title: Student-selected courses in a medical school: scope and relationships.
abstract: BACKGROUND
  There is a dearth of reports in the literature of school-wide appraisals of the student-selected approach in medical education.
  
  
  OBJECTIVE
  This paper appraises the scope of student-selected components in a medical programme and analyses the relationships of achievement and motivation with choices of optional courses.
  
  
  METHODS
  The prospective study involved 247 students from seven class-cohorts. Statistics checked the differences between groups, as well as the association between the students' academic motivation and achievement with the extent of their selections between optional courses and peer-tutoring activity.
  
  
  RESULTS
  Most students explored multiple options, including pre-clinical, clinical and non-medical subjects among the domains of learning experienced. A fifth of them earned more student-selected credits from optional courses than the requisite minimum. Twenty courses accounted for 80.2% of optional-course enrolments. Choices between optional courses and peer-tutoring activity reflected distinct learner features. Five variables-selective-credits need, achievement, intrinsic motivation to experience stimulation, and (negatively) peer-tutoring activity and intrinsic motivation to accomplish-explained 43% of the variability in optional-course credits. Nevertheless, a higher-level blend of optional-course and peer-tutoring selections related to greater cognitive achievement and intrinsic motivation.
  
  
  CONCLUSIONS
  This work describes the variety of responses in extent and type of choices in a mix-option approach to student-selected credits. The findings suggest interrelationships of achievement and motivation toward purposeful blending of student-selected educational activities.
authors.affiliation: University of Brasilia, Brazil.
authors.forename: Dejano T
authors.initials: DT
authors.lastname: Sobral
mesh_terms: D000328:Adult; D001938:Brazil; D002755:Choice Behavior; D003479:Curriculum; D005260:Female; D006801:Humans; D008297:Male; D018794:Problem-Based Learning; D011446:Prospective Studies; D012577:Schools, Medical; D013337:Students, Medical