registrars' definitions of cultural safety with a community derived definition of cultural safety. The most frequently cited aspects of cultural safety included accessible healthcare, appropriate attitude, and awareness of differences.

Achievement Emotions of Medical Students: Do They Predict Self-regulated Learning and Burnout in an Online Learning Environment?

BACKGROUND

Achievement emotions have been proven as important indicators of students' academic performance in traditional classrooms and beyond. In the online learning contexts, previous studies have indicated that achievement emotions would affect students' adoption of self-regulated learning strategies and further predict their learning outcomes. However, the pathway regarding how different positive and negative achievement emotions might affect students' burnout through self-regulated learning among medical students in online learning environments remains unclear. In this study, the aim is to investigate how achievement emotions and self-regulated learning predict burnout among medical students in online education.

METHODS

This study involved 282 medical students who had attended online courses due to the sudden shift of learning mode caused by the COVID-19 pandemic in 2022. Confirmatory factor analysis was performed to examine the hypothesized factor structure, and structural equation modelling was conducted to test the hypothesized relationships among factors.

RESULTS

The results of structural equation modelling revealed that medical students' self-efficacy positively predicted their enjoyment (β = .57) and online self-regulated learning (β = .54). Learning-related boredom inhibited students' adoption of online self-regulated learning strategies (β = -.24), and it was positively associated with their burnout (β = .54). Learning-related anxiety was a positive predictor of online self-regulated learning (β = .38).

DISCUSSIONS

The results of this study suggest that achievement emotions experienced by medical students had a significant impact on their online self-regulated learning and burnout. Specifically, the experience of learning-related boredom was detrimental to the adoption of self-regulated learning strategies and increased the likelihood of burnout. However, learning-related anxiety, despite being a negative achievement emotion, was positively associated with students' online self-regulated learning. These findings have important implications for online teaching and learning, particularly in the post-pandemic era.

Relationship between digital capabilities and academic performance: the mediating effect of self-efficacy

AIMS

To assess digital capabilities and academic performance among nursing students and investigate the mediating role of students' self-efficacy.

BACKGROUND

In the context of education and technology, digital capabilities, self-efficacy, and academic performance among nursing students are interconnected concepts. Students who use their digital capabilities and competencies combined with their belief in the ability to efficiently perform learning tasks could improve their academic endeavors. Nevertheless, insufficient consideration has been placed on research understanding of the mediating roles and broad elements that influence their relationships.

METHODS

A cross-sectional, correlational, descriptive, and quantitative study was established. During the 2022-23 academic year, data were gathered from 200 students. The Hayes Process Model 4 macro was employed to investigate the role of students' self-efficacy mediating effect on the association between digital capabilities and academic performance.

RESULTS

The digital capability level and self-efficacy level were high. Additionally, the academic performance level was moderate. The mediation analysis revealed that the direct effect of digital capabilities on student performance in the presence of the mediator was significant (b = 0.0063, p = 0.022). Hence, self-efficacy partially mediated the relationship between digital capabilities and student performance.

CONCLUSION

The study emphasized the importance of improving students' digital capabilities that enhance their confidence and self-actualization. In addition, nursing students are encouraged to improve their sense of self-efficacy throughout their tenure in college because it is a predictor of future success.

Validity and reliability of the Persian version of modified motivated strategies for learning questionnaire: a methodological study among medical students

BACKGROUND

Medical undergraduates need to improve their techniques for learning in the different settings of learning in clinical rotations. Reflective learning, in which a person can learn from their experiences, is among the most well-known learning skills. In this study, we aim to translate the newly developed modified form of the motivated strategies for learning questionnaire (MSLQ) to Persian and evaluate its reliability and validity among medical students.

METHODS

This study was performed on medical students in clinical stages at the Shiraz University of Medical Science in 2022. The modified MSLQ questionnaire was used in this study which is a 32-item tool measuring different aspects of self-reflecting, including self-orientation, feedback-seeking, critical thinking, and self-regulation. This questionnaire was translated into Persian properly. Cronbach's alpha and confirmatory factor analysis were used to ascertain the reliability and validity of the tool.

RESULTS

A total of 325 medical students consisting of 174 men and 151 women with an average age of 23.79 (± 2.21) were enrolled. Path diagrams of confirmatory factor analysis for both standardized regression coefficients and t-values and all the fitness indicators were in favor of the proper validation of the translated version. The overall Cronbach's alpha for the questionnaire was 0.9, and the value for each of four subscales was above 0.7.

