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Table 1 Motivation questionnaires used in this study, items indicated with (R) are reverse scored items

From: Motivation and competence of participants in a learner-centered student-run clinic: an exploratory pilot study

Academic Motivation Scale (AMS)
The AMS, Academic Motivation Scale, was originally described by Vallerand et al. [26] in French as the EME (l’échelle de motivation en education) [26], and in 1992 in English as the AMS [24]. This instrument has 28 items, scored on a 7-point Likert scale. The individual items are grouped into subscales for which the scores are calculated as the average score of the individual items within these subscales (these subscales are Intrinsic, extrinsic identified, Extrinsic introjected, Extrinsic external regulation, Amotivation, and the more overarching subscales controlled motivation and autonomous motivation, see also Fig. 1). The AMS is based on the conceptual framework of the Self-determination Theory and is used to differentiate between intrinsic and extrinsic motivation. In 1993 Vallerand et al. studied the validity and reliability of the AMS to measure motivation (types) [25].
Using the scale (1–7), indicate to what extent each of the following items presently corresponds to one of the reasons why you go to medical school
1: Does not correspond at all
4: Corresponds moderately
7: Corresponds exactly
1 Because with only a medical school degree I would not find a high-paying job later on. Extrinsic – external regulation
2 Because I experience pleasure and satisfaction while learning new things. Intrinsic – to know
3 Because I think that a medical school education will help me better prepare for the career I have chosen. Extrinsic – identified regulation
4 For the intense feelings I experience when I am communicating my own ideas to others. Intrinsic – experience stimulation
5 Honestly, I don’t know; I really feel that I am wasting my time in medical school. Amotivation
6 For the pleasure I experience while surpassing myself in my medical studies. Intrinsic – towards accomplishment
7 To prove to myself that I am capable of completing my medical degree. Extrinsic – introjected regulation
8 In order to obtain a more prestigious job later on. Extrinsic – external regulation
9 For the pleasure I experience when I discover new things never seen before. Intrinsic – to know
10 Because eventually it will enable me to enter the job market in a field (medical) that I like. Extrinsic – identified regulation
11 For the pleasure that I experience when I read interesting medical authors. Intrinsic – experience stimulation
12 I once had good reasons for going to medical school; however, now I wonder whether I should continue. Amotivation
13 For the pleasure that I experience while I am surpassing myself in one of my personal accomplishments. Intrinsic – towards accomplishment
14 Because of the fact that when I succeed in medical school I feel important. Extrinsic – introjected regulation
15 Because I want to have “the good life” later on. Extrinsic – external regulation
16 For the pleasure that I experience in broadening my knowledge about medical subjects which appeal to me. Intrinsic – to know
17 Because this will help me make a better choice regarding my medical career orientation. Extrinsic – identified regulation
18 For the pleasure that I experience when I feel completely absorbed by what certain medical authors have written. Intrinsic – experience stimulation
19 I can’t see why I go to medical school and frankly, I couldn’t care less. Amotivation
20 For the satisfaction I feel when I am in the process of accomplishing difficult academic activities. Intrinsic – towards accomplishment
21 To show myself that I am an intelligent person. Extrinsic – introjected regulation
22 In order to have a better salary later on. Extrinsic – external regulation
23 Because my medical studies allow me to continue to learn about many things that interest me. Intrinsic – to know
24 Because I believe that a few additional years of education (medical) will improve my competence as a worker. Extrinsic – identified regulation
25 For the “high” feeling that I experience while reading about various interesting medical subjects. Intrinsic – experience stimulation
26 I don’t know; I can’t understand what I am doing in medical school. Amotivation
27 Because medical school allows me to experience a personal satisfaction in my quest for excellence in my studies. Intrinsic – towards accomplishment
28 Because I want to show myself that I can succeed in my medical studies. Extrinsic – introjected regulation
Intrinsic Motivation Inventory (IMI)
The IMI, Intrinsic motivation inventory, was originally used by Ryan in 1982 to study intrinsic motivation and self-regulation in laboratory experiments [29]. Later on, the IMI has also been used in educational settings (sports, dental education) to study psychometric properties in real practice [28, 36]). The IMI has several subscales, of which interest/enjoyment is considered the main self-report measure of intrinsic motivation [30]. The subscale usefulness is considered relevant in the process of internalization, that drives the transition from controlled to autonomous motivation (see Fig. 1) [27]. Other subscales include perceived choice, perceived competence, effort, felt pressure and tension, and relatedness. Intrinsic motivation for this particular project was measured using the IMI-subscales subscale interest/enjoyment, usefulness and perceived choice, for which the questions are displayed below. Given the IMI is project/subject specific, it could only be measured in participants who participated, and was therefore measured after participation, see Fig. 2.
Using the scale (1–7), indicate to what extent each of the following items presently corresponds to your opinion
1: Not true at all
4: Somewhat true
7: Very true
1 I believe that doing this project could be of some value for me. Value/usefulness
2 I believe I had some choice about doing this project. Perceived choice
3 While I was doing this project, I was thinking about how much I enjoyed it. Interest/enjoyment
4 I believe that doing this project is useful for improved concentration. Value/usefulness
5 This project was fun to do. Interest/enjoyment
6 I think this project is important for my improvement. Value/usefulness
7 I enjoyed doing this project very much. Interest/enjoyment
8 I really did not have a choice about doing this project. Perceived choice (R)
9 I did this project because I wanted to. Perceived choice
10 I think this is an important project. Value/usefulness
11 I felt like I was enjoying the project while I was doing it. Interest/enjoyment
12 I thought this was a very boring project. Interest/enjoyment (R)
13 It is possible that this project could improve my studying habits. Value/usefulness
14 I felt like I had no choice but to do this project. Perceived choice (R)
15 I thought this was a very interesting project. Interest/enjoyment
16 I am willing to do this project again because I think it is somewhat useful. Value/usefulness
17 I would describe this project as very enjoyable. Interest/enjoyment
18 I felt like I had to do this project. Perceived choice (R)
19 I believe doing this project could be somewhat beneficial for me. Value/usefulness
20 I did this project because I had to. Perceived choice (R)
21 I believe doing this project could help me do better in medical school. Value/usefulness
22 While doing this project I felt like I had a choice. Perceived choice
23 I would describe this project as very fun. Interest/enjoyment
24 I felt like it was not my own choice to do this project. Perceived choice (R)
25 I would be willing to do this project again because it has some value for me. Value/usefulness