The Impact of a Medical Curriculum on Motivation and Well-being Among Medical Students

Abstract

Aim The aim of this thesis was to determine the impact of critical aspects of a medical curriculum on motivation and well-being, and how these constructs affect academic achievement among medical students. Method A multi-methods approach incorporating systematic review and quantitative and qualitative studies was undertaken. More specifically, this approach included reviewing the literature of motivation and well-being among medical students; exploring motivation and well-being by year level of a curriculum and admissions criteria (qualitative study); evaluating the effect of a medical curriculum on motivation and well-being over time (longitudinal study); examining motivation and well-being among ethnic groups (cross-sectional study); evaluating a change of medical curriculum on motivation and well-being (cross-sectional comparative study); and investigating associations between motivation, well-being and academic achievement (person-oriented approach). Results The systematic review found valuable associations between the constructs of motivation and well-being that were moderated by demographic and curriculum variables. Furthermore, it indicated a relationship may exist between motivation, well-being and academic achievement. The qualitative study found clear differences in student expression between admissions criteria and year level, suggesting that the curriculum and sociocultural influences are mediators of motivation and wellbeing. Furthermore, changes in motivation and well-being occur longitudinally, which differ by year level of the curriculum and admissions criteria. The cross-sectional study found differences in motivation and well-being among indigenous and ethnic minority medical students. The comparative cohort study found no significant differences in motivation and well-being between cohorts of medical students under traditional and revised curricula; however, differences were found among students in their clinical years of training. Finally, associations between motivation and wellbeing were observed, which had a relationship with academic achievement over time. Conclusion A medical curriculum has an impact on motivation and well-being, which differs by year level, admissions criteria, and ethnicity. Furthermore, a relationship exists between motivation and well-being, and academic achievement. These findings have implications for student recruitment and retention, student equity and curriculum development, and highlights the challenges of facilitating learning environments and curricula that support optimal forms of motivation and enhance well-being for all students.