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Intrinsic motivation of preclinical medical students participating in high-fidelity mannequin simulation
  1. Brent Thoma1,2,
  2. Emily M Hayden1,3,
  3. Nelson Wong1,3,
  4. Jason L Sanders4,
  5. Greg Malin5,
  6. James A Gordon1,3
  1. 1MGH Learning Laboratory and the Division of Medical Simulation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
  2. 2Department of Emergency Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  3. 3Gilbert Program in Medical Simulation, Harvard Medical School, Boston, Massachusetts, USA
  4. 4Harvard Affiliated Emergency Medicine Residency, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, Massachusetts, USA
  5. 5Department of Academic Family Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  1. Correspondence to Dr Brent Thoma, EM Residency Training Program, Room 2686 Royal University Hospital, 103 Hospital Drive, Saskatoon, Saskatchewan, Canada S7N 0W8; brent.thoma{at}


Introduction While medical schools strive to foster students’ lifelong learning, motivational theories have not played an explicit role in curricular design. Self-determination Theory is a prominent motivational theory. It posits that perceived autonomy, competence and relatedness foster intrinsic motivation. This study explores the effects of autonomy on intrinsic motivation in medical students participating in high-fidelity mannequin simulation.

Methods A non-randomised crossover trial compared first-year medical students participating in (1) required simulation sessions with predetermined learning objectives and (2) extracurricular simulation sessions with student-directed learning objectives. An adapted Intrinsic Motivation Inventory (IMI) was used to assess intrinsic motivation, perceived autonomy, competence and relatedness. Each participant completed the IMI survey after each type of session. Variables were compared with signed-rank tests.

Results All 22 participants completed the IMI after both types of session. Perceived autonomy was significantly higher during extracurricular simulation (p<0.001), but intrinsic motivation, competence and relatedness were not. Intrinsic motivation correlated with autonomy (RS=0.57 and extracurricular simulation, ES=0.52), competence (RS=0.46 and ES=0.15) and relatedness (RS=0.51 and ES=0.64). The IMI subscales had good internal consistency (Cronbach's α=0.84, 0.90, 0.90 and 0.76 for intrinsic motivation, autonomy, competence and relatedness, respectively).

Conclusions Extracurricular sessions increased students’ perceived autonomy, but they were highly intrinsically motivated in both settings. Further study is needed to understand the relationship between perceived autonomy and intrinsic motivation in medical education learning activities. The IMI shows promise as a measurement tool for this work.

  • Self-determination theory
  • Preclinical medical education
  • Medical simulation

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