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The Importance of Supporting Autonomy in Medical Education

Geoffrey C. Williams, MD, PhD; and Edward L. Deci, PhD
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From the University of Rochester, University of Rochester School of Medicine and Dentistry, and The Genesee Hospital, Rochester, New York. Grant Support: By grant DK 50807 from the National Institute of Diabetes and Digestive and Kidney Diseases (Dr. Williams) and grant HD 19914 from the National Institute of Child Health and Human Development (Dr. Deci). Requests for Reprints: Geoffrey C. Williams, MD, PhD, Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY 14627. Current Author Addresses: Drs. Williams and Deci: Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY 14627.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;129(4):303-308. doi:10.7326/0003-4819-129-4-199808150-00007
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Many thoughtful leaders in medicine have asserted their belief that when physicians are more humanistic in their interactions with patients, their patients have more positive health outcomes.Consequently, many advocates have called for the practice of teaching students and residents to provide more humanistically oriented care. This article reviews research from motivational psychology, guided by self-determination theory, that suggests that when medical educators are more humanistic in their training of students, the students become more humanistic in their care of patients. Being humanistic in medical education can be achieved through support of the autonomy of students. Autonomy support means working from the students' perspectives to promote their active engagement and sense of volition with respect to learning. Research suggests that when educators are more supportive of student autonomy, students not only display a more humanistic orientation toward patients but also show greater conceptual understanding and better psychological adjustment.


Grahic Jump Location
Figure 1.
The self-determination model applied to medical education.
Grahic Jump Location




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