Use this URL to cite or link to this record in EThOS:
Title: The self-determination theory of motivation in dental education : testing a model of social factors, psychological mediators, academic motivation and outcomes
Author: Orsini, Cesar A.
ISNI:       0000 0004 7226 2683
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 2017
Availability of Full Text:
Access from EThOS:
Access from Institution:
Background: Motivation plays a vital role in dental students' learning experience and wellbeing. Self-determination theory differentiates between autonomous and controlled motivation and amotivation, where autonomous motivation corresponds to the most selfdetermined form of regulation. Previous research has found that several social educational factors, mediated by students' satisfaction of their basic psychological needs of feeling autonomous, competent and related to important others, predicts autonomous motivation. In turn, autonomous motivation leads to more positive educational outcomes compared to controlled motivation or amotivation. So far, however, few studies have investigated the process of motivation in health professions education from the perspective of the Selfdetermination Theory. A systematic review was conducted within this thesis, identifying determinants, such as an autonomy supportive learning climate and feedback, that predicted students' autonomous motivation. No studies were found that tested mediation effects between determinants and motivation. In turn, students' self-determined motivation was found to predict different affective, behavioural and cognitive outcomes. These studies, however, came mainly from medical education. Despite its relevance for students' development, very little is known about the process of motivation in dental students. This indicates a need to understand its various aspects, which may lead to evidence-based interventions to foster students optimal functioning. Purpose: To test a model of academic motivation in dental education by analysing the associations between autonomy-support and quantity and quality of feedback, as determinants, and self-determined motivation, mediated by students' basic psychological needs satisfaction. This, followed by testing the associations between self-determined motivation and the behavioural outcomes of deep and surface study strategies and academic performance, and the affective outcomes of vitality and self-esteem. Finally, we aimed to test whether the model worked different for female and male students, and by year of curriculum. Methods: We conducted a correlational cross-sectional survey study at the dental school of the University San Sebastian in Chile. All dental students from year 1 to 6 were invited to participate and to answer a questionnaire package containing demographic data and previously validated self-reported instruments. Data on academic performance were obtained from the administrative department. Data analysis involved five phases. First, internal consistency of all measures was assessed by means of Cronbach alpha. Second, descriptive and group comparisons were computed by means of independent t-test to assess gender differences and MANOVA to assess year-of-curriculum differences. Third, bivariate correlations were assessed amongst all measures. Fourth, mediation was tested through a series of regression analyses. Finally, the entire model was assessed by means of structured equation modelling, for the overall student sample as well as for the subgroups of females and males and different years of study. Data were analysed with the PASW and AMOS software. Results: A total of 924 students (90.2% response rate) agreed to participate and completed the questionnaires. Cronbach's alpha values of all instruments ranged from .641 to .912. Students' autonomous motivation for attending university was higher than controlled motivation and amotivation, showing an overall self-determined profile. Females endorsed higher than men both autonomous and controlled motivation, while men endorsed amotivation higher. The overall motivation profile, however, did not show significant gender differences. Across the six years, students showed an overall self-determined profile, in which autonomous motivation decreased when transitioning to clinical years, to rise again in the final year. The contrary was found for students' amotivation scores, while controlled motivation declined as they entered clinical-based years. Bivariate correlations showed that both determinants were positively correlated with students' basic psychological needs satisfaction and with autonomous motivation. In turn, the latter was positively associated with behavioural and affective outcomes. All these associations showed a decreasingly positive correlation from autonomous motivation to amotivation. Mediation regression analyses showed both determinants predicting dental students' autonomous motivation, however, this influence was not direct, it was mediated by students' perceptions of the satisfaction of their basic psychological needs. Finally, structured equation modelling indicated that the data fitted the model well, and showed both determinants positively predicting students' satisfaction of their basic psychological needs, which positively influenced autonomous motivation over controlled motivation. In turn, the gradual shift from controlled to autonomous motivation positively predicted affective and behavioural outcomes. Moreover, the associations followed a similar pattern, with minor deviations, when tested by gender and by year of study. Discussion and conclusion: In the context of this research, dental students' autonomous motivation was indirectly predicted by the social educational factors of teachers' autonomysupport and quantity and quality of feedback, being mediated by students' satisfaction of their basic psychological needs. Students' acting out of autonomous motivation showed enhanced deep study strategies and better academic performance, experienced higher vitality and self-esteem, and showed lower surface study strategies. This suggests that autonomous motivation leads to important outcomes, decreasing from controlled motivation to amotivation. Whilst students in different years of study showed an autonomous motivation profile, there were important differences that showed that students' transition from basic/preclinical to clinical years influenced their motivation and should therefore be taken into account when planning interventions to enhance students' motivation. Results are discussed in light of self-determination theory and considering its implications on curriculum development, teaching and learning, clinical training, assessment, faculty development, peer-assisted-learning and dentist-patient relationship. Significance: This is the first study, in health professions education, to test a Selfdetermination theory-based model including determinants, mediators, motivation and outcomes. This research also expands to dental education the study of motivation based on an empirically verified psychological theory. The results provide strong support for the Selfdetermination theory of motivation in dental education and provide acceptable evidence that the quality of motivation and satisfying students' psychological needs are important in determining positive educational outcomes amongst dental students. Therefore, many successes and failures in a number of elements of dental and health professions education may be understood through the lens of this theory. As such, efforts should be made in various aspects of dental education to support learners' sense of autonomy, competence and relatedness, which may have an extensive influence on dental education and on students' wellbeing. Future research should confirm or refute our results in other dental education settings.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.H.P.E.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: LC Special aspects of education ; RA0421 Public health. Hygiene. Preventive Medicine ; RK Dentistry