A two factor model of performance approach goals in student motivation for starting medical school
Jacqueline I. Wilson
The University of the West Indies
This study explores what motivates a student to enter medical school by first measuring students' strength of motivation and then by looking for relationships between motivation and career-related values and approaches to learning. Validated and reliable questionnaires were used to obtain data. This study found no differences in strength of motivation based on sex, nationality or age, but it did find that the reasons underlying motivation to enter medical school are interrelated and based on interpersonal and intrapersonal factors such as wanting to help people, being respected and successful and fulfilling a sense of achievement. An examination of the data, drawing on correlation and multiple regression analyses, confirmed performance approach and performance avoidance goal structures in first-year medical students. It also yielded a two factor model of the performance-approach goal structure. Students motivated to do better could be driven either by positive self esteem or by perceiving medicine as a means of enhancing their social status. Students who set their own goals and work towards them are more likely to succeed. Future recommendations include investigating if and how students' motivations change over time.
Acceptance into medical school is based on academic achievement in high school or beyond. It was not until 2009 that non-academic criteria were introduced. Students come with differing reasons for studying medicine which impact on their achievements and choices. This quantitative study is driven by the questions: How strong is the students' motivation for entering this medical school? What are students' motivations for entering this medical school?
Within performance goal orientation, Elliot (1999) makes a distinction between performance approach goals and performance avoidance goals. Performance approach goals refer to an orientation towards demonstrating high ability, whereas performance avoidance goals refer to an orientation towards avoiding demonstrating low ability. This suggests that students with performance approach goals are positively motivated to try to do better than others, while students with performance avoidance goals are negatively motivated to try avoiding failure or appearing incompetent.
Previous work has found that students' motivations may be underpinned by their personality and approaches to learning (McManus et al., 2006). Approaches to learning may be described as surface, deep or strategic. A surface approach is driven by a fear of failure; a deep approach is motivated by intrinsic interest, while a strategic approach may be motivated by a need to be successful (Newble & Entwistle, 1986). While having different attitudes to learning, medical students may demonstrate distinct and positively correlated patterns of internal and external motivations, thereby supporting the idea that both sources of motivation are interrelated (Sobral, 2004). As autonomous achievement motivation is positively associated with academic achievement, self regulation and meaningful learning strategies (Arnold & Feighny, 1995; Sobral, 2004), and students' goal structure reciprocally affects their motivation, engagement and achievement (Ames & Archer, 1988), it is important to uncover students' goal structures and learning approaches to help them develop autonomous motivations and strategies and thereby fulfil their potential.
This study draws from achievement goal orientation theory to examine the strength of motivation and the underlying goal structure which motivates students to enter medical school. The purpose of this study is to determine what motivates a student to enter medical school by first measuring students' strength of motivation and then by examining relationships between motivation to enter medical school and career related values and approaches to learning.
Reliability coefficients as measured by Cronbach's alpha for SMMS, career related values and strategic learning were above 0.80. Cronbach's alpha for surface learning was 0.77 and for deep learning was 0.70. These high values attest to the reliability of the scales.
The mean score on the SMMS was 63.0 with a standard deviation of 9.0. This represented strong motivation to study medicine. Independent samples t-tests and ANOVA revealed that there were no significant differences between the mean scores on the SMMS based on age, sex, nationality or approaches to learning. The following significant differences in means are worth mentioning. On one item of the SMMS scale, females scored significantly and moderately lower than males (eta squared =.04): "As soon as I would discover that it would take me ten years to qualify as a doctor, I would stop studying." In addition, females scored significantly higher than males in their fear of failure approach to learning (eta squared =.06).
The relationships between students' strength of motivation and career related values and approaches to learning were small to moderate as shown in Table 1. Motivation to study was significantly and positively associated with prestige and deep and strategic approaches to learning and negatively associated with income, avoidance of role strain and surface approach to learning. At the level of significance where p<.05, academic interest, role support and bioscientific and biosocial orientations to medicine were not significantly related to motivation.
