Control-value theory: Using achievement emotions to improve understanding of motivation, learning, and performance in medical education: AMEE Guide No. 64

Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4712, USA.
Medical Teacher (Impact Factor: 1.68). 03/2012; 34(3):e148-60. DOI: 10.3109/0142159X.2012.651515
Source: PubMed


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.

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    • "fourth-year selected students and non-selected students ). Age and gender were treated as covariates in the analyses because motivation has been found to increase with age[1,25], and to be higher and more intrinsic in female than male students in some studies[1,33]. Multiple comparisons were corrected for by performing Bonferroni post-hoc analyses. "
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    ABSTRACT: Medical schools try to implement selection procedures that will allow them to select the most motivated students for their programs. Though there is a general feeling that selection stimulates student motivation, conclusive evidence for this is lacking. The current study aims to use the perspective of Self-determination Theory (SDT) of motivation as a lens to examine how medical students’ motivation differs in relation to different selection procedures. The hypotheses were that 1) selected students report higher strength and autonomous motivation than non-selected students, and 2) recently selected students report higher strength and autonomous motivation than non-selected students and students who were selected longer ago. First- (Y1) and fourth-year (Y4) medical students in the six-year regular programme and first-year students in the four-year graduate entry programme (GE) completed questionnaires measuring motivation strength and type (autonomous-AM, controlled-CM). Scores were compared between students admitted based on selection, lottery or top pre-university GPA (top GPA) using ANCOVAs. Selected students’ answers on open-ended questions were analysed using inductive thematic analysis to identify reasons for changes in motivation. The response rate was 61.4 % (n = 357). Selected students (Y1, Y4 and GE) reported a significantly higher strength of motivation than non-selected students (Y1 and Y4 lottery and top GPA) (p < 0.01). Recently selected students (Y1 and GE) reported significantly higher strength (p < 0.01) and higher AM (p < 0.01) and CM (p < 0.05) than non-selected students (lottery and top GPA) and Y4 students who were selected three years ago. Students described that being selected enhanced their motivation as they felt autonomous, competent and that they belonged to a special group. These reported reasons are in alignment with the basic psychological needs described by Self-Determination Theory as important in enhancing autonomous motivation. A comprehensive selection procedure, compared to less demanding admission procedures, does not seem to yield a student population which stands out in terms of autonomous motivation. The current findings indicate that selection might temporarily enhance students’ motivation. The mechanism through which this occurs seems to be through feelings of autonomy, competence and relatedness inspired by selection.
    Full-text · Article · Jan 2016 · BMC Medical Education
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    • "As demonstrated in Table 10.1 , previous research has typically employed a combination of self-report and physiological measures to identify stress patterns in particular . The few studies within medical education that have examined a broader range of emotions from a learning and achievement perspective have typically relied on self-report measures (e.g., Artino et al., 2010 ; Fraser et al., 2012 ; 2014 ; Hunziker et al., 2011 ; Kasman, Fryer-Edwards, & Braddock, 2003 ). As such, there is a need to consider a more diverse array of emotional states and measures. "
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    ABSTRACT: Emotions serve an important role in learning and performance, yet their role in medical education has been largely overlooked. In this chapter, we examine how multiple research methodologies and measures can be used to detect and analyze emotions within authentic medical learning environments. Our goal is to highlight conceptual, methodological, and practical considerations that should be attended to by researchers, educators, and medical professionals interested in examining the role of emotions within medical education. Findings from our literature review and empirical work suggest that appraisal models that treat emotions as multi-componential (e.g., control-value theory) can provide a fruitful framework for examining links between emotions and learning. In terms of measuring emotions, self-report can be useful with respect to scalability and capturing subjective experience, whereas behavioral and physiological measures provide continuous data streams and are less susceptible to cognitive or memory biases. Other factors researchers and health sciences professionals should take into consideration when selecting a measure of emotion include: efficiency; level of granularity; and person-centered versus group-level analyses. Recent work suggests that multiple measures of emotions can be integrated into affect-aware learning technologies to aid instructional design by detecting, tracing, and modeling emotional processes during learning.
    Full-text · Chapter · Jan 2016
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    • "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. "
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    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.
    Full-text · Article · May 2015 · Instructional Science
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