Stefanos A Tsikas, Volkhard Fischer
The longitudinal patterns of study motivation suggest both pragmatic recalibrations, as students' idealized views of medical practice meet clinical realities, and the subtle influence of hidden curricula that may erode altruistic motives. The moderate decline in prosocial motivation perhaps further reflects an incomplete professional identity formation process, highlighting the need for curricular and cultural strategies that sustain empathy and intrinsic engagement throughout medical training.
BACKGROUND: Motivation is a key determinant of students' engagement, learning strategies, and professional development in medical education. However, little is known about how different motivational dimensions change within individuals across training. The Hannover Screening of Study Motivation panel survey offers a unique opportunity to map how medical students' motives evolve over time.
METHODS: Using the first five waves of data at Hannover Medical School, Germany (N = 1,218 subjects), we applied confirmatory factor analysis to validate three theoretically grounded dimensions of study motivation: extrinsic, autonomous, and prosocial. We then extracted standardized factor scores and modeled their trajectories with mixed-effects regressions.
RESULTS: Prosocial motivation (e.g., the desire to help others) dominates overall, but declines moderately but significantly within individuals. At the same time extrinsic motivation (e.g., job security, prestige) increases modestly. Autonomous motivation exhibits the greatest within-person stability. Motivational differences also align with career aspirations: students with stronger extrinsic motives gravitate toward high-status specialties, pro-social motivation is associated with social work and general patient care. Female students display less extrinsic and higher prosocial motivation, compared to males. We find no meaningful associations between any motivational dimension and early academic outcomes.
CONCLUSIONS: The longitudinal patterns of study motivation suggest both pragmatic recalibrations, as students' idealized views of medical practice meet clinical realities, and the subtle influence of hidden curricula that may erode altruistic motives. The moderate decline in prosocial motivation perhaps further reflects an incomplete professional identity formation process, highlighting the need for curricular and cultural strategies that sustain empathy and intrinsic engagement throughout medical training.