CONCLUSIONS

Our study showed that the Persian-translated version of the modified MSLQ is valid and reliable without taking too much time and effort to implement. We recommend that the developed tool be distributed to medical students from other Iran universities.

Assessing cultural safety in general practice consultations for Indigenous patients: protocol for a mixed methods sequential embedded design study

BACKGROUND

Assessment of cultural safety in general practice consultations for Indigenous patients is a complex notion. Design and development of any assessment tool needs to be cognizant that cultural safety is determined by Indigenous peoples and incorporates defined components of cultural safety and current educational theory. Consideration of how social, historical, and political determinants of health and well-being impact upon the cultural safety of a consultation is also important. Given this complexity, we assume that no single method of assessment will be adequate to determine if general practice (GP) registrars are demonstrating or delivering culturally safe care. As such, we propose that development and assessment of cultural safety can be conceptualised using a model that considers these variables. From this, we aim to develop a tool to assess whether GP registrars are conducting a culturally safe consultation, where cultural safety is determined by Aboriginal and Torres Strait Islander peoples.

METHODS

This protocol will be situated in a pragmatic philosophical position to explore cultural safety primarily from the Australian Aboriginal and Torres Strait Islander patients' perspective with triangulation and validation of findings with the GP and GP registrar perspective, the Aboriginal and Torres Strait Islander community, and the medical education community. The study will integrate both quantitative and qualitative data through three sequential phases. Data collection will be through survey, semi-structured interviews, an adapted nominal group technique, and a Delphi questionnaire. We aim to recruit approximately 40 patient and 20 GP participants for interviews, conduct one to five nominal groups (seven to 35 participants) and recruit fifteen participants for the Delphi process. Data will be analysed through a content analysis approach to identify components of an assessment of cultural safety for GP registrars.

DISCUSSION

This study will be one of the first to explore how cultural safety, as determined by Indigenous peoples, can be assessed in general practice consultations. This protocol is shared to stimulate awareness and discussion around this significant issue and prompt other studies in this area.

Optimizing the Learner's Role in Feedback: Development of a Feedback-Preparedness Online Application for Medical Students in the Clinical Setting

Feedback is an essential component of medical education, especially during clinical rotations. There is growing interest in learner-related factors that can optimize feedback's efficiency, including goal orientation, reflection, self-assessment, and emotional response. However, no mobile application or curriculum currently exists to specifically address those factors. This technical report describes the concept, design, and learner-based feedback of an innovative online application, available on mobile phones, developed to bridge this gap. Eighteen students in their third or fourth year of medical school provided comments on a pilot version of the application. The majority of learners deemed the module relevant, interesting, and helpful to guide reflection and self-assessment, therefore fostering better preparation before an upcoming feedback session. Minor improvements were suggested in terms of content and format. The learners' initial positive response supports further efforts to engage in validity and evaluation research. Future steps include modifying the mobile application based on learners' comments, evaluating its efficacy in a real clinical setting, and clarifying whether it is most beneficial for mid-rotation or end-of-rotation feedback sessions.

Developing low-achieving medical students' self-regulated learning using a combined learning diary and explicit training intervention

INTRODUCTION

The development of self-regulated learning (SRL) is an essential educational component of remediation for low-achieving students. The aim of this study was to design, implement, and evaluate a longitudinal SRL intervention combining both a structured learning diary and explicit SRL training in a cohort of low-achieving undergraduate medical students.

MATERIALS AND METHODS

A mixed methods quasi-experimental study was conducted, with a pretest-posttest study in the intervention group and comparison of the GPA and course grade of the intervention group with a historical comparison group. A questionnaire and focus group explored the participants' perceptions about the intervention.

RESULTS

The SRL scores (total and rehearsal, organization, critical thinking, metacognitive regulation, time management and environment management) and course grade of participants were significantly improved in the intervention group. The course grade of participants was significantly higher than the comparison group but the GPA was not significantly different. Overall, the participants were positive about the intervention.

CONCLUSIONS

This study was the first in medical education to evaluate the effectiveness and user acceptability of an SRL intervention that combined a structured learning diary and explicit SRL training in low-achieving medical students. Further research is recommended in different contexts and with larger number of students.

