In this AMEE Guide, we consider the emergent theoretical and empirical work on human emotion and how this work can inform the theory, research, and practice of medical education. In the Guide, we define emotion, in general, and achievement emotions, more specifically. We describe one of the leading contemporary theories of achievement emotions, control-value theory (Pekrun 2006), and we distinguish between different types of achievement emotions, their proximal antecedents, and their consequences for motivation, learning, and performance. Next, we review the empirical support for control-value theory from non-medical fields and suggest several important implications for educational practice. In this section, we highlight the importance of designing learning environments that foster a high degree of control and value for students. Finally, we end with a discussion of the need for more research on achievement emotions in medical education, and we propose several key research questions we believe will facilitate our understanding of achievement emotions and their impact on important educational outcomes.
"Despite these advances in research, to our knowledge no studies to date have examined how emotional states relate to other facets of self-regulation and performance among medical residents. Recently, calls have been made for theory-based research to examine the nature of emotions using control-value theory and multiple methodologies (including real-time assessments) across diverse phases and contexts of medical education (Artino et al. 2012). Thus, further empirical work is needed, including research that focuses on training outside the classroom, in settings that more closely approximate clinical practice, such as simulations. "
[Show abstract][Hide abstract] ABSTRACT: This study examined the nature of cognitive, metacognitive, and affective processes among a medical team experiencing difficulty managing a challenging simulated medical emergency case by conducting in-depth analysis of process data. Medical residents participated in a simulation exercise designed to help trainees to develop medical expertise, effective leadership, and team management skills. Purposive sampling was used to select one team for case study based on overall performance. Video and audio data were collected from the simulation and debriefing session and a follow-up interview was conducted with the team leader. Performance measures were also collected from expert raters (i.e., experienced staff physicians). Video data were reviewed and coded for cognitive, metacognitive, and emotional events exhibited by team members during the simulation. Interview and debriefing transcripts were coded for themes related to these regulatory processes. Results from quantitative and qualitative analyses revealed that the team exhibited lower-order cognitive and metacognitive process (e.g., summarizing, providing information) more often than higher-order processes (e.g., evaluation, reasoning). Furthermore, team members expressed negative emotions (e.g., anxiety) more often than positive emotions (e.g., enjoyment). Chi square analyses of the team leader revealed that negative emotions were significantly more frequently preceded by lower-order processes compared to higher-order processes. Qualitative thematic analyses provided further corroboration of these findings. The findings suggest that medical trainees (particularly teams experiencing difficulty managing a challenging case) may require further scaffolding in their use of regulatory processes within medical emergencies. The results from this study are discussed in terms of implications for theories of self-regulation, methodological advances, and instructional design for medical education.
[Show abstract][Hide abstract] ABSTRACT: In medical education, the effect of the educational environment on student achievement has primarily been investigated in comparisons between traditional and problem-based learning (PBL) curricula. As many of these studies have reached no clear conclusions on the superiority of the PBL approach, the effect of curricular reform on student performance remains an issue. We employed a theoretical framework that integrates antecedents of student achievement from various psychosocial domains to examine how students interact with their curricular environment. In a longitudinal study with N = 1,646 participants, we assessed students in a traditional and a PBL-centered curriculum. The measures administered included students' perception of the learning environment, self-efficacy beliefs, positive study-related affect, social support, indicators of self-regulated learning, and academic achievement assessed through progress tests. We compared the relations between these characteristics in the two curricular environments. The results are two-fold. First, substantial relations of various psychosocial domains and their associations with achievement were identified. Second, our analyses indicated that there are no substantial differences between traditional and PBL-based curricula concerning the relational structure of psychosocial variables and achievement. Drawing definite conclusions on the role of curricular-level interventions in the development of student's academic achievement is constrained by the quasi-experimental design as wells as the selection of variables included. However, in the specific context described here, our results may still support the view of student activity as the key ingredient in the acquisition of achievement and performance.
Advances in Health Sciences Education 01/2015; DOI:10.1007/s10459-015-9584-2 · 2.12 Impact Factor
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