Self-determination theory in ophthalmology education: factors influencing autonomy, competence and relatedness in medical students

BACKGROUND: The affective components of learning, including student motivation, has yet to be thoroughly investigated in undergraduate ophthalmology education. This study aims to use Self-Determination Theory (SDT) as a framework to describe the variations in student perceptions of motivation in studying ophthalmology through their satisfactions of autonomy, competence and relatedness, and to highlight factors that stimulate or hinder this. METHODS: Penultimate year medical students from a single tertiary educational institution undertaking a clinical placement in ophthalmology participated in in-depth interviews to explore factors affecting their perceptions of motivation in studying ophthalmology. Interviews were transcribed and analysed according to the principles of interpretive phenomenography through the theoretical framework of SDT. RESULTS: Of the 39 students invited, 10 agreed to participate. Variations in perceptions of experiences generated the outcome space. Participants experienced either amotivation, external locus extrinsic motivation, internal locus extrinsic motivation and intrinsic motivation (conceptions of the outcome space). This was described with respect to their satisfaction of autonomy, competence and relatedness (dimensions of the outcome space). Additionally, 21 factors that impacted on motivation were identified, of which five over-arching factors impacted all three basic psychological needs – guidance, growth mindset, assessment, curricular pressure and extracurricular pressure. CONCLUSIONS: The findings of this study provide a unique insight into the motivation of medical students studying ophthalmology. This provides an exciting opportunity for medical educators to address the affective aspect of learning.