Item | Pearson's correlation | Significance |
Strategic approach to learning | .366** | 0.000 |
Prestige | .298** | 0.001 |
Deep approach to learning | .295** | 0.001 |
Biosocial orientation to medicine | .181* | 0.051 |
Academic interest | 0.034 | 0.721 |
Bioscientific orientation to medicine | -0.081 | 0.388 |
Role support | -0.135 | 0.147 |
Income | -.245** | 0.008 |
Surface approach to learning | -.275** | 0.003 |
Avoid role strain | -.317** | 0.001 |
** Correlation is significant at the 0.01 level (2-tailed) * Correlation is significant at the 0.05 level (2-tailed). |
Besides the correlations shown in Table 1, some variables within the three approaches to learning were significantly correlated with motivation to study medicine. In order to study how motivation related to other variables, standard multiple regression was used to identify the most important predictors of motivation to study medicine. Motivation scores were regressed on the three approaches to learning: surface, deep and strategic along with career related values and are summarised in Tables 2, 3 and 4, respectively. Inspection of scatter-plots supported the assumption that relationships between variables were linear. The three tables yield three models for motivation to study medicine.
In the first model, motivation for studying medicine was kept constant while values and surface approach to learning were independent variables. Table 2 displays the correlations between variables, the unstandardised regression coefficients (B) and intercept, the standardised regression coefficient (beta), the semi-partial correlations and R=.593, R2= .352 and R2 adjusted = .317. R for regression was significantly different from zero, F(6, 115)=9.878, p<.05. This table shows that there were six independent variables which contributed significantly to motivation to study medicine and predicted about 32% of variability in motivation.
Model 1 | Unstandardised coefficients | Standardised coefficients Beta | t | p | |
B | Std. Error | ||||
(Constant) SMMS | 52.245 | 6.025 | 8.672 | .000 | |
Surface approach | -.392 | .106 | -.424 | -3.708 | .000 |
Avoid role strain | -.570 | .124 | -.380 | -4.589 | .000 |
Prestige | .341 | .122 | .231 | 2.787 | .006 |
Biosocial orientation | .317 | .156 | .166 | 2.034 | .044 |
Alertness to assessment | .589 | .250 | .191 | 2.354 | .020 |
Fear of failure | .683 | .246 | .316 | 2.773 | .007 |
Table 3 presents the second model which was generated by using values and deep approach to learning as independent variables. The table displays the correlations between variables, the unstandardised regression coefficients (B) and intercept, the standardised regression coefficient (beta), the semi-partial correlations and R=.594, R2= .353 and R2 adjusted = .329. R for regression was significantly different from zero, F(4, 115)=15.111, p<.05.
Model 2 | Unstandardised coefficients | Standardised coefficients Beta | t | p | |
B | Std. Error | ||||
(Constant) SMMS | 23.383 | 8.428 | 2.774 | .006 | |
Deep approach to learning | .225 | .103 | .174 | 2.183 | .031 |
Prestige | .333 | .120 | .226 | 2.772 | .007 |
Avoidance of role strain | -.522 | .116 | -.348 | -4.507 | .000 |
Achieving | 1.333 | .330 | .318 | 4.039 | .000 |
As Table 3 shows, there were four independent variables which contributed significantly to motivation to study medicine. Altogether about 33% of variability in motivation was predicted by knowing scores on the four independent variables.
Model 3 | Unstandardised coefficients | Standardised coefficients Beta | t | p | |
B | Std. Error | ||||
(Constant) SMMS | 44.677 | 6.749 | 6.619 | .000 | |
Strategic approach to learning | .252 | .065 | .294 | 3.844 | .000 |
Avoidance of role strain | -.340 | .135 | -.226 | -2.517 | .013 |
Prestige | .451 | .117 | .306 | 3.849 | .000 |
Lack of purpose | -.755 | .230 | -.259 | -3.276 | .001 |
Income | -.243 | .114 | -.205 | -2.134 | .035 |
Table 4 presents a model for strategic learners and displays the correlations between variables, the unstandardised regression coefficients (B) and intercept, the standardised regression coefficient (beta), the semi-partial correlations and R=.667, R2= .444 and R2 adjusted = .419. R for regression was significantly different from zero, F(5, 115)=17.599, p<.05.
