RESUMO
PURPOSE: Remote clinical learning (RCL) may result in learner disengagement. The factors that influence medical student motivation during RCL remain poorly understood. The authors aimed to explore factors that affect medical student motivation during RCL and determine potential strategies to optimize student motivation during RCL. METHOD: In December 2020, the authors conducted semistructured interviews with third- and fourth-year medical students at the University of California, San Francisco, who had experienced RCL. The authors coded transcripts and conducted an inductive thematic analysis using self-determination theory (SDT), which describes autonomy, competence, and relatedness as essential for motivation, as a sensitizing framework. RESULTS: Twelve students were interviewed. Four themes were identified and aligned with SDT: balancing flexibility and structure (autonomy), selecting appropriate resources (competence), setting reasonable expectations (competence), and building and maintaining community (relatedness). Students described a sense of tension between desiring flexibility and appreciating structure and accountability during RCL; a preference for high-yield, curated resources presented in an organized format during RCL; instances in which the remote curriculum fell short of their expectations or professional goals or in which they felt they had missed out on key clinical learning; and support sought from peers, mentors, and instructors during RCL, as well as the contribution of remote learning technology to a sense of community. CONCLUSIONS: The authors propose 4 guiding principles to address implementation of remote clinical curricula: provide students with choice within the bounds of a well-defined curriculum, curate and organize learning materials carefully and intentionally, orient students to the goals and objectives of the curriculum and discuss students' expectations for professional development, and incorporate structured opportunities for remote mentorship and peer-peer interaction and optimize these opportunities using technology. Educators can draw on the themes, guiding principles, and potential strategies identified to promote and maintain learner motivation during RCL.