Diversity of Strategies for Motivation in Learning (DSML)—A New Measure for Measuring Student Academic Motivation

Although the Motivated Strategies for Learning Questionnaire (MSLQ) has been widely used to measure student motivation, researchers have raised questions regarding its length and several problematic statements. This study introduces a new questionnaire, adapting items from the MSLQ and including three new key themes of course utility, procrastination and use of diverse sources. A total of 1246 students from a university in the northwest of England, studying a range of subjects and from across all grade boundaries, fully completed the questionnaire. Factor analysis suggested a 24-item questionnaire, including 6 factors: test anxiety, self-efficacy, source diversity, study skills, self-regulation and course utility. The measure, Diversity of Strategies for Motivation in Learning (DSML), has good predictive power for students with or without academic successes, and it can be used as a quick and an early alert monitoring tool to measure student motivation and study skills. The DSML has supported various interventions; however, further testing is required in other cultures, languages and educational environments (such as schools and colleges).

Telling My Story: Applying Storytelling to Complex Economic Data

Our experience with business and economic students indicates limited understanding and confidence when working with macroeconomic data such as unemployment rate, labor force participation rate, business cycles, and price indexes. To close this gap, the authors have developed and evaluated a college classroom experiential activity defined as the Storytelling Project (SP) conducted in nine principles of economics courses in a mid-size private university over a period of two years during the COVID-19 pandemic. In the SP, students wrote personal stories that assisted them in connecting with their audience and then visually presented complex economic data. A workbook supplemented the SP with learning objectives, tasks, multiple examples of data analysis, storytelling techniques, and videos. Participants completed a self-efficacy and attitude survey of perceived cognition, confidence, and motivation and took an assessment to evaluate cognitive competencies. The survey and assessment results were compared against students who did not complete the SP. Our results indicate that the SP and the workbook are effective experiential learning activities that improve data analysis and communication skills among college students. Students show more confidence and motivation in macroeconomics and data analysis at the end of the semester. Knowledge or cognitive competency is ranked higher among those completing the SP.

Adapting the Motivated Strategies for Learning Questionnaire to the Japanese Problem-Based Learning Context: A Validation Study

The COVID-19 pandemic has greatly changed medical education, and medical trainees' self-regulation has become more emphasized. In Japan, the concept of self-regulated learning has not been fully applied in health profession education due to a lack of effective measurement tools. We aimed to validate the translated Japanese version of the Motivated Strategies for Learning Questionnaire in the context of Problem-Based Learning (J-MSLQ-PBL). The questionnaire employs a seven-point Likert-type scale with 81 items and is categorized into two sections: motivation and learning strategies. An exploratory factor analysis (EFA) was conducted by using Promax rotation to examine the factor structure of the scale, using the collected data from 112 Japanese medical students. Factor extraction was based on a scree plot investigation, and an item was accepted when the factor loading was ≥0.40. In the motivation section, the extracted factors from the EFA were well aligned with the subscales of the original MSLQ, including "Self-Efficacy for Learning and Performance", "Task Value", "Self-Efficacy for Learning and Performance", "Test Anxiety", "Extrinsic Goal Orientation", and "Intrinsic Goal Orientation". In the learning strategies, the extracted factors poorly matched the structure of the original subscales. This discrepancy could be explained by insufficient translation, the limited sample size from a single medical school, or cross-cultural differences in learning strategies between Western and Japanese medical students. Only the motivation part of the J-MSLQ-PBL should be implemented to measure the competency elements of self-regulated learning in Japan.

Correlates, motivating factors, and barriers of engaging in regular self-reflection among public health students in higher education-A mixed methods approach

Despite the wide implementation of self-reflection in higher education, the body of literature has predominantly focused on students from the clinical health sciences rather than public health. The objective of this study was to evaluate the correlates as well as to explore the motivating factors and barriers of engaging in regular self-reflection among public health students in higher education. We used a mixed methods approach (explanatory sequential design), comprising a cross-sectional survey (quantitative phase) followed by in-depth interviews (qualitative phase). We evaluated the association between reflection frequency as well as the perceptions and facilitators in reflection using the modified Breslow-Cox proportional hazards regression model. Prevalence ratio (PR) was generated. Thematic data analysis was carried out to analyse the qualitative data. Quantitative findings revealed being a regular reflector was positively associated with being more motivated to learn when one applied self-reflection (adjusted PR 1.60, 95% CI 1.17-2.20), the perception of being more prepared for a public health career in the future (adjusted PR 1.28, 95% CI 1.02-1.60), as well as being given enough opportunities to carry out self-reflection in the public health modules (adjusted PR 1.24, 95% CI 1.05-1.45). Qualitative findings revealed most students started their self-reflection mainly due to extrinsic factors such as institutional support, social support, teacher influence and environmental influence. Of these, the most prominent was teacher influence, indicating that they are key agents in promoting self-reflection. Students expressed that it would be important to cultivate intrinsic motivation to sustain their practice of self-reflection along the learning journey such as for the development of career-related professional skills. Other than intrinsic motivation, environmental influences were also important to promote continual reflection among students such as the availability of ample opportunities. Prominent barriers to address included external student factors such as the imbalanced power relationship between teacher and student, and internal student factors such as the perception that self-reflection was too cumbersome and time consuming.

