Internal medicine clerks' motivation in an online course: a mixed-methods study

Med Educ Online. 2025 Dec;30(1):2445915. doi: 10.1080/10872981.2024.2445915. Epub 2025 Jan 1.

Abstract

Purpose: At LUMC, a Small Private Online Course (SPOC) was developed complementary to the clinical learning environment of the internal medicine clerkship. The developers used the self-determination theory in the design of the SPOC's assignments aiming to improve learners' intrinsic motivation. This study investigates the impact of the SPOC and its specific assignments on student motivation.

Methods: The study uses a mixed-methods approach. The authors describe a quantitative analysis of students' responses on an intrinsic motivation inventory (IMI), and a qualitative thematic analysis of semi-structured group interviews, respectively.

Results: Seventy-eight students (response rate 42%) filled out the IMI. Their scores were (7-point Likert scale): interest/enjoyment 3.76, competence 4.02, choice 3.53, value/usefulness 4.20, relatedness 3.85. Thematic analysis of the interviews (14 students) revealed seven themes: collaboration with peers, usefulness, SPOC-related factors, workload, motivation, and performance.

Conclusions: Motivation could be optimized creating useful, authentic cases that train skills that are directly transferrable to clinical practice. Challenging, interesting and student-generated assignments positively influenced students' autonomy and motivation. Lack of awareness of online performance negatively affected the feeling of competence. Perceptions of online collaboration were suboptimal. The study can be helpful for other teachers to enhance motivation while developing online courses.

Keywords: Clinical learning; clerkships; motivation; online course; thematic analysis.

MeSH terms

  • Adult
  • Clinical Clerkship*
  • Clinical Competence
  • Education, Distance*
  • Female
  • Humans
  • Internal Medicine* / education
  • Interviews as Topic
  • Male
  • Motivation*
  • Personal Autonomy
  • Students, Medical* / psychology
  • Young Adult

Grants and funding

The author(s) reported there is no funding associated with the work featured in this article.