As Table 4 shows, there were five independent variables which contributed significantly to motivation to study medicine. Altogether about 42% of variability in motivation was predicted by knowing scores on the five independent variables.
There are different types of motivation leading to different outcomes even when the level of motivation is high. As did previous work (Murdoch et al., 2001), this study found that motivation to study medicine as determined by the SMMS scale was strong in this cohort of first year students. There was no significant difference in strength of motivation based on age, sex, nationality or approach to learning.
Other studies have found that males were more likely to pursue medicine for the prestige (Wierenga et al., 2003) and the income (Greenhalgh, Seyan, & Boynton, 2004), but these findings were not supported in this study. However, fear of failure was more important to females than males. Females had a slightly stronger motivation to pursue medicine and would be willing to spend extra time doing so, although fear of failing and a lack of support would inhibit their motivation (McHarg et al., 2007).
There were two variables which correlated negatively and significantly with motivation to study: income and avoidance of role strain, while prestige correlated positively with motivation. This compared with other studies which found reasons behind motivation to include prestige, respect, helping others and interest in science (McManus et al., 2006; Wierenga et al., 2003). In both sexes, the stronger their motivation to study medicine, the less likely they were interested in pursuing medicine for the money or the status it brings and the more altruistic their reason for beginning their career.
The deep and strategic approaches to studying dominated this sample. Other work has found that females tend to score higher on the deep approach and males on the surface approach (Mattick, Dennis, & Bligh, 2004), however, that was not confirmed in this study. Previous work has also found more surface learning in younger students (Aaron & Skakun, 1999), but this too was not confirmed. In fact, the surface learning strategy of unrelated memorising was higher in students aged 22 years or older.
The results of this study suggest that there are different types of motivation for studying medicine. Other studies have confirmed three goal orientations of mastery, performance, and alienation (Archer, 1994; Perrot, Deloney, Hastings, Savell, & Savidge, 2001). Only performance goal orientation was supported in this study.
The results of the linear regressions suggest that there are two goal structures at work here: performance approach and performance avoidance. Urdan & Mestas (2006) found interpersonal, intrapersonal and ambiguous reasons for the pursuit of these types of goals, and that the same reasons could appear across both types of goals. Model 1 in Table 2 speaks to a performance avoidance goal structure. The correlations of prestige, biosocial orientation, and alertness to assessment demands are low but positively associated with motivation to study. Prestige refers to the value placed on competitive and intellectual achievement (Murdoch et al., 2001). Surface learning and avoidance of role strain correlate negatively with motivation. Surface learning is predominantly motivated by a fear of failure which in turn promotes superficial learning. This model suggests an apathetic approach to learning unmotivated by helping others and the demands of the work and unwillingness to invest time and energy needed to study medicine.
In contrast, the other two models speak to two performance approach goal structures. In both cases, a deep or strategic approach to learning is positively correlated with motivation to study medicine while avoidance of role strain is negatively correlated with motivation. This suggests that learners with a deep or strategic approach possess a desire to demonstrate competence. In Model 2, prestige and positive self motivating thoughts are also positively correlated with motivation. In Model 3, prestige positively correlated with motivation while income and lack of purpose are negatively associated with motivation. Model 2 suggests more intrapersonal reasons (of pride and self esteem) for performance approach goals as would be expected with a deep approach to learning, while Model 3 suggests more interpersonal reasons of social comparison and status (Urdan & Mestas, 2006) as evidenced in strategic learners
In the performance oriented student, achievement motivation may be high, but without the intrinsic interest, strategic or surface approaches may be adopted (Tan & Thanaraj, 1993). Fear of failure, lack of confidence and a surface approach impact negatively on academic achievement (Mayya, Rao, & Ramnarayan, 2004). Performance oriented students tend to be younger and worry more about failure and gaining approval. Intrinsic goal framing results in better conceptual learning and enjoyment of learning than extrinsic goal framing which predicts pride, anxiety and a strategic and sometimes narrow approach to learning (Pekrun, Elliot, & Maier, 2006; Vansteenkiste, Simons, Lens, Soenens, & Matos, 2005). Mastery orientation and its subsequent enjoyment and involvement with material sometimes come with age and experience (Bye, Pushkar, & Conway, 2007; Harju & Eppler, 1997).