Understanding Student Characteristics in the Development of Active Learning Strategies

Student evaluations after non-lecture, active learning sessions at Michigan State University, College of Osteopathic Medicine, have yielded bipartite responses with one group responding favorably and the other group negatively. The purpose of this study was to understand the characteristics, motivation, and learning strategies of medical students that find value in, appreciate, and perceive active learning sessions to be beneficial and those of students that do not. We generated a survey, based on the Motivated Strategies for Learning Questionnaire (MSLQ), that included questions regarding overall student motivations for learning, learning strategies that students employed throughout medical school, and their perceptions of active learning. Following an active learning session on hyperammonemia, we administered the modified MSLQ survey. Using the results of this survey, we validated the modified MSLQ and identified correlations between student characteristics and their perception of the active learning session. We found that, in general, students with high task value, intrinsic goal orientation, self-efficacy for learning and performance, and control of learning beliefs felt more positively about their experience in the active learning session. Understanding the characteristics, motivations, and learning strategies that help students find value in active learning sessions will help medical educators develop future curricular material so that these exercises will better engage and be more effective with a greater number of learners.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-022-01550-9.

Pre-Clinical Medical Students' Use of Motivational and Cognitive Study Strategies During Anatomy Learning: A Three-Year Cross-Sectional Survey

Medical students' motivation and study strategies are crucial in determining academic performance. This study aimed to assess the motivation and learning strategies of medical students as well as their association with performance in anatomy examinations. The Motivated Strategies for Learning Questionnaire, two focus group discussions, and students' current anatomy cumulative grade point average (cGPA) were used. Generally, the medical students strongly felt that anatomy is fundamental to the practice of medicine and surgery. This result was consistent with high task value scores of 5.99 ± 1.25. They were also driven by extrinsic goal orientation (5.59 ± 1.42) and intrinsic goal orientation (5.08 ± 1.26). Most medical students typically relied on elaboration (5.35 ± 1.25) ahead of other cognitive strategies namely rehearsal (5.30 ± 1.11), organization (5.15 ± 1.34), and lowest-rated critical thinking (4.77 ± 1.19). The students also relied on resource management strategies, effort regulation (5.15 ± 1.20) and time and study environment regulation (5.03 ± 1.03) more than the moderately scored peer learning (4.95 ± 1.50) and help-seeking (4.95 ± 1.09). In the focus group discussions, students reported that they often narrate or explain to each other what they would have read and understood from anatomy lectures, tutorials, and textbooks. They also bemoaned the lack of institutional support for stress burdens. The motivation and learning strategies subscales were not correlated with anatomy cGPA. Males were driven by extrinsic goals and experienced significantly higher levels of test anxiety than females (P < 0.05). Knowing the motivation and learning strategies students employ early in the medical curriculum can be leveraged to promote self-directed learning and academic achievement.

Psychometric Properties of the MSLQ-B for Adult Distance Education in China

In the education context, The Motivational Strategies for Learning Questionnaire (MSLQ) is extensively used in assessing self-regulated learning strategies. However, more research is needed to address whether it is applicable for distance education. The exploratory and confirmatory factor analysis were used to test the Chinese version of the Motivated Strategies for Learning Questionnaire part-B for distance learning (MSLQ-B-DL) using two samples totalling 385 participants. This paper substantiates MSLQ-B-DL's criterion-related, convergent, and factorial validity, as well as its internal consistency, in China. Specifically, the concurrent validity of the MSLQ-B-DL was shown from three aspects: (a) the negative correlation of MSLQ-B-DL with trait procrastination; (b) the positive correlation of MSLQ-B-DL with self-control; and (c) the positive correlation of MSLQ-B-DL with instrumental help-seeking and the former's negative correlation with help-seeking avoidance and executive help-seeking. Finally, this study highlights the MSLQ-B-DL's validity and reliability in evaluating the learning strategies in adult distance education in China.

