Effects of Enhanced Expectancies and Autonomy Support on Learning Medical Motor Skills

The optimizing performance through intrinsicmotivation and attention for learning (OPTIMAL) theory proposes that enhancing expectancies for future performance and supporting learners’ autonomy facilitate motor performance and learning. However, the effects of these factors on the performance of medical motor skills such as suturing have not been understood.

This study aimed to investigate the effects of enhanced expectancies and autonomy support (AU) on motor performance, learning, and self-efficacy of a medical motor skill.

Participants were 63 right-handed medical students in the pre-clinical stage of their studies (years 1 and 2 of medical education). They were randomly assigned to 3 groups: (a) social-comparative feedback (SCF), (b) AU, and (c) control (CO) groups. A vertical mattress suture was chosen as a motor task. Following the pretest with 2 trials, all participants were exposed to a 5-day practice phase. The retention test was performed 1 week after the practice phase. During the practice phase, the SCF group received positive feedback at the end of the day. The AU group was given the option of choosing the color of silk sutures. The participants in the CO group practiced without any feedback or choosing the color of silk sutures. Suturing quality and self-efficacy were measured as dependent variables.

Positive SCF led to a better suturing performance on the retention test; however, AU did not enhance motor learning of a suturing motor task. Moreover, positive SCF increased self-efficacy during the acquisition phase and on the retention test, while AU had no positive effects on self-efficacy.

The present findings support the OPTIMAL theory by demonstrating that enhanced expectancies in the form of positive SCF can facilitate learning medical motor skills (i.e., vertical mattress suturing).