The findings of this study support only performance goal orientation in these students and suggest that first year students perceive medical school as an environment in which they need to do better than others. The goal structures of performance approach and performance avoidance were confirmed in this study. Performance avoidance students could be defined by their surface approach to learning, fear of failure, lack of desire to engage in long term care of patients and need to limit difficulties in fulfilling their perceived obligations as would be physicians. Performance approach students could be defined by their deep or strategic approach to learning, the value they placed on intellectual achievement and their lack of worry about fulfilling their perceived obligations as would-be physicians. This study also yielded further information on underlying motivations for performance oriented students. Students positively motivated to do better than others could be driven either by positive self esteem or by perceiving medicine as a means of enhancing their social status.
Generalising the findings of this study to other settings is limited as only students from one medical school were surveyed. The study also relied on students' self ratings of their approaches to learning, career related values and motivations to enter medical school. Other instruments besides the ones used in this study have been used to ascertain achievement goal orientation. Nevertheless, this study generated goal structures independent of these measures using scales with high reliability indices.
Students with approach goals are less likely to engage in task avoidance behaviour and more likely to achieve their goals. Students who set their own goals and work towards them are more likely to succeed. Present day selection processes should be modified to include measures of motivations to study medicine. Students' motivations for studying medicine impact on their well being and performance. Investigating if and how motivations change as students progress through medical school is worthy of future study.
Ames, C., & Archer, J. (1988). Achievement goals in the classroom: Students' learning strategies and motivation processes. Journal of Educational Psychology, 80(3), 260-267.
Archer, J. (1994). Achievement goals as a measure of motivation in university students. Contemporary Educational Psychology, 19(4), 430-446.
Arnold, L., & Feighny, K. M. (1995). Students' general learning approaches and performances in medical school: A longitudinal study. Academic Medicine, 70(8), 715-722.
Bye, D., Pushkar, D., & Conway, M. (2007). Motivation, interest, and positive affect in traditional and nontraditional undergraduate students. Adult Education Quarterly, 57(2), 141-158.
Elliot, A. J. (1999). Approach and avoidance motivation and achievement goals. Educational Psychologist, 34(3), 169-189.
Greenhalgh, T., Seyan, K., & Boynton, P. (2004). "Not a university type": Focus group study of social class, ethnic, and sex differences in school pupils' perceptions about medical school. British Medical Journal, 328(7455), 1541-1546.
Harju, B. L., & Eppler, M. A. (1997). Achievement motivation, flow and irrational beliefs in traditional and nontraditional college students. Journal of Instructional Psychology, 24(3), 147-157.
Mattick, K., Dennis, I., & Bligh, J. (2004). Approaches to learning and studying in medical students: Validation of a revised inventory and its relation to student characteristics and performance. Medical Education, 38(5), 535-543.
Mayya, S., Rao, A. K., & Ramnarayan, K. (2004). Learning approaches, learning difficulties and academic performance of undergraduate students of physiotherapy. The Internet Journal of Allied Health Sciences and Practice, 2(4). http://ijahsp.nova.edu/articles/vol2num4/mayya.htm
McHarg, J., Mattick, K., & Knight, L. V. (2007). Why people apply to medical school: Implications for widening participation activities. Medical Education, 41(8), 815-821.