Adaptation and Validation of the Motivated Strategies for Learning Questionnaire for Spanish Adolescents

This work adapts and validates the scale of the motivated strategies for learning questionnaire (MSLQ), which is used to measure motivation. For this, an instrumental design was carried out with the purpose of analyzing the psychometric properties of the instrument. The sample consisted of 307 participants enrolled in compulsory secondary education. Reliability with fit indices were good in model B (proposed) with composite reliability, global reliability index, and Cronbach's alpha. The original model (A) presented small problems that had to be adjusted when carrying out the translation. We concluded that adaptation and subsequent validation of the MSLQ instrument into a Spanish context was positive. In this sense, adequate adjustment rates have been achieved. However, in its contextual adequacy, the need arises to modify the presentation of the items alluding to intrinsic motivation due to the difficulty of measuring such a construct. Among the implications reached in this study is the possibility of having a validated instrument for the Spanish adolescent context to measure motivation on educational aspects. Furthermore, this tool can serve as the basis for the design of other instruments that measure this construct in other age ranges.

Patients Encounter as a Motivating Factor for Academic Performance in a Medical Neuroscience Course

BACKGROUND

The integration of patient encounters into the first year of the medical school curriculum is known to be of vital importance in the development of critical thinking and communication skills. We investigated whether exposure of first year medical students to patient encounters during a first year medical school neuroscience course result in a high level of motivation associated with the clinical encounter, and whether this high level of motivation translates to higher academic performance as measured by their performance on formative and summative examinations.

METHODS

First year medical students interacted with patients presenting with different neurological disorders in a small group informal session. Following the small group interactions with patients, students participated in a large group debriefing session involving discussions with peers, biomedical sciences faculty, and clinicians. Students then completed a survey designed to assess their motivation in correspondence with the Attention, Relevance, Confidence, and Satisfaction (ARCS) model of motivation. These results were then correlated with students' performance in the neuroscience examinations.

RESULTS

The total mean score was high for all categories of the ARCS model of motivation (4.26/5) and was highest for Relevance (4.46/5). When these motivation scores were correlated with students' performance on the formative and summative examinations, a significant positive correlation was found between motivation and performance on both the formative (r = 0.85) and summative (r = 0.95) neuroscience examinations.

CONCLUSION

Encounters with patients presenting with neurological disorders during a first year medical neuroscience course result in a high level of motivation associated with the clinical encounter, and this was positively correlated with their academic performance.

Using the cognitive apprenticeship model to identify learning strategies that learners view as effective in ward rounds

BACKGROUND

Cognitive apprenticeship model (CAM) is an instructional model for situated learning. There is limited data available on application of the CAM in clinical settings. The aim of the study was to identify learning strategies using CAM, which in the opinion of learners are effective in ward rounds.

METHODS

Participants were residents and medical students who rotated through internal medicine at Aga Khan University Hospital, Karachi. We sought learners' opinion on a structured questionnaire based on four principal dimensions of cognitive apprenticeship. A previously determined set of 10 defined competencies were compared with CAM's six teaching/learning (T/L) methods (modelling, coaching, scaffolding, articulation, reflection and exploration) as well. Mean and SD were calculated. Mann-Whitney test was used to compare scores.

RESULTS

Of 195 participants, there were 100 men (51.3%) and 95 women (48.7%). Perceived learning for six T/L methods, ranged from 3.7 to 3.9 (max=5). Coaching and scaffolding had the highest scores. Statistically significant difference between the student and resident groups was noted. Medical students perceived coaching and scaffolding (4.1 and 4.05) and residents rated coaching, articulation and exploration as most effective (3.9 and 3.8). Majority (82.1%) reported a positive learning environment in wards.

CONCLUSIONS

CAM enabled to identify two T/L methods (scaffolding and coaching) that are important for learning in ward round. Limited differences in perceived effectiveness of the T/L methods indicate that variety can be used to sustain interest in learners. Positive learning environment, team diversity and tasks of increasing complexity contribute to learning.

