An exploratory study of goal orientations of traditional block and longitudinal integrated clerkship students

Abstract

Background

Achievement goal theory links goal setting, motivation, and learning and describes three orientations: ‘mastery’ (seeking learning), ‘performance’ (seeking positive judgments), and ‘performance-avoidance’ (avoiding negative judgments). Mastery orientation is considered most adaptive. The authors investigated goal orientations of traditional block clerkship (TBC) and longitudinal integrated clerkship (LIC) students.

Methods

This was an exploratory study conducted at one US medical school. Three hundred and twenty students completed an anonymous survey consisting of three tools with validation evidence: Patterns of Adaptive Learning Survey, Task-choice Goal Measures, and Questionnaire Goal Choice Items. The authors analyzed the data using regression analyses, Chi-square, and Wilcoxon’s rank-sum tests.

Results

While all students rated mastery items most highly on the five-point Likert scale (mean 4.58/5.00), LIC students rated performance-orientation lower (β = −0.36, p = .04), chose personal mastery-orientation items more frequently (92% vs. 64.4%, p = .005), and perceived their learning environment as promoting less performance (β = −0.60, p = .002) and performance-avoidance (β = −0.78, p < .001) compared to TBC students.

Conclusions

LIC and TBC students differed in their report of personal and clerkship goal orientations. These differences may inform educational design and future research to promote students’ mastery orientation.

Keywords:

• Achievement goal theory
• goal orientations
• longitudinal integrated clerkship
• traditional block clerkship
• undergraduate medical education

Acknowledgements

The authors thank Harvard Catalyst Biostatistics Consulting for providing advice on statistical tools used in this study.

Prior presentations

Lin-Beckford S, Osman N, Hirsh D. Exploring Medical Student Goal Orientations and Perceived Classroom Goal Structures during Clinical Rotations. Duke-NUS Consortium of Longitudinal Integrated Clerkships (CLIC) Conference, October 23–25, 2017, Singapore.

Disclosure statement

DAH is the director of the Cambridge Integrated Clerkship, Harvard Medical School’s longitudinal integrated clerkship. NYO is the site director of Harvard Medical School’s internal medicine clerkship at the Brigham and Women’s Hospital. As a medical student in 2017, SLB participated in a Harvard Medical School traditional block clerkship but did not complete the survey. At the time of the study, EK was the Director of the Center for Evaluation at Harvard Medical School.

Additional information

Funding

This study was supported by the Brigham and Women’s Hospital Institutional Award, Minority Faculty Career Development Award, given to NY Osman.

Notes on contributors

Stephanie Lin-Beckford

Stephanie Lin-Beckford, M.D., is an instructor of medicine at Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.

Nora Y. Osman

Nora Y. Osman, M.D., is an associate professor of medicine and site director of the Harvard Medical School internal medicine clerkship, Brigham and Women’s Hospital, Boston, MA, USA.

Edward Krupat

Edward Krupat, Ph.D., is a medical education research specialist at Brigham and Women’s Hospital, Boston, MA, USA.

David A. Hirsh

David A. Hirsh, M.D., is an associate professor of medicine, associate dean, undergraduate medical education, and director of the Harvard Medical School Cambridge Integrated Clerkship, Harvard Medical School, Boston, Massachusetts, and Cambridge Health Alliance, Cambridge, MA, USA.