title: Motivational profiles of medical students: association with study effort, academic performance and exhaustion.
abstract: BACKGROUND
  Students enter the medical study with internally generated motives like genuine interest (intrinsic motivation) and/or externally generated motives like parental pressure or desire for status or prestige (controlled motivation). According to Self-determination theory (SDT), students could differ in their study effort, academic performance and adjustment to the study depending on the endorsement of intrinsic motivation versus controlled motivation. The objectives of this study were to generate motivational profiles of medical students using combinations of high or low intrinsic and controlled motivation and test whether different motivational profiles are associated with different study outcomes.
  
  
  METHODS
  Participating students (N = 844) from University Medical Center Utrecht, the Netherlands, were classified to different subgroups through K-means cluster analysis using intrinsic and controlled motivation scores. Cluster membership was used as an independent variable to assess differences in study strategies, self-study hours, academic performance and exhaustion from study.
  
  
  RESULTS
  Four clusters were obtained: High Intrinsic High Controlled (HIHC), Low Intrinsic High Controlled (LIHC), High Intrinsic Low Controlled (HILC), and Low Intrinsic Low Controlled (LILC). HIHC profile, including the students who are interest + status motivated, constituted 25.2% of the population (N = 213). HILC profile, including interest-motivated students, constituted 26.1% of the population (N = 220). LIHC profile, including status-motivated students, constituted 31.8% of the population (N = 268). LILC profile, including students who have a low-motivation and are neither interest nor status motivated, constituted 16.9% of the population (N = 143). Interest-motivated students (HILC) had significantly more deep study strategy (p < 0.001) and self-study hours (p < 0.05), higher GPAs (p < 0.001) and lower exhaustion (p < 0.001) than status-motivated (LIHC) and low-motivation (LILC) students.
  
  
  CONCLUSIONS
  The interest-motivated profile of medical students (HILC) is associated with good study hours, deep study strategy, good academic performance and low exhaustion from study. The interest + status motivated profile (HIHC) was also found to be associated with a good learning profile, except that students with this profile showed higher surface strategy. Low-motivation (LILC) and status-motivated profiles (LIHC) were associated with the least desirable learning behaviours.
authors.affiliation: VUmc School of Medical Sciences, Postal address: VU University Medical Center Amsterdam, Institute of Education and Training, Postbus 7057, A-114, Amsterdam, MB 1007, the Netherlands. R.Kusurkar@vumc.nl
authors.forename: Rashmi A
authors.initials: RA
authors.lastname: Kusurkar
authors.forename: Gerda
authors.initials: G
authors.lastname: Croiset
authors.forename: Francisca
authors.initials: F
authors.lastname: Galindo-Garré
authors.forename: Olle
authors.initials: O
authors.lastname: Ten Cate
mesh_terms: D004522:Educational Status; D005221:Fatigue; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D011581:Psychological Tests; D012737:Sex Factors; D013337:Students, Medical / Q000523:psychology*