Examining the Motivation of Health Profession Students to Study Human Anatomy

Students' motivation is a vital determinant of academic performance that is influenced by the learning environment. This study aimed to assess and analyze the motivation subscales between different cohorts (chiropractic, dental, medical) of anatomy students (n = 251) and to investigate if these subscales had an effect on the students' anatomy performance. A 31-item survey, the Motivated Strategies for Learning Questionnaire was utilized, covering items on intrinsic and extrinsic goal orientation, task value, control of learning belief, self-efficiency for learning and performance, and test anxiety. First-year dental students were significantly more anxious than chiropractic students. Second-year chiropractic students attached more value to anatomy education than second-year medical students. The outcome of this research demonstrated a significant relationship between first- and second-year chiropractic students between anatomy performance and motivation subscales controlling for gender such as self-efficacy for learning and performance was (β = 8, CI: 5.18-10.8, P < 0.001) and (β = 6.25, CI: 3.40-9.10, P < 0.001) for first year and second year, respectively. With regards to intrinsic goal orientation, it was (β = 4.02, CI: 1.19-6.86, P = 0.006) and (β = 5.38, CI: 2.32-8.44, P = 0.001) for first year and second year, respectively. For the control of learning beliefs, it was (β = 3.71, 95% CI: 0.18-7.25, P = 0.04) and (β = 3.07, CI: 0.03-6.12, P = 0.048) for first year and second year, respectively. Interventions aimed at improving these motivation subscales in students could boost their anatomy performance.

Utility of 3D Printed Cardiac Models for Medical Student Education in Congenital Heart Disease: Across a Spectrum of Disease Severity

The most common modes of medical education for congenital heart disease (CHD) rely heavily on 2-dimensional imaging. Three-dimensional (3D) printing technology allows for the creation of physical cardiac models that can be used for teaching trainees. 3D printed cardiac models were created for the following lesions: pulmonic stenosis, atrial septal defect, tetralogy of Fallot, d-transposition of the great arteries, coarctation of the aorta, and hypoplastic left heart syndrome. Medical students participated in a workshop consisting of different teaching stations. At the 3D printed station, students completed a pre- and post-intervention survey assessing their knowledge of each cardiac lesion on a Likert scale. Students were asked to rank the educational benefit of each modality. Linear regression was utilized to assess the correlation of the mean increase in knowledge with increasing complexity of CHD based on the Aristotle Basic Complexity Level. 45 medical students attended the CHD workshop. Students' knowledge significantly improved for every lesion (p < 0.001). A strong positive correlation was found between mean increase in knowledge and increasing complexity of CHD (R² = 0.73, p < 0.05). The 3D printed models, pathology specimens and spoken explanation were found to be the most helpful modalities. Students "strongly agreed" the 3D printed models made them more confident in explaining congenital cardiac anatomy to others (mean = 4.23, ± 0.69), and that they recommend the use of 3D models for future educational sessions (mean = 4.40, ± 0.69). 3D printed cardiac models should be included in medical student education particularly for lesions that require a complex understanding of spatial relationships.

Prediction of academic achievement based on learning strategies and outcome expectations among medical students

BACKGROUND

One of the most important indicators of the effectiveness of teaching can be the academic achievement of learners, which can be influenced by different factors such as learning methods and individual motivations. The purpose of this study was to determine the ability of predicting academic achievement based on learning motivation strategies and outcome expectations based on a theoretical model.

METHODS

This descriptive-analytic study was conducted with the participation of 380 male and female students of nine faculties of medical sciences of Shahid Beheshti University of Tehran. Multi-stage sampling along with the questionnaire of motivational strategies for learning and student outcome expectation scale were used for data collection. The college grade point average (CGPA) of students' past grades was considered as the academic performance variable. Data analysis was performed using Structural Equation Modeling (SEM) in AMOS software.

RESULTS

The mean score of the structure of learning strategies, motivational strategies, outcome expectations, and students' GPA did not show significant statistical differences in terms of gender, marital status, residence location, field of study, and educational level. There was a direct and significant relationship between the motivational strategies' structures (R = 0.193, p < 0.001) as well as learning strategies (R = 0.243, p < 0.001) and the CGPA, while there was no relationship between outcome expectations and CGPA. Path analysis revealed that self-regulating learning strategies and motivational strategies can predict the academic achievement of these students.

CONCLUSIONS

Considering the importance of active and independent learning among medical students, it is necessary for lecturers to use interactive and student-oriented patterns of teaching. Also, students should become familiar with self-regulating learning skills to better understand the information they receive.