McManus, I. C., Livingston, G., & Katona, C. (2006). The attractions of medicine: The generic motivations of medical school applicants in relation to demography, personality and achievement. BMC Medical Education, 6(11). http://www.biomedcentral.com/1472-6920/6/11
Murdoch, M., Kressin, N., Fortier, L., Giuffre, P. A., & Oswald, L. (2001). Evaluating the psychometric properties of a scale to measure medical students' career-related values. Academic Medicine, 76(2), 157-165.
Newble, D. I., & Entwistle, N. J. (1986). Learning styles and approaches: Implications for medical education. Medical Education, 20(4), 162-175.
Nieuwhof, M. G., ten Cate, O. T. J., Oosterveld, P., & Soethout, M. B. (2004). Measuring strength of motivation for medical school. Medical Education Online, 9(16). http://www.med-ed-online.org/res00106.htm
Pekrun, R., Elliot, A. J., & Maier, M. A. (2006). Achievement goals and discrete achievement emotions: A theoretical model and prospective test. Journal of Educational Psychology, 98(3), 583-597.
Perrot, L. J., Deloney, L. A., Hastings, J. K., Savell, S., & Savidge, M. (2001). Measuring student motivation in health professions' colleges. Advances in Health Sciences Education, 6(3), 193-203.
Pintrich, P. R., Conley, A. M., & Kempler, T. M. (2003). Current issues in achievement goal theory and research. International Journal of Educational Research, 39(4-5), 319-337.
Pintrich, P. R., & Schunk, D. H. (2002). Motivation in education: Theory, research and applications (2nd ed.). Upper Saddle River, NJ: Merrill Prentice Hall/Pearson Education, Inc.
Powell, A., Boakes, J., & Slater, P. (1987). What motivates medical students: How they see themselves and their profession. Medical Education, 21(3), 176-182.
Schunk, D. H. (1991). Self-efficacy and academic motivation. Educational Psychologist, 26(3&4), 207-231.
Sobral, D. T. (2004). What kind of motivation drives medical students' learning quests? Medical Education, 38(9), 950-957.
Tait, H., Entwistle, N. J., & McCune, V. (1998). ASSIST: A reconceptualisation of the Approaches to Studying Inventory. In C. Rust (Ed.), Improving students as learners. Oxford: Oxford Brookes University, The Oxford Centre for Staff and Learning Development.
Tan, C. M., & Thanaraj, K. (1993). Influence of context and preferred learning environments: Approaches to studying physiology. Medical Education, 27(2), 143-159.
Urdan, T., & Mestas, M. (2006). The goals behind performance goals. Journal of Educational Psychology, 98(2), 354-365.
Vansteenkiste, M., Simons, J., Lens, W., Soenens, B., & Matos, L. (2005). Examining the motivational impact of intrinsic versus extrinsic goal framing and autonomy-supportive versus internally controlling communication style on early adolescents' academic achievement. Child Development, 76(2), 483-501.
Weiner, B. (1985). An attributional theory of achievement motivation and emotion. Psychological Review, 92(4), 548-573.
Weiner, B. (1992). Human motivation: Metaphors, theories, and research. Thousand Oaks, CA: Sage.
Wierenga, A. R., Branday, J. M., Simeon, D. T., Pottinger, A., & Brathwaite, B. (2003). Motivation for and concerns about entering a medical programme. West Indian Medical Journal, 52(4), 304-310.
Authors: Jacqueline Wilson is a Lecturer of Educational Technology at the Centre for Medical Sciences Education, The University of the West Indies and an EdD candidate at Northcentral University, Arizona. Her particular interests include e-learning in medical education and learning styles and strategies in distributed learning environments. Email: jacqui.wilson@sta.uwi.edu Please cite as: Wilson, J. I. (2009). A two factor model of performance approach goals in student motivation for starting medical school. Issues In Educational Research, 19(3), 271-281. http://www.iier.org.au/iier19/wilson.html |