Table 1 Student motivation in relation to autonomy

Students were undertaking the course of their own volition, and applied themselves academically because they wanted to, not because it would go on their transcript.

“The fact that the course is voluntary and that the marks have no impact on my degree enables me to approach the course with a proud sense of achieving above and beyond the basic demands of the course”.

“The pressure to perform for marks is only out of desire to learn and not for a number on your CV”.

Self directed learning tasks promoted individual and group autonomy.

“There is a set reading for each night from Cunningham’s Dissection manual, but the course provides you with the freedom to learn from whatever resources you find useful. The wide range of external resources broadened my appreciation of surgical anatomy and my understanding of medicine as a whole”.

“The combination of set reading for each evening plus a chance to apply and reinforce the knowledge the following day gives a very strong incentive to keep up with the reading and strongly reward independent study. There were different learning strategies employed across the group to cover the material. (i.e. we were not told how to learn it).”

Students felt that they high quality of teaching, and the particular balance between structured teaching and self-directed learning.

“Because the quality of teaching in this course is high, self-directed learning tasks are beneficial”.

“We were able to do the activities, but would ask for help if we needed it”.

Team members collaborated with each other, and with their supervisors to shape the quality of their learning.

“Everyone put in effort in the group and played their roles well (i.e. someone looking up books/pictures) whilst the others dissected. The supervisors made it fun and lighthearted which bred a sense of collegiality”.

“Having mini tutorials in groups of six makes the learning more individualized. Independent learning is fostered with each tutor providing us with individualized feedback throughout the course”.

Students felt they were treated as equals by supervisors, given clear outcomes, but the freedom to explore areas throughout the day that they needed to.

“There is a genuine sense of partnership from the senior tutors, assuming we will commit to the effort required and so treating us as adults embarking on a journey, rather than students who need to be controlled to be taught”.

“We were not constantly supervised, we were able to break for self-directed learning during the day, enabling us to answer any burning questions and explore unknown or taxing areas”.