How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self-determination theory

Purpose: Internalization of students' motivation towards an intrinsic form is associated with increased interest, commitment, learning, and satisfaction with education. Self-Determination theory postulates that intrinsic motivation and autonomous forms of self-regulation are the desired type of motivation; as they have been associated with deep learning, better performance and well-being. It claims three basic psychological needs have to be satisfied in order to achieve intrinsic motivation. These are the needs for autonomy, competence and relatedness. This study aims to provide a review on how these basic psychological needs are encouraged in undergraduate students so they can be transferred to the clinical teaching environment. Methods: Electronic searches were performed across four databases (Medline, Embase, PsycINFO, and ERIC), relevant journals, and retrieved bibliography of selected articles. In total, searches produced 4,869 references, from which 16 studies met the inclusion criteria. Results: Main themes were coded in three categories: The support of autonomy, competence and relatedness. The research-based evidence appears to be of reasonable quality, and indicates that teachers should work to satisfy students' basic psychological needs to foster internalization of self-regulation. Our findings suggest that teachers should interact with students in a more 'human centred' teaching style, as these actions predict motivational internalization. Several themes emerged from different contexts and further investigation should expand them. Conclusion: This review identified actions that clinical teachers could implement in their daily work to support students' self-determination. Autonomy supportive teaching in health professions educations would benefit students and may actually result in more effective